Review Reports

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The manuscript is a scoping review focused on the characteristics of surveys on consumers’ food safety knowledge, attitudes, and practices (KAP) in home settings in high-income countries. The authors took into consideration peer reviewed articles and grey literature, however, they stated different data about publication years (e.g. “pre-2000” (line 346), “2000–2023” (lines 24, 132), “an update … was conducted on 3 August 2023” (line 163) which is misleading as at least they missed the publications published in the last 5 months (August-December) in 2023. As the article was submitted in 2026, the readers would expect that review covering also publications between 3 August 2023 and March 2026. In this missing period some articles were even published in the journal Foods but are not included in the current version of the manuscript.

The authors used their “rapid review related to pregnant women in high-income countries” ([Ref. 29], published in 2023) to build their scoping review on “consumers related surveys in high-income countries” and therefore talk about 8 or 15 key features, and comment them as “new”/ “new feature”, updated/updated from previous review or previous in the text (lines 284-349) and in Table 3. It really does not make any sense to introduce a feature “start and end date”, especially when this feature is based on the 5-year periods of publishing.

The article is written in such a way that the reader cannot connect data presented to the references, because 274 references are not listed the main part of the manuscript, but they are listed in the Supplementary materials without authors and article titles. So, for example, in Table 3 the last column related to the “previous rapid review of the authors” [Ref. 29]” does not bring any useful information for the reader, especially not because the reader would expect references cited.

For the “Key feature 14: Food Safety Topics” I would expect more details (e.g. not just “Mixed (2 topics)” or “Mixed (3 topics)” or “Mixed (4 topics)” but specified topics), which is valid also for Figure 2, which shows the results present in row columns 5 and 6 of Table 3. Sometimes questionnaires are long and the authors describe the results obtained in the same survey with several topics in more than one article (also in Foods).

I hardly believe that all studies in references listed included knowledge AND attitude AND practices. I strongly recommend the authors revise the manuscript and the reference list also considering these parameters in such a way that it would be clear which studies really involved K, A and P, and which involved K and P, etc.

The word “survey” in the title and in the abstract (lines 18, 34, 41) should most probably be replaced with “studies”, because it is not in agreement with the content of the manuscript, which talks also about qualitative data analysis (line 292, Table 3).

Other corrections needed are listed below. The manuscript might become suitable for publication in Foods after major revisions that would include addition of data about the studies published in this period (2023-2026).

 

LIST OF OTHER CORRECTIONS NEEDED:

1. Due to repetitions some parts of section 3.1 should be rewritten.
2. All references listed, including those in the Supplementary materials should include all data required by Instructions for Authors. In the current version of the Supplementary materials authors and titles are missing, while in the current version of the main part of the manuscript access dates, … are missing.
3. References listed in Supplementary materials should also be listed in the reference list of the main part of the manuscript.
4. I recommend the authors check all the references again, and correct mistakes (e.g., in line 65: ref [4] is not related to the WHO as should be according to the text).
5. Typos (missing spaces, full stops, capital letters, etc.) should be corrected (e.g., lines 85 and 89, Table 2).
6. Table 3: Italian word “ante”?
7. There is no need to introduce abbreviation if it is not often used in the manuscript (e.g., FBD (line 61) is used only once).
8. Abbreviations should be introduced before being used (e.g., MeSH in line 159).
9. Some sentences should be rewritten as they contain surnames of the authors and the numbered references (e.g., lines 92, 104, 106, 109, 137, 360). Surnames should be deleted.
10. The number of high-income countries should be added.
11. FIGURE 1: Fonts are too small to be readable.
12. FIGURE 2: Fonts are too small to be readable.
13. FIGURE 3: Figure 3 should be deleted, as data like “start and end date” or “article type” (93%). The text in Figure 3 was not readable without enlargement (on the screen) of 200%, otherwise the fonts are too small to be readable.
14. SUPPLEMENTARY MATERIAL, 3.) Detailed Search strategies for Governmental documents (grey literature):

• Data from FAO, WHO should not be listed under the category “Non-European countries”.
• The Tables should be presented in a more condensed way without the repetition of the first row (“Searching String”).
• Dates when the searches were performed should be added.

15. SUPPLEMENTARY MATERIAL, 5.) Citation list of 274 relevant articles captured in this Scoping review:

• All references listed, including those in the Supplementary materials should include all data required by Instructions for Authors.

Author Response

Please find attached the point-by-point response to all comments.

 

 

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

This is a very interesting and well-written review manuscript on consumers’ food safety knowledge, attitudes, and practices (KAP) in home settings in high-income countries. The provided background is adequate with many recent and relevant references. The aim of the paper is clear and the methodology is sound. The Discussion includes an in-depth analysis of the relevant literature and the claims of the authors are well-supported by the presented evidence. A few minor corrections:

1. Legends for Tables 1-3 and Figure 1 are very short. Please add some more detail about the information presented there.
2. Line 24: Briefly define 'grey literature' in the context of your manuscript
3. Figure 2: For the decimals, replace comma with full stop. The chart title can be removed.
4. Line 458: provide a reference for the earlier review that you mention here
5. Line 475: Clarify for whom this review will be helpful, e.g. policy advisors, public health advisors, survey researchers, policy makers, etc.

Author Response

Please find attached the point-by-point response to all comments.

 

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

This manuscript presents a scoping review of surveys assessing consumer food safety knowledge, attitudes, and practices (KAP) in home settings across high-income countries. While the work addresses an important public health topic and demonstrates substantial effort in synthesizing 274 documents, the manuscript suffers from several significant methodological and presentational shortcomings. The 15-feature framework is conceptually useful but its derivation, validation, and application lack transparency. The analysis is largely descriptive with minimal critical synthesis, and the discussion fails to meaningfully engage with the implications of observed heterogeneity. The writing contains redundancies, structural inconsistencies, and incomplete reporting. The core scope and data are potentially valuable, but the current presentation does not meet the standards expected for publication in a high-quality SCI journal. Based on this evaluation, the manuscript requires major revisions.

 

Title

1. The title is descriptive but overly verbose.

 

Abstract

2. The claim that "Most surveys adopted primary data collection, cross-sectional designs, closed-ended items, quantitative analyses, non-incentivised participation" is presented as a finding, but the abstract does not provide the corresponding percentages. Quantitative precision is expected in an abstract reporting results.
3. The phrase "suggesting some consistency in core methodological choices" is immediately followed by "Substantial variability was observed..." – this juxtaposition is contradictory and confusing. Clarify whether the conclusion emphasizes consistency or variability.
4. The abstract concludes with recommendations ("More consistent reporting, cautious harmonisation, and the potential reuse of validated items...") that are not directly supported by any specific finding reported in the abstract. Include a brief reference to the evidence that justifies these recommendations.

 

Introduction

5. The introduction lacks a clear statement of the gap in knowledge that this scoping review addresses. While the authors mention that "heterogeneous survey methodologies limit comparability," they do not explicitly state whether any prior synthesis of methodological characteristics exists.
6. Section 1.1 cites that "an estimated 30–40% of foodborne disease cases occur in domestic settings" with reference [4]. However, the original WHO source should be examined – is this a global estimate or specific to certain regions? Given that the review is restricted to high-income countries, the relevance of a global estimate (which may be driven by low- and middle-income country data) needs justification.
7. The introduction mentions "nutritional risks" (line 57) as a category of food safety risks. This is unconventional, as nutritional risks (e.g., deficiencies, excess intake) are typically distinguished from food safety (microbiological and chemical hazards). The authors should either justify this inclusion or remove it, as it is not reflected in the subsequent analysis of "food safety topics" (Key feature 14 includes "nutritional" as a category, but this is not explained).
8. The research sub-questions are not consistently addressed in the results section. Specifically, sub-question (c) "Do studies address specific target population (e.g. age/susceptibility) or geographic areas?" is partially addressed by Key feature 5 (target population) and Key feature 13 (geographical location), but there is no synthesis of whether geographic areas correlate with specific target populations or whether certain populations are under-studied in specific regions.
9. The introduction would benefit from a clear definition of "home food safety (HFS)" as operationalized in this review. The authors mention "handling, storage, and preparation practices" but do not specify whether cleaning, dishwashing, refrigerator organization, or leftovers management are included. This ambiguity affects the interpretation of Key feature 14 (food safety topics).

 

Materials and Methods

10. The search strategy for grey literature using "Google Advanced Search" (lines 169-170) is concerning. Google searches are not reproducible due to algorithm personalization and temporal variability. The authors should specify whether they used a standardized browser, cleared cache/cookies, documented the search date, and whether any attempts were made to verify search result stability. Without this, the grey literature search lacks scientific rigor.
11. The methods state that "For each website, a common core search string... was applied, and adapted as needed at the site level." The exact core search string is not provided in the manuscript or clearly referenced in the supplementary material. Without this, readers cannot assess the consistency of the grey literature search across countries.
12. The authors searched websites in English for all countries, but also conducted additional searches in Italian, Spanish, and Chilean Spanish "to leverage the language expertise of the review team." This introduces language bias – why were these three languages chosen? What about French, German, Dutch, Japanese, Korean, or other languages spoken in high-income countries? The authors should either justify this selection or acknowledge it as a limitation.
13. The screening process (lines 208-213) reports that "Two reviewers (F.M., M.V.) independently screened all documents; disagreements were resolved by consensus with a third reviewer (A.M.)." However, no inter-rater reliability metric (e.g., Cohen's kappa) is reported. For a scoping review of this size, reporting agreement statistics is standard practice to demonstrate screening reliability.
14. The data extraction template was "piloted independently by both reviewer teams on a sample of 10-15 studies" (lines 223). The sample size is vague (10-15) and the outcome of piloting is not described – what changes were made? How many rounds of iteration occurred? Without this detail, the validation of the extraction form is opaque.
15. The authors state that "no formal critical appraisal of methodological quality was undertaken" (lines 237-240). While this is acceptable for scoping reviews per JBI guidance, the authors later make recommendations about "more consistent reporting" and "cautious harmonisation" that imply judgments about study quality. The discussion should explicitly acknowledge that without quality appraisal, recommendations for methodological improvement are based on observed variability, not on demonstrated superiority of any particular approach.
16. The methods do not specify how the 63% homogeneity threshold (introduced in the Discussion, line 425) was determined. Was this threshold pre-specified in the protocol? If not, its post-hoc introduction is a potential source of bias. The authors should either justify the threshold or remove it and present the findings without arbitrary categorization.

 

Results

18. The results section reports that 1,984 records were identified from five databases, and 623 duplicates were removed. However, the breakdown of duplicates by database is not provided, nor is the total number of records per database. This information is useful for assessing search coverage and overlap.
19. Key feature 1 (Article type) classifies studies as "experimental (primary data collection)". However, in survey research, "experimental" typically implies manipulation of variables or random assignment. Most cross-sectional surveys are observational, not experimental. The authors appear to use "experimental" to mean "primary data collection" – this is a misnomer and should be corrected to "Primary data collection" or "Original survey research."
20. Key feature 3 (Testing) – the classification of "pre/post assessments" as "Testing" is unclear. The authors report that "Testing was not conducted in approximately 84% of the documents". This implies that only 16% of studies included pre/post designs. However, given that 91% of studies were cross-sectional (Key feature 2), cross-sectional studies cannot by definition include pre/post testing. The "Not applicable" category (19 studies, line 290) is ambiguous – does this refer to observational/secondary analyses? The relationship between Key features 2 and 3 needs clarification.
21. Key feature 5 (Target population) – the classification of "adults" as including "elderly individuals, vulnerable participants, or volunteers not belonging to a specific population group" (line 300) creates overlapping categories. If "vulnerable populations" are defined separately (elderly, immunocompromised, pregnant), then elderly individuals should not also be counted in "adults." The authors need to clarify the mutually exclusive classification rule. This affects the reported percentages (73% adults, 20% vulnerable, 7% representative samples).
22. Key feature 6 (Survey question types) – the inclusion of "Likert" within "Closed questions" (Table 3) is methodologically questionable. Likert scales produce ordinal data and are often analyzed differently from binary or multiple-choice closed questions. The authors should either justify this aggregation or report Likert-type items separately.
23. Key feature 8 (Sample size) – the categories are ≤1,000; 1,000-10,000; 10,000-51,000. The upper bound of 51,000 appears arbitrary. Why not 50,000 or 100,000? The authors should explain the basis for these cut-points. Additionally, the category "not applicable" (12 studies) and "not reported" (2 studies) are combined in Table 3 but should be separate.
24. Key features 9 and 10 (Survey aims and conclusions/discussion) are reported as having identical distributions (Cat.1: 113; Cat.2: 143; Cat.3: 18). This perfect correlation is suspicious and suggests either data handling error or tautological classification (i.e., conclusions were coded to match aims). The authors should explain how aims and conclusions were coded independently and why the distributions are identical.
25. The results do not report any analysis of overlap or correlation between key features. For example, are studies with larger sample sizes more likely to use statistical tests? Do online surveys differ from face-to-face surveys in their thematic scope? Such analyses would strengthen the descriptive synthesis.
26. Figure 1 (PRISMA flow diagram) is mentioned but not provided in the manuscript excerpt. The authors should ensure that the figure clearly distinguishes between scientific and grey literature throughout the flow, as the text reports separate numbers for each. The current text reports exclusion reasons for grey literature (e.g., "88 documents (79.3%) were excluded as irrelevant") but these percentages are calculated within each grey literature subgroup – this should be clearly indicated in the figure legend.
27. The results mention "Supplementary material (number 5)" containing the complete list of 274 included documents. However, the authors do not report any basic bibliometric analysis – e.g., the range of publication years (beyond the grouped intervals), the most prolific journals, or the most cited studies. Such information would help readers understand the landscape of this research field.

 

Discussion

28. The authors introduce a homogeneity threshold of "median threshold of 63%" to categorize features as "relatively homogeneous" versus "less homogeneous." The justification for this specific threshold is not provided. Moreover, the calculation of the 63% figure is not explained – is this the median percentage across all features? The authors should either provide a clear statistical rationale or abandon the threshold and describe variability qualitatively.
29. The discussion identifies seven "relatively homogeneous" features (the "shared methodological core") but does not name them explicitly. The reader is forced to infer which features fall above or below the 63% threshold. The authors should list these features clearly, as the current presentation (referring to Figure 3, which is not provided in the excerpt) is insufficient.
30. Section 4.2 discusses "homogeneous key features" but the content is largely descriptive restatement of results rather than interpretation. For example, the observation that "93% of studies used primary data collection" is reported without discussing why secondary analyses are so rare, or whether this represents a gap in the literature (e.g., lack of data reuse, lack of longitudinal datasets). The discussion should move beyond description to interpretation and implication.
31. The statement that "face-to-face or telephone administration was reported in approximately 51% of documents", the authors do not discuss the potential implications of administration mode on social desirability bias. Face-to-face interviews may yield different responses than anonymous online surveys, particularly for sensitive topics like food hygiene practices. This is a notable omission.
32. The discussion of "less homogeneous key features" (section 4.3) states that "variability should not be interpreted as a sign of methodological weakness". This defensive framing is unnecessary. Instead, the authors should critically examine whether certain types of variability are problematic (e.g., lack of validated instruments) versus desirable (e.g., adaptation to local contexts). A more nuanced analysis is needed.
33. The discussion mentions that "evidence was concentrated in Europe and the United States" but does not discuss the under-representation of other high-income countries (e.g., Canada, Australia, Japan, South Korea, Singapore, Gulf states). The authors should consider whether this geographic concentration reflects actual research activity or search/language limitations (given that searches were primarily in English plus three additional languages).
34. The discussion does not address the potential for publication bias. Peer-reviewed literature may over-represent studies with statistically significant findings or novel results, while grey literature (government reports) may have different methodological characteristics. The authors report differences between scientific and grey literature in Table 3 (e.g., sample size distributions) but do not interpret these differences or discuss their implications for synthesis.
35. The authors recommend "embedding HFS within broader behavioural frameworks" but do not specify which frameworks (e.g., Theory of Planned Behavior, Health Belief Model, Social Cognitive Theory) were observed in the included studies or are recommended for future research. This recommendation is too vague to be actionable.
36. The discussion lacks a critical reflection on the limitations of the KAP survey approach itself. Knowledge-attitude-practice surveys assume a linear relationship between knowledge, attitudes, and behaviors, which is well-documented as problematic (the "knowledge-behavior gap"). The authors should acknowledge this limitation and discuss whether any included studies attempted to measure actual behavior (e.g., observation) rather than self-reported practices.

 

Conclusion

37. The conclusion states that the review "identifies a shared methodological foundation alongside substantial and context-dependent variability". This is essentially a restatement of the results, not a synthesis or forward-looking conclusion. The conclusion should articulate specific, actionable recommendations for future research based on the findings.
38. The authors claim that the 15-feature framework "provides a more detailed and scalable structure for analysing HFS-related KAP surveys". However, they do not provide guidance on how future researchers should use this framework – should they report all 15 features in every survey paper? Should editors require this? The conclusion should include concrete suggestions for implementation.
39. The final sentence mentions "pre/post assessments" as a recommendation, but given that 84% of studies did not include testing (pre/post designs), and 91% were cross-sectional, this recommendation seems disconnected from the observed reality of the field. The authors should justify why pre/post designs are preferable given the predominance of cross-sectional research.
40. The manuscript contains numerous instances of redundant phrasing. The writing style is inconsistent, alternating between concise scientific prose and verbose, redundant phrasing. A thorough language edit is recommended.

 

Author Response

Please find attached the point-by-point response to all comments.

 

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

The authors made several corrections; however, further revisions are necessary. One of the major drawbacks of the manuscript is that it does not include peer-reviewed articles published from August 3, 2023, until submission in 2026, leaving over 30 months of new literature unaddressed. According to the manuscript, only nine peer-reviewed papers were published from 2021 to 2023, so I expect the number from August 3, 2023, to 2026 is not much higher. The authors should add these data to the manuscript, which would significantly improve its usefulness. Additional required corrections are listed below. The manuscript may become suitable for publication in Foods after major revisions, including the addition of data on studies published during this period (2023–2026).

 

LIST OF OTHER CORRECTIONS NEEDED:

 

1. There are several typos in the text (e.g. lines 115, 332).
2. Addition of subsections in sections 2.2. and 2.4 would improve the organization of the manuscript.

 

TITLE:

3. The authors should exclude “ATTITUDES” from the title and also from the whole manuscript, because they excluded “ATTITUDES” from the study (Table 2: 4^th bullet point in the column “Inclusion criteria”: “Focus on home food safety and consumers’ behavior and knowledge only”. Consequently, KAP should be replaced with KP in the whole manuscript.

 

ABSTRACT:

4. Lines 22-25: Words are missing.
5. The text should be written in more condensed form.
6. KAP or KP (see the comment for the TITLE)?

 

FIGURE 1:

1. The resolution should be improved.
2. Figure 1 title should be written as a title and not as a figure.
3. Inappropriate use of capital letters should be corrected (e.g., Review, Trials, Title, Websites, Preer-reviewed, Grey, Full text, etc.).
4. Duplications in the same windows should be removed (e.g., “Records removed before screening: Duplicate records removed” – “the second “removed” should be deleted.).
5. Some bullet points do not start with capital letters. Why?
6. Why is EFSA Journal listed separately under “identification of studies via databases (scientific literature)” and “identification of studies via other methods”. The term “methods” in “identification of studies via other methods” is not appropriate and should be replaced by the more appropriate term (e.g., “source”).
7. Something is wrong in the bottom window on the right side of Figure 1. How can in the same window be the following data: “out of scope (n=3)” “out of scope (n=7)”? Also, the order of everything should be corrected.
8. Numbers in all 4 bottom windows of Figure 1 are not correct – the SUMs are not correct (e.g., 15+11+7+6+6+3+2+1+1 is not 57, but it is 52).
9. The authors should specify how they treated the review papers. It would be very useful even to have the number of review papers specified in Figure 1.

 

FIGURE 2:

10. Figure 2 should be deleted, because it presents the same data as table 3 for feature number 14.
11. Fonts are too small.
12. X-axis and y-axis titles should be added.
13. Y-axis line should be added, and x- and y-axis lines should be black to be visible.
14. Replace “single, mixed (2 topics), mixed (3 topics), mixed (4 topics)” with 1-4 and use “Number of topics” as an x-axis title.
15. Text (graph title) “Food safety topics per study (number)” above the graph should be deleted.

 

FIGURE 3:

16. The new version of Figure 3 should be deleted, as data presented are not related to the current version of the manuscript. For example, 54 presented for “publication year 2011-2020”, 38 presented for “2 Topics”, 47 presented for “(Europe”, … cannot be found in Table 3.
17. Text (graph title) “Key features” above the graph should be deleted.
18. Figure 3 title should be rewritten.
19. X- and Y-axis of the graphs should have titles.
20. X- and Y-axis lines should be black to be visible.
21. Fonts are too small.

 

TABLE 2:

22. Title should be rewritten, because it is not correct that “EACH column represents…”
23. “Studies in English …” should be replaced with “Publications in English…” in the column “Inclusion criteria”.
24. Why was ATTITUDE, which in even in the manuscript title not included in the “Focus on home food safety and consumers’ behavior and knowledge only” in the column “Inclusion criteria”.
25. The authors should specify how they treated the review papers, as these papers should not be included in the data presented in Table 3, Figures 2 and 3.

 

TABLE 3:

26. Additional column with appropriate references should be added. In the current version the reader cannot connect data presented with any of the references.
27. Use more logical orders for the 3^rd column “Category”, so that the order would not be dependent on the numbers presented in the following columns, but rather in the alphabetic order or growing number of participants involved, year.
28. The meaning of “Cat.1-3” is not explained for Feature numbers 9 and 10 in the Table 3 and not in the text. Categories should be specified in the text and also unter the table.
29. Replace the name of the Key feature 15 “start date – end date” with the more appropriate one (e.g. publications period).
30. It should be specified under the table and in the text what the “Not applicable (observational)” means in the column “Category” and the “Feature number 15”.

 

REFERENCES:

31. All references used for preparing Tables and Figures should be added to the list of References in the main part of the manuscript.
32. Full journal names should be replaced by abbreviated journal names.
33. Some references do not provide all data required (e.g., [15], [36]).

 

SUPPLEMENTARY MATERIAL:

34. The first page should include manuscript title, authors and the journal name.
35. SUPPLEMENTARY MATERIAL, 6.) Citation list of 274 relevant articles captured in this Scoping review:
36. The bulleted title “Scientific literature (247 papers)” should be deleted to avoid repetition.
37. Full journal names should be replaced by abbreviated journal names.

Author Response

We sincerely appreciate the Reviewer’s insightful comments and the time dedicated to the evaluation of our manuscript. In the attachment, we provide a detailed, point-by-point response to all comments raised, along with a description of the corresponding revisions made in the manuscript.

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

The authors’ revisions have significantly improved the manuscript. It could be accepted for publication in its current form.

Author Response

We would like to express our sincere appreciation to the Reviewer for the positive evaluation of our work and for the valuable feedback provided throughout the review process.

 

Author Response File: Author Response.pdf