1 

### Review of Literature on Consumer Use of Label Statements and Findings Relevant to Planned Action on Minimum risk Insect Repellents US EPA OPP June 2009

Summary of findings:

A disclaimer aids a consumer in making an info rmed purchase decision only if it is read, understood, and believed.

Though most people may read most of an insect repellent label, few people will read all of it, and many
will thus not notice a disclaimer.

Additionally, sinc e an exempted product is likely to be perceived as non-toxic or safe, people are less likely to read all parts of the label – and, consequently, are less likely to
notice a disclaimer.

Consumers who already are familiar with the product are even less likely
to read the label and notice a
disclaimer.

Even if a disclaimer is read, it is likely to be misunderstood or discounted, since people will use their previous
information and biases to rationalize why the disclaimer is there.

If the disclaimer contradicts information people already believe, they will neither
understand nor believe it.

In general, most people do not rea d, understand, or believe a disclaimer. In the specific case of minimum risk insect repellents, this group would incl ude an extremely small subs et of all consumers of insect repellents, resulting in a majority of c onsumers who are not making a fully informed purchase
decision.2 

# Do people read the label?

Summary of findings:

• Most people think they read the label. Howev er, actual label reading depends on several factors related to the product and the user

• Label reading is not thorough and no t all parts are likely to be read

Details:

1) HealthStyles 2008 (EPA analysis of Porter Novelli national survey data):

• 24% of people who buy insect repellents report that they do not read the label.

• Actual rates of not reading the label may be higher than this self-reported response.

2) EPA OPPTS, 1999. ( Consumer Labeling Initiative) : Inconclusive findings regarding label reading. Three factors appeared to influence label usage overall.

1) Familiarity: The more familiar the respondents were with a product, the less likely they

were to read the label. Consequently, consumers interviewed about household
cleaners/disinfectants indicated th at they rarely read labels fo r those kinds of products, while respondents in the indoor insectic ide and outdoor pesticide intervie ws tended to look at labels for those products more often, since it wa s a product they did not use regularly/

2) Risk perception (to the user, children, pets , or the environment): If a product was considered to be potentially harmful if used improperly, the respondents were more likely to look at the label before using it than if they did not perc eive the product to be particularly toxic.

3) Perceived ease or difficulty of product use: Products available in aerosol cans and trigger sprays, for example, as well as enclosed roach ba its that the consumer simply sets out, were perceived by consumers as easy to use. Consum ers, therefore, were less likely to read directions when using those products. Labels of products requiring th e most preparation - indoor fogger products requiring extensive site preparation or outdoor pesticides that required dilution or attachment of a nozzle and hose, for example - tended to be read more
often. Information on the label helps you select the best insect repellent for you.

58% 24% 13% 5% Yes

Don't read the label

No

No answer3 • Do people read labels? Not completely, and not thoroughly

- Consumers do not read labels as carefully as they think they do. Respondents said they had read the use instructions, but di d not remember the ‘it is a violation of federal law’ part at the top of all pesticide instructions.

- Least likely to be read: Precautionary and hazard statements, unless there was a preconceived risk of that particular product.

Potential implications for minimum-risk insect repellents: These are familiar products that are perceived as safe or non-toxic and that are easy to apply, so rates of reading labels on these products may be among the lowest of all consumer pesticide products.



# Do people read the disclaimer / statement?

Summary of findings:

• People believe they read disclaimers, but most actually do not read precautionary statements, warnings, or similar information on products

• They do not read precautionary statements at the time of purchase, or when selecting a product

• They generally believe that they already know the information, they don’t need to know it, or they just don’t feel like reading it. The size of the warning has little to do with whether they read it or not.

• Exception: If the product is perceived as very hazardous, they are more likely to read directions & cautions before using it.

Details: 1) HealthStyles 2008 (EPA analysis of Po rter Novelli national survey data):

• 79% say they would read the disclaimer.

2) EPA OPPTS, 1999. ( Consumer Labeling Initiative) : Inconclusive. Most do not pay attention to precautionary statements, warnings, or other information on the product. A statement regarding EPA review or a disclaimer could be considered a warn ing or precautionary
statement. From the CL I literature review:

• An evaluation of consumer labels on non-pesticide products found that consumers do not search out or read precautionary statements before purchasing a product. (Marvos, Dean, and Krenzelok, 1986.) (CPSC, 1995. Product Labeling Guide, Literature Review, p. 2-13.)

• It is unlikely that consumers rely on cauti on labels alone to assist them in making decisions about the safety of a product, concluded a study of 720 panelists. The study found that 66% of the panelists do not read precautionary information I probably would not
notice the
disclaimer Read disclaimer, but buy the product anyway Read the disclaimer and buy something else Total

n respondents 1069 612 3424 5105 % of all surveyed 21% 12% 67%4 on product labels . (Kraus and Slovie, 1988. (Consumer Risk Perceptions of Household Chemicals, p. 48.)

• King County ran two sets of consumer focus groups in 1993 on consumer “hazardous” household products to determ ine general public awareness about such products. When they asked participants to select one of six bathroom cleaning products, almost none of the participants looked beyond the product
name to make a selection

. Participants said they would “look for a product they knew, or they would look at the la bel to see if it was meant to do the job.” Participants were not accustomed to reading the labels very thoroughly. (Brattesani, 1993. Metro Hazardous Household Products Focus Groups Report, p. 8.)

Findings from CLI surveys:

• Some people say they ‘never read’ certain parts of the label (storage, disposal, ingredients).

(Table and graphic copied from CLI 1999 Phase II report, p. 59)5 Reasons why people never read parts of the label of indoor insecticides and household cleaning products

0 10 20 30 40 50 60

Just do not Do not

understand Already

know Do not need

to know Do not have

time Print too

small No answer% of respondents who never read these partsof the label indoor insecticides disposal indoor insecticides storage indoor insecticides ingredients
household cleaner disposal household cleaner storage household cleaner ingredients

(Data for chart is from CLI 1999 Phase II p. 65)

• If it’s hazardous, they will read it:

• Studies showed that consumer percep tion of product ha zardousness is the most significant indicator of whether or not they will read the precautionary label, followed in significance by the level of familiarity with a product. Leonard et al. ( 1989, 70 undergraduates) found that the more hazardous a product was perceived to be, the more willing the subjects were to read the warning.

• Similarly, Godfrey et al. (1983, 32 unde rgraduates) and Wogalter et al. (1986, 70 undergraduates) found that perceived hazardousness was the most important determinant of willingness to read a warning label. Godfrey et al. found that subjects ha d a lower perception of hazardousness with more familiar products, and Lerner (1985, 80 undergraduates) found that individuals with “benign” experi ences are often less likely to read and comply with warnings. (CPSC. 1995. Product Labeling Guide, Literature Review, pp. 6-3 to 6-5.)

3) Hadden, 1991. (“Regulating Product Risks Thr ough Consumer Information”):

• “In study after study, people are found to ignore warning labels ... one reason people ignore warning labels is that they are familiar with the subject.” (p. 97)

Potential implications for minimum-risk insect repellents: These products will likely be perceived as not at all hazardous, and consumer s may be unlikely to read any warnings or
disclaimers on them.6 

# Do people understand the statement / disclaimer?

Summary of findings:

• People frequently misunderstand and misremember parts of the label, ev en if they read it
several times

• Even if label format or wording is changed, people continue to misunderstand certain things

• Labels in general and specific statements in part icular cannot stand alone: they need to be part of a broader campaign to increase in formation. Otherwise, people understand the label statements using their previous knowledge

• This previous knowledge often includes defini tions of terms that vary across contexts

Details: 1) EPA OPPTS, 1999. ( Consumer Labeling Initiative) : Certain sections of the label misunderstood by everyone.

- “Certain sections of the labels were uniformly misunderstood by respondents in all categories. Not understood or misunderst ood by participants in interviews:

o Statement of violation of law

o EPA registration information

o Chemical names of products” (CLI Phase 1996 Phase I p. 11)

2) Mason and Scammon, 2000. (“Health Claims and Disclaim ers: Extended Boundaries and Research Opportunities in Consumer Interpretation”)

- “ Disclosures on the product packages may suffer from lack of noticeability.
Consumers who notice disclosures may have little recall of the information . Even after repeated exposure and caref ul reading of the disclaimer, consumers’ comprehension of the message may differ with indirect or awkward wording or simply different wording.” (p. 146)

3) EPA OPPT, 1994. ( Determinants of Effectiveness for Environmental Ce rtification and Labeling Plan) :

• “This report analyzes factors related to the effectiveness of environmental labeling in the U.S., to ascertain whet her additional information about the environmental burdens of a product’s manufacture, use, and disposal can effectively shift cons umer choices” (p. i)

• “The general public’s awareness of th e underlying issues is an important determinant of success for a labeling program” (p. ii)

• “A labeling program will be most readily understood when it is part of a broader public information campaign” (p. ii)

• “Studies have shown that labels of any format have the potential to be poorly understood by consumers” (p. ii)

• “Changing the behavior of a significant portion of consumers requires an integrated campaign to increase awarene ss, understanding and provide incentives
for individuals to make the desired changes” (p. iii)

• Summary of conclusions on p. iii: Without accurate, consistent information, people make up their own mind.7 4) National Consumers League. Naturally Misleading

.

• There is an abundance of claims regarding ‘nat ural’ in products, with different standards for different types of products. (p. 5)

• “The FDA does not define or regulate the us e of the word ‘natural’ on personal care or cosmetic products” (p.8) (Consumers may consider insect repellents to be a personal care product, and not realize that it is a pesticide.)

5) GAO Report to Congress, 2009. ( Dietary Supplements ):

• “Consumers are not well-informed about the safety, efficacy, and labeling of dietary supplements. ... a majority of adu lts are misinformed about the extent to which government regulates the safety of vitamins, minerals, and food supplements. According to [a 2002 Harris Po ll], over half of respondents believed that dietary supplements are approve d by a government agency.” (p. 32)

• Labels as a whole are misunderstood: “In 2003, an analysis of 100 dietary supplement labels by the Department of Health and Human Services’ Office of Inspector General found that the dietary supplement labels were limited in their ability to guide the informed and appropriate use of dietary supplements among consumers and ofte n did not present information in a
manner that facilitates consumer understanding.” (p. 32)

• Putting information on a labels ≠ informed use: “Weaknesses in the regulatory system may increase the likelihood of unsafe products reaching the market, and a lack of consumer knowledge increases the potential health risk s associated with uninformed consumption.” (p. 34)

Potential implications for minimum-risk insect repellents: A disclaimer statement, particularly one that is not part of a broader information and education campaign, probably
would not be understood even if noticed and remembered.



# Do people believe the statement / disclaimer?

Summary of findings:

• People arrive at a decision to purchase a pr oduct with certain beliefs. A disclaimer cannot change those beliefs

• People believe labels when they confirm what they already know, not when they present
new information

o There are inherent beliefs regarding “natur al”: positive, good, beneficial, safe.

• When there are contradictory statements on a la bel, people believe the one that they want
to believe

o The source of the information may play a part in this

• There are 5 probable reactions to reading a disclaimer on a product someone intends to purchase. None of these probable react ions includes believing the disclaimer

Details: 1) Mason, Scammon, and Fang, 2007. (“The Impact of Warnings, Disclaimers, and Product Experience on Consumers' Percep tions of Dietary Supplements”):

• “Two experiments explored the impact of disclosures (warning and disclaimer) and product experience (heavy, light, and nonusers) on consumers' perceptions of dietary8 supplements. In general, the government-mandated disclaimer did not impact

consumers' beliefs about either the efficacy or the safety of dietary supplements; for most consumers, the disclaimer is unlik ely to achieve its intended results. However, when product experience was examined, an alyses show that heavy product users responded differently to the disclosures than did light product users and nonusers. Results point to the importance of understanding the influence of individual differences on the interpretation of product disclosures by specific consumer segments.” (p. 74)

2) FDA, 2005 ( Working Paper, Strength of Science Disclaimers ):

• What do they already know? There is a “need to better understand the operating assumptions that influence consumers’ reacti ons to health claim statements and the way consumers’ assumptions and knowledge may affect their perceptions in this communication situation” (p. 34)

• People do not automatically believe label statements.

o “The first task of the label reader is to judge whether a claim deserves trust.” (p. 38)

o People pay attention to and understand and believe labels when they confirm what they know – not when they present new information.

o “Even when strength of science disclaim ers were easier to comprehend (with the familiar communication device of report card grade) they did not show the
intended effects. ... This communication failure would follow from consumers’ inaccurate prior assumptions about the scientif ic support for unqualified health claims.” (p. 34)

o “These findings suggest that consumers’ prior beliefs about the certainty of science for a health claim are not easily supplanted by new information in the
claim. These prior beliefs apparently play an important role in determining how consumers understand and respond to health claims.” (p. 36)

3) FDA, 1999. ( Sunblock Final Monograph, FR Notice ):

• “When consumers see the term ‘sunscreen’ or similar sun protection terminology in the labeling of a product, they expect the product to prot ect them in some way from the harmful effects of the sun, irrespect ive of other labeling statements.” (p. 28204)

4) France and Bone, 2005. (“Policy makers' paradigms and evidence from consumer interpretations of dietary supplement labels”) :

• “The regulation of marketplace information regarding health and nutrition is in flux. Nowhere, perhaps, is this more evident th an in the dietary supplement industry.... Our study suggests that a direct-effects consumer decision-making model does not apply in this context; instead, consumers process label clai ms through various biasing filters.” (p. 27)

5) Redmond and Griffith, 2005. (“Consumer perceptions of f ood safety education sources: Implications for effective strategy development”) :

• “The public does not equally trust all sources of information about food safety and trust
of information about food-related hazards ma y be an important determinant of public
reaction to risk information. I ndeed, it is considered that trust of information may be as an important determinant for effectiven ess of information as the content of
information itself. ” (p. 467)9 

### What assumptions are people bringing to natural insect repellent labels?

6) National Consumers League. Naturally Misleading

.

• Natural has the presumption of safe. Natural is attractive.

o “In a January 2002 survey recently commissioned by NCL, 86 percent of the participants believed that pr oducts advertised or labele d as ‘natural’ were safe. Three out of four of those surveyed expect ed these ‘natural’ pr oducts to contain at least 90 percent natural ingredients.” (p. 4)

o “In the focus groups, most respondents were positively predisposed to products with the ‘natural’ claim” (p. 5)

o “When the focus groups were questioned about a ‘natural’ labeled product, many participants persisted in attributing safety benefits based on the natural claim

. ‘If it’s natural, it must be good,’ stated one participant.” (p. 5)

• “The NCL survey revealed that the majority of the participan ts (64 percent) are very or
somewhat confident that the claim of ‘natur al’ accurately describes the ingredients and processes for that product.” (p. 5)

6) GAO Report to Congress, 2009 ( Dietary Supplements ):

• “Furthermore, during the course of our revi ew, most experts we spoke with noted that, generally, consumers are not well-informed about the safety and efficacy of dietary supplements. These experts explained that many consumers believe various myths about dietary supplements. For example, cons umers may believe that if a product is natural, it must be safe; if a little is good, than more must be better.” (p. 33)



### People tend to understand what they want to, and may not believe label statements or disclaimers they disagree with.

7) Mason and Scammon, 2000. (“Consumer perceptions of f ood safety education sources: Implications for effective strategy development”):

• Different parts of the label have different effects on people: “ Ford and colleagues (1996), when investigating the interaction of health claims and nutrition facts panels,
found that the health claims and nutrition in formation on labeling had independent effects
and that the claims affected consumers’ beliefs. The health claims significantly affected consumers’ health beliefs, even when co ntradicted by unfavorable or ambiguous
nutrition information.” (p. 146)

• There are five common ways to interpret th e FDA disclaimer on supplements (p. 147):

1. Misread or misunderstand the disclaimer – sometimes understanding the opposite

2. Rationalize or explain why it is there (“legal reasons,” “bureaucracy”) rather than
think about what it means.

3. Glad that the FDA is not involved (because of negative perception of the govt/FDA)

4. Use it to make brand comparisons. Belief that disclaimer = more thorough company.
5. Disregard it completely and assume that a ll products must meet a minimum standard or be checked (“the truth is anything that’s on the shelf has been checked by the FDA.
It wouldn’t be there if it weren’t safe.”)10 o “First, several informants were unaware of the lack of substantiation of the health claims because they either had never read the disclaimer when purchasing supplements or had simply misread it and thought that the FDA
had evaluated the health claims.” (p. 147)

o “Second, when asked about the disclaimer, several informants appeared confused by it and tended to disregard or rationalize its meaning, explaining that it was just a bureaucratic or legal thing. For example, one 65-year-old male informant indicated that the disclaimer was there just because the FDA was too slow and had not yet had the opportunity to evaluate the claims. These informants only considered why the disclaimer might be on the label but not what it meant or its possible implications. ” (p. 147)

o “Third, several informants we re glad that the FDA was not involved. Rather than question what it meant that the health claims had not been evaluated, they saw it as a good thing that the FDA did not regulate supplements, because they feared that the agency would restrict access to such products.” (p. 147)

o “Fourth, some informants, recognizing that only some brands carried the label disclaimer, used its presence or absence to make brand comparisons. Because the
disclosure is triggered by an affirmative claim, those supplements not making a claim do not need to carry the disclaimer.” (p. 147)

o “Last, even though our informants had read the disclaimer and we had explained its meaning, they still believed that the FDA evaluated supplements. For example, a 43-year-old female informant explained that though the disclaimer states the product has not been tested: ‘The truth is anything that’s on the shelf has been checked by the FDA. It wouldn ’t be there if it weren’t safe.’” (p. 147)

Potential implications for minimum-risk insect repellents: People will likely use the context of a positive opinion of natural products when evaluating any disclaimer, and, thus, may not believe any claims that imply the product has no t been tested, may not work, has limited utility, or may be harmful.



# Making an informed purchase decision

Summary of findings:

• Disclaimers on labels are not an effective way to influence consumers to use products more safely or in more appropriate ways

• People will act only if they have serious concerns. A disclaimer provides information that may or may not become part of their risk-a ssessment decision, and may or may not lead
them to informed action.

Details:

1) EPA OPPT, 1994 ( Determinants of Effectiveness for En vironmental Certific ation and Labeling
Plan ):

• “Research suggests that a signi ficant portion of consumers te nd to ignore warning labels,
and the consumers who do read labels often misinterpret their me anings. Other studies suggest that “few warning la bels lead to appropriate responses by consumers” and “people act to mitigate a risk only if they think the risk is high enough to merit concern” (p. 28) (cited in Hadden 1991).11 2) Hadden, 1991 (“Regulating Product Risks Through Consumer Information”):

• “ Information policies have unconsidered side e ffects. First, their effectiveness rests on assumptions that people will read labe ls, understand them, and act on them. These assumptions are called into question by a wide range of experimental and field data. Second, information policies are generally regressive in impact. Consumers with fewer monetary resources typically also have fewer of the ki nd of resources needed to understand and use information” (p. 93)

• “Understanding is only th e prelude to acting. ... A small set of empirical studies support
the inference that few warning labels lead to appropriate responses by consumers.” (p. 99)

• A study of a nutrition label pr ogram “found that the program greatly increased people’s knowledge but scarcely affected their purchases. ... A large st udy in which additional risk information was provided to patients already taking prescription drugs for several different conditions showed that new information hardly changed patients; compliance with the drugtaking regiment ... these re sults demonstrate that people act to mitigate a risk only if they think the risk is high enough to merit concern .” (p. 99)

• “ Both research and cognitive theory call into question the accuracy of the assumption that people will read, understand, and act upon product warning information” (p. 100)

• Groups disproportionately at risk : “People may trade time or money to reduce or avoid a risk of properly informed about it. However, if certain groups cannot use the information, they are systematically placed at higher risk” (p. 101).

3) Eggers and Fischhoff, 2004. (“Setting Policies for Consumer Communications: A Behavioral Decision Research Approach”) :

• There is a difference between presenting clear instructions vs. additional information. Instructions may be followed, but additional information may not have an impact: “Most researchers believe that there is value in well-designed labels that concisely communicate a potential hazard. Studie s of warnings focus on situations that have one correct response (e.g., not using hair dryers in the bath tub) rather than situations in which different choices might be best for different people (e.g., whether to use a supplement, whether to accept the risk of a beneficial product).” (p. 16)



### Successful statements / disclaim ers have yet to be found:

4) FDA 2009 (Public Hearing / Request for Comments on Use of Symbols to Communicate Nutrition Information):

• FDA wants to know: “What is consumer interpretation of the co-existence of front-label nutrition symbols and nutrition sy mbols present on the tags of supermarket shelves, when available? When do consumers use sym bols and what do they use them for? Do nutrition symbols on food labels direct consumers toward purchase of foods that bear them and, if so, to what extent?” (2007 request for comments)

• What they found out (2009 memo summarizing comments):

o Contradictory.

 “ As for possible influences of nutri tion symbols on product choices, some
comments observed increases in sales of products carrying sym bols relative to sales of products ca rrying no symbols. Meanwhile, ot her comments cited research suggesting that nutrition symbols have only a limited influence on the frequency and quantity of consumption of pr oducts carrying such symbols. Comments also provided some information suggesting an association between the presence of12 nutrition symbols on food products , or purchase of symbol-carrying products, and higher intakes of certai n nutrients or products. Yet other comments raised the possibility that nutrition symbols may have an insignificant role in actual purchase decisions.” (p. 3)

o Two years after requesting comments, FDA still needs more information:

 “ Though the public hearing generated some information on consumer issues related to nutrition symbols, the public he aring produced little usable research or other information on the majority of consum er issues listed in the public hearing
notice. Many of the questions asked in the public hearing notice remain

unanswered ...While we do have a clearer unde rstanding of the nutritional basis for many existing nutrition symbol programs and of the types of foods that bear nutrition symbols, there are many gaps in our understand ing of consumer interpretation and use of such symbols.”

Potential implications for minimum-risk insect repellents: It is unlikely that a disclaimer on a minimum risk insect repellent product would br ing about informed consumer decisions on how well such a product would meet each consumer’s needs.

Sources:

Eggers, Sara L. and Baruch Fischhoff. 2004. “S etting Policies for Consumer Communications: A
Behavioral Decision Re search Approach.” Journal of Public Policy & Marketing 23(1): 14-27.

EPA OPPT, 1994. Determinants of Effectiveness for Envi ronmental Certification and Labeling Plan

. April 1, 1994. EPA-742-R-94-001. Online through Na tional Service Center for Environmental Publications (NSCEP): http://nepis.epa.gov

EPA OPPTS, 1999. Consumer La beling Initiative, 1996 – 1999. EPA 742-R-99-004. Online at http://www.epa.gov/pesticides/re gulating/labels/c li-research.htm

FDA, 1999. Sunblock FR Notice: May 21, 1999: “S unscreen Drug Products for Over-The-Counter Human Use; Final Monograph” Online at http://www.fda.gov/Drugs/DevelopmentApprov alProcess/DevelopmentResources/Over-theCounterOTCDrugs/Statuso fOTCRulemakings/ucm072134.htm

FDA. 2005. Working Paper: Effects of St rength of Science Disclaime rs on the Communication Impacts of Health Claims . Brenda Derby and Alan Levy. Center for Food Safety and Applied Nutrition. September 2005. Online at: http://www.fda.gov/OHRMS/doc kets/dockets/03N0496/03N-0496- rpt0001.pdf

FDA. 2009. Public Hearing / Request for Commen ts: Use of Symbols to Communicate Nutrition Information. July 19, 2007 and 2009. Online at www.regulations.gov Docket FDA-2007-N-0198 (formerly Docket No. 2007N-0277)

France, Karen Russo and Paula Fitzgerald Bone. 2005. “Policy makers' paradigms and evidence from consumer interpretations of dietary supplement labels” Journal of Consumer Affairs 39(1): 27-
51. 2005.13 GAO 2009. Report to Congress - Dietary Supplements: FD A Should Take Further Actions to Improve Oversight and Consumer Unde rstanding on Dietary Supplements . 2009. GAO-09-250

Hadden, Susan G. 1991. “Regulating Product Risks Through Consumer Information.” Journal of Social

Issues 47(1): 1991. p. 93-105

HealthStyles 2008 (Porter Novelli Company. Da ta analysis available from EPA OPP)

Mason, Marlys J. and Debra L. Scammon (2000) , “Health Claims and Disclaimers: Extended Boundaries and Research Opportunitie s in Consumer Interpretation,” Journal of Public Policy & Marketing , 19 (Spring), 144-150.

Mason, Marlys, Debra Scammon, and Xiang Fang. 2007. “T he Impact of Warnings, Disclaimers, and Product Experience on Consumers' Perceptions of Dietary Supplements” Journal of Consumer Affairs , 41(1): 74-99. 2007.

National Consumers League. Naturally Misleading . Online at: www.nclnet.org/naturalsreport.pdf

Redmond, Elizabeth C. and Christopher J. Griffi th. 2005. “Consumer perceptions of food safety education sources: Implications fo r effective strategy development.” British Food Journal

, 107(7): 467-483.