Health Professionals' Attitudes and Educational Needs Regarding New Food Processing Technologies



ABSTRACT:  This project evaluates the attitudes of food and health professionals to 3 new food processing technologies that have been developed to respond to consumer demands such as superior taste, longer shelf life, higher nutritional content, health benefits, and environment-friendly processing. Educational brochures for high pressure (HP), pulsed electric field (PEF), and ohmic heating (OH) processes were developed based on the current literature and consumer information needs. An internet web survey was conducted to determine information needs of food and health professionals and to assess their satisfaction with the data provided in the educational brochures. Health professionals hold a positive attitude toward HP, OH, and PEF. No negative attitudes or discomfort were reported. More people indicated they were very comfortable with HP than any other technology, and as a consequence this technology received the highest scores of likeliness to be included in health professionals' recommendations.


Consumers are interested in receiving information about new developments in food and nutrition; however, consumers may be confused because of the multiple sources and quality and content of information (IFIC 2005; ADA 2006). Media reports frequently do not provide enough information or provide conflicting information, leading to consumer food and nutrition misinformation (ADA 2006). One way to avoid consumer confusion is through educational programs. To influence consumer attitudes and behavior, people need to trust the information source (Eiser and others 2002; Frewer and others 2003). Food and health professionals are considered legitimate sources of information by consumers (ADA 2000). Therefore, educational activities should be lead by professionals in food and health science because other sources may not provide sufficient or accurate information. Food and health professionals need sufficient, accurate, and timely information in new developments in food and nutrition (Weaver and Marcotte 1988; ADA 2000, 2006; Schmidt 2000; Worsley 2000). Equipped with appropriate educational materials, health professionals are able to convey accurate information through personal contacts, educational programs, and media outreach. These activities could contribute to more accurate understanding and, under appropriate circumstances, increased acceptance of new technological approaches.

The acceptance of a novel technology is highly dependent on the information provided to the consumer. Acceptance may be increased if consumers perceive direct benefits from use of the technology (Bruhn and Mason 2002; Fox 2002; Butz and others 2003). Food attributes, such as good taste, microbiologically safe, absence of pesticides and additives, and extended shelf life, form part of consumer demands and expectations (Cardello 2003; Patterson 2005; Costa and Jongen 2006; van den Heuvel and others 2006; Wansink and Wright 2006).

High pressure (HP), pulsed electric fields (PEFs), and ohmic heating (OH) processes are among the new methods for processing foods that may result in better overall appearance and flavor when compared to conventional heating (Hogan and others 2005; Toefl and others 2005; Vicente and others 2006). However, currently there are few products in the market processed by these technologies but their price may be slightly higher than conventionally processed products and their safety record is not as long term compared to products processed by traditional methods. Consumer attitudes toward these technologies could play an important role in expanding their use by the food industry.

Only a few consumer studies have been conducted about these alternative technologies. Deliza and others (2005) measured consumer perception of pressurized juices; Cardello (2003) measured the effect of testing products processed by alternative technologies with and without information. Butz and others (2003) measured attitudes of German, French, and British consumers toward high-pressure processing.

The purpose of this research was to determine the information needs of food and health professionals and assess their satisfaction with the data provided in educational brochures on HP processing, PEF processing, and OH.

Materials and Methods

Brochures on HP, PEF, and OH were prepared. Topics covered were based upon focus group research, which identified the information consumers wanted (Bhumiratana 2005). Four focus groups (35 people) were conducted with primary household food shoppers in California to explore the attitudes toward the safety and quality of processed foods, understanding of the use of the term, “pasteurized,” especially as pertained to nonthermal methods to destroy pathogens, and to identify the information needed to feel comfortable with novel food processing methods. Consumers indicated that they would like processed foods that tasted like food freshly prepared at home. Participants also mentioned that foods processed by new methods should offer consumer benefits, such as better flavor, assurance of safety, and minimal environmental impact.

Brochure technical content was based upon a review of the food technology literature. The book, Novel Food Processing Technologies (Barbosa-Cánovas and others 2005) provides an overview of each technology. Key references in OH include Ruan and others (2001, 2002) and Goullieux and Pain (2005). HP and PEF processings are reviewed by Clark (2006a, 2006b). An overview of HP processing is available from Hogan and others (2005). Food processing fact sheets for the food processing industry by Ramaswamy and others (2004a, 2004b, 2004c) are available on-line. Additional references, including effects on quality and nutritional value, are available from the authors.

The brochures were divided into the following sections: introduction, potential benefits, description of the process, products in the marketplace, microbiological safety of the process, institutions that evaluate process safety, environmental impact of the process, worker safety issues, history of the process, and companies using the process. Further, since it was expected that health professionals may want to verify or seek additional information, a section on references was added (see Brochure).

The brochures were evaluated for scientific accuracy by experts (4) from the Univ. of California Davis, Ohio State Univ., and USDA Eastern Regional Research Lab. and modified as recommended. Next, they were reviewed by graduated students in agricultural sciences for clarity prior to evaluation and pretested with 10 members of the target population. Response to an electronic version of the brochures was evaluated by an internet-based survey posted on Survey Monkey. The questionnaire followed the guidelines of a web-based survey in that it was designed to be self-administered, a pull down menu listed options in a multiple choice question, and volunteers were required to complete each section before proceeding to the next question. The questionnaire was divided into the following parts: general instructions, previous knowledge about the technologies, importance of the food attributes for health professionals, and importance of information about new technologies. Next, the participants were asked to read the brochure. Attitudes were assessed after reading about each technology. Demographic information was collected at the end (see Survey). The target participants for the survey were people involved in food, nutrition, or health education. Volunteers were contacted by email through the Natl. Directory of Food and Nutrition Extension Contacts and a food safety conference for health professionals in California, U.S.A. The latter consisted of educators working in the Women Infants and Children (WIC), school nutrition, and other health education programs.

SAS version 9.1 (SAS Inst., Cary, N.C., U.S.A.) was used for the statistical analysis. The level of confidence was setting at alpha = 0.05. Univariate analysis (analysis of variance [ANOVA]) and Fisher's LSD multiple comparison and multivariate analysis (principal component analysis) were used to obtain an image representation of the technologies as well as the influence of the information presented in the brochures.

Results and Discussion

An invitation to assist in the evaluation of the 3 brochures describing new technologies was sent to 120 health professionals. A total of 44 responses were received for a response rate of 37%. Most respondents were female (88%) between 41 to 50 y (25%) and 51 to 60 y (39%), and of White/Caucasian ethnicity (72%). The educational level was evenly distributed between bachelor, master, and doctoral degrees with similar values for each.

Significantly more health professionals have heard about HP processing than either of the other food processing technologies. Most of the health professionals reported not having previously heard about PEF and OH technologies, 66% and 64%, respectively. In contrast, 64% reported that they have heard about HP processing (F= 13.39, 2/86 df, P < 0.0001, LSD = 0.3152). See Figure 1 for an illustration depicting the percentage who have heard about with each technology. Most health professionals indicated they have no knowledge of these technologies, 57% for PEF, 61% for OH, and 36% for HP. The level of knowledge about HP processing technology was significantly higher from the other 2 technologies (F= 15.01, 2/86 df, P < 0.0001, LSD = 0.2407), however, only 5% reported that they had “a lot” and 30% reported “some knowledge” of this process. Greater knowledge of HP processing could reflect the fact that HP is the most developed technology with food science courses discussing this method, more research reported in the literature, and some products in the marketplace (Ramaswamy and others 2004a; Hugas and others 2002).

Figure 1—.

Percentage of health professionals who have heard about HP, PEF, and OH technologies.

When asked about their attitude toward personal selection of foods processed by a new technology, most of the health professionals (84%) indicated that they generally do not try these products before reviewing information about the technology. Microbiological safety, consumer benefits, description of the process and the institution that conducts research to evaluate safety and potential benefits are the areas health professional consider most important in their review of new process technologies, as shown in Table 1. Next in importance is the impact of the process on the environment and the number of products in the marketplace. Worker issues, history of the process, and the number or name of companies using the new process are significantly lower in importance. Microbiological and chemical safety of the process was considered a basic requirement for product acceptance. The importance of source and type of information on health professional's perception of a technology is consistent with the research of other investigators (Bruhn and Mason 2002; Eiser and others 2002; Cardello 2003; Frewer and others 2003).

Table 1—.  Overall importance of a topic when evaluating a new technology.
  1. AMeans sharing superscript (a, b, c, d) do not differ significantly. A 5-point scale from 1 = Very unimportant to 5 = Very important was used.

Microbiological safety of the new process4.92a  
Benefits of this new method4.78ab
Description of the new process4.54ab
Institutions that evaluate process safety4.43ab
Environmental impact of process4.35bc
Products in the marketplace4.30bc
Worker safety issues3.86cd
History of the new process3.70d
Companies using the new process3.57d
LSD 0.5063

Health professional's response to information needs regarding HP processing, PEF, and OH is consistent with their attitude toward new processing technologies in general. The name of the technology and any prior attitudes toward these processes do not appear to trigger unique questions or concerns. Microbiological safety, potential benefits, and the description of the process are the most important factors influencing their acceptance, as illustrated in Table 2. The overall importance of each topic does not differ by technology except for the knowledge of the companies using a technology is greater for acceptance of HP than PEF, and OH.

Table 2—.  Overall influenceA of the topics presented in the overview for each process.
Subject areaBGeneralHPPEFOH
  1. AIn columns means sharing superscript do not differ significantly. A 5-point scale from 1 = No influence to 5 = Very great influence was used.

  2. BThere were no significant differences among technologies in each topic except in companies using the new process indicated by *; means sharing the same capital letters in this row are not significantly different from each other LSD = 0.3078.

Microbiological safety of the new process3.79a  3.82a  3.75a  3.80a  
Benefits of this new method3.51ab3.48ab3.45ab3.59ab
Description of the new process3.50ab3.48ab3.39ab3.64ab
Environmental impact of process3.17bc  3.20bcd3.11bc3.18bc
Institutions that evaluate process safety3.08bc3.27bc  2.95bcd  3.02cde
Products in the marketplace2.98cd 3.00bcde2.82cd 3.11bcd
Worker safety issues 2.85cde 2.84cde2.82cd 2.89cde
History of the new process2.61de2.70de2.57de2.59de
Companies using the new process*2.44e  A 2.59eB 2.23eAB 2.57e
LSD 0.4554 0.5353 0.5181 0.5235

When food health professionals are selecting food, they indicate that the most important factors are safety, nutritional value, and sensory properties. The importance of these factors is illustrated in Table 3. Price is a secondary consideration compared to these food characteristics. Uses only natural ingredients and organically produced are each significantly less important than the other factors listed in the survey.

Table 3—.  Importance of each food attribute when selecting processed food.
  1. Attributes sharing the same letter are not significantly different LSD = 0.432, P < 0.05.

  2. A 5-point scale was used from 1 = Very unimportant to 5 = Very important.

Microbiologically safe4.9a
Absence of toxic substances4.8a
Nutritional value4.8a
Appearance and color 4.6ab
Texture 4.5ab
Like freshly prepared4.2b
Uses only natural ingredients3.4c
Organically produced2.8d

Information provided in the brochures appears to meet the information needs of health professionals. When given the opportunity, participants do not list other topics that they wish to be addressed. Further, health professionals appear satisfied with the extent of the information provided within each topic area. On a scale of 1 to 5, with 5 meaning very comfortable, health professionals rate their comfort level with each technology as 4 or higher, as shown in Table 4. Participants are significantly more comfortable with HP and OH than PEF (P < 0.05). Greater comfort with HP could be because the brochure indicates that HP is the most developed technology with more research reported in the professional literature on safety and effectiveness, more products in the market and the concept is consistent with prior knowledge through their professional training on the effect of pressure in food processing. Professionals may realize that OH is an improvement over thermal treatment because of rapid uniform heat distribution. The process, therefore, may offer nutrition and sensory benefits to the consumers. Destruction of bacteria by PEFs is a newer concept so the lower initial comfort level is not unexpected. Overall, comfort level is in the somewhat comfortable or higher level. The somewhat higher comfort level is consistant with the findings of other investigators who have found that the majority of people are interested in buying foods processed by new technologies in the marketplace after reading science-based information on the technologies (Bruhn and Mason 2002; Fox 2002; Cardello 2003; Bhumiratana and others 2007).

Table 4—.  Comfort rating after reading the brochures of each technology.
  1. Means sharing the same letter are not significantly different. A 5-point scale was used from 1 = Very uncomfortable to 5 = Very comfortable.

HP4.27aP < 0.05
LSD 0.2418 

The likelihood to recommend food products processed by these technologies is positively correlated to health professional's level of comfort (r= 0.702, df = 42, P < 0.05), as illustrated in Figure 2. The mean likelihood to recommend is slightly less than the mean level of personal comfort, which is understandable since the educational brochure alone is not sufficient to recommend an item. Product taste as well as suitability for the specific individual may contribute to a decision to recommend a product (Sijtsema and others 2002).

Figure 2—.

Correlation between comfort level after reading the brochures and likeness to recommend products process with these technologies to consumers.

When asked if they would pay a 10% premium for products processed by these technologies, the majority of health professionals indicated they are very or somewhat likely to buy. The benefits of more nutritious, better tasting, staying fresh longer, and environment friendly products generated the greatest interest, as illustrated in Table 5. A more nutritious product was significantly more important to this audience than an environment-friendly process. Because respondents were health professionals, the likelihood of paying a higher price for better nutrition was not surprising. Of note is their willingness to pay more for a product processed by HP if the product has better taste. Sensory properties are a key driver in the acceptability of a new product (Cardello 2003). Health professionals were no exception to this pattern. Microbiological and toxicological safety are basic expectations, and nutritional value is a priority to this audience; however, sensory properties, including flavor, appearance, and texture, are of upmost importance. While the general public values freshness highly (Wansink and Wright 2006), health professional in this survey expressed less relative importance to “stays fresh longer.” Perhaps this difference relates to the emphasis in the brochure on processed rather than raw food.

Table 5—.  Benefits for which health professionals are most likely to pay a 10% premium.
  1. ABenefits (overall mean) sharing the same letter are not significantly different LSD = 0.3186, P < 0.05.

  2. Bns indicates not significant difference among technologies in the benefit evaluated; *indicates significant difference at P < 0.05; means sharing the same letter are not significantly different.

  3. A 5-point scale was used from 1 = Not likely to 5 = Very likely.

More nutritious (4.08a)HP4.16ns 
Better taste (4.05ab)HP4.23*LSD = 0.2237a
PEF3.95 b
OH3.98 b
Stays fresh longer (3.91ab)HP4.02ns 
Process is more environment friendly (3.75b)HP3.77ns 

The web was rated by participants in this survey as the most convenient method to receive information about new food processes or technologies. A professional journal or a technical report was the next most preferred means of receiving information. Some respondents volunteered that they liked receiving information via email. See Table 6 for health professional's rating of each inform sources. A preference for the internet might be because of the constant improvement and development of web services. Since this survey contacted health professionals through an internet web survey, it is not surprising that participants are accustomed to using the internet as a medium of receiving information.

Table 6—.  Most convenient way to reach health professionals audience.
  1. Means sharing superscript do not differ significantly P < 0.05. A 5-point scale was used from 1 = Very inconvenient to 5 = Very convenient.

Web site4.73a
Professional journal3.98b
Technical report 3.57bc
Presentation at society meeting3.36c
LSD 0.4850

While it is convenient to use email to contact volunteers and post the survey on the internet, exclusive use of the internet is also a limitation as it precludes educators who do not have ready availability of computers or are less familiar with computer technology. Further, although 120 educators were asked to evaluate the material, only 44 read all 3 fact sheets and completed the survey. A higher response rate and corresponding larger sample size would enhance the validity of the findings. The responses are likely from those health educators who are interested in learning about new approaches to food preservation. These individuals may have different attitudes than those who did not respond. Therefore, the positive attitudes toward HP processing, PEF, and OH indicates that some, but not necessarily all, health professionals view these technologies as potentially advantageous.


In general, health professionals hold positive attitudes toward HP processing, OH, and PEF. Information about these technologies did not generate negative attitudes among this sample of health professionals. A higher level of comfort was associated with HP processing than any other technology; this technology also received the highest scores of likelihood to be recommended in educational programs or to clients.

Potential benefits and assurance as to product safety are the most important information needs for health professionals. Better nutrition and better flavor were the key drivers for the conditional purchase of products processed by these newer food processing technologies.

Educational materials, such as the ones developed in this project, can be used to improve the acceptability of new technologies by addressing issues that health professionals consider relevant. Further, the brochures can serve an information resource to respond to media or consumer questions. Health professionals could use the information to design a “new products in the marketplace” informational session for other professionals or the public. The 2nd author made a brief slide presentation describing the technologies coupled with product sampling, which was positively received by lay audiences. Participants were interested to learn how new products such as the plastic bags of guacamole were processed and they were excited to hear that pressurizing raw oysters extended freshness and offered a higher level of safety. A consumer fact sheet designed around the topics presented in the health professional brochure served as take home material.


The authors gratefully acknowledge support for this project from USDA CSREES Z1000765, Safety of Food Processed by Four Alternative Processing Technologies.