Survey

‘Latest survey shows that 3 out of 4 people make up 75% of the world’s population.’ ~ Stephen Hawking

Introduction

The general public is an important stakeholder in our solution, and their opinion should therefore be carefully considered when designing it. For this reason we decided to conduct a survey. On our human practices page we have extensively explained the steps we took to design our survey. Key concepts we considered whilst designing our survey were responsibility and safety. By carefully designing an informed consent and information statement fitting for a survey, we ensured that our participants were well informed of the research they were participating in. Through a rigorous procedure we ensured that the questions themselves were relevant to the research aim, in small quantities, understandable, and most importantly: not open to interpretation. We ensured all of this through several design steps, mainly including multiple peer-reviews and a focus group to test our survey in the field. All the steps we took in designing the survey, as well as the informed consent statement we used, can be found back on our human practices page.

The questions

The aim of our survey was to find out the following:

• How concerned is the Dutch population about avian influenza?;
• Is de Dutch population concerned about vaccinations in the animal industry in general, and does this change for avian influenza specifically?;
• Is the Dutch population concerned about GMOs in general, and in the food/animal industry specifically?;
• Would the Dutch population be accepting of our GMO viral protection strategy in the animal industry in general, and would this change for avian influenza specifically?;

To answer these questions, we decided on the following questions:

Questions regarding demographics:

• Education
• Age
• Gender
• Living area (by Dutch state)
• Frequency of eating meat
• Email address (we only needed this to remove a participant's data from our dataset if requested. The email address would never be published)

Questions regarding research aim (answer input was a scale from 0 (strongly disagree) - 10 (strongly agree)). Translated to English:

• In general, I support vaccination of livestock, if it is safe for consumers and animals, and better protects animals from disease.
• I am concerned about the presence of vaccines in meat that has been proven safe for consumption.
• I would eat meat from animals that have been vaccinated if research shows it is safe.
• I support treating chickens with a vaccine if it specifically prevents the spread of the highly contagious influenza virus among poultry, as long as it remains safe for consumers and poultry.
• Before I buy any meat item, I always check carefully whether it comes from a vaccinated animal.
• Personally, I worry about outbreaks of the highly contagious bird flu in wild birds.
• Personally, I am concerned about outbreaks of the highly contagious bird flu in the poultry industry.
• I support the way we raise poultry in the poultry industry in The Netherlands.
• We need an alternative (such as vaccination) to the current measures to stop the spread of the avian influenza virus among poultry (e.g., culling, confinement, transport restrictions).
• In general, I favor treating livestock lungs with genetically modified organisms (GMOs) if it is safe for consumers and animals, and better protects animals from disease.
• I am concerned about the presence of GMOs in meat that has been proven safe for consumption
• I am generally concerned about GMOs in the food industry (such as GMO tomatoes).
• I would consume meat from animals treated with a GMO if research shows it is safe, and GMOs are not present in the meat.
• I support GMO treatment of livestock, rather than regular vaccination, if it is safe and cheaper.
• I favor GMO treatment of livestock, rather than regular vaccination, if it is safe, cheaper, and more protective against the spread of disease.
• I support treating chickens with a GMO if it specifically prevents the spread of the highly contagious influenza virus among poultry, as long as it remains safe for consumers and poultry.
• I would consume eggs from chickens treated with a GMO if research shows it is safe, and GMOs are not present in eggs.
• I prefer animal products (such as meat or eggs) from livestock that have GMOs living in their lungs to vaccinated livestock.

One additional question in between question no. 9 and no. 10 (before the GMO questions) was added to gain a perspective in what the Dutch general public thinks about GMOs through an interactive way:

• The first word that comes to mind when you think of "Genetically Modified Organisms (GMO, English: GMO).

The questions stated above all made up our survey, and were carefully designed in order to provide us with valuable data. Note that the questions are not exclusively about avian influenza and GMOs specific to our protection strategy. This is because we saw no need to narrow down the scope of the questions to specifically fit our own research, as we could still conclude answers from questions with a broader scope (e.g. disease, rather than avian influenza; and animals, rather than poultry). Because of this, iGEM teams in the future that are doing similar research on other diseases might be able to gain some valuable insights from our survey as well. The actual survey was sent out using an online survey tool. We have attached a pdf version of our survey in figure 1 below.

Figure 1. The complete survey that we used for our research transformed into a pdf file and translated to English.

Note that figure 1 is merely an indication of what our survey would look like on paper, especially the questions. This file, and its layout and structure, is not the same as the one that we used for our actual survey.

To end this section off, we would like to briefly address our hypothesis and expected findings as mentioned on our human practices page. First of all, we think that the concerns about avian influenza are not that high across The Netherlands. It might be that people living in high density poultry industry areas could be more concerned as the problem is situated more closely to home. We hypothesized that the general public would not be too fond of our alternative protection strategy as it involves GMOs in the food industry, something that often is not looked kindly on in the EU, as well as The Netherlands. However, we also suspected that this might change for the better if the participant worries more about avian influenza outbreaks, and would therefore consider our strategy earlier. We think that the public opinion on vaccinations is tolerant, as we have just lived through a pandemic which taught almost every inhabitant of the world about viral disease and vaccinations.

Results

In total we have received 217 survey responses. Of these responses we decided to only include completed responses to prevent biases, which left us with 167 filled out surveys which we used for our data analysis. Figure 2 shows a graphical summary of our sample.

Figure 2. Graphical summary of our survey data (n = 167) included in our analysis. Mean age was 37.8 years old (SD = 16.8). A: Barplot showing the distributions of educational levels among survey participants; B: Barplot showing the gender ratios of our survey participants; C: Geomap showing the distribution of survey participants across the Dutch map; darker colors representing more survey responses. D: Barplot representing the weekly amount of consumed meat items among survey participants on the y-axis.

We managed to include 167 individual responses in our data analysis. The calculated desired sample size (385, calculated on our human practices page) is higher, meaning that the results presented in this survey will have a reduced power level. Moreover, figure 2A shows that our sample leans to the high end of the educational spectrum. The higher education of our sample does not fully represent he Netherlands with accuracy. Numbers from the Dutch government (2019) show a lower educated distribution among adults of; university: 16%, dutch HBO: 25%, dutch MBO/highschool: 53%, primary school: 6% [1]. Versus our survey, which shows a higher educated distribution; university: 41%, dutch HBO: 37%, dutch MBO/highschool: 21%, primary school: 1%. The average age found in the survey (37.8 years old, SD = 16,8) is somewhat lower, but representative of that of The Netherlands in 2022 (42.3) [2]. Our survey had slightly higher female respondents (figure 2B), and the respondents in general were mostly from the Northern-Netherlands. Groningen, Fryslân, Drenthe, and Overijssel for example made up 76% of our survey respondents (figure 2C). Figure 2D shows that weekly meat consumption was as we had hoped for, with no specific overrepresentation of groups such as vegetarians or excessive meat eaters (over 21 individual items per week).

Responses from vegan, vegetarian, and pescotarian demographics to questions related to preferring, buying, or consuming animal products are highly unpredictable and difficult to interpret. As we cannot accurately represent their opinion through these questions, and considering their opinion is simply less relevant to these questions, we have decided to exclude this demographic for analysis of these specific questions. This is relevant for data presented in figures 3 and figure 5. To see which questions are affected by this exclusion, you can check out the respective figure descriptions.

Figure 3. Violin chart showing the distribution of answers on the 0 - 10 spectrum for the first half of the survey about their general opinion on avian influenza, the poultry industry, and vaccination. *For the questions regarding consuming, buying, or preferring animal products (3.5, 3.8, 5.9) we have excluded vegan, vegetarian, and people that only eat fish from the analysis as their responses are unpredictable. *For the questions regarding consuming, buying, or preferring animal products (3.5, 3.8, 5.9) we have excluded vegan, vegetarian, and people that only eat fish from the analysis as their responses are unpredictable nor relevant to our analysis.

First of all, we asked participants whether they support the way we keep and breed animals in the poultry industry in The Netherlands (figure 3.7). Interestingly, our figure shows high peaks around the middle, which indicates that there is a relatively high frequency of people that are situated in the middle. The mean answer on this question was 4.3 (SD = 2.5), which indeed reveals a low average with a slight tendency to the middle. It is also notable that the answers are more widespread compared to results from other questions found in figure 3.

After analyzing the opinion on the poultry industry in general, we looked at how concerned people are about the avian influenza pandemic. We have found that on average, this concern was rated in the middle of the spectrum for both the outbreaks in general (mean = 6.0, SD = 2.7) and for outbreaks in the poultry industry specifically (mean = 6.0, SD = 2.7) as seen in figure 3.2 and figure 3.3. When looking at the violin chart for both of these questions (figure 3.2, 3.3) you can see that the shape of the distribution looks highly similar to each other, which explains why the means are almost identical. It appears that survey respondents do not discriminate between avian influenza in general or avian influenza in the poultry industry. Overall it appears that the concern of the public is not that high, with widely varying answers among our sample. In addition, people in our survey agree that there should be an alternative such as vaccination to the culling, transport restrictions, and caging of poultry (figure 3.1, mean = 7.1, SD = 2.1). Although our sample shows that the concern about avian influenza is not that high as indicated in the previous paragraph, our sample shows higher agreement on that there should be an alternative to the strategies in place now.

When asked whether a participant checked whether their meat came from a vaccinated animal the average response was 1.7 (SD = 2.1) (figure 3.9). This shows that the general public represented by our sample, when it comes to vaccination in the meat industry, do not actively check whether they are eating vaccinated meat. This is probably the result of rigorous safety policy in the food industry; people can assume their food is safe, so why would they check? The low mean found in the question posed in figure 3.9 might also be explained by the fact that people in general just do not care that much about vaccination, or that they are very accepting of vaccinations in the meat industry. To further elaborate on this, we included quite a few questions about vaccinations and the meat industry.

The public opinion towards vaccination appears to be quite tolerant. In general, people approve (mean = 7.8, SD = 1.8) of vaccinations in the animal industry (figure 3.4). When it comes to particularly tackling avian influenza with a vaccination strategy (figure 3.6), support even slightly rises to a mean of 8.1 (SD = 1.6). Again these plots are highly similar, with very similar means showing us that tolerance to vaccination in the meat industry is high, with a slight increase when it comes to tackling avian influenza specifically. Moreover, when asked whether they would be willing to consume vaccinated meat (figure 3.5), participants tended to answer on the higher end of the spectrum (mean = 7.9, SD = 1.8). Again, these results reflect the general opinion on vaccinations as shown on figures 3.4 and 3.6 to be tolerant. Lastly, we asked participants whether they would be concerned about the presence of vaccines in their consumption meat (figure 3.8). Accordingly, our participants answered on the lower end of the spectrum (mean = 3.9, SD = 2.6), showing low concerns on average. Still, considering their tolerance to vaccination, we were surprised to see the concern this high, as a mean of 3.9 is very close to the middle of our spectrum. It is also notable that the opinions of people were more spread among our sample, with the highest recorded standard deviation of the questions shown in figure 3. This is also well reflected by the violin chart created for the question in figure 3.8. These appear to show that although people agree with a low standard deviation that livestock should be vaccinated to fight disease, and are willing to eat meat coming from this livestock, they still show relatively high concerns about the virus particles that could be present in their meat. Note that all these questions specifically state that the meat is always safe for consumption, and the vaccinations are safe for both humans and animals. These results might suggest that even though these assumptions are made, there is still a slight tendency to worry about vaccines present in animal products, with more widespread answers among participants compared to questions regarding whether we should vaccinate animals.

Figure 4. Word cloud representing the first word participants thought of when reading ‘GMO’. Words that appeared more frequently are larger size, while words that appeared less frequently are smaller in size

After the questions regarding vaccinations, we asked participants the following question: ‘The first word that comes to mind when you think of "Genetically Modified Organisms (GMO, English: GMO).’, the results of which are depicted in figure 4 in a word cloud. When looking at these results, it appears that our sample does not have a high acceptance of GMOs in general. The most frequent words were ‘unnatural’ (frequency = 9), ‘bad’ (frequency = 5), ‘improvement’ (frequency = 4). In general, it looks like the words depicted in the cloud share a tendency to have a negative/neutral charge such as ‘outrageous’, ‘scary’, ‘dangerous’, whereas words with an exclusively positive charge such as ‘good’ appeared less frequently. It is hard to draw conclusions from data such as figure 4, but in general it appears that our sample associates the word GMO more often with negatively charged words, namely ‘bad’. It is difficult to gain a perspective on the public opinion from these results, as words like ‘unnatural’ do not directly indicate that a participant is against GMOs in general. Therefore, we have asked all participants numerous questions regarding GMOs in the food industry, and GMOs in the light of our proposed solution (figure 5).

Figure 5. Violin chart showing the distribution of answers on the 0 - 10 spectrum for the second half of the survey about their general opinion on GMOs and GMOs in the light of our solution. *For the questions regarding consuming, buying, or preferring animal products (5.2, 5.3, 5.5, 5.9) we have excluded vegan, vegetarian, and people that only eat fish from the analysis as their responses are unpredictable nor relevant to our analysis.

After considering the opinion on vaccinations of our sample representing the Dutch general public, we looked at what their opinion would be with regards to GMOs in the food industry. First, we looked at the general concern of our sample with regards to GMOs in the food industry (e.g. GMO tomatoes), the results of which are depicted in figure 5.8. When asked whether the participants felt concerns about GMOs in the food industry, they responded with highly varying answers. For this question we identified the highest standard deviation among participants with a value of SD = 2.8, which is also shown by the violin plot (figure 5.8). Generally the reponses inclined to move towards the lower end of the spectrum: indicating less concerns (mean = 4.0). These results tell us that in general the public is not against GMOs in the food industry, but are still situated in the middle of the spectrum with a lot of different opinions among participants.

We first started looking at whether people would support treating animals with GMOs that would live in their lungs to fight disease better (figure 1.1). In general people favor this action, showing a positive average of 7.2 (SD = 2.3). Still this number is lower when asked the same question about vaccinations (figure 3.4, mean = 7.8, SD = 1.8). This difference illustrates that the acceptance on average of vaccination is higher. Still, the average acceptance of using GMOs is relatively high on average on its own.

When it comes to specifically combatting the highly pathogenic avian influenza using GMOs treatment of poultry lungs (figure 5.4), we found mean of 7.5 (SD = 2.1), which is higher than the acceptance of using GMOs to prevent disease in general mentioned in the paragraph above (figure 1.1, mean = 7.2, SD = 2.3). This shows the same trend we have seen when comparing acceptance of vaccination in general (figure 1.1, mean = 7.2, SD = 2.3) to acceptance of vaccination to specifically fight avian influenza outbreaks in poultry (figure 1.6, mean = 8.1, SD = 1.6).

Looking at whether our sample would comsume meat from animals that have been treated with a GMO (figure 5.2), we identified a mean response of 7.5 (SD = 2.1), indicating that people would certainly be willing to consume it on average. This is similar to the results we gathered for the same question about vaccination (figure 3.5, mean = 7.9, SD = 1.8), although here the acceptance is certainly higher. Participants on average filled in 4.1 (SD = 2.7), when it came to their concerns about the presence of GMOs in meat coming from GMO treated animals deemed safe for consumption (figure 5.9). Again, the results, and their shape in the violin chart, are highly similar to the same question about the presence of vaccines in meat (figure 3.8, mean = 3.9, SD = 2.7). As could be expected, concerns about GMOs are relatively higher. Interestingly you can find the same trends in both the GMO (figure 5.9) and vaccine (figure 3.8) question: high standard deviation and a relatively high concern about the presence of GMOs/vaccines in their meat with regards to their relatively high approval of GMOs/vaccines to fight disease.

The most interesting questions to us were about a potential preference for our strategy over the regular vaccination strategies; putting the two against one another. We were not expecting a tendency towards our own strategy, as it is a very novel way to treat disease. Still, we figured we would include it to see how our solution is perceived in respect to regular vaccination. Figure 5.5 illustrates this, by asking whether a participant would prefer meat from an animal treated with a GMO, rather than a vaccination to fight disease. The average response to this question was 5.3 (SD = 1.9), indicating a neutral response which suggests that respondents do not necessarily have a preference. This might be explained by the fact that both the vaccine strategy and GMO strategy include the assumption that they are safe for human consumption.

We also included the same question framed differently. Rather than preferring the meat from said animal, we asked participants whether they would prefer the action of treating animals with GMOs over vaccination if it would be cheaper (figure 5.6, which therefore also includes vegans, vegetarians, and pescotarians). We found an average response of 7.1 (SD = 2.4), which is higher than expected after analyzing the results from the question depicted in the previous paragraph (figure 5.5).

Lastly, we posed the same question from figure 5.6, but added a condition which stated that animals would be better protected using GMOs, to see whether this would change public opinion (figure 5.7). If the animals would also be better protected, participants appeared to slightly prefer a GMO strategy even more (mean = 7.5, SD = 2.3) compared to the same question where a GMO strategy would only be cheaper (figure 5.6, mean = 7.1, SD = 2.4).

Figure 6. Boxplot showing the willingness of people to eat different animal products after a specific treatment to protect against disease. *For this analysis vegans, vegetarians, and people that only eat fish were left out as their responses are unpredictablenor relevant to our analysis.

For the implementation of our solution, we also wanted to see whether we could identify a specific target group of poultry where our solution would be most accepted by the general public. Therefore, figure 6 shows the difference between acceptance of meat and eggs from animals treated with GMOs to fight disease, added with the acceptance of meat from vaccinated animals for perspective. The mean acceptance of GMO treated animal meat and eggs were 7.4 (SD = 2.1), and 7.5 (SD = 2.1) respectively. These results do not show a significant difference between the two types of animal products.

Discussion

First of all, it is important to consider that all of the questions regarding vaccination and GMOs in the food industry had crucial assumptions. The assumptions named were regarding the ensured safety to human and livestock health, as well as an assumption that GMOs would not be present in meat (regarding GMO questions). When interpreting this data, it is important to keep this in mind. These assumptions were included since our strategy, as well as vaccinations, can never be implemented if it would not be safe to the consumer or animal in anyway. We included this statement to remind the participant of this. We were looking for their ‘gut-feeling’; whether they support it from their own point of view, and whether they would refrain from buying it if they see it in the supermarket.

In conclusion, our survey reveals that people in general are accepting of our specific solution, with only slightly higher acceptance averages than conventional vaccination strategies. When combatting avian influenza specifically, survey results showed that the participants were more accepting of disease combating strategies, even if they would include novel strategies such as GMOs (although still slightly lower compared to vaccination). Our survey did not reveal that people would prefer vaccination or a GMO treatment when consuming animal products. Moreover, it does appear that people would prefer a GMO strategy if it is cheaper and would provide for better protection against disease. We also did not identify extra concerns about the presence of GMOs in meat deemed safe for consumption, when compared to concerns about the presence of vaccines in meat deemed safe for consumption. Still, we were surprised to see how high this concern was for both considering the fact that people are very willing to buy meat coming from vaccinated/GMO treated animals; this was certainly not what we hypothesized beforehand.

We were also surprised to see that the general concern about avian influenza is relatively low (around 6 out of 10). This was also the case for concerns about avian influenza outbreaks in the poultry industry specifically. In contrast to the interviews we have conducted with stakeholders that were very concerned, and considering the millions in damages and millions of birds that die or need to be culled, we would have definitely expected a higher number; even though this number is still on the ‘concerned’ side of the spectrum.

Although the demographic of our sample is a limitation of our study, the results were definitely worth studying and analyzing, and they have uncovered some interesting findings. Besides a sample size which decreases the impact of our results, the largest impact on our results would be the unrepresentative educational distribution among our participants in contrast to the larger Dutch population. This is very likely to have influenced our results (e.g. about GMOs and vaccination) for the better. As demographics that are higher educated often are more accepting of these types of topics [3, 4, 5]. If we would have had more time, we could have kept the survey going on longer. With the benefit of hindsight, we would recommend future teams carrying out a survey together as part of a collaboration/partnership in order to get more results which are better spread across the country (or world for that matter). This would have also given us the ability to study differences between Dutch states, which now was not an option considering we would not have enough responses from every individual state, therefore skewing our results.

To make reliable conclusions with a higher impact on the Dutch public opinion, a higher sample size is needed, which preferably represents the Dutch population with higher accuracy with regards to educational level. The response to our solution and the acceptance of our strategy is relatively positive when compared to responses we received regarding vaccination. It looks like willingness to accept strategies such as our own increases when addressing high impact epidemics such as the avian influenza crisis. Still, we have to thoroughly consider the fact that we included the assumption that the strategy has to be safe for animals, and food products have to be safe for consumption for humans. These will be important factors to consider while designing our final solution, as it could mean that the public opinion would otherwise not approve.

Check out our integrated human practices page to see how we integrated these results in our final design.

References

[1] Maslowski, R. (2020). Onderwijs. In: De sociale staat van Nederland: 2020. Accessed on Oktober 1, 2022 from https://digitaal.scp.nl/ssn2020/onderwijs.

[2] CBS: Centraal Bureau van Statistiek. (2022, 25 februari). Age distribution. Statistics Netherlands. Accessed on October 1, 2022, from https://www.cbs.nl/en-gb/visualisations/dashboard-population/age/age-distribution

[3] Ridda, I., Chamberlain, R., Haber, R. & Rashid, H. (2021, 5 april). Letter to the editor to: Verger P and Dubé E. Restoring confidence in vaccines in the COVID-19 era, expert review of vaccines, 2020; 19(11):991-3. Expert Review of Vaccines, 1–3. https://doi.org/10.1080/14760584.2021.1903880

[4] Špernjak, A., Jug Puhmeister, A., & Šorgo, A. (2021). Public opinions and knowledge about microorganisms. Research in Science & Technological Education, 1-19.

[5] Bevanda, L., Žilić, M., Ećimović, B., & Matković, V. (2017). Public opinion toward GMOs and biotechnology in Bosnia and Herzegovina. In CMBEBIH 2017 (pp. 452-458). Springer, Singapore.