Impact of Messaging Strategy on Consumer Understanding of Food Date Labels.

OBJECTIVE: Explore consumer understanding of the food industry's 2-date labeling system and the relative effectiveness of messages in increasing understanding. DESIGN: Participant understanding of date labels assessed before and after random assignment to 1 of 7 messages explaining the meaning of the labels. SETTING: US online survey through Amazon Mechanical Turk collected responses from July 29, 2019, to August 5, 2019. PARTICIPANTS: Adults aged 18 years or older who speak English (n = 2,607). INTERVENTION: Seven message variations. VARIABLES MEASURED: Behaviors, awareness, and understanding of date labeling, and effectiveness of messages and opportunities for improving them. ANALYSIS: Pearson's chi-square test of independence, Wald chi-square test of association, McNemar's test of marginal homogeneity, and logistic regression. RESULTS: The majority of respondents use date labels to make decisions and believe they know what the labels mean; however, only 64.0% and 44.8% knew the general meaning of the Best If Used By and Use By labels, respectively. Even fewer understood their specific meanings. Overall, education increased general understanding to 82.0% for Best If Used By and 82.4% for Use By (P < 0.001). The effectiveness of the educational message did not vary significantly by message variation. CONCLUSIONS AND IMPLICATIONS: Consumer education is needed to improve understanding of the 2-date labeling system, ultimately improving food safety and decreasing wasted food. This study highlights opportunities for effective educational communication.

Dengue Sentinel Traveler Surveillance: Monthly and Yearly Notification Trends among Japanese Travelers, 2006-2014.

BACKGROUND: Dengue is becoming an increasing threat to non-endemic countries. In Japan, the reported number of imported cases has been rising, and the first domestic dengue outbreak in nearly 70 years was confirmed in 2014, highlighting the need for greater situational awareness and better-informed risk assessment. METHODS: Using national disease surveillance data and publically available traveler statistics, we compared monthly and yearly trends in the destination country-specific dengue notification rate per 100,000 Japanese travelers with those of domestic dengue cases in the respective country visited during 2006-2014. Comparisons were made for countries accounting for the majority of importations; yearly comparisons were restricted to countries where respective national surveillance data were publicly available. RESULTS: There were 1007 imported Japanese dengue cases (Bali, Indonesia (n = 202), the Philippines (n = 230), Thailand (n = 160), and India (n = 152)). Consistent with historic local dengue seasonality, monthly notification rate among travelers peaked in August in Thailand, September in the Philippines, and in Bali during April with a smaller peak in August. While the number of travelers to Bali was greatest in August, the notification rate was highest in April. Annually, trends in the notification rate among travelers to the Philippines and Thailand also closely reflected local notification trends. CONCLUSION: Travelers to dengue-endemic countries appear to serve as reliable "sentinels", with the trends in estimated risk of dengue infection among Japanese travelers closely reflecting local dengue trends, both seasonally and annually. Sentinel traveler surveillance can contribute to evidence-based pretravel advice, and help inform risk assessments and decision-making for importation and potentially for subsequent secondary transmission. As our approach takes advantage of traveler data that are readily available as a proxy denominator, sentinel traveler surveillance can be a practical surveillance tool that other countries could consider for implementation.