International Tourists Choices and Satisfaction of Small Restaurants in Thailand The Influence of Food Safety Indicators

Journal of Foodservice Business Research
ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/wfbr20
International tourists’ Choices and satisfaction of

small restaurants in thailand: the influence of food
safety indicators
Mehri Yasami, Kullada Phetvaroon & Hongrui Zhu
To cite this article: Mehri Yasami, Kullada Phetvaroon & Hongrui Zhu (2022) International tourists’
Choices and satisfaction of small restaurants in thailand: the influence of food safety indicators,
Journal of Foodservice Business Research, 25:5, 499-532, DOI: 10.1080/15378020.2021.1964340
To link to this article: https://doi.org/10.1080/15378020.2021.1964340
Published online: 23 Aug 2021.
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JOURNAL OF FOODSERVICE BUSINESS RESEARCH
2022, VOL. 25, NO. 5, 499–532
https://doi.org/10.1080/15378020.2021.1964340
International tourists’ Choices and satisfaction of small

restaurants in thailand: the influence of food safety
indicators
Mehri Yasamia, Kullada Phetvaroon a
, and Hongrui Zhu b
a
Faculty Of Hospitality And Tourism, Prince Of Songkla University, Phuket, Thailand; bInternational
College For Sustainability Studies, Hospitality and Tourism Management Department, Srinakharinwirot
University, Bangkok, Thailand
ABSTRACT KEYWORDS
Travelers’ increasing concern about restaurant-associated food Food safety risk; foodborne
borne illness makes food safety very important to destination illness; tourist satisfaction;
foodservice operators. While previous research has shed light on restaurant hygiene quality
the impact of destination different restaurant service quality
attributes on tourists’ satisfaction, there is a lack of research
identifying the dimensions of food safety indicators driving
tourist’s restaurant selection and satisfaction solely. This study
aims to fill the gaps by developing a scale measuring 433
international tourists’ perceptions about hygiene standards in
Phuket small restaurants. Confirmatory factor analysis revealed
a four-factor model that influences tourists’ restaurant selection.
These factors were: waitstaff’s appearance and personal
hygiene, cleanliness of restaurant, toilet hygiene, and food
safety information cues. Cleanliness of restaurant and waitstaff’s
appearances and personal hygiene were two key factors influ
encing tourist satisfaction of small restaurants. The significance
of restaurant hygiene quality has received less attention in
tourism marketing literature, thus this study adds further impor
tance by underlining its implication to the sustainable manage
ment of destination restaurants. However, this study suffered
from several limitations, for instance, the study’s framework, the
inability to generalize the results due to the research scope and
context, and the concurrence of data collection with the COVID-
19 pandemic which pave the way for future studies.
Introduction
Consumer apprehensions over food safety have increased at present time.
A spate of food scares in recent years related to dioxin-contaminated eggs,
the presence of melamine in milk powder, and food of animal origin con
taminated with salmonella bacteria, highlighting the increased risk of expo
sures to toxic metals and pathogens in low, medium, and high-income
countries (Wang et al., 2019). While those food safety related-risks arose in
the food processing and manufacturing industry, reports of foodborne disease
CONTACT Mehri Yasami mehri.yasami@yahoo.com Faculty Of Hospitality And Tourism, Prince Of Songkla
University, Phuket Campus, 80 Moo 1 Vichitsongkram Road, AmphurKathu, Phuket, Thailand 83120
© 2021 Taylor & Francis
500 M. YASAMI ET AL.
outbreaks associated with the foodservice industry as the final stage of food
preparation continued to increase (Valero et al., 2016). The previous studies
have found that the risk of developing foodborne illnesses largely increases
when eating food in public food service establishments, particularly restau
rants (Bhattacharya et al., 2020; Gautret & Parola, 2017; Kariyono, 2021;
McNeil, 2019; Thirkell et al., 2019; Torso et al., 2015).
Since our study area was Phuket in the Southern region of Thailand, we
need to share some available information about food poisoning in this coun
try. Thailand is suffering from the burden of foodborne illness as it is part of
South-East Asia where food poisoning is the second highest cause of mortality
(World Health Organization, (2015). In Thailand, there are many cases of
alleged foodborne illnesses associated with certain restaurants and other
commercial eateries and the issue remains one of the major consumer con
cerns (Joob & Wiwanitkit, 2015; Khaenda et al., 2016; Kongtunjanphuk, 2018).
According to the Thai Ministry of Public Health, almost a million cases of
acute diarrhea caused by eating contaminated food, and more than 120,000
cases of food poisoning are reported annually (Chinda & Suanmali, 2017).
Restaurants in Thailand are partially responsible due to unhygienic food
handling practices, which have been found to play a prominent role in devel
oping foodborne illnesses (Joob & Wiwanitkit, 2015; Phyu et al., 2019).
However, inbound tourists in Thailand commonly experience foodborne ill
nesses (O’ Connor & Nguyen, 2018), since food poisoning among tourists,
known as traveler’s diarrhea, is the most common travel-induced illness that
affects many tourists visiting developing countries (Leder, 2015).
Although, as with other international destinations, the majority of food
borne illnesses among tourists in Thailand go unreported, international tra
velers very often contact a foodborne illness when dining at Thai restaurants,
particularly in areas with standards of sanitation lower than those to which
travelers’ immune systems are accustomed (Kittitrakul et al., 2015). The
findings of Wongleedee (2013) revealed that up to 46% of UK tourists suffered
from food poisoning at least once during their stay in Thailand. The existence
of persistent reports of foreigners experiencing severe food poisoning in
Thailand even death after eating food at local restaurants makes the threat of
food poisoning for tourists in Thailand a stark reality (O’ Connor & Nguyen,
2018).
Inadequate cooking, inappropriate holding temperature, poor food hand
lers’ hygiene, and cross-contamination are persistent food safety risk factors as
documented by worldwide epidemiological research (Griffith, 2003).
However, the majority of these risk factors takes on foodservice operator’s
perspective because most of these practices and procedures are handled by
operators and are not visible to consumers, whereas, from the consumer’s
perspective, food safety risk factors may relate to the cleanliness of
a restaurant’s physical environment, including its equipment, and that of the
JOURNAL OF FOODSERVICE BUSINESS RESEARCH 501
waitstaff in the restaurant (Park, 2014; Trafialek et al., 2020). Overall, con
sumers heavily rely on their subjective judgment of a variety of observable
hygiene indicators. The restaurants’ front-of-the-house sanitation such as the
cleanliness of the dining utensils, tables and chairs, the cleanliness of eating
area, the cleanliness of bathrooms, and the cleanliness of staff’s appearance and
personal hygiene as well as the level of the crowdedness of restaurants are
visual indicators that consumer use to evaluate the risk of food safety and the
likelihood of developing foodborne diseases at any restaurant at which they
may consider eating (Aksoydan, 2007; Barber et al., 2011; Danelon & Salay,
2012; Ha et al., 2016; Leach et al., 2001; Lee et al., 2012; Liu & Lee, 2018; Min,
2016; Park, 2014; Park et al., 2016; Seo et al., 2015; Tyrewalah, 2014; Yasami
et al., 2020b).
Moreover, food inspection results posted on a restaurant’s window and
online reviews posted by other customers in restaurant websites or social
media platforms that facilitate people sharing their experience with restaurants
as well as friends and family recommendations (i.e., word-of-mouth or WOM)
help potential customers to reduce the risk of developing a foodborne illness
while dining in a restaurant (Aik et al., 2018; Ali et al., 2019; Choi et al., 2013,
2019; M. G. Kim et al., 2018; K. Harris et al., 2018; Pantelidis, 2010; Seo et al.,
2015; Yeung & Yee, 2013).
In the specific context of restaurants, the literature suggests that consumers’
heavily reliance on food hygiene indicators can have a significant impact on
restaurant choice (Aik et al., 2018; H. C. Choi et al., 2010). Although food
safety/ hygiene was considered as an underlying factor driving consumers’
restaurant choice, the studies that examine how tourists evaluate the food
safety level of destination restaurants are still scant. An exceptional study was
conducted by Yasami et al. (2020b) in Malaysia, which echoed research carried
out by Henson et al. (2006), Leach et al. (2001), Liu and Lee (2018), and Park
et al. (2016). However, despite the fact that travelers have increasing food
safety concerns in the places they visit (Reichel et al., 2007), to date, there has
been very little research attention directed to understanding the importance of
food safety/hygiene indicators in tourist restaurant choice in the destination
cities such as Phuket. Phuket is located in southern Thailand. It is the country’s
largest island and the second most favored international tourist destination in
Thailand (Millington, 2019). This island is no longer just a beach resort while
the gastronomy sector records a significant contribution of $3.6 billion to the
local economy annually (Mueanhawong, 2019). Whether chili-hot or gently
bland, Phuket local food plays a vital role in projecting a great food image,
tourist food satisfaction, and loyalty intentions (Yasami et al., 2020b). The
city’s ability to convey, sustain, and revive ancient recipes that were passed
down from generation to regeneration within local communities made Phuket
the only city in South-East Asia that was designated by The UNESCO’s
Creative Cities Network as a creative city of gastronomy in 2015 (Krasae-in
& Rodjanathum, 2018). As is evident from the above discussion, Phuket is the
place in which restaurant safety/hygiene concerns and their possible impacts
on restaurant selection need to be studied from the tourist perspective.
Furthermore, it has been widely acknowledged that these cues are critical to
ensure customer satisfaction and a business’ sustainability (Alhelalat et al.,
2017; Almohaimmeed, 2017; Cha & Borchgrevink, 2018; Kala, 2020; H. Kim &
Bachman, 2019; Lap-Kwong, 2017; P. Liu & Lee, 2018; Y. Y. Liu & Jang, 2009;
Truong et al., 2017). Although destination restaurants are commonly expected
to satisfy the physiological needs of travelers such as hunger and thirst, local
food and culinary traditions are also the main suppliers of one of the genuine
cultural experiences of tourists (S. Kim & Ellis, 2015) as they make a gateway
into destination culture via taste, food procurement, preparation, and entire
dining environment (Henderson, 2014). It is important to examine the overall
tourist satisfaction with destination food, considering the critical role of
restaurants’ service attributes in increasing awareness of a tourist destination’s
identity and gastronomic culture (Ingerson & Kim, 2016) and its undeniable
role in destination attractiveness. Yet, no simple study provides a thorough
understanding of the importance of food safety/hygiene cues and their influ
ence on tourists’ selection and satisfaction of small restaurants in Phuket.
Thus, the purposes of this study were (1) to identify the underlying dimen
sions of food safety/hygiene cues that international tourists use in selecting
destination restaurants and (2) to examine the food safety dimensions that
influence tourist satisfaction. In the next section, existing literature relevant to
food safety risk, food safety risk factors from the consumer perspective, and
restaurant food safety and tourist satisfaction will be reviewed.
Literature review
Food safety risks in the restaurant industry
Even though foodborne illness may occur at any point in the food supply
chain, from farm to fork, the foodservice sector has become a risky setting for
such illnesses. Outbreaks of foodborne diseases have been widely reported as
being associated with eating at restaurants (Bhattacharya et al., 2020; Gautret
& Parola, 2017; Kariyono, 2021; McNeil, 2019; Thirkell et al., 2019; Torso et al.,
2015). Regardless of the type of eating place, whether it is a school canteen
where meals are served to students, or a fine-dining restaurant where services
are offered to more up-market customers, food safety is a serious challenge
faced by the foodservice industry. For instance, in the USA, the Center for
Disease Control and Prevention [CDC] (2019) revealed 841 outbreaks of
foodborne illnesses in 2017 The CDC also reported 14,481 cases of food
poisoning in the same year while 64% of the foodborne illnesses outbreaks
and 48% of the food poisoning cases were associated with dining at
restaurants. Similarly, more than 50% of the foodborne illness outbreaks in the
UK have been linked to foodservice establishments (Jones et al., 2017).
Consumer concern relating to food safety in the UK has now increased to
the extent that 45% of people regard restaurants as being most responsible for
food safety (“Survey shows,” 2020). Moreover, in Thailand, the Thai
Department of Disease Control (2021, p. 1) reported 87,093 food poisoning
cases in 2020. Although these numbers might be an underestimation as there
are potentially many unrecognized or unreported cases (O’ Connor & Nguyen,
2018), such a large number of food poisoning in Thailand still raises a red flag
for foodservice establishments as eating out is a common trend in Thailand
and Thais have outstanding tendency to eat out at least 56 times per month (“4
Outstanding Trends,” 2017). Overall, consumers have been found to be less
confident about standards of food safety in foodservice establishments (Cha &
Borchgrevink, 2018; Omari & Frempong, 2016). Knight et al. (2007) found
that a large number of consumers believe that restaurants’ operational stan
dards, capabilities, and dedication to food safety standards are lower than
those of farmers, food processors, and food manufacturers, and even lower
than those of grocery stores and supermarkets.
Over the past decade, food safety has progressively become a more impor
tant consumer trend and purchase driver (Cui et al., 2019; Hsu et al., 2016).
Henson et al. (2006) asserted that the perception of food safety in the context
of restaurants might be inherent in a wide-ranging set of determinants that
influence the choice of a restaurant. A number of studies have supported
Henson and his colleagues’ work (2006) by addressing food safety as the
restaurant selection variables (Adam et al., 2014; Aik et al., 2018; Bai et al.,
2019; Choi et al., 2019; Park et al., 2016) and customer satisfaction determi
nant (Cha & Borchgrevink, 2018). However, few studies have been conducted
about tourists’ reliance on food safety as the decisive factors in the choice of
a restaurant.
Food safety risk factors from the consumer perspective
Food safety risks continue to be a worldwide public health issue (World

Health Organization (2020)) both in respect to foodborne illness outbreaks,
which account for 600 million illnesses and 420,000 deaths globally (Overbey
et al., 2017) as well as the purported risks associated with the use of chemical
additives in food processing, and the consumption of genetically modified
food (Yeung & Morris, 2001). Risk has been defined as “a combination of the
probability, or frequency, of occurrence of a defined hazard and the magni
tude of the consequences of the occurrence” (The Royal Society, 1992). With
regard to food hazards, the risk associated with food-related microbiological
hazards is “a function of the probability of an adverse health effect and the
severity of that effect, consequential to a hazard(s) in food.” (European
Commission Scientific Committee for Food, 1997). Therefore, food safety

includes all practical aspects of processing, preparing, handling, or serving
food undertaken to preserve the quality of food and to ensure that it is not
contaminated with possibly harmful biological hazards (Griffith, 2006).
Commercial eateries, mainly restaurants have been implicated as one of the
most frequent settings for foodborne illness outbreaks due to foodservice
operators’ lack of food safety knowledge and conducting poor food hygiene
practices (Gould et al., 2013). However, in practice, it is difficult for consumers
to evaluate the food hygiene/safety prior to purchase and consumption
because the key indicators influencing a restaurant’s food safety are generally
not observable and usually hidden in the backstage of the restaurant, in the
food supply, preparation, and storage areas (Henson et al., 2006). For example,
it is impractical for consumers to determine the reliability of the food markets
from where restaurants purchase raw materials or dinner patrons cannot take
the temperature of food with a thermometer or use a microbiological diag
nostic kit to detect food contaminated with microorganisms. Thus, the most
important factors applied by consumers to judge the levels of food hygiene/
safety of eating places in order to decide where to eat are visual cues such as the
restaurant’s external appearance, the cleanliness of dining area and utensils,
staff’s appearance and clothing, and the restroom hygiene (Aksoydan, 2007;
Barber & Scarcelli, 2009, 2010; Leach et al., 2001; Lee et al., 2012; Liu & Lee,
2018; Min, 2016; Park, 2014; Park et al., 2016). However, past studies consider
restaurant cleanliness attributes as a part of functional service quality dimen
sion (Gronroos, 1984) or tangible construct of service quality (Bujisic et al.,
2014; Parasuraman et al., 1985) and conclude that customer’s perception of
a restaurant’s cleanliness significantly influences customer’s judgment of the
overall restaurant’s service quality (Barber et al., 2011; Barber & Scarcelli, 2010;
Truong et al., 2017; Yu et al., 2018). Although food quality is likely to be of
more concern to customers than various dimensions of service quality in the
restaurant selection (Duarte Alonso et al., 2013) and customer revisit intention
(Liu & Tse, 2018), the results of the studies investigating the effects of restau
rants’ different service quality dimensions on customer restaurant selection or
repeat crowdedness indicated that customer decisions to select or return to
a restaurant were mostly based upon restaurant cleanliness attributes (Barber
et al., 2011; Barber & Scarcelli, 2010). Besides restaurant cleanliness attributes,
consumers may choose a restaurant based on the crowdedness of the restau
rant (Danelon & Salay, 2012; Ha et al., 2016; Tyrewala, 2014) assuming that
a crowded restaurant indicates a higher restaurant reputation (D. Y. Kim et al.,
2010), a better quality of food and service (Tse et al., 2002; D. Y. Kim et al.,
2010) and a higher standard of restaurant food safety/hygiene practices
(Tyrewalah, 2014).
Besides the visual food safety indicators, the provision of food safety-related
information in the form of inspection notices whether represented by a letter
grade, score, or logo has a significant impact on restaurant choice (Aik et al.,
2018; Choi et al., 2013, 2019; M. G. Kim et al., 2018). The restaurant inspection
notice is issued by local health authorities and measures restaurant compliance
with the front of the house and backstage sanitation codes. In Phuket, hygiene
standards for food premises are established by the Phuket Health and
Sanitation Department and a satisfactory restaurant official inspection report
will be issued in the form “Clean Food Good Taste” logo. Inspection notices
whether issued in the form of a letter, score, or logo provide more accurate
information about restaurant food safety/hygiene practices that cannot be
observed by consumers (Uggioni & Salay, 2014). Moreover, today’s consumers
commonly share their experiences and opinions with others about restaurants.
Online restaurant reviews and social media postings have become popular as
an important source of information for diners to choose a restaurant (Luo &
Xu, 2019). They increasingly help report and address restaurants’ food safety
violations (Effland et al., 2018; J. K. Harris et al., 2017), thus not surprising that
other customers’ reviews and evaluations are found decisive factor in restau
rant selection (Ha et al., 2016). However, word of mouth (WOM), either in the
traditional form made by a specific group of people (Ali et al., 2019; K. Harris
et al., 2018; Yeung & Yee, 2013) or in the form of restaurant reviews posted on
various social media platforms (Ha et al., 2016; Luo & Xu, 2019; Pantelidis,
2010; Seo et al., 2015; Yasami et al., 2020b), are other mediums that consumers
perceive important in their assessment of restaurants’ food safety/hygiene and
choices. These results suggest that the hygiene quality in the form of visible
food safety indicators and external sources of information on restaurant safety
can be treated as a separate dimension of service quality influencing the
decision-making process of consumers.
Leach et al. (2001) highlighted a number of factors which consumers use to
assess the standards of food hygiene in a commercial eatery and identified six
factors consisting of “the exterior of the premises and their management,” “the
interior of the premises and their management,” “staff working in the pre
mises,” “the food and drink,” “immediate environment,” and “recommenda
tion, advertisement, and facilities.” Following that study, five factors
(restrooms, dining room experience, exterior, food handling, and employees)
were used by Park et al. (2016) to explain the hygiene indicators that people
usually employ in the choice of full-service restaurants. The consumers’ own
observation relating to standards of hygiene, restaurant quality, crowdedness
of the restaurants, and external sources of information were the four factors
explored by Henson et al. (2006) to clarify which indicators of restaurant food
safety were important in consumer decision making. Three clues were applied
by Liu and Lee (2018) to assess restaurant cleanliness from a customer per
spective. They were functional clues or food-related attributes (e.g., freshness
and temperatures of foods), mechanic clues or restaurant exterior/interior,
restroom, and dining room’s appearance, and human clues or waitstaff’s
appearances and safe food handling behaviors. Although food safety/hygiene

indicators were considered as an underlying factor driving consumers’ assess
ment of the food safety and restaurant choice, there has been insufficient
research conducted to investigate how international tourists develop an
understanding of the food safety risks in the places where they eat. The
exceptional work conducted by Yasami et al. (2020b) revealed the interna
tional tourists’ intentions to utilize food safety cues in the choice of Malaysian
local restaurants. The results classified food safety indicators into three factors
consisting of visual food safety cues, information food safety cues, and level of
the crowdedness of restaurants.
Upon literature, food safety/hygiene from the consumer perspective is the
condition that can be seen, felt, learned from other people’s experiences, and
perceived to reduce the risk of developing any foodborne illness. Upon
literature, consumers’ perception of food safety is reflected by different
safety/hygiene dimensions that influence restaurant selection. Hence, we
hypothesized the following:
H1: International tourists use different food safety/hygiene dimensions in the

choice of destination restaurants.
Restaurant food safety and tourist satisfaction

The expectation-disconfirmation theory is the most widely accepted theory
to explain customer satisfaction in the service industry (Oh, 1999). Oliver
defined satisfaction as “the summary psychological state resulting when the
emotion surrounding disconfirmed expectations is coupled with the consu
mer’s prior feelings about the consumption experience” (1980, p. 29). In
consonance with the ECT’s definition of satisfaction, consumers engage in
a sequential process to reach satisfaction. The process starts before purchas
ing, once consumers make their primary expectations of the product/service.
After the product/service has been utilized, they develop their perception
about the product/service performance and compare it with their expecta
tions. If the product/service performance meets their prior expectations, the
confirmation results in satisfaction. In the context of tourism, satisfaction is
“the extent of overall pleasure or contentment felt by the visitor, resulting
from the ability of the trip experience to fulfil the visitor’s desire, expecta
tions and needs in relation to the trip.” (Chen & Tsai, 2007, p. 1116);
therefore, tourist satisfaction with destination restaurants can be defined as
a high level of delight created by consuming restaurant food products and
services.
A number of factors including food quality (Konuk, 2019; Ramanathan
et al., 2016), service quality (Khan et al., 2013; Namin, 2017; Nguyen et al.,
2018), and price (Abdullah et al., 2018) have been found in the hospitality
literature to influence customer satisfaction with a restaurant. Restaurant
service quality as seen in the customer’s judgment of the overall excellence
of the service (Zeithaml, 1988) is a multidimensional construct (Parasuraman
et al., 1988). While service quality and customer satisfaction are two distinct
concepts (Oliver, 1993), there is a strong and positive relationship between
them. Sureshchandar, Rajendran, and Anantharaman (2002, p. 372) stated
that “there exists a great dependency between service quality and customer
satisfaction, and an increase in one is likely to lead to an increase in another.”
Although there is no consensus on the individual dimensions that make
restaurant service quality, the researchers focus on five dimensions of tangi
bles, reliability, responsiveness, assurance, and empathy (Marković et al.,
2011). Tangibles dimension refers to restaurant physical facilities, equipment,
and staff appearance (Parasuraman et al., 1988) and some researchers consider
restaurant and employees’ cleanliness attributes as a part of tangibles dimen
sion (Bujisic et al., 2014; Parasuraman et al., 1985) or expected dimension of
service quality (Marković et al., 2011, 2010). Several studies concluded that
customer’s perception of a restaurant’s cleanliness or hygiene quality signifi
cantly influences customer’s judgment of the overall restaurant’s service qual
ity (Barber et al., 2011; Barber & Scarcelli, 2010; Truong et al., 2017; Yu et al.,
2018) as the main factor driving customer satisfaction (Khan et al., 2013).
However, it is well documented in the marketing literature that the outcome
of the consumer’s positive perception of restaurant performance on the food
hygiene attributes is the positive post-consumption evaluation or satisfaction
(Alhelalat et al., 2017; Almohaimmeed, 2017; Cha & Borchgrevink, 2018; Kala,
2020; H. Kim & Bachman, 2019; Lap-Kwong, 2017; P. Liu & Lee, 2018;
Y. Y. Liu & Jang, 2009; Truong et al., 2017). The results of Almohaimmeed’s
research (2017) demonstrated that hygiene quality, including the clean dining
area and the personal hygiene of staff as a new dimension of restaurant quality,
is a key determinant of customer satisfaction. Another study conducted by
Truong et al. (2017) also revealed that cleanliness or hygiene quality such as
staff’s hygiene, the cleanliness of the dining area, tables, and eating utensils
significantly influence customer overall satisfaction with a restaurant.
Alhelalat et al. (2017) showed that customer perception of personal service
practices of restaurant staff (e.g., the cleanliness of waitstaff’s appearances and
clothing) significantly predicts customer satisfaction with a restaurant.
Furthermore, Liu and Lee (2018) suggested that mechanic indicators or
restaurant exterior/interior, restroom, and dining room’s appearance as well
as human indicators or waitstaff’s appearances and proper food-handling
procedures directly influenced overall customer satisfaction of a restaurant.
Researchers have also indicated that restaurant-related cleanliness attributes
have a significant positive effect on the level of satisfaction a tourist feels about
a particular destination restaurant (Cha & Borchgrevink, 2018; Kala, 2020;
Lap-Kwong, 2017; Y. Liu & Jang, 2009). Consistent with these findings, the
results of H. Kim and Bachman (2019) found that restroom cleanliness and
personal hygiene items have a significant positive impact on tourist satisfac
tion with a restaurant. Following the literature review, the four hypotheses of
the present study were developed based on the fact that the four identified
factors of restaurant food safety/hygiene in the pilot study (see Table 1) impact
tourist satisfactionTable 2.
H2: The factor of cleanliness of restaurants has a positive relationship with

tourist satisfaction.
H3: The factor of food safety information cues has a positive relationship with
H4: The factor of toilet hygiene of restaurants has a positive relationship with
H5: The factor of waitstaff’s appearance and personal hygiene has a positive
relationship with tourist satisfaction.
In the following sections, the study’s methodology, construct development,

sampling and data collection, and a pilot study in the search process will be
described, along with data analysis techniques that ensure valid and reliable
results addressing the study’s objectives.
Methodology
Construct development
Since the objective of this research is to provide a holistic understanding of

how food safety/hygiene cues influence international tourists’ choices and
satisfaction when visiting small restaurants in Phuket, rather than interpreting
what the meanings of food safety/hygiene cues are to tourists, a quantitative
method is more suitable as it allows to recruit a larger number of participants
to achieve such an objective. Thus, a self-administered questionnaire was
developed to collect data. The questionnaire consisted of three sections: the
first section required subjects to rate the importance of the 25 food hygiene
indicators in the choice of a Thai restaurant during their stay. The respondents
indicated their level of importance based on a five-point Likert scale (1 = not
important, 5 = very important). The 25 measurement items for food safety
cues were adopted from past studies (Henson et al., 2006; Leach et al., 2001;
Park et al., 2016; Yasami et al., 2020b). However, some amendments were
made to accommodate cultural influences. Some items related to food
Table 1. Descriptive Statistics, Communality and Factor Loading of Scale Item from Exploratory
Factor Analysis (n = 197).
Factor (Cronbach’s alpha) Mean Communality Factor loading
(SD)
Eigen value % of variance
explained
Factor 1- Cleanliness of restaurant (0.917) 6.971 26.45
There are no flies in the restaurant. 3.78 (.792) 0.677 0.748
No bad smell/odor in the restaurant. 3.86 (.744) 0.733 0.749
The outside/exterior of the restaurant is clean. 3.85 (.735) 0.756 0.698
Any equipment seen is clean. 3.91 (.733) 0.767 0.713
All food service areas and surfaces are clean. 3.79 (.715) 0.602 0.736
The menu is clean. 3.77 (.845) 0.580 0.700
If visible, the kitchen looks clean. 3.92 (.759) 0.575 0.806
The sink for hand wash is clean. 4.04 (.713) 0.510 0.812
The table and chairs are clean. 3.92 (.755) 0.520 0.732
The utensils for serving food are clean. 3.79 (.750) 0.578 0.717
The restaurant has the Clean Food Good Taste logo. 3.73 (.876) 0.527 0.656
Factor 2- Food safety information cues (0.892) 3.679 15.41
There is a high level of the international tourists’ 3.89 (.820) 0.675 0.786
crowdedness in the restaurant.
There is a high level of the local people’s crowdedness in 3.56 (.910) 0.671 0.823
the restaurant.
There are positive reviews about the restaurant posted by 3.56 (.864) 0.584 0.836
other tourists on TripAdvisor.
There are positive reviews about the restaurant posted by 3.65 (.858) 0.538 0.839
people on Facebook, Yelp, Twitter, and other social
media platforms.
The tour guide highly recommends the restaurant. 3.68 (.853) 0.521 0.766
Factor 3- Toilet hygiene (0.938) 3.178 14.94
There is no evidence of insects in toilets. 3.46 (1.275) 0.759 0.860
Toilets and urinals are well maintained and clean. 3.59 (.805) 0.912 0.954
Trash bins in toilets are available and not full. 3.51 (.842) 0.836 0.912
Toilet paper and soap are available. 3.46 (.900) 0.869 0.930
Factor 4- Waitstaff’s appearance and personal hygiene 1.598 10.26
(0.838)
The waitstaff’s hands are clean. 4.06 (.915) 0.729 0.810
The employees are wearing clean and tidy uniforms and 4 (.900) 0.789 0.859
look clean.
The waitstaff shows high standards of personal hygiene 4.04 (.932) 0.727 0.806
demonstrated by staff, no bad habits, i.e. coughing or
sneezing onto food or hands and then touching food,
touching hair then food, biting nails, etc.
developed by Leach et al. (2001), such as, “food is served/displayed at the right
temperature (e.g., hot food is served hot),” “food served appears fresh,” “food
is cooked adequately,” and “no foreign object is found in food or drink
served,” were not applicable in the present study as they could not be observed
and evaluated before purchasing. Nineteen of the statements described the

visual food safety indicators of the restaurant pertaining to waitstaff, toilets,
the restaurant’s environment, equipment, and exterior. The six remaining
statements were relevant to the level of the crowdedness of the restaurant,
the food inspection results, other customers’ reviews posted on social media
platforms, and tour guide recommendations.
The second section assessed tourists’ overall satisfaction with the destina
tion restaurants. For this section, the authors adopted and adapted the food
satisfaction measurement items from the studies done by Kala (2020). The
participants were asked to rate their level of agreement for four statements
(i.e., “I enjoyed both tangible & intangible strengths of visited Thai restau
rants.,” “I enjoyed pleasant moments with family and/or friends while having
Thai restaurant services.,” “Thai food attributes and restaurant services put me
in a good mood.,” and “I am very satisfied with my overall dining experience at
Thai restaurants,” based on a five-point Likert scale (1 = strongly disagree,
5 = strongly agree).
The respondents were also to provide information relating to their socio-
economic characteristics in the final section of the questionnaire. The initial
version of the questionnaire was vetted by a panel of experts in the fields of
food hygiene and hospitality management and their feedback on the clarity
and appropriateness of the items helped the development of the final version.
The questionnaire was also pre-tested with 30 international tourists for its
accuracy, ease of understanding, and was amended appropriately based on the
comments of the respondents. A pilot study was undertaken with a sample of
211 international tourists in Phuket small restaurants in order to finalize the
list of food hygiene/safety items in the study’s questionnaire for distribution in
the main phase of data collection.
Pilot study and organization of the research instrument

For the pilot study, a sample of 211 questionnaires was received from the
respondents, out of which 197 were found useable. As recommended by
Awang (2015), Exploratory factor analysis (EFA) using principal component
extraction with Varimax rotation was employed as a preliminary step to gain
a deeper insight into the factorial structure of the questionnaire data to derive
a number of plausible meaningful factors in the context of Phuket, Thailand.
The Kaiser-Meyer Olkin test was used to measure the sampling accuracy and
produced a coefficient of 0.86 and Bartlett’s test was significant at the 0.001
level, which confirmed that the sample was adequate to conduct EFA (Hair
et al., 2010). To identify satisfactory items, the cutoff point for the factor
loadings was set at an absolute value of 0.5, and items with communalities of
less than 0.5, and multiple high loadings were deleted (Hair et al., 2012).
Two attempts were made to extract the final results. At the first attempt, two
items reporting cross-loading and communalities of less than 0.5 were dis
carded from further analysis. They were: “Staff are not seen dipping their
fingers into food and licking them to taste.” and “The rubbish area is clean and
tidy..” Based on the second EFA results, four factors with an eigenvalue of 1.0
or higher were detected. The 23 remaining food safety items were then re-
arranged according to which factor they reflected. These factors accounted for
67.07% of the total variance in the importance scores derived from the sample
of respondents. The details are reported in Table 1. The first factor was
cleanliness of restaurant (Cronbach’s alpha = 0.917) accounting for 26.45%
of the variance. The items which loaded strongly onto the first factor reflected
the hygiene standard of the restaurant’s internal and external environment as
well as the restaurant’s equipment while a single item related to the food
inspection report. The second factor labeled food safety information cues
(Cronbach’s alpha = 0.892) appeared to be associated with external sources
of information including other customers’ reviews posted on different social
media platforms (e.g., TripAdvisor as a travel-specific website, Yelp, Twitter,
Facebook, or other social media platforms), tour guide advice, and two items
related to the level of the crowdedness of the restaurants (either by tourists or
locals) that all accounted for 15.41% of the variance. All items that loaded
heavily onto the third factor, toilet hygiene (Cronbach’s alpha = 0.938), repre
sented the hygiene indicators associated with clean toilets. This factor
accounted for 14.94% of the variance. The load of the toilet-related cleanliness
items as a subset of cleanliness of restaurant on a separate factor of toilet
hygiene, indicated that tourists are concerned with restaurant cleanliness, with
the cleanliness of restrooms as an important factor when they select
a restaurant. The final factor was waitstaff’s appearance and personal hygiene
(Cronbach’s alpha = 0. 838), which accounted for 10.26% of the variance with
only three indicators loading onto this factor. However, the items shown in
Table 1 were used for constructing the study main questionnaire.
Sampling and data collection

The data analysis methods employed were considered in determining the
appropriate study sample size. According to Kline (2011), the proper sample
size for data analysis using structural equation modeling (SEM) depends on
the model’s complexity. SEM usually needs a sample size of 100 to 200 (Hair
et al., 2010), however, deviation of the sample from the true characteristics of
the entire population (sampling error) can be reduced by increasing the size of
the sample (Mehdi, 1992, p. 373). Therefore, a sample size in excess of 520 was
initially sought in this study.
According to the USDA Foreign Agricultural Service (2018), restaurants in
Thailand can be divided into three categories: quick-service restaurants, full-
service restaurants, and small restaurants. This study only focused on small
restaurants that are SMEs-Small Medium Enterprises with the highest propor
tion, roughly 80% of all restaurants in Thailand (USDA Foreign Agricultural
Service, 2018). Similar to full-service restaurants, small restaurants have an
area where food is served directly to customers seated at a table but the
minimum price for a full meal is around 80–100 Thai Baht (US dollars 2.6–
3.3) which is more affordable for tourists. However, full-service restaurants in
Thailand are mostly Japanese, Italian, Chinese, American, and Vietnamese
restaurants while small restaurants in Thailand are local restaurants that often
serve Thai food. The data were collected in Phuket from November 2019 to
January 2020 at small restaurants in Phuket Old Town and Patong Beach, both
of which are the most important tourist hot spots with many small restaurants.
Due to the lack of reasonably priced public transportation in Phuket, particu
larly at night, international tourists tend to visit and dine at food service
establishments in Phuket Old Town in the late morning or early afternoon.
To reflect this consumer profile, the questionnaires were collected during the
daytime from 11 a.m. to 4 p.m. from the 30 selected restaurants at both sites
(15 restaurants each). 14–16 subjects on average were selected from each of the
restaurants using a random sampling technique whereby every fifth tourist
was approached for participation. The selection of restaurants was based on
the voluntary permission of the restaurant owners, ensuring ethical practice.
In selecting the sample, the minimum length of a tourist’s stay in Phuket was
required to be five days. A minimum of a five-day stay gives tourists a high chance
to try more destination restaurants providing them useful insights about the most
important food safety indicators in assessing the safety of Phuket small restaurants
and restaurant choice. This research inclusion criterion is more vital for group tours
that have no freedom in the first two days of their stay. International travelers,
18 years or older visiting the selected restaurants were approached after they
finished their meals and invited to participate in this research. Thus, they had
more “neutral” time to fill up the questionnaires to prevent threats to reliability. If
they agreed to participate by signing the Informed Consent Agreement, they were
asked to complete the questionnaire. However, this study does not need the ethical
clearance as it was an exempt study category with lower than minimal risk based on
the University’s Ethics in Human Research guidelines (Intusoma, 2018)
In total, two levels of the survey were carried out and the same
sampling inclusion criteria were considered for both levels of the survey.
The authors used the data collected by the first survey to organize the
research instrument as discussed in the pilot study section. The second
survey as the main phase of data collection included the 23 remaining
food safety items from the pilot study, scale items on tourist satisfaction,
and items asking respondents’ socio-economic characteristics. In
the second survey, of the 520 distributed questionnaires, 446 were
returned. The response rate was 85.8% indicating that this study enjoyed
an acceptable response rate as the acceptable response rate in the tourism

studies is > 58.20%. (Ali et al., 2021). Of these, 13 responses with errors
and incompletion were discarded and a total of 433 useable questionnaires
was obtained for further analysis (83.3% usable response rate). Prior to
data analysis, the assumptions of multivariate normality such as normality
distribution, homoscedasticity, linearity, and multicollinearity, which
underlie the application of SEM were verified. However, no univariate
or multivariate outliers were detected. Covariance-based SEM (CB-SEM)
was employed for the main phase of data analysis. Based on the two-stage
approach suggested by Anderson and Gerbing (1988), Confirmatory
Factor Analysis (CFA) was first conducted using AMOS, version 23, to
figure out the existence of a relationship between observed variables and
their underlying latent constructs (Hair et al., 2010). Once the adequacy of
the measurement model in terms of validity and reliability was supported,
the structural model was used to show the causal and correlational
relationships among latent variables (Samah, 2016).
Results
Sample Profile
Of the respondents, 62.4% were female and 37.6% were male; 69.1%
were from the USA, European countries, Australia and New Zealand;
75% held a bachelor’s degree or higher; 86.4% were between the ages of
18 and 44, while 61.7% had a monthly income of 2000 USD $ or less;
75% of the respondents planned their trips individually; 27.5% had
visited Phuket before while 72.5% had not. 4.8% or 11 of the respon
dents had experienced foodborne illness during their stay. Out of which
5 persons reported their disease and doctors confirmed that they had
food poisoning (see Table 2).
Confirmatory factor analysis

CFA with maximum likelihood estimation was conducted to assess the
adequacy of the measurement model comprising four factors and to
establish the reliability and validity of the research constructs. To
check the adequacy of the model fit, widely used fit indices comprising
relative chi-square (< 5.0), goodness-of-fit (GFI > 0.9) and adjusted
goodness–of- fit (AGFI > 0.9), comparative fit index (CFI > 0.9), incre
mental fit index (IFI > 0.9), and root-mean-square error of approxima
tion (RMSEA < 0.08) were employed (Awang, 2015; Bentler, 1990; Hair
et al., 2010). According to Samah (2016), a positive threshold value of
0.5 for item loadings provides a reliable indicator for each construct.
Table 2. Sample Profile (n = 433).

Variable Category Frequency Percent
Gender Male 163 37.6
Female 270 62.4
Age 18–24 93 21.5
25-34 249 57.5
35–44 32 7.4
45-54 31 7.1
55–64 23 5.3
65 or Older 5 1.2
Nationality Asian 85 19.6
African 30 6.9
American 86 19.9
European 101 23.3
Middle East 19 4.4
Oceanian 112 25.9
Level of Education Up to High School 32 7.4
Diploma 76 17.6
Bachelor Degree 266 61.4
Master Degree 54 12.5
Doctoral Degree or Higher 5 1.1
Monthly Household Income Under US$ 1,000 108 25
$1,000 – $1,999 159 36.7
$2,000 – $2,999 81 18.7
$3,000 – $3,999 78 18
$4,000 – $4,999 7-- 1.6--
$5000 – $5,999
$6000 or More
Trip Arrangement Tour Package 108 24.9
Individually Planned 325 75.1
Past Visit of Phuket Yes 119 27.5
No 314 72.5
Past Experience with Foodborne Illness during Their Stay Yes 21 4.8
No 412 95.2
Therefore, an item “There is no evidence of insects in toilets.” with

a loading value of less than 0.5 was deleted.
The standardized factor loadings of all the items were between 0.641 and
0.902. The measurement model displayed satisfactory fit measures (see Table
3) and overall, the CFA results indicated that the four-factor food hygiene
model was well-fitted to the data. To establish convergent validity, the com
posite reliability (CR) and average variance extracted (AVE) were applied as
suggested by Hair et al. (2010).
Table 3. Fit Indices for CFA.

Fit indexes Measurement Model
χ2 367.216
df 198
χ2 (df) 1. 855
AGFI 0.911
GFI 0.930
IFI 0.968
CFI 0.968
RMSEA 0.044
As shown in Table 4, the AVEs were all greater than 0.5 and the CRs for all
the research constructs were above the recommended value of 0.7, thus
confirming the adequacy of the convergent validity. The discriminant validity
was determined by comparing the square root of the AVE for each individual
construct with its corresponding correlations with other constructs (Fornell &
Lacker, 1981). The larger square roots of the AVE values in all cases confirmed
the discriminant validity of the constructs (see Table 4). In sum, the result of
the CFA for the four-factor food safety/hygiene model supported the first
hypothesis (H1), indicating that international tourists use different dimen
sions of food safety/hygiene indicators in the choice of destination restaurants.
A second CFA was used to assess the model fit and the factor loadings of the
tourist satisfaction and four food safety factors in one measurement model.
The adequacy of the measurement model was evaluated based on the criteria
of convergent validity, discriminant validity, and model fit. The second CFA
results established evidence of discriminant validity and convergent validity in
the measurement model and a very good model fit the data (see Table 5–6). All
factor loadings for the observed variables measuring the same construct were
higher than 0.05, ranging from 0.64 to 0.92.
The descriptive statistics of the study’s constructs and items are shown in
Table 7. The level of importance attributed to the various food safety/hygiene
cues was assessed upon a five-point Likert scale. A large numerical score
indicates a high importance level. As depicted in Table 7, the most important
and least important food safety/hygiene factors that international tourists use
in the choice of destination restaurants were waitstaff’s appearance and per
sonal hygiene (M = 3.76, SD = .758) and food safety information cues
(M = 2.80, SD = .495) respectively. While the food safety/hygiene indicator
of “the sink for hand wash is clean” demonstrated the maximum contribution
to restaurant selection (M = 4.11, SD = .753), the item “there are positive
reviews about the restaurant posted by other tourists on TripAdvisor” was the
least important food safety cue in restaurant selection (M = 3.45, SD = .876).
In order to identify the key food safety factors affecting tourist satisfaction
with destination restaurants, a structural model has been established (see
Figure 1). The results of the fit indices confirmed the good fit of the data to
the structural model with RMSEA equal to 0.042, χ2 = 508.218 (df = 284,
Table 4. Results of Discriminant Validity and Convergent Validity for Four-Factor Model.
FSIC WAPH CR TH Composite Reliability Average Variance Extracted
FSIC 0.726 0.847 0.527
WAPH 0.166 0.857 0.892 0.734
CR 0.352 0.176 0.713 0.919 0.509
TH 0.414 0.312 0.353 0.798 0.839 0.637
Note: Square roots of AVEs shown diagonally in boldface; Food Safety Information Cues = FSIC; Waitstaff’s
Appearance and Personal Hygiene = WAPH; Cleanliness of Restaurant = CR; Toilet Hygiene = TH.
Table 5. Fit Indices of Overall

Measurement Model.
Fit indexes Measurement Model
χ2 508.218
df 284
χ2 (df) 1.790
AGFI 0.901
GFI 0.920
IFI 0.967
CFI 0.967
RMSEA 0.42
Table 6. Results of Discriminant Validity and Convergent Validity of Overall Measurement Model.
FSIC TS WAPH CR TH Composite Average Variance Extracted
Reliability
FSIC 0.726 0.847 0.527
TS 0.326 0.864 0.919 0.509
WAPH 0.166 0.297 0.857 0.839 0.637
CR 0.352 0.363 0.176 0.713 0.892 0.734
TH 0.416 0.349 0.312 0.353 0.798 0921 0.746
Note: Square roots of AVEs shown diagonally in boldface; Food Safety Information Cues = FSIC; Tourist
Satisfaction = TS; Waitstaff’s Appearance and Personal Hygiene = WAPH; Cleanliness of Restaurant = CR; Toilet
Hygiene = TH.
p < .05), and χ2 /df equal to 1.79. Other fit indices included GFI = 0.92, CFI = 0
0.967, and IFI = 0.967.
Path coefficients estimated by SEM and hypothesis testing results are pre
sented in Table 8. The standardized path coefficients obtained from the struc
tural model indicated that all four factors of cleanliness of restaurant (β = 0.224,
p < .001), waitstaff’s appearance and personal hygiene (β = 0.185, p < .001), food
safety information cues (β = 0.155, p < .006), and toilet hygiene of restaurants
(β = 0.147, p < .01) were positively and significantly related to tourist satisfac
tion using p < .05 in three different magnitudes (see Table 8). These four factors
explain 23.8% (R2 = 0.23.8) of the variance in tourist satisfaction of small
restaurants in Phuket, although, cleanliness of restaurant followed by waitstaff’s
appearance and personal hygiene had the higher levels of explanatory power for
tourist satisfaction with the p values less than 0.001. Since a very low p value,
p values less than 0.001, provides a very strong evidence against the null
hypothesis regardless of sample size (Sterne & Smith, 2001), thus any effect
that would have been significant with stricter recommendations of a p < .001
has more evidential value and less errors than an effect only significant at
p < .05. As a result, we suggest that high p-values (p-values > 0.001) provide
relatively weak support for H3 and H4. In sum, the study’s results have
supported hypotheses H2 and H5 with the more confidence and the least errors.
Table 7. Mean Score and Standard Deviation of the Study’s Constructs and Items (n = 433).
Construct Item Mean
(SD)
CR 3.69
(.551)
There are no flies in the restaurant. 3.84
(.802)
No bad smell/odor in the restaurant. 3.95
(.765)
The outside/exterior of the restaurant is clean. 3.90
(.797)
Any equipment seen is clean. 4.00
(.733)
All food service areas and surfaces are clean. 3.83
(.796)
The menu is clean. 3.76
(.879)
If visible, the kitchen looks clean. 3.98
(.812)
The sink for hand wash is clean. 4.11
(.753)
The table and chairs are clean. 4.00
(.768)
The utensils for serving food are clean. 3.87
(.798)
The restaurant has the Clean Food Good Taste logo. 3.77
(.873)
FSIC 2.80
(.495)
There is a high level of the international tourists’ crowdedness in the restaurant. 3.87
(.815)
There is a high level of the local people’s crowdedness in the restaurant. 3.48
(.875)
There are positive reviews about the restaurant posted by other tourists on TripAdvisor. 3.45
(.876)
There are positive reviews about the restaurant posted by people on Facebook, Yelp, 3.57
Twitter, and other social media platforms. (.851)
The tour guide highly recommends the restaurant. 3.46
(.824)
TH 3.61
(.706)
Toilets and urinals are well maintained and clean. 3.57
(.773)
Trash bins in toilets are available and not full. 3.58
(.876)
Toilet paper and soap are available. 3.48
(.895)
WAPH 3.76
(.758)
The waitstaff’s hands are clean. 3.90
(.884)
The employees are wearing clean and tidy uniforms and look clean. 3.84
(.902)
The waitstaff shows high standards of personal hygiene demonstrated by staff, no bad 3.91
habits, i.e. coughing or sneezing onto food or hands and then touching food, touching (.893)
hair then food, biting nails, etc.
TS 3.85
(.757)
I enjoyed both tangible & intangible strengths of visited Thai restaurants. 3.92
(.898)
I enjoyed pleasant moments with family and/or friends while having Thai restaurant 3.91
services. (.854)
Thai food attributes and restaurant services put me in a good mood. 3.92
(.861)
I am very satisfied with my overall dining experience at Thai restaurants. 3.75
(.935)
Note: Cleanliness of Restaurant = CR; Food Safety Information Cues = FSIC; Toilet Hygiene = TH; Waitstaff’s
Appearance and Personal Hygiene = WAPH; Tourist Satisfaction = TS.
Figure 1. The Structural Model.
Table 8. Results of Hypothesis Testing (H2-H5).

Hypothesis Path B β S.E. C.R. P
H2 CR →TS 0.302 0.224*** 0.072 4.182 <0.001
H3 FSIC →TS 0.227 0.155** 0.082 2.761 0.006
H4 TH→TS 0.153 0.147* 0.060 2.564 0.01
H5 WAPH→TS 0.182 0.185*** 0.049 3.735 <0.001
Note. Cleanliness of Restaurant = CR; Food Safety Information Cues = FSIC; Toilet Hygiene = TH; Waitstaff’s
Appearance and Personal Hygiene = WAPH; Tourist Satisfaction = TS.
***p < 0.001, **p < 0.01, *p < 0.05
Discussion
The first objective of this study was to identify the dimensions of food safety/
hygiene cues that international tourists use in the choice of destination
restaurants. As pointed out earlier, several studies in the field of consumer
behavior have explored the dimensionality of restaurant hygiene indicators
(Henson et al., 2006; Leach et al., 2001; Park et al., 2016; Yasami et al., 2020a).
Contrary to the three-factor and five-factor models proposed in previous
research (Leach et al., 2001; Park et al., 2016; Yasami et al., 2020a), the present
study recognized four underlying restaurant-food safety/hygiene factors that
international tourists use in the choice of destination restaurants
A possible explanation for this difference is that the previous studies were
conducted in different geographical areas (the UK, USA, and Malaysia), while
the current study was conducted in Thailand, where different cultural and
contextual factors apply. In the study conducted by Leach et al. (2001) and
Park et al. (2016), the respondents were local consumers, whereas the present
study surveyed international tourists. The different cultural backgrounds of
the respondents, the various destination food and culinary cultures, and the
destination restaurants’ operating practices are other factors that cannot be
ignored. Secondly, the methodology used by the previous studies was different,
and in particular, Leach et al. (2001) employed the Delphi technique to derive
the foodservice hygiene factors. Unlike previous research, the current study
has tested the reliability and validity of the factors derived through SEM, even
though EFA was conducted to identify the food hygiene factors in the context
of Thailand’s small restaurant industry.
The study’s outcomes suggest that international tourists assess the food
safety and hygiene of a restaurant based on four aspects to decide where to eat:
cleanliness of restaurant, external sources of food safety information cues,
toilet hygiene, and waitstaff’s appearance and personal hygiene. Based on
Leach et al. (2001), Park et al. (2016), and Yasami et al.’s (2020a) study
findings, there are some common factors, such as the importance of food
safety information cues, the exterior and interior of the premises, the table and
its immediate environment, working staff, and restroom hygiene. However,
the aspects of restaurants and services making up the various factors were
different in this study. For example, Leach et al.’s exterior and interior factors
of the premises and the table as well as its immediate environment were
grouped under a broader factor in the current study, namely cleanliness of
restaurant, because the different themes and individual factors identified by
Leach et al. (2001), such as the immediate environment and the interior and
exterior of the restaurant are very difficult to distinguish in the Thai context.
Many Thai restaurants do not operate in a closed environment and the tables
and chairs are often set up outside the restaurant or in a public area, and this
makes it difficult to clearly distinguish the interior and exterior of the
restaurant. In many cases, restaurant equipment, utensils, the kitchen, the

rubbish area, and the service area are all part of the entire restaurant and they
are visible to passersby.
Moreover, the item of inspection certificate posting at the restaurant loaded
onto the first factor, cleanliness of restaurant, instead of loading onto Henson
et al.’s factor of external sources of information. The way of reporting inspec
tion results might be the possible reason for such a difference. Unlike Western
countries where food inspection grades are issued in the form of a letter or
number indicating the level of restaurant hygiene and food safety, in Thailand,
restaurants that meet the sanitation criteria will be awarded by the “Clean
Food Good Taste” logo and usually displayed at restaurants’ entrance
(Kongchuntuk, 2002).
Contrary to Henson et al.’s (2006), the level of restaurant crowdedness was
not a separate factor and loaded onto the factor related to food safety informa
tion cues. It is more likely that the number of people eating in a restaurant,
either tourists or locals, may provide tourists with valuable information about
standards of restaurant food safety/hygiene practices (Tyrewalah, 2014) as
more crowded restaurants would be expected to be associated with a higher
rate of turnover of fresh ingredients, quite apart from indicating where locals,
who could be expected to know the best restaurants, chose to eat.
However, the factor of food safety information cues was one of the food
safety/hygiene dimensions that influenced international tourists’ choices of the
destination restaurants, although, it was the least important factor. Unlike the
other three factors, food safety information cues do not directly/indirectly
affect the safety of the food nor the level of restaurant hygiene standards.
Nevertheless, tourists may associate the hygiene level of food with positive
reviews and recommendations of other customers who have past experiences
with a particular restaurant. Therefore, in common with any purchasers of
goods or services which cannot be evaluated prior to purchase, tourists may
use both traditional and online WOM to reduce the risks inherent in the
purchase and consumption of food at a restaurant (Hussain et al., 2017). For
instance, online word of mouth (eWOM) in the form of restaurant reviews
posted on restaurant websites or different social media platforms are perceived
as more important by customers in their appraisals of restaurant hygiene and
choices (Ha et al., 2016; Luo & Xu, 2019; Pantelidis, 2010; Seo et al., 2015;
Yasami et al., 2020b). In particular, online customer reviews are globally
accessible by tourists through different social media platforms and can
empower potential shoppers to make better purchasing decisions (Hennig-
Thurau et al., 2004). Hence, it is not surprising that food safety information
cues emerged as one of the food safety/hygiene factors.
In accordance with the results of the foregoing studies in the literature and
result sections, the relationships between food safety/hygiene factors and
tourist satisfaction were found conclusive, underlining the importance of
food safety and hygiene of local food in destination restaurant marketing and
branding. Endorsing the findings of Alhelalat et al. (2017), Almohaimmeed
(2017), Cha and Borchgrevink (2018), Kala (2020), and H. Kim and Bachman
(2019), and Lap-Kwong (2017), Liu and Lee (2018), Y. Liu and Jang (2009),
and Truong et al. (2017), researchers advocate that cleanliness of restaurant
and employees’ attributes have the potential to make a meaningful contribu
tion to overall tourist satisfaction. These two factors, waitstaff’s appearance
and personal hygiene followed by cleanliness of restaurant also showed the
higher level of importance perceived by tourists in restaurant selection com
pared to the other factors. In sum, the results of the study suggest that the
higher a tourist evaluates the cleanliness of the restaurant and employees, the
higher is the level of satisfaction.
Conclusion
Upon existing literature, the present study provided the first in-depth analysis
of how international tourists assess the food safety of restaurants, which
impacts on restaurant choice and tourist satisfaction in Thailand, a country
where the hygiene level of its food premises can often lag far behind the
sanitation standards in developed countries. The study’s results revealed four
food safety/hygiene factors that international tourists use to select a restaurant.
These factors were: waitstaff’s appearance and personal hygiene cleanliness of
restaurant, toilet hygiene and food safety information cues. Cleanliness of
restaurant and waitstaff’s appearances and personal hygiene were two key
factors driving tourist satisfaction with destination restaurants. The results
of this study contribute to food safety and restaurant sanitation research in the
context of tourism. It was the only study that developed a scale measuring
international tourists’ perceptions of destination restaurant hygiene in the
context of Thailand’s small restaurant industry. This scale was empirically
tested and supported for its constructs’ convergent and discriminant validity.
The study results also suggested that food safety/hygiene factors may differ
based on the destination culture as different countries, even tourism destina
tions within a country have different foodservice operating practices. Thus,
tourists may apply different dimensions of food safety indicators to judge food
safety/hygiene standards in restaurants in different destinations.
However, the high importance international tourists place on the cleanli
ness of restaurants and employees suggested that managers of small restau
rants in Thailand may differentiate their products/services from those of their
competitors with best practices that help them to maximize and maintain the
hygiene standards at restaurants. The results of the study may persuade the
Phuket Health and Sanitation Department in collaboration with the Phuket
branch of the Tourism Authority of Thailand (TAT), regularly inspect small
restaurants, particularly in tourism areas to ensure that these restaurants are
serving safe food by a well-trained staff in a clean environment because even

one single case of tourist food poisoning can easily damage a destination’s food
image. It seems to be more critical for Phuket where UNESCO has designated
this city as a Creative City of Gastronomy. A regular supervision system by
upgrading the standard of hygiene and service quality of food eateries creates
a unique charm for Phuket while providing more attraction for tourists who
seek food variety and novelty as the genuine cultural experiences of their trips.
The Thai small restaurant operators are also encouraged to be awarded the
Clean Food Good Taste logo by meeting the sanitation criteria set by the Thai
health authorities as inspection notice in any format are expected to reassure
consumers about the safety of unobservable operating practices of restaurants
(Uggioni & Salay, 2014).
Furthermore, this study makes meaningful contributions to tourism satis
faction literature. In spite of the fact that this work has some levels of
similarities with the past research (Alhelalat et al., 2017; Cha &
Borchgrevink, 2018; Kala, 2020; H. Kim & Bachman, 2019; Lap-Kwong,
2017; P. Liu & Lee, 2018; Y. Y. Liu & Jang, 2009; Truong et al., 2017), the
present study is the first attempt in the context of the restaurant industry that
has treated restaurant hygiene quality in the form of observable food safety/
hygiene indicators and food safety-specific information cues as a separate
dimension of service quality influencing tourist satisfaction. Simply, the
major contribution of the study to the tourism literature was the inclusion
of restaurant hygiene quality in the form of four-model food safety factors
contributing to tourist satisfaction in the absence of other service quality
dimensions.
Based on the result, cleanliness of restaurant and waitstaff’s appearance and
personal hygiene were the two key factors that strongly contribute to tourist
satisfaction. Therefore, restaurant owners should ensure that environment and
equipment of restaurants (e.g., furniture, utensils, restaurant exterior, dining
area, sink for hand wash, menu) are clean, hygienic, and attractive to satisfy
tourists. Since excellent restaurant services can be easily spoiled by the wait
staff who wear untidy uniforms and show poor standards of personal hygiene,
well-groomed waitstaff with appropriate serving manners should be empha
sized to reflect the restaurant compliance with the reliable hygiene standards.
To conclude, it is extremely important to improve the dining hygiene
quality attributes of Phuket small restaurants. TAT’s Phuket branch in
collaboration with the city’s Health and Sanitation Department should
design a well-organized food safety training program for both restaurant
owners/managers and employees. A well-designed training program helps
ensure food safety, a consistent quality product, and a sanitary environment
under which foods are produced and served. If carried out effectively, high
food safety, restaurant hygiene quality, and sanitation provide an unrivaled
opportunity for Phuket to remain confident and seemingly untroubled by
the food safety problems and boost culinary tourism as a lucrative niche
tourism market (Walter, 2017) by offering a variety of local foods in its food
stalls and restaurants demonstrating the island’s unique traditions, legends,
and stories. It helps Phuket as a Creative City of Gastronomy to strengthen
the creation, distribution, and dissemination of food authenticity essential
to tourist satisfaction and unpaid positive word of mouth (Zhang et al.,
2019).
Limitations and practical implications

However, the present study is not without limitations and the results should be
interpreted with some caution. Firstly, the framework of the study is its largest
limitation, as it restricted the authors’ work to its own objectives. Several
indicators of food safety such as the freshness of food, food temperature,
and food cooking level were not considered as they were experience features
and cannot be evaluated before purchasing food. Since those food safety
indicators of food quality are tied to overall tourist satisfaction with destina
tion restaurants (Abdullah et al., 2018; Konuk, 2019; Ramanathan et al., 2016),
leaving aside them may influence the study results. This would mean that the
four-factor model of hygiene quality is not the only service quality dimension
that affects tourist satisfaction, which highlights the need for research on other
service quality dimensions that may impact tourist satisfaction in Thailand
small restaurants. Secondly, this study was limited to small restaurants in
Phuket, Thailand. Thus, the results may not be generalized to other types of
restaurants or restaurants outside Thailand. Further, the differences between
demographic characteristics and the importance of evaluation indicators were
not determined. Thirdly, the data was collected at the beginning of the
COVID-19 pandemic, this might have had an effect on the tourists’ perception
of food safety and restaurant hygiene influencing their overall satisfaction of
the destination restaurants. As communicated by media and global health
organizations at the beginning of the coronavirus outbreak in China, corona
virus is mostly spread by respiratory droplets released when people talk,
cough, or sneeze, and wearing masks and handwashing with soap and water
can eliminate the further spread of the virus. The high importance of food
safety indicator of “the sink for hand wash is clean” in restaurant selection
among other cues may reflect international tourists’ concerns regarding the
novel health crisis. Therefore, cleanliness of restaurant and the waitstaff are
expected to more influence tourist satisfaction compared to the high level of
the restaurant crowdedness due to nonobservance of social distance, which
increases the risk of infection. Finally, the research instrument was developed
in English language. Thus, international tourists with less or no English
literacy such as Chinese travelers had no contribution to the completion of
the questionnaires while Chinese have been the biggest group of tourists to
Phuket in the recent years (Chan, 2019). These limitations suggest potential
avenues of inquiry for future studies.
Although this study suffers from some limitation, the findings can still be
valuable in prioritizing the areas related to gastronomy in promoting tourist
satisfaction because the capability to consistently satisfy customers is particu
larly critical in the restaurant industry as satisfaction has been widely demon
strated to positively affect loyalty intentions, either repeat visits or word of
mouth endorsement (Adnan et al., 2018; Anggraeni et al., 2020; Azila et al.,
2017; Jin et al., 2016; Liu & Lee, 2018), while the latter being the best promo
tion tool in the good/service industry (Richins, 1983).
We have no conflicts of interest to disclose
ORCID
Kullada Phetvaroon http://orcid.org/0000-0003-1203-3742
Hongrui Zhu http://orcid.org/0000-0001-8052-3888
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International Tourists Choices and Satisfaction of Small Restaurants in Thailand The Influence of Food Safety Indicators

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Journal of Foodservice Business Research

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International tourists’ Choices and satisfaction of

Mehri Yasami, Kullada Phetvaroon & Hongrui Zhu

To link to this article: https://doi.org/10.1080/15378020.2021.1964340

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International tourists’ Choices and satisfaction of small

Food safety risk factors from the consumer perspective

Food safety risks continue to be a worldwide public health issue (World

Commission Scientific Committee for Food, 1997). Therefore, food safety

appearances and safe food handling behaviors. Although food safety/hygiene

H1: International tourists use different food safety/hygiene dimensions in the

Restaurant food safety and tourist satisfaction

H2: The factor of cleanliness of restaurants has a positive relationship with

In the following sections, the study’s methodology, construct development,

Since the objective of this research is to provide a holistic understanding of

and evaluated before purchasing. Nineteen of the statements described the

Pilot study and organization of the research instrument

Sampling and data collection

an acceptable response rate as the acceptable response rate in the tourism

Confirmatory factor analysis

Table 2. Sample Profile (n = 433).

Therefore, an item “There is no evidence of insects in toilets.” with

Table 3. Fit Indices for CFA.

Table 5. Fit Indices of Overall

Figure 1. The Structural Model.

Table 8. Results of Hypothesis Testing (H2-H5).

restaurant. In many cases, restaurant equipment, utensils, the kitchen, the

serving safe food by a well-trained staff in a clean environment because even

Limitations and practical implications

We have no conflicts of interest to disclose

Wongleedee, K. (2013). Food safety management: Concerns from EU tourists in Thailand.

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