Risk Communication when Serving Customers with Food Allergies in Restaurants PDF
Preview Risk Communication when Serving Customers with Food Allergies in Restaurants
RISK COMMUNICATION WHEN SERVING CUSTOMERS WITH FOOD ALLERGIES IN RESTAURANTS IN THE UNITED STATES by HAN WEN B.A., Sun Yat-sen University, 2010 M.A., University of Houston, 2012 AN ABSTRACT OF A DISSERTATION submitted in partial fulfillment of the requirements for the degree DOCTOR OF PHILOSOPHY Department of Hospitality Management and Dietetics College of Human Ecology KANSAS STATE UNIVERSITY Manhattan, Kansas 2015 Abstract Food allergies affect nearly 15 million Americans, and accommodating customers with food allergies has become a challenge for the restaurant industry. One third of the fatal food allergy reactions occurred in restaurants, and it is important for the restaurant industry to properly communicate and manage the food allergy risks. This study explored perceived risks and risk communication related behaviors of restaurant staff when serving customers with food allergies by using both qualitative (interviews) and quantitative (online survey) approaches. Telephone interviews with 16 restaurant managers were audio-recorded, transcribed verbatim, and organized to identify themes. Most participants were aware of the severity of food allergy reactions but perceived that it was the customers’ responsibilities communicating their food allergies with restaurant staff before placing their orders. Training for service staff on food allergies and risk communication topics were limited, and some managers perceived such training unnecessary for restaurant business. Findings from interviews were used to develop an online survey instrument. The survey instrument was pilot-tested and distributed to restaurant employee panels by an online survey research firm. Of 1,328 accessed the survey, 316 usable survey responses (23.8%) were collected from full-service restaurant service staff. Data analyses included descriptive statistics, independent samples t-test, ANOVA, and regression analyses. Results indicated that limited information about food allergies was provided on printed (35.1%) or online menus (28.2%), and very few restaurants had separate menus (8.5%) or complete ingredient lists (14.6%) for customers with food allergies. Meanwhile, restaurant servers lacked knowledge about common food allergens (12.7% correct), differences between food allergies and intolerances (34.2% correct), and government regulations related to food allergies (15.5% correct). Most restaurant servers (82.0%) agreed or strongly agreed that initiating communication and preventing food allergy reactions were responsibilities of customers with food allergies. Perceived severity of food allergy reactions, previous communication training, sources of media exposure, and perceived responsibilities of preventing food allergy reactions were found to influence restaurant servers’ risk reduction and communication behaviors (R2=0.367, p<0.001). Restaurateurs, foodservice educators, food allergy advocates, and policy makers may use these findings when developing food allergy training and strategies to prevent food allergy reactions in restaurants. Words: 350 Keywords: Food allergy, restaurant, manager, servers, risk perception, risk communication RISK COMMUNICATION WHEN SERVING CUSTOMERS WITH FOOD ALLERGIES IN RESTAURANTS IN THE UNITED STATES by HAN WEN B.A., Sun Yat-sen University, 2010 M.A., University of Houston, 2012 A DISSERTATION submitted in partial fulfillment of the requirements for the degree DOCTOR OF PHILOSOPHY Department of Hospitality Management and Dietetics College of Human Ecology KANSAS STATE UNIVERSITY Manhattan, Kansas 2015 Approved by: Major Professor Dr. Junehee Kwon Copyright HAN WEN 2015 Abstract Food allergies affect nearly 15 million Americans, and accommodating customers with food allergies has become a challenge for the restaurant industry. One third of the fatal food allergy reactions occurred in restaurants, and it is important for the restaurant industry to properly communicate and manage the food allergy risks. This study explored perceived risks and risk communication related behaviors of restaurant staff when serving customers with food allergies by using both qualitative (interviews) and quantitative (online survey) approaches. Telephone interviews with 16 restaurant managers were audio-recorded, transcribed verbatim, and organized to identify themes. Most participants were aware of the severity of food allergy reactions but perceived that it was the customers’ responsibilities communicating their food allergies with restaurant staff before placing their orders. Training for service staff on food allergies and risk communication topics were limited, and some managers perceived such training unnecessary for restaurant business. Findings from interviews were used to develop an online survey instrument. The survey instrument was pilot-tested and distributed to restaurant employee panels by an online survey research firm. Of 1,328 accessed the survey, 316 usable survey responses (23.8%) were collected from full-service restaurant service staff. Data analyses included descriptive statistics, independent samples t-test, ANOVA, and regression analyses. Results indicated that limited information about food allergies was provided on printed (35.1%) or online menus (28.2%), and very few restaurants had separate menus (8.5%) or complete ingredient lists (14.6%) for customers with food allergies. Meanwhile, restaurant servers lacked knowledge about common food allergens (12.7% correct), differences between food allergies and intolerances (34.2% correct), and government regulations related to food allergies (15.5% correct). Most restaurant servers (82.0%) agreed or strongly agreed that initiating communication and preventing food allergy reactions were responsibilities of customers with food allergies. Perceived severity of food allergy reactions, previous communication training, sources of media exposure, and perceived responsibilities of preventing food allergy reactions were found to influence restaurant servers’ risk reduction and communication behaviors (R2=0.367, p<0.001). Restaurateurs, foodservice educators, food allergy advocates, and policy makers may use these findings when developing food allergy training and strategies to prevent food allergy reactions in restaurants. Words: 350 Keywords: Food allergy, restaurant, manager, servers, risk perception, risk communication Table of Contents List of Figures ............................................................................................................................... xii List of Tables ............................................................................................................................... xiii Acknowledgements ....................................................................................................................... xv Dedication .................................................................................................................................... xvi Chapter 1 - Introduction .................................................................................................................. 1 Introduction ................................................................................................................................. 1 Statement of Problems ................................................................................................................ 5 Null Hypotheses .......................................................................................................................... 7 Justification ................................................................................................................................. 7 Purpose ........................................................................................................................................ 8 Objectives ................................................................................................................................... 8 Significance of the Study ............................................................................................................ 9 Practical Implications ............................................................................................................... 10 Limitations and Future Research .............................................................................................. 10 References ..................................................................................................................................... 12 Chapter 2 - Literature Review ....................................................................................................... 16 Food Allergies in the United States .......................................................................................... 16 Food Allergy ......................................................................................................................... 16 Prevalence of Food Allergies ................................................................................................ 18 The Legal Environment as Related to Food Allergy ................................................................ 20 Federal Legislation and Regulatory Guidelines .................................................................... 20 State- and City-Level Legislation ......................................................................................... 22 Dining Experiences of Customers with Food Allergies ........................................................... 24 Dining Out with Food Allergies ........................................................................................... 24 Perceived Causes of Food Allergy Reactions ....................................................................... 25 Prevention Strategies ............................................................................................................ 27 Food Allergies in the Restaurant Industry ................................................................................ 28 Benefits of Serving Customers with Food Allergies ............................................................ 28 Risk Involved in Serving Customers with Food Allergies ................................................... 29 viii Food Allergy Training .......................................................................................................... 31 Risk Communication ................................................................................................................ 33 Risk Perception ..................................................................................................................... 33 Risk Communication ............................................................................................................ 34 Food Safety Risk Communication ........................................................................................ 37 Food Allergy Risk Communication ...................................................................................... 39 References ..................................................................................................................................... 42 Chapter 3 - Methodology .............................................................................................................. 50 Qualitative Study: Individual Interviews .................................................................................. 50 Sample Selection ................................................................................................................... 51 Instrument Development ....................................................................................................... 51 Data Collection ..................................................................................................................... 53 Data Analysis ........................................................................................................................ 54 Quantitative Study: Online Survey ........................................................................................... 55 Sample Selection ................................................................................................................... 55 Measures and Instrument Development ................................................................................ 57 Demographic Characteristics ............................................................................................ 57 Food Allergy Training ...................................................................................................... 57 Food Allergy Knowledge .................................................................................................. 58 Food Allergy Risk Perceptions and Related Factors ........................................................ 58 Risk Communication Behaviors ....................................................................................... 59 Food Allergy Risk Communication Strategies ................................................................. 61 Validation of the Instrument ............................................................................................. 61 Data Collection ..................................................................................................................... 61 Data Analysis ........................................................................................................................ 62 References ..................................................................................................................................... 64 Chapter 4 - Exploring Food Allergy Risk Communication and Management Issues in Restaurants ............................................................................................................................................... 66 Abstract ..................................................................................................................................... 66 Introduction ............................................................................................................................... 67 Methods .................................................................................................................................... 70 ix Target Population and Study Sample Selection .................................................................... 70 Development of Interview Questions ................................................................................... 70 Data Collection and Analysis ................................................................................................ 71 Results & Discussion ................................................................................................................ 72 Food Allergy Awareness ....................................................................................................... 72 Food Allergy Training .......................................................................................................... 74 Food Allergy Risk Perceptions ............................................................................................. 76 General Food Allergy Risk Perception ............................................................................. 76 Specific Food Allergy Risk Perceptions ........................................................................... 77 Food Allergy Risk Communication .................................................................................. 78 Information Sharing .......................................................................................................... 80 Communication Procedures .............................................................................................. 81 Food Allergy Risk Communication Strategies ................................................................. 82 Food Allergy Risk Management and Comparison ................................................................ 82 Food Allergy Risk Management Plans ............................................................................. 82 Food Allergy Risk vs. Food Safety Risk .......................................................................... 83 Conclusion & Implications ....................................................................................................... 84 Limitations ................................................................................................................................ 86 Acknowledgement .................................................................................................................... 87 References ..................................................................................................................................... 88 Chapter 5 – Risk Communication when Serving Customers with Food Allergies in Restaurants ............................................................................................................................................. 100 Abstract ................................................................................................................................... 100 Introduction ............................................................................................................................. 101 Literature Review ................................................................................................................... 103 Food Allergies and the Restaurant Industry ........................................................................ 103 Dining Experiences of Customers with Food Allergies ..................................................... 104 Food Allergy Risk Perception and Risk Communication ................................................... 106 Methodology ........................................................................................................................... 107 Sample Selection ................................................................................................................. 108 Instrument Development ..................................................................................................... 108 x
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