Improving Food and Medication Recall Notifications to Enhance Consumer Safety: Survey of Consumer Attitudes (Preprint)

BACKGROUND In the United States, consumers bear the primary responsibility for identifying food and medication recalls through a fragmented system of press releases and decentralized websites. Current notification methods rely heavily on mass media, failing to reach consumers directly or effectively. Hospitalizations and deaths linked to contaminated food increased from 2023 to 2024 despite a decrease in total recalls. Most drug recalls are voluntarily initiated by manufacturers after products have entered the market rather than through pre-distribution detection. OBJECTIVE To assess consumer perceptions and behavioral responses to current food and medication recall systems in order to identify gaps and develop actionable strategies to enhance transparency and safety outcomes through a digital notification infrastructure. METHODS We conducted an online survey to assess health context, recall experience, concern and confidence regarding recalls, information sources, behavioral responses, attribution of responsibility, and perceptions of recall transparency and communication. RESULTS After exclusion criteria were applied, 120 responses were included for data analysis. Respondents expressed great concern about food and medication recalls overall. Personal experience with recalls was not significantly associated with elevated concern (food: 45.7% vs 35.0%, P=.48; medication: 80.0% vs 63.3%, P=.29). While only 35.6% (42/118) of participants affected by a recall have taken direct action related to that recall, 75.2% (88/117) report prospectively changing their purchasing or consumption habits as a result. Younger adults (≤ 34) expressed greater confidence in the timeliness of the current system compared to older respondents. Education level was significantly associated with concern about food recalls (P=.04), with the concern among those with a bachelor’s degree. Respondents most commonly learned about recalls through mass communication channels and identified timeliness, lack of clarity, and technical jargon as primary frustrations. A majority supported using loyalty cards, credit cards, or health insurance data to receive personalized, real-time alerts. CONCLUSIONS Consumers want to learn about food and medication recalls in a timely manner using targeted notifications. Demographic differences were modest but consistent, with younger and more educated respondents expressing greater concern. These findings provide a compelling need for a digital infrastructure that integrates retail and healthcare data to provide targeted, plain-language notifications. Such a system is essential to bridge the gap between regulatory harm detection and consumer safety actions. Future work will explore how to address regulatory gaps needed to implement these digital systems in the U.S. and how to assess the effectiveness of new models. CLINICALTRIAL Not applicable