Risk Communication when Serving Customers with Food Allergies in Restaurants

204 Pages·2015·1.36 MB·English

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