BOX 5-1

A Three-Step Process to Design Consumer Guidance on Balancing Benefits and Risks Associated with Seafood Consumption

Step 1: Scientific benefit-risk analysis and balancing of the benefits and risks (including attention to characteristics [e.g., age, sex] that distinguish target populations and the effects of potential food substitutions made by consumers).

Step 2: Empirical analysis of consumer perceptions and decision-making (understanding decision contexts and their variability; eliciting input from consumers regarding how they perceive and make choices) (see Chapter 6).

Step 3: Design and evaluation of the guidance program itself (including the format of guidance, program structure and media [e.g., brochures, websites, public meetings or programs, radio spots, point-of-purchase displays, hotlines], and the combination of communication products and processes) (see Chapter 7).

scientific assessment and balancing of the benefits and risks associated with seafood consumption is a complex task. Diverse evidence, of varying levels of completeness and uncertainty, on different types of benefits and risks must be combined to carry out the balancing required in the first step in designing consumer guidance. To produce coordinated benefit-risk advice requires combining expertise from several disciplines, as this committee has done.

In other settings, balancing benefits and risks has been approached through a variety of summary metrics. These include: Quality Adjusted Life Years (QALYs), which combine the quantity and quality of life; Disability Adjusted Life Years (DALYs), which are the sum of years of potential life lost due to premature mortality and the years of productive life lost due to disability (Gold et al., 2002); monetary measures; utility measures (estimates from multi-attribute utility analyses); and deliberative decision-making exercises. These decision-making exercises focus on trade-offs as a means to inform policymakers about, first, decision attributes of different choices and, second, development of means-ends objectives networks that illustrate values people want to achieve and how they think those can best be achieved (Gregory and Wellman, 2001; Gregory et al., 2001). However, in the case where benefits and risks have an outcome on the same endpoint,

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