N = 11) and narrative analysis were conducted in Phase I. In Phase II, variables approximating the key themes that emerged in Phase I were selected from an existing dataset (N = 67), and relationships were examined using bivariate associations. The sample consisted of low-income Black, Indigenous, men of color (BIMOC) in a batterer intervention program (BIP). Adverse life experiences shaped participants’ world view via mistrust in others, stifling emotions and vulnerability, and a sense of personal guilt and shame. These orientations were then carried into adult relationships where men coped using social isolation to manage challenges, negatively affecting intimate relationships. For some men, mental health exacerbated these circumstances. Significant bivariate and multivariate associations supported this narrative. This study lays the foundation for future research to examine the potential effects of social support on IPV perpetration. BIPs should consider augmenting programming to enhance men’s social networks to support their use of nonviolence after program completion.Relational health has emerged as a consistent factor that can mitigate the effects of trauma among children; however, less is known about relational health with adults, particularly related to intimate partner violence (IPV) perpetration among racially and socioeconomically marginalized men. The Exploratory Sequential Design, Taxonomy Development Model was used. Semi-structured interviews ( Stemming from systemic racism and poverty, Black, Indigenous, and youth of color face an unequal burden of adversity and trauma in the United States ,2. TraumDrawing from trauma theory, trauma can be defined as an event, or series of events, that is experienced by an individual as physically or emotionally harmful or life threatening, and can have lasting effects on functioning and well-being ,11. The Experiences in early life determine the organization and functioning of the adult brain . ExposurResearch demonstrates that the consistent presence of a caring adult or “relational health” is a primary protective factor that can mitigate the effects of adversity and trauma . Social Positive relational interactions mitigate activation of stress responses and produce regulating effects that are central to healing, recovery and healthy development after traumatic experiences . The preThere is a substantial body of literature that examines the effect of childhood trauma on adult mental health, with most studies focusing on outcomes such as chronic depression, posttraumatic stress disorder (PTSD), substance abuse, and other mental health disorders ,28. AnotThe positive effects of social support on individuals’ physical and mental health and well-being has been well-documented in the literature . GreaterOf the research examining the effect of social support and isolation on IPV, the majority focuses on victimization. Social support has been linked to improved psychological well-being following IPV victimization , as wellThere is a robust body of research linking adverse childhood experiences (ACEs) and trauma with numerous deleterious outcomes in later stages of development; however, comparatively less research exists on protective factors that can ameliorate the long-term effects of early adversity on outcomes later in life, especially focusing on IPV. Theory and empirical research support the notion that relational health can promote resilience and healthy development for children in the face of adversity . ExtendiThe current study explored the association between childhood trauma, social support, and IPV perpetration using mixed methods with a sample of low-income Black, Indigenous, Men of Color (BIMOC) in a batterer intervention program (BIP) as a requirement of probation. The study was conducted in two phases and was guided by the following research questions: (1) How has childhood trauma shaped relationships with others among men with recent histories of IPV; (2) How does social support affect men’s relationships with their intimate partners; and (3) Are the key factors identified in men’s narratives  associated with social support and IPV perpetration?Due to limited guiding frameworks or theories to understand the potential relation between social support and IPV perpetration among men with histories of trauma, an exploratory mixed methods design was used. The Exploratory Sequential Design , TaxonomParticipants were 18 years or older, spoke fluent English, and were referred to a BIP as a requirement of a domestic violence charge. Men completed the surveys at their referral appointment with their probation officer before beginning the BIP in order to have a more representative sample . They completed the survey in a private office at the probation office, receiving $25 and light food/drink for their time. The original survey conducted from November 2017 to December 2018 consisted of 414 questions assessing men’s exposure to adverse childhood experiences (ACEs), mental health, physical health, attitudes, social networks, IPV, violence among non-intimate partners, and incarceration history (See ). For thn = 7; Phase II: 76.1%), high school graduates , employed , and reporting less than $20,000 in annual income . See A total of 67 men participated in the original survey. Eight of the possible 67 completed a semi-structured interview, and three of these men consented to a follow-up interview, resulting in 11 semi-structured interviews. The mean age of the men was 35, with the majority being Black  and an unction; ,55). TheComplex trauma symptomology. Three subscales of the Structured Interview for Disorders of Extreme Stress-Self Report (SIDES-SR) measured complex trauma symptoms in the past month. Alterations in regulation of affect and impulses  measures affect regulation, modulation of anger, and other destructive behaviors, which served as a proxy for the theme “Stifling Vulnerability and Emotions.” Serving as a proxy for the theme “Guilt and Shame,” Alterations in self-perception  measures feelings of guilt, shame, and that “no one can understand.” Alterations in relations with others  measures one’s “inability to trust,” victimizing, and victimizing others, which served as a proxy for the theme “Mistrust of Others.” Response options for each item were 0 = No, 1 = Yes. The total score for each subscale represents the count of trauma symptoms related to each subscale. This measure has shown good reliability and construct validity —I’ve grown up a lot, you know? The world’s a big, scary place and there’s some awful people in it. You know, there’s good people, too, but you’ve got to be careful. You’ve got to be careful. You can’t be vulnerable, because people will take advantage of you if they can.” (Chris)The feeling of abandonment was not solely experienced at the interpersonal level. Michael, an 18-year-old Black man, reporting no annual income and completing some high school, told a narrative which illuminated the larger cultural or societal norms affecting him by way of heightened fear of stigmatization and marginalization, contributing to a diminished sense of relational support. Specifically, Michael described feeling social pressure as an African American man to hide his history of sexual abuse due to the stigma in his community that boys who are sexually victimized by another man are labeled homosexuals. The fear of being stigmatized primed him to feel that nobody, not even his own family, would ever be there to support him.“I told you I was sexually molested by one of my family close friends or whatever. And I feel like if I ever told any other soul in my family I knew for a fact I would be looked down bad. But, it’s not that I didn’t want to, you know, because my family, you know, is a Black, is, you know, African American family, you feel me? And you know, the African American community, they really don’t [sic] look down on gay people, whatever. And I’m not [gay], you feel me? I just got molested. And I was scared. I didn’t know what to do, you feel me? I was scared to tell anybody because I know for a fact how my family is...I would never hear the end of it for the rest of my life. You gay this, this that and the third. But really, I was just thinking like, nobody was there for me so from that point on I always thought that nobody would be there for me.” (Michael)The combined effects of traumatic experiences and receiving insufficient amount of support, care and understanding from others shaped men’s views of how others would treat them throughout their lives, contributing to their decreased sense of relational support in general.In the larger sample of the current study, nearly 30% of men were considered socially isolated see . In the “It seems crazy to be thirty and I’m like, if I threw a birthday party this summer, like, who would be there? It would just be family, you know?” (Anthony)Chris described being saddened by a lack of friends to rely on for support as a middle-aged man.“It’s sad. I don’t have a relationship, I don’t have any friends that I trust, you know? I mean, but I knew that. But you asking me having to say it out loud to somebody, even somebody who I don’t know, it’s a hard pill to swallow. That a fifty-year-old man can’t say he has one friend in this whole world that he can go to now and say, hey, I trust you. I need to talk to you. I need to be with you.” (Chris)Stressors in adulthood such as emotional or financial challenges also contributed to isolation of several men. For example, Jamar  described that he did not want to talk about his feelings with others when he was feeling depressed and would just “hide away” from his family and friends. Cameron  described isolating himself when having financial challenges to figure out “how to get money”.Men who isolated themselves described a dissatisfaction or feeling of sadness about their isolated status. The question is, then, why these men chose isolation as a coping strategy when they find it maladaptive. Narratives told by men further illuminated several mechanisms leading to participant’s social isolation and how isolation affected their relationships with other people, particularly with intimate partners.Mistrust of others. Four men shared a sense of mistrust of others and mentioned that as a result of mistrust, they refrained from closely interacting with others and isolated themselves when renewed experiences of betrayal and abandonment emerged in adulthood. For example, Tyler  described experiencing an “ultimate betrayal” from his previous intimate partner who cheated on him and shared his “dark secrets” with the other man. Tyler says that he “should have never told her anything”, and he also reported that he expects “nothing at all” from his family members because they had not shown him the level of care and favor that he showed them. When asked about how he reacts to the experiences of betrayal from others like these, he reported that he would isolate himself.“[When feeling betrayed] I want to go, like, isolate myself from people. Like, I kind of like, been doing a good job at it, too.” (Tyler)Anthony said that he does not hang out with friends and isolates himself because his friends “tarnished” his relationship with his intimate partner and also tried to “keep him down” in negative environments and moods. He goes on to explain that people are only friends with him for personal gain, such as when he suggests that his friends were trying to “get” his then girlfriend.“That was something I had to learn, too, because people will be haters. They will see you being happy and it wasn’t necessarily [obvious], but it would be like, you know, we all chilling, I got my lady with me, and somebody would make a inappropriate joke. It’s, like, c’mon, like, you see my lady right here, why would you even bring the subject up or why would you even start talking about that? And I didn’t realize [it] before, but I realize it now. Like, they were on the low hate, you know what I’m saying? On the low trying to get her. … I think having friends in that early relationship, that’s, I think that did mess up my relationship with my daughter’s mother … I don’t think [having friends around] matters that much because people only going to be around you for what they can get from you, what they can get out of you, what they can gain from the situation … So, and I know that. And if my friends, they want to hold me down, they want to, you know what I’m saying, keep me down, I just can’t run with it, you know?” (Anthony)James is a 40-year-old Native American/Alaskan Native man, who reported earning less than 10k/year, with a GED/HS diploma. He also reported he mistrusted people after having issues with friends, which contributed to his tendency to isolate himself.“I don’t trust too many people at all … As far as friends goes, I never really had, I’d never really allow myself to have too many friends, because I didn’t know what they were being my friend for, you know? … So, I kind of like, isolate myself. You know what I mean? Not on purpose, I just don’t feel like being bothered, you know?” (James)Taken together, trauma and adversity paired with a lack of social support contributed to men’s mistrust of others in general, shaping their tendency to choose isolation as a strategy to cope with stressors in adulthood.Stifling Vulnerability and Emotions. Notably, men did not explicitly discuss the association between childhood experiences and their tendency to isolate themselves as coping mechanisms for stress in adulthood; however, Jamar describes how his father raised him to “hold in” his emotions which led him to restrict his emotions with friends. He describes how his limited ability to rely on others in times of need can be emotionally overwhelming.“I’m the strong person. I need to hold it in. I need to be the example. That’s how I was raised. So, I didn’t know how to really talk to nobody when I had issues or problems or emotions or say when I’m sad or hurt. No, I didn’t know what that meant. I was that rock, you know? I was supposed to be that strong one and can accomplish anything, you could deal with any situation.” (Jamar)“Ever since I was younger, and I just kept, I keep things in. I don’t express myself as much as I should. I’ve looked at it as being weak or didn’t want to expose myself or felt, put a persona on, but, it was hard for me for a while to express and touch or, and talk about things that may happen to me or bothered me … I had a lot of pressure. I was always the leader, I was always the person to look up to and depend on and that’s been mostly, basically the story of my life. Even friends. It just became overwhelming, you know, I think now I’m looking back at it. Even friends found, I mean, it was amazing. It’s amazing. It was overwhelming.” (Jamar)Men also expressed a fear of being taken advantage of, encouraging them to stifle their vulnerability. Three men described that they were taken advantage of in close relationships, such as intimate partners, once they expressed their vulnerability with them. For example, Tyler said that his intimate partner shamed him for his “dark histories” he shared with her and later cheated on him, which he described as a “betrayal”. Chris said that, although he does not try to suppress his emotions, he recognizes that letting “too much be shown” lets other people take advantage of him.“I try to pride myself on [being able to open up emotionally] although now I’ve realized it’s gotten me in trouble, because I’ve shared too much and I let too much be shown. I think sometimes you can be too raw with someone and they can take that and use that to their advantage.” (Chris)These narratives suggest that the socially learned or prescribed masculine norms of emotional suppression and experiences of being taken advantage of when showing their vulnerability to others may have led these men to further refrain from expressing any vulnerable emotions. As a result, these men tended to isolate themselves rather than talking with others about their struggles when feeling stressed.Guilt and Shame. Two men also described that guilt and shame served as a reinforcing mechanism that prevented them from sharing their emotions during times of great stress in adulthood, prompting social isolation. Tyler said that he did not express his feelings of stress resulting from adversities in adulthood such as incest because he felt guilty and ashamed.“I mean, you’ll be the first person outside of my wife and pastor, I told you, I told you. But, my family...it’s incest. Like, that shit rampant in my family. That’s why I don’t like talking about it. You get what I’m saying? That shit ain’t normal. … It’s just that, like, it feels shameful. Like, I feel kind of guilty. Like, it’s your fault.” (Tyler)James described that, although he is now able to open up emotionally after receiving therapies, he used to feel stigmatized based on the adversities he faced in adulthood such as homelessness. This stigma made him fear how others would judge him and subsequently held his feelings in.“I slept on porches in the wintertime, I done walked around all day because people, you know, they looking at me all funny. They’re not saying they don’t want me around, but I could feel the energy like, oh, man, he around. He’s about to be asking for stuff... … And I just learned [in therapy] how to open up and just express myself. So, no, I’m not influenced [by what others think of me], like, I feel what I feel. I’m not going to hold it in because of what somebody else would think. They’re going to judge me like this, they’re going to judge me like that, they’re going to think about me like this, they’re going to think about me like that. I don’t [hold in my emotions] anymore. I have, in the past, you know, but not no more.” (James)Taken together, men’s past adversities and social pressure at the family, peer and societal level prompted them to restrict their emotions and isolate themselves.Mental health. The lack of social support in adulthood may have a detrimental impact on their overall mental health, deteriorating the emotional instability of those who were already suffering from significant stress. Chris mentioned that he has suffered from frustration and depression since being abandoned from his family members and intimate partners after his father passed away, a person whom he considered one of his few social supporters. Jamar also described how his social isolation contributed to his increased dependence on alcohol and drugs. In a relatively extreme case, Tyler even experienced auditory hallucinations and even started to harm himself as he continued isolating himself:“But, no, [isolating myself is] not healthy, though, because that isolation could lead to other stuff, you know, me getting trapped in my thoughts, and I start hearing them voices again. Hearing them voices I start hurting myself and doing little weird stuff and I don’t want to do all that.” (Tyler)Based on men’s narratives, bivariate associations were examined to assess if the relationships described in men’s narratives were evident in the larger sample and if they were significantly correlated with IPV perpetration in the past year. Following this, we then ran simplified OLS regression models using “total IPV frequency” as the outcome variable to assess if the associations held see .r = −0.277, p < 0.05) and “not feeling loved”  were negatively associated with social support in adulthood. Considering the associations between ACEs and IPV perpetration, sexual abuse was positively associated with psychological aggression  and IPV injury . “Not feeling loved” was positively associated with psychological aggression  and physical IPV . “Not feeling protected” was positively associated with physical IPV  and IPV injury . Results from the OLS model indicated that the increased report of traditional 10 ACEs and the decreased report of social support significantly predicted increased overall IPV frequency (p = 0.007). At the predictor level, men reporting a greater number of traditional ACEs were more likely to report greater levels of IPV perpetration, controlling for social support. When modeling the extended ACEs checklist with social support, this model was not significant.Men in the study reported an average of 3.5 (SD = 2.66) ACEs on the original ACEs Checklist and an average of 8.58 (SD = 4.96) ACEs on the expanded ACEs checklist See . The assMistrust of others. Half of the men in Phase I explicitly acknowledged that their mistrust of others impacted their relationships in adulthood. In Phase II, “Alterations in relationships with others” (a proxy measure for mistrust of others) was negatively associated with men’s social support , and it was positively associated with men’s perpetration of psychological aggression , physical assault , and IPV injury . Results from the OLS model indicated that together, men’s increased symptoms of “Alterations in relationships with others” and decreased social support significantly predicted higher frequency of IPV perpetration (p = 0.006). At the predictor level, men experiencing greater level of “Alterations in relationships with others” were more likely to report higher frequencies of IPV perpetration, controlling for social support.Stifling Vulnerability and Emotions. Men’s collective narrative described how they stifled their emotions to protect their vulnerability, but this led to isolation as a coping mechanism during stressful times. The survey data from the larger sample showed that the severity of the men’s trauma symptoms is negatively associated with the level of their social support , indicating that men with greater trauma may be more likely to be socially isolated. Bivariate associations in the larger sample show that men’s “Alterations in regulation of affect and impulses”  was positively associated with psychological aggression . Results from the OLS model indicated that increased symptoms of “Alterations in regulation of affect and impulses” and decreased social support together significantly predicted higher rates of IPV perpetration (p = 0.013). At the predictor level, men experiencing greater “Alterations in regulation of affect and impulses” were more likely to report a higher frequency of IPV perpetration, controlling for social support.Guilt & Shame. Men described how their guilt and shame served as a mechanism to hide their emotions and to isolate themselves. According to the bivariate analysis, men who reported greater social support were also less likely to report complex Alterations in self-perception, particularly related to guilt and shame, in the past month . In turn, men’s “Alterations in self-perception” were significantly associated with IPV psychological aggression  and injury  perpetration. Results from the OLS model indicated that increased symptoms of “Alterations in self-perception” and social support significantly predicted higher rates of IPV perpetration among men (p < 0.001). At the predictor level, men experiencing greater levels of “Alterations in self-perception” were more likely to report higher rates of IPV perpetration, when controlling for social support.Mental Health. Some men described how their mental health impacted their social and intimate relationships in the narrative analysis; the relations between social networks, mental health, and IPV were validated in the larger sample. That is, men who reported larger social networks were more likely to report positive mental health well-being . In turn, men’s self-rated mental health well-being was significantly associated with decreased psychological aggression , physical assault , and injury  perpetration. In the OLS model, men’s report of lower levels of mental health and social support significantly predicted higher rates of IPV perpetration (p = 0.022). At the predictor level, men reporting lower levels of mental health well-being were more likely to report greater levels of IPV perpetration, controlling for social support.This study employed a novel, exploratory design to identify potential factors stemming from childhood that were reinforced throughout the life course, which contributed to the relational development of BIMOC with criminal justice involvement. To our knowledge, this study is the first to explore the effects of social support on socioeconomically disadvantaged men’s IPV perpetration and adds to the growing body of literature examining the effects of ACEs and trauma on men’s IPV perpetration.Men in this study reported higher rates of childhood adversity and trauma compared to men in the general population , which aThe link between ACEs and IPV perpetration is not deterministic and must be considered in the context of other risk and protective factors. To that end, the majority of men in the qualitative sample described how the combined effect of traumatic experiences and a lack of relational support from family shaped their worldview to expect that no one would be there for them . Similar research has found that “betrayal trauma”  can have significant negative effects on an individual’s trust in others, thus impacting their future social relationships . PreviouAligning with Trauma Theory, the worldview imparted from early experiences of trauma and adversity shaped BIMOC’s relationships with others. This internal schema developed in childhood led men to use social isolation as a coping mechanism in adulthood that, in turn, adversely affected their interpersonal relationships (such as when Tyler described feeling betrayed and isolating himself as a result). We identified three underlying mechanisms that potentially reinforced men’s early worldviews and perpetuated the use of isolation as a coping strategy: namely, the mistrust of others, stifling vulnerability and emotions, and guilt and shame. This narrative was supported in the quantitative follow-up  with significant bivariate associations and OLS regression models found between each of these potential mechanisms, low social support, and increased IPV. Similarly, researchers examined maladaptive interpersonal styles, negative experiences in childhood, and core self-schemas in a study of 300 nonclinical adults . ResearAdditionally, the current study’s findings indicated that the schemas adopted by men  were associated with less social support  and increased IPV. These results align with and add to the limited body of research unpacking the underlying mechanisms of IPV perpetration. For example, LaMotte and colleagues found that mistrust of others mediated the relationship between experience of trauma and intimate partner aggression among 83 heterosexual couples . Tezel aThough the collective narrative shared by men was validated in the larger sample, the results stemming from these men’s experiences may not be transferable  or generalizable (in the quantitative paradigm) to other populations. Caution should be used when considering nonmandated clients or clients who are not of low-income or identify as BIMOC. Phase II of the study was limited in sample size and statistical power to test the associations with more advanced models that included key covariates (such as age) or a sophisticated analytic procedure such as structural equation modeling. The study aims were met given that the study was exploratory; however, further research with larger samples including clinical and nonclinical populations, and more sophisticated analyses are needed to validate the study findings. Finally, we chose to model “total IPV frequency” rather than modeling each subtype for the OLS regression models to simplify the results for interpretation and to reduce the risk of Type I error; however, from a clinical perspective, total frequency is less meaningful because there is no true “zero” because the sample is made up of men who have perpetrated at least some IPV. Emphasis of these findings should be placed on the confirmation of the relationship.Batterer interventions are an existing structure to develop social support among men. In their current form, most BIPs focus on creating honest, self-disclosing intimate relationships among men. Building from the strength of current programming, BIPs could be augmented to enhance men’s relationships with each other in a number of ways. First, practitioners should screen for social support, social isolation and mental health problems to identify high-risk clients and target resources and referrals as appropriate. As practitioners work with men at risk for IPV perpetration, they should consider the facets of the Relational Cultural Model of Development and the corresponding Relational Cultural Therapy  to builFuture qualitative studies should build upon this exploratory research, and quantitative studies should confirm narratives of men with similar early life experiences who did not perpetrate IPV to identify protective factors that may mitigate this pathway. Qualitative studies should explore existing sources and potential avenues to enhance social support  among adolescent boys and men, especially among those exposed to adversity and trauma. Given the critical context of structural racism, these studies should also explore how sociocultural experiences interact with relational health among adolescent boys identifying as Black, Indigenous, and People of Color, with varying income statuses. Quantitative studies with larger samples should test the protective effects of social support  on men’s risk of IPV perpetration. Furthermore, researchers should design studies with attention to how development may affect the relationship between men’s relational health, maladaptive coping strategies, and IPV. Finally, the moderating effect of social isolation on the relation between men’s mental and emotional health and IPV perpetration should be examined in quantitative studies with larger samples.


We used observations from those markets to examine how consumers and vendors identify and avoid or manage food safety risks and whom they hold responsible and trust when it comes to ensuring food safety. At the level of the vendor, consumers mentioned seeking “clean” or “neat” vendors or stalls. Cleanliness was primarily related to the appearance of the vendor, stall, and surroundings; reliance on trusted, known vendors was also noted. Food products themselves were largely evaluated based on visual cues: insects, holes, and colors—with some reliance on smell, also. Similarly, vendors assessed safety of food from suppliers based on a visual assessment or reliance on trusted relationships. On the second research question, both consumers and vendors largely placed responsibility for ensuring food safety on government; when asked specifically, consumers also named specific steps that vendors could take to ensure food safety. Consumers and vendors also generally felt that they could limit many food safety risks through identifying the “good” products in the market or from suppliers. The paper discusses the implications of these results for behavior change interventions.This paper uses detailed data from in-depth interviews with consumers ( Foodborne illness is estimated to be responsible for a disease burden comparable to malaria, contributing to about half a million deaths annually , particuIndeed, food safety risks are widespread in Nigeria, including through contamination, adulteration, misbranding, illegal trading, inadequate export and import controls, and no or inappropriate training of food handlers ,13. A reIn high-income countries, food safety risks are usually managed by actors throughout the supply chain, with considerable oversight from governmental food safety system functions such as permitting, inspections, and detection of and response to illness outbreaks ,16. MostIn the absence of functioning control systems, mitigation of food safety risk falls to supply chain actors such as vendors and to consumers. Indeed, studies elsewhere have documented that consumers and vendors have strategies they use to mitigate food safety risks, such as buying from trusted sources ,20. MostDesigning appropriate behavior change approaches to reduce food safety risk, however, requires understanding what strategies people already use—to build upon them where helpful and correct them where not ,22. ThisHow do consumers and vendors identify and avoid or manage food safety risks in a market setting?Whom do vendors and consumers hold responsible and trust when it comes to ensuring food safety in market settings? The research questions are:The results are discussed in the context of prior research on similar topics in other settings, to draw implications for the design of behavior change interventions focusing on food safety in markets in Nigeria and other LMICs. A companion paper  examinedThis study used an adapted Focused Ethnographic Study (FES) approach ,29, whicFieldwork, conducted by trained local interviewers in February–May 2021, consisted of in-person interviews with consumers and vendors as well as a structured observation in each market. Respondents were recruited through market visits. To be eligible, consumers needed to shop in at least one target market, at least once a month, and have primary or shared responsibility for purchasing food for their household. Quotas were set for the following consumer characteristics: men, women, those under age 30, those over age 30. Vendors needed to sell at least one focus food in a target market at least once a month. In Phase 1, three vendors each for beef, fish, and GLV were chosen (as these foods were thought to have the highest associated food safety risk) and one vendor each for soybean, maize, rice, and cowpea was interviewed. In Phase 2, based on priorities identified in Phase 1, only GLV and fish vendors were interviewed (12 of each). The sample size for consumers was 16 in Phase 1 and 31 in Phase 2; for vendors, it was 13 and 24, respectively. The research followed standard ethical procedures, as well as local COVID-19 protocols, and all participants provided signed informed consent. Interviews were audio recorded in Hausa, then transcribed and translated into English. Quantitative data were analyzed in Excel and Stata SE15, while transcripts were analyzed through hand-coding or using the qualitative data software ATLAS.ti. All quotations in the text are presented verbatim, aside from small corrections to typos and punctuation, and annotated with a de-identified code for the respondent.Demographic information for the consumers and vendors is given in Though the methods originally called for interviewing both female and male vendors, no eligible female vendors were identified for the majority of the foods studied. Interviewed vendors are thus all men. The typical vendor is around age 40 and a Hausa Muslim who may have completed primary school but likely is not educated at a higher level. About a third of vendors sold foods in addition to the ‘focus foods’, in particular, grain/legume vendors tended to sell multiple types of grains/legumes and GLV vendors often sold other vegetables. The observations revealed numerous challenges in keeping food safe within a market setting . All thrAs noted in , interviThe main actions consumers took to ensure they acquired safe food began at the step of choosing a vendor within a market. While some did mention cleanliness as playing a role in the initial choice of deciding which market to visit, market choice was driven by other factors: prices, breadth of products, convenient location, and habit. Once choosing a vendor, however, more than half of consumers noted criteria related to food safety—namely, cleanliness—as being one factor considered. This was particularly true in the second phase of the study, when questions on vendor choice appeared after those discussing food safety as a health issue, suggesting some effect of framing. some of them look dirty and you won’t like to interact with such a person, so you go to another person. Some are neat but their goods are pricey… things are expensive, but one will still want a seller that you trust will not cheat you.–C1207, a 31-year-old female consumerI have one to two vendors that I buy things from, [emphasis added]there are products I buy from other people because of their hygienic level.–C1209, a 40-year-old male consumerThere are people who are more hygienic than the others. There are some products I buy from my vendor, and [emphasis added]Men were particularly likely to mention cleanliness as a factor. The main things that respondents mentioned regarding vendor and shop cleanliness were: cleanliness of the table ; neatness of the table or wares ; cleanliness of the vendor; cleanliness of the surroundings; cleanliness of the food ; presence of insects; and proper food handling. A few also mentioned goods being covered or stored in containers or not being stored on the ground, one noted lack of a smell, and another noted good flooring.[At the market], the only thing I look out for is when the place is clean. When the place is neat and very attractive, I’ll get what I want to get. If the environment and shop is unkempt, sometimes I doubt things from them, but it is clean and neat, I get things from there…. The person too should be clean… The outfits, and the neatness of the person, the personal hygiene of the person: you don’t go and meet with the person… [if he] looks as if he is from a mechanic workshop.–C2201, a 25-year-old male consumer how he [the vendor] handles those stands, does he normally sweep… does he wash those bowls that he’s using …there are some people even the bowl will be up to 100 years, they will not wash it! They don’t mind how it’s being taken care of, what they are concerned about is money, how they will get money. So I’m being concerned about those things.–C2210, a 35-year-old female consumerSome of them [the vendors], this spinach when they bring it, they just keep it on the ground and that ground is not a clean environment… when they keep it on the ground people step on it and also the ground it dirty, after picking it they will not wash it they will just pick it and put it on top of the table, so that spinach has already be contaminated with disease on the ground.–C2211, a 40-year-old female consumerIntegrated with the choice of a vendor was the choice of a specific food product. As food safety issues and food traits vary widely across food types, this was examined through the specific focus foods, with a focus on beef, GLV, and fish . Most rSometimes you get good ones, and sometimes you get bad ones. Every day is not Sallah [Eid al-Fitr] or Christmas day. That’s a market for you.–C2204, a 40-year-old female consumerFor cowpea, the food for which consumers had the most food safety concern, weevils were detected through physical damage and contamination (holes and weevils being visibly present), while chemicals were detected via a bad smell.Sometimes when I go to the market to buy beans [cowpea] and I noticed the beans has many holes on it or weevils, I don’t buy it. I prefer to buy something good…. I think when one buys beans that are weevil infested, it is very possible that after eating, it will cause one to be stooling. [Also] when I notice the chemicals in beans is too much, I don’t buy it. Because when the chemical is too much, it has bad effect on the beans.–C1205, a 53-year-old male consumerFor rice, consumers were worried about the presence of stones in local rice varieties . These were hard to detect visibly at the point of purchase, so customers instead reported using trusted vendors and/or buying foreign industrially processed rice, which was thought to be free of stones.I have one [vendor], I always prefer buying rice from him because he is also very honest. Anytime I want to buy ‘stone free’ rice, he has always given me the assurance that what he will give me has no stones…. So, once I get home, I will be expecting to hear complaints about the rice after cooking it, like the normal complaints when I buy rice that has stones, but to my surprise, no one will have anything bad to say about the rice.–C1211, a 38-year-old male consumerFor maize and soybean, concerns over food safety were very limited, and respondents noted that they took no steps to avoid unsafe versions. In contrast, beef was associated with food safety issues by many consumers—second only to cowpea as a cause of concern. However, most consumers felt that they could make decisions to avoid unsafe beef. In general, consumers felt beef was safest when purchased raw and cooked at home, so that one could control the cooking process and avoid contamination during or after. Signs noted for recognizing unsafe beef (in descending order of frequency of mention) included the color ; bad smell; presence of flies at the purchase point/on the meat; presence of dust; unclean vendor; type of tables used or their cleanliness; use of an official abattoir; and taste. Two consumers noted that keeping meat packaged in plastic for a long time could lead it to spoil, and a couple respondents noted that the use of trusted vendors would help them to avoid unsafe beef. Yes, and when I noticed a food vendor is very neat, and always drives away dust from his meat, then it shows that the meat will be good…. I will take a good look at the meat seller to know if he is neat, and I will also look at the environment, then the way the meat is being displayed. I take note of all that. But if it happens that I send someone to get it, I will not know anything much, and we may end up just cooking it. Like I said earlier, if I buy from those I trust, I have nothing to worry about.–C1205, a 53-year-old male consumerFish commonly available in Birnin Kebbi include fresh tilapia, mackerel, and catfish, as well as smaller dried fish and fried ready-to-eat fish. For Phase 1 of the study, discussions of fish focused on catfish, which is sold alive and reported to be the most commonly purchased fish. In Phase 2, the discussion broadened to also include fresh tilapia, but this was not very commonly purchased. Fish were associated with a moderate amount of food safety concern in the minds of consumers: considerably less than cowpea or beef, but somewhat more than rice. Of those consumers (approximately 40%) with no concern, several reported fish to be safe because they were “healthy” foods recommended by health personnel for other reasons: “No, I don’t think this fish can harm anyone,” one female consumer explained, “because it is a body-building food and helps prevent heart disease” . However, some respondents noted safety concerns associated with fish: spoilage over time, worms, being ill or dead before sale, and chemicals being used in raising or catching fish. Three-quarters of interviewed consumers felt they could recognize safe fish in the market through various signs (in descending order of frequency of mention): alive or moving fast, the color, the texture (not being sticky or slippery), other aspects of the fish’s appearance , appearance of the vendor and sale environment, taste, and smell. One respondent also mentioned avoiding vendors and buying fish directly from fishermen or fish farmers. When I am buying fish, I take note of how they react inside the water. If they move very fast and are lively inside the water, it means such a fish is healthy. But when you notice a very dull fish in the water, it shows that fish is sick, and I don’t go for that fish. And to know a harmful or dead fish even when they have already cut it, there is a foam-like whitish substance that comes out of the mouth. So, when I noticed such, I don’t allow them to sell it to me. There are things I am very careful to note when buying fish.–C1211, a 38-year-old male consumerSome of the fresh fish, when you look at the rubber the fish were inside, the water will be dirty. Some of the vendors keep their fish in rubber with water that is clean. You will see the fish swimming about. Then I select the one that I want. And then the table the vendors use in cutting the fish, some of the vendors will use it to cut their fish and flies will be swarming on the table. While some of the vendors, if they use their table, they make sure that they clean the table. You will not know if they use the table or not. Because it will be clean.–C2212, a 30-year-old female consumerIt was generally noted that fresh fish were the safest form. Dried and fried fish were seen as riskier, due to contamination  after cooking/drying, unsafe cooking practices , or because the cooking/drying made it hard to determine the fish’s original type and quality.Overall, consumers had a moderate level of concern about food safety of GLV, more than fish but less than beef or cowpea. The concerns most commonly mentioned were specifically related to insects or chemicals, with less common mention of washing with unclean water, spoilage, and dirt. Women were particularly likely to note safety concerns related to GLV. All consumers who had concerns about unsafe GLV felt they could recognize which were safe. The main ways of recognizing safe GLV were all based on visual signs: no insect damage (holes) or visible worms/insects, color (green as opposed to yellow or red), otherwise looking ‘fresh’, and not being visibly dirty. A few consumers noted that leaves should be kept fresh with water (without specifying clean water), and two noted that large leaves indicated fertilizer use (and were thus a bad sign). A few respondents noted that using a trusted vendor was a way to avoid unhealthy GLV. While visual signals were widely used, their interpretation differed some across consumers.If the vegetable looks good, I will buy it, but if it has patches of holes and insect bites, I won’t buy it. And also the ways I know if they are good or not is from the color: if it is very greenish, then it is good, but if it looks yellowish, then it is bad.–C1205, a 53-year-old male consumerCheck if it has holes or not, the size of the leaf, if it is too big it means it has a lot of fertilizer, so it means it doesn’t have the nutrients required… the more attractive it looks, the more problems it has because it means it has a lot of fertilizers.–C2216, a 50-year-old female consumerWhen the leaf is red in color, the vegetable is bad, but when it is green and fresh it is good. The reason why it turns out to be reddish in color could be as a result of the fertilizers applied…. I can’t really say if the red vegetables can cause harm, but it is better to go for the fresh ones.–C1202, a 24-year-old female consumerIn Phase 1, when cleanliness was not explicitly mentioned by the interviewer, only one consumer noted that it was important to have a clean vending environment for GLV, but when asked directly in Phase 2, many consumers noted paying attention to the cleanliness of the environment and/or vendor, or their hygiene-related practices. Markers that were considered included: the vegetables themselves being clean or washed, well-arranged, covered, or not on the ground; the vendor being clean (including his/her clothes); and the table or setting being clean.  check the neatness of the environment and the person you’re buying from… The table that they put the vegetables [needs] to be clean, and they should use a sack to cover the vegetables; at least they should cover it from all the dust that carries all these diseases, and it will maintain the green leaves from morning till evening.–C2211, a 40-year-old female consumer[One] should look at how well arranged the table is: they should not just join lettuce and spinach and moringa in one place, the moringa should be in its own place, the lettuce, and the remaining vegetables.–C2202, a 31-year-old male consumerConsumers also noted that cooked vegetables were generally safer than those eaten raw, and one noted specifically avoiding any that had been pre-cut or prepared in the market, as they were likely to cause diarrhea.For GLV, fish, and beef, possible coping mechanisms for potentially unsafe food were examined—i.e., if the respondent bought the food at the market and worried it might be unsafe, was there anything they could do to it at home that might make it safer? About a quarter of respondents felt there was nothing that they could do—they would just throw it out after purchase . Among the majority who felt they did have coping strategies for unsafe foods, those named included  washing with water, washing with salt, boiling (sometimes including discarding the water and re-boiling), and (for beef) cooking with certain seasonings. Two noted washing GLV and/or fish with vinegar and one noted washing GLV with commercial “vegetable wash” products.For me, I normally use salt to rinse the beef before boiling it. I rinse it like 2 to 3 times. After rinsing it, I add Maggi seasoning, curry, thyme, etc., to reduce the smell of the meat, if it has any, and that’s it, it becomes safe.–C1216, a 28-year-old female consumer…there’s a way a mother can put in place to reduce the risk of diarrhea, that is, by proper washing of vegetables and fruits. When you buy beef from the market, the first thing when you come back is to wash using vinegar.… it kills unseen germs, that’s what vinegar is used for; in a place where there is no vinegar, you use salt.…–C2210, a 35-year-old female consumerIn general, women appeared more likely to name different strategies for coping with unsafe foods than men. While coping mechanisms for unsafe grains/legumes were not examined in detail, respondents noted various home-based practices, such as carefully washing rice to remove stones, freezing cowpea to kill weevils, and cooking beans/rice with potash. When asked about ways to prevent diarrhea or foodborne illness , participants noted washing food (5 of 31 consumers), avoiding particular foods or eating less of them (3), buying from a clean shop/vendor (3), handwashing or personal hygiene (2), cooking food well (2), and covering food (1).Most consumers mentioned having previously heard information or advice about food safety. The main sources mentioned were friends or neighbors (10 out of 14 people), parents (4) and other relatives (6), radio (6), television (5), and doctors or health workers (5). Less commonly cited sources included district government officials, text messages, and women’s organizations. Men generally named more information sources than women and were more likely to name friends/neighbors and radio, whereas women were more likely to mention parents. When asked to whom they would turn for advice on food safety issues, relatives were most commonly named, followed by doctors and health workers, friends/neighbors, and market or environmental officials. Nearly all households had TVs and mobile phones, whereas only about half had radios; radio was thus a comparatively commonly cited information source, whereas mobile phone messaging was rarely cited, despite widespread phone ownership. Messages heard by more than one person included the importance of washing food before preparing, having a clean setting for cooking/food preparation, avoiding chemicals, washing hands or pots, and avoiding unclean food or water. Consumers often expressed limited confidence in the information they had heard.…on radio and television, they usually talk about food hygiene, environmental cleanliness, and the need for pregnant women to always eat body-building food… I also get informed from friends, but one cannot verify the information, if it is true or false. We only accept it as it is…. There was a time I was told that there are beans with chemicals that can cause harm to the body. When I heard about it, I stopped buying beans so as not to fall a victim.–C1205, a 53-year-old male consumerI heard that eating unhealthy fish can cause bodily harm on a radio show. They informed us that eating an unhealthy fish will make one fall sick. But I don’t even know how to identify unhealthy fish, so all that we are discussion here now is just my personal thoughts…I may be wrong please, so you don’t say I’m misleading you.–C1214, a 30-year-old manCowpea. The cowpea vendor interviewed generally aligned with the interviewed consumers in terms of how he would identify safe cowpea, but with more detailed techniques: absence of weevils was detected by lack of holes and visible weevils/eggs; it was also noted that cowpea infested with weevils would be warm to the touch, indicating it was unsafe. Chemicals were detected by smell—as a cowpea vendor noted, “nobody will come to buy beans without smelling it” . Avoidance was also a strategy used:Yes, [consumers complain about] beans [cowpea], once they discover it has pests, they complain. Me, I hardly [ever] buy beans that have pests, I prefer not having [them] than to have the ones that has pests. So, they complain about that.–V1110, a 38-year-old grain and legume vendorRice. As for consumers, the main issue vendors noted in connection with rice was the presence of stones. Consumers were said to ask about and look to see this when deciding whether to buy. To determine quality/safety, rice was inspected to be clean, free of chaff, and free of stones. Maize. For maize, vendors had fairly little concern about quality or safety issues (as in the consumer interviews); three vendors specifically noted that maize was safe because no chemicals were used on it. The main issues that were named were dirt and remainders of the cob left in. Detection of such issues was also visual and entailed ensuring a strong unbroken bag, no visible dirt, and it being dry. No respondents mentioned aflatoxins. Soybean. Soybeans were also not a main source of vendor concern related to quality and safety; indeed, it was noted that they were less prone to pests than cowpea, which was an advantage to selling them even though they had a fairly small market. In addition to stones, vendors noted unripe or spoiled beans, and dirt or sand. [Consumers’ second-most-common complaint is] sorghum that has stones, and soybeans…. When I get complaints like that … what I do is after coming back from where I buy, outside Kebbi, we get laborers to select the stones out of the grains…. I will tell [customers] I am sorry; it is something that will not happen again, and that you are trying your best to bring something good for sale in the market.–V1110, a 38-year-old grain and legume vendorFor beef, problems identified were sick animals, spoilage , use of animal medications, and presence of dirt or flies on the meat. Quality/safety of meat was usually determined by visual inspection: to see that it had a good color  and was not too bloody. A firm texture and lack of odor were also noted, as was asking the supplier if the animal was healthy. Unlike for the other focus foods, two beef vendors noted the importance of a clean sale environment and vendor in communicating safety/quality and encouraging customers to purchase. If you discover that the meat looks soft, honestly the meat is not safe to eat. But if the meat looks high quality…just take a look at that meat, is there any way you can say that you didn’t enjoy the meat? Is there a way they will give you this meat and you will say you didn’t enjoy eating it? You will enjoy it because you know the quality… But if the animal is sick…it will look like this…not attractive.–V1105, a 35-year-old beef vendorMeat with dirt is not healthy … because the business requires neatness. From where we buy up to where we sell, needs to be clean. It’s not healthy if the color changes: maybe it’s left-over meat and the person did not take good care of the meat, the color will be kind of dark.–V1112, a 25-year-old beef vendorVendors of fresh products (as opposed to grains/legumes) generally construed food safety in general terms as related to “freshness”. Risk appeared to be assessed along a continuum of freshness, with the problem of safety arising only at the outer extreme; at intermediate stages, declining quality or freshness was more of a business concern to vendors than a food safety issue per se. To explore this, we engaged Phase 2 vendors in an exercise intended to identify commonly recognized points along a food quality continuum, focusing in depth on two foods: fish and GLV. Vendors were presented with a board divided into four sections, representing levels of food quality . Vendors were asked to describe signs that would be evident in fish or GLV at each of the four levels, and these data were synthesized to create a continuum of commonly recognized signs of quality for each focus food . SeveralWhile vendors could sell some foods that were not fully fresh, once food became unsafe, vendors’ only recourse was to dispose of it. Fish and especially GLV vendors thus considered themselves to be on a “ticking clock” from the moment they received their product from suppliers: without access to refrigeration, the transition from peak freshness to unsalable product can occur within a day or even hours. GLV in particular begins its decline within minutes of harvest. The risk of being left holding product that is less-than-fresh (even inedible) was a preoccupation for vendors. There are challenges we face from this business. An example is, when every fish you have is dead, you will end up selling them for even less than you bought them. People love buying fish that are killed in their presence. But when you have fish that are already dead, you will have to convince someone to buy the fish and give the person confidence that the fish is still in good condition.–V2115, a 40-year-old fish vendorSeriously, I really used to make a profit in this business, and I’m proud of the business I am into. But there are times you enjoy the business—that is when you sell and make profit—and times you will not want to do this business, especially during heat. It’s hard to maintain the freshness of the vegetables because of the hotness of the weather.–V2121, a 25-year-old GLV vendorTo slow the decline in quality, vendors drew on a limited repertoire of actions. Fish vendors ensured that the fish’s water was changed regularly and that they were protected from the sun during transport; few described other actions . GLV vendors described cutting the roots from fresh greens after they received them from suppliers, washing any sand from the leaves, covering them with a sack to protect them from drying winds and sun, and periodically sprinkling with water to keep their appearance fresh. The choice of suppliers could also play a role in mitigating potential safety or quality issues. Vendors noted both using preferred, trusted suppliers and “shopping around” in a wholesale market to find the best quality-price combination. The main driver of choice named when it came to choosing a supplier was high-quality products, followed by affordable prices and the ability to buy on credit. Two vendors mentioned seeking a trustworthy or honest supplier, which was also described in terms of having a quality product and being truthful about it and being honest in pricing. What is important to consider during business is that I look for a healthy animal, that I won’t be doubting when buying it. And, again, if I come to where to sell it, I will still check if the animal is healthy before slaughtering it, because if it’s not healthy, then there will be plenty of trouble, and I don’t want that.–V1112, a 25-year-old beef vendorIf I know my fish is not healthy or good, I worry that customers will not use it and [will] start complaining. If I see any sign of fish that has a problem, I do not buy… I prefer not to buy to harming shoppers.–V1111, a 55-year-old fish vendorVendors generally felt comfortable discussing quality issues with suppliers and trusted that suppliers would be honest in their reports on food quality, or that it would be clear from a visual inspection. Fish and beef vendors in particular noted that they would search for healthy animals and inquire about that from the supplier. The main reported reaction to a poor-quality product was simply to not buy it and leave the market empty handed or, if the problem was discovered after purchase, to not patronize that supplier again. If I discover that the meat is not good for consumption, I will not buy it… I choose good meat so that I will be able to sell good meat to my customers, so that they will visit me again. I would not like to sell bad meat to my customers. It will scare them away, and they will not come back to me again tomorrow… There are people who [buy potentially harmful meat], but I don’t.–V1105, a 35-year-old beef vendorAsked to consider who ought to be taking charge of food safety, most vendors (8 of 13) proposed some arm of government, including health personnel and city officials. Other suggestions included market leaders and suppliers. Only two vendors initially noted that some responsibility rests with vendors themselves, but following prompts from the interviewer, five vendors acknowledged that vendors could also play a role. Similarly, most consumers  referred to the government, and five more specifically mentioned health officials. Beyond government, consumers interviewed mentioned market management/officials (3 of 16 respondents), vendors (3), suppliers/farmers (3), consumers themselves (2), security officers (1), and traditional leaders (1).Only some consumers thus held vendors responsible for ensuring food was safe. While most consumers opined that the food they were getting from vendors was safe, most also felt that, were a vendor to be in possession of unsafe food, he/she would be unlikely to tell potential customers. Consumers recognized two sources of risks associated with vendors: some vendors were dishonest and would knowingly prioritize profits over quality/safety; others were simply unaware.As noted on the subject of avoiding unsafe food, some consumers seemed to feel a lack of agency when selecting a vendor who could guarantee safe food:Well, they [vendors] can sell anything they like, because we are not the sellers, we only buy from them. You know a vendor will never bring beef to the market and say the beef he has for sale is unsafe. They can only say it is good… They can’t tell, since they’re in a business, everyone wants to sell their products, so they will never tell the consumer if anything is wrong with it.–C1201, a 30-year-old female consumerWell, I don’t think they [vendors] know [whether the fish they are selling is safe]. They don’t because most that sells fish, they are…permit me to use the word, illiterates. And their eyes are closed. Their own is just for them to look for money. So, they don’t care if it is safe or unsafe for the consumers.–C1209, a 40-year-old male consumerSometimes you get good ones, sometimes you get not-too-good ones. For example, old [beef] stock that has been kept in the fridge overnight and brought out in the morning to be sold as fresh beef. Very bad. The same with killing of sick animals. The sickly animals are slaughtered because the meat sellers want to make money while no one is considering the people that will buy it to eat.–C2204, a 40-year-old female consumerAsked what vendors could do to reduce food safety risks, consumer respondents generally noted specific actions like washing or covering food, using fewer chemicals, not storing food on the ground, sourcing high-quality products, or keeping themselves and/or their selling environment clean. Additionally, involved authorities were named (particularly to undertake inspections), engaging the vendors’ union, providing training, having certified vendors, having a complaints/reporting mechanism for vendors who sell unsafe food, and/or promoting cleanliness. Three respondents also noted the need to provide refrigeration.If they [vendors] can reduce the way the flies perch on the vegetables it will be very good… Because you don’t know where the flies had perched, and they will stay on the vegetables and people will come and buy…. They should make sure the place is not smelly and it is clean.–C2201, a 25-year-old male consumerVendors should by all means make sure they slaughter the animals [cows] themselves. Just like they do in other developed countries, the government should make sure there are teams of inspectors who inspect the abattoir daily to make sure what they are selling is safe for consumption.–C1209, a 40-year-old male consumerThis paper used detailed data from interviews with consumers and vendors in three traditional markets in Birnin Kebbi, Nigeria, as well as observations from those markets, to examine how consumers and vendors identify and avoid or manage food safety risks and whom they hold responsible and trust when it comes to ensuring food safety. The research provided novel insights into consumer and vendor decision-making in a context where food sold in local markets cannot be assumed to be safe. Considering the first question, consumers deployed two main strategies to decrease the risk of purchasing unsafe food: choosing the right vendor and choosing the right food. As noted in a study in Vietnam, the choice of market was largely not influenced by food safety concerns, and was instead routinized . At the Comparing to existing guidance on best practices for food safety in traditional markets , some elReliance on trusted, known vendors was also noted, particularly for goods for which quality was difficult to determine via inspection, like stone-free rice. This aligns to findings from Vietnam ,38, GhanFor food products themselves, these were largely evaluated based on visual cues: insects, holes, and colors, with some reliance on smell, also. Similarly, vendors assessed safety of food from suppliers based on a visual assessment or reliance on trusted relationships. While research in Kenya has found vendors to have different food safety perceptions than consumers , here thTurning to the second research question, both consumers and vendors largely placed responsibility for ensuring food safety on government. Nigeria has adopted multiple food safety-related policies covering multiple stages of both domestic and export value chains . The maiThe lack of perceived mutual accountability also somewhat contrasts with strong agency in other areas of perceived risk control. With some exceptions, consumers and vendors generally felt that they could limit many food safety risks through identifying the “good” products in the market or from suppliers and, in the case of consumers, mitigating risk through in-home practices. This was in some contrast to consumers’ views on vendors: a significant share of consumers felt they had little ability to ensure the veracity of a vendor’s claims and might well be being sold unsafe or poor-quality products—similar to findings for street food sellers in Ghana . VendorsThe study had certain limitations. The research focused primarily on seven foods; while these span food groups and represent many foods commonly eaten in Nigeria, some  are omitted. The sample was small and not fully representative of the local population. In particular, no female vendors were identified as eligible for interviewing, and the consumer sample was relatively affluent and well-educated, compared to the average for urban Nigeria. The study results would thus benefit from being examined additionally through larger-sample, survey-type research.We conclude by drawing on the study results to offer suggestions for improving food safety in Nigerian markets. Given that, for consumers, food safety was most relevant when it came to selecting a vendor (as opposed to a market), leveraging consumer demand to improve vendors’ food safety behavior is promising. This could be done, for example, through a “clean vendor” certification approach . To be There may also be a role for educating consumers on signs that vendors are following “best practices” for market food safety, as several of these were never mentioned. Vendors and consumers will likely be more responsive to interventions that focus on issues of freshness and quality, rather than food safety per se: both consumers and vendors tend to speak of quality/freshness and safety somewhat interchangeably, or as occurring along a continuum. For vendors of perishable foods, their key challenge is how to obtain a profit for goods that are losing value with each hour. They are likely to see value in any intervention that can change the equation, whether on the supply side through improving transport or storage conditions, or on the demand side, for instance by using new approaches to expand customer reach. For consumers, freshness is already valued, and building on that with a more in-depth understanding of spoilage, contamination, and their consequences could help ensure a closer correlation between the types of cues they use to make decisions on food safety and actual markers of food safety risk.Both consumers and vendors placed primary responsibility for ensuring food safety on the government. As noted above, however, there are various weaknesses in existing Nigerian food safety policy and enforcement. Based on prior analyses ,18, key In summary, this study has made it clear that vendors and consumers in Birnin Kebbi deploy a range of strategies to detect and mitigate potential food safety risks. While some of these do not align with scientific evidence on causes of food safety risk, many do, and they constitute a solid foundation of techniques to build upon with future interventions. At the same time, consumers and vendors largely place responsibility for food safety on government, not themselves, and have conflicting views of their personal agency in ensuring safe food. Interventions will thus need to focus not only on practical steps that can be taken to reduce food safety risk, but also on convincing vendors and consumers of the need, and their ability, to act to increase mutual accountability across food system actors.


In our PNAS article “Stewardship of global collective behavior” , we descIn their letter , Cheong But it’s not clear what this would entail by way of practical, safe, ethical, and effective intervention. Have there ever been successful, voluntary, large-scale reductions in the scale of any aspect of human social life?Nor is there reason to believe that an arbitrary, hasty, and heuristically decided large-scale restructuring of our social networks would reduce the long tail of existential risk. Rather, rapid shocks to complex systems are a canonical source of cascading failure . Moving Nor do we share the authors’ optimism about what scientists can accomplish with “a collective chorus … through every digital channel” . It is dOur views do align when it comes to the “now-or-never urgency” that Cheong and Jones  highlighAs scholars, our job is to call attention to underappreciated threats and to provide the knowledge base for informed decision-making. Academics do not—and should not—engage in large-scale social engineering. Our grounded view of what science can and should do in a crisis must not be mistaken for lassitude or unconcern. Worldwide, the unprecedented restructuring of human communication is having an enormous impact on issues of social choice, often to our detriment. Our paper is intended to raise the alarm. Providing the definitive solution will be a task for a much broader community of scientists, policy makers, technologists, ethicists, and other voices from around the globe.


Models based on the uniqueness of addiction processes between behavioral addictions are highly contentious, and the inclusion of gaming disorder in the addiction nosography remains controversial. An exploratory approach could clarify a hypothesized common and subjectively identifiable process in addictive behaviors and the necessarily different expressions of the disorder due to behavior specificities, in particular the sociocultural characteristics and profiles of users.The aim of this study was to describe the nature of contacts to a help service by exploring commonality and specificities of burden and help-seeking for problem gambling or gaming.This was an observational quantitative-qualitative study. We included all contacts  to a helpline for gamers, gamblers, and relatives over a 7-year period. We constituted a text corpus with online questions and summaries of contacts by phone or chat. We collected basic sociodemographic data, including the device used to contact the service (phone or internet), contacting the service for oneself (“user”) or being a relative of a user and type of relative, gambling (yes/no), gaming (yes/no), and age and sex of the gambler/gamer. We describe the corpus descriptively and report the computerized qualitative analysis of online questions, chat, and summary of phone calls. We performed a descendant hierarchical analysis on the data.A total of 14,564 contacts were made to the helpline, including 10,017 users and 4547 relatives. The corpus was composed of six classes: (1) gaming specificities, (2) shared psychological distress and negative emotions, (3) the procedure for being banned from gambling, (4) the provided help, (5) gambling specificities, and (6) financial problems.Negative emotions and shared distress linked to gambling and gaming support current scientific consensus that these behaviors can produce psychological distress in se; however, meaningful differences were observed in core symptoms of addiction between gamers and gamblers, beyond specificities related to the behavior itself: loss of control was elicited in the class corresponding to gambling specificities and not by gamers and their relatives. The International Classification of Diseases (ICD)-11 recognizes two behavioral addictions , which pBeyond these models based on the uniqueness of addictive disorders, comparisons between addictive behaviors in the same study are scarce. Furthermore, the literature lacks a clear picture of the differences between potential addictive behaviors, particularly in the representation of the behavior itself, the associated disorder, and the inner experience and perception of the disorder by users and their relatives. Few studies have made comparisons between gaming and gambling. A previous qualitative study found significant overlap in the experience of people living with a substance use problem and a behavioral addiction/problem . HoweverThese differences in profiles support the biopsychosocial model in addictions , where aThe treatment gap is considerable in behavioral addictions, with fewer than 12% of pathological gamblers seeking help from a health professional . The epiWe performed a quantitative-qualitative analysis of all contacts to a nonface-to-face help service over 7 years. All contactors voluntarily called or wrote to the help service asking for help or counseling regarding gaming or gambling. No diagnostic or screening assessment was performed or required to access the help service. Our aim was to explore, without a priori assumptions, the burden of gaming and gambling cited by contacts to a help service by phone and internet. Our hypothesis was that we would find both commonalities and specificities in the burden linked to gaming and gambling problems from the perspectives of users and their relatives.We report the computerized qualitative analysis of all contacts to a public national help service in France for gamers, gamblers, and their relatives since its creation in 2010 until 2018. This governmental help service, “Joueurs Info Service,” is part of a global plan for information and prevention on alcohol, substance, gaming, and gambling addictive behaviors. This is a national remote help service for gambling, gaming, and other addictions, and is also in charge of listing, updating, and making available to the public the national directory of specialized addiction structures. “Joueurs Info Service” is based on the rules of anonymity, confidentiality, neutrality, and nonjudgment in its missions of information, advice, support, and guidance of the public. Helpers are trained psychologists specialized in addictive behaviors. They empathically and actively listen to contactors and can refer them to another health facility if appropriate following their own clinical judgment. Summaries are written for phone calls and chats with helpers. These summaries do not follow a particular plan, and the level of detail and content of the summary is left to the discretion of the helpers, although they are encouraged to document the contact as exhaustively as possible. A single number and website for “Jeu Info Service”  allows gamers, gamblers, and their relatives to talk to professional helpers by phone, chat, or written question with delayed answers. The same helpers respond to gambling and gaming contacts. We included all contacts from users and their relatives to the help service by phone when the helper completed a summary and online  when the helper considered contacts to be in the scope of the help service . Nonincluded contacts were categorized by helpers as not within the scope of the helpline and were most commonly prank calls and errors . Included contacts were then people reporting having a problem with gambling, gaming, or a relative’s gaming or gambling behavior, and seeking help or counseling.The merged corpus was composed of summaries of calls and chat discussions written by helpers, and the content of questions written directly by contactors. In the manuscript, the word “user” will designate both gamblers and gamers. Basic sociodemographic data were collected, including the device used to contact the service (phone or internet), contacting the service for oneself (“user”) or being a relative of a user and the type of relative, gambling (yes/no), gaming (yes/no), age of the gambler/gamer, age category , and sex of the gambler/gamer.A content text analysis was performed on the corpus using the open-source automated analysis software Iramuteq  according to the Reinart method , which i2χ tests. Significant forms and variables are presented (P<.01). Given the size of the corpus, we chose to present only forms and variables with 2χ>100 within a class. This automated text-mining approach generates similar themes to traditional qualitative content analysis, and is thus considered to be a reliable text analysis , as they think that he feels lonely” (sister of a gambler via phone contact).Feelings of powerlessness of the user expressed by relatives/life partners:“Her husband gambles. When she tries to talk about it, he gets into a terrible rage” .“She is very angry with her sister-in-law because she gave money to help her and she doesn’t seem to care” .“The father wants to hit him and restrains himself [since he stole money for video games], the mother is angry and feels hatred toward him, they don’t understand what’s happening” .Negative emotion and psychological distress expressed by users:“He feels empty and feels like he’s lost years just gaming and hasn’t grown up” .“This young woman is very concerned about normality and shows a strong feeling of guilt and shame” .“She’s aware that if she thinks she is [addicted to video games], there’s suffering behind it. She can’t figure out why she’s feeling bad” .“He feels difficulty in relating to others, inhibition, shame, and guilt about not being able to take part in a discussion. He played video games for 4 years, cutting himself off from others, now feels out of step, with concentration difficulties [...], depressed” .“She feels lonely and isolated, the gambling, for the last year, fills her loneliness” .2χ=84.8, P<.001): “His life partner has no trust in him” . Anger was also present in this class , manifested both by users and relatives, and characterizes communication and the relationship between users and their relatives as the outcome of lack of trust and powerlessness : “He has questions about gambling ban” .This class was elicited by gamblers : “I support and refer this user toward the clinical outpatient center […] because he says he bets more and more on horse races with less and less control” .The class related to provided help was mostly elicited in contacts with users themselves . The words “adrenalin,” “[not being able to] stop,” “can’t,” “control,” “desire to make money,” and “chasing” were significantly associated to this class and reflect symptoms of gambling disorder, especially the core symptom of addiction that is loss of control, and gambling expectations focused on excitement and making money. This class was mostly elicited by gamblers .“He can’t get over the money he’s lost and keeps chasing losses” .“He realizes that he is losing control. He is looking for the desire to make money but also the excitement of the risk of losing” .“He explains very well what gambling provides: adrenalin, feeling of being surrounded” .“Keeps chasing losses, and that’s all he thinks about all the time. He’s fed up and wants to stop” .“I'm exhausted, I've spent all my savings on gambling and I can’t stop it's stronger than me... please help me...” .The words “win” and “lose” were also significantly associated to this class, along with words related to the gambling practice in itself .2χ=887.3, P<.001) and barely in gambling , especially life partners : “The women is calling about her brother, who she just discovered has a casino addiction and a huge debt. The family is in shock” . Critical financial situations and debts due to gambling were reported repeatedly along with suicidal thoughts: “says he has so many debts [due to gambling] that he feels there is no other solution than suicide” .This class was more strongly elicited by relatives than by users themselves .2χ values (>100) between forms and the classes, and between the passive independent variables and the classes .Our quantitative-qualitative explorative study allowed for exploration without any a priori burdens linked to gaming and gambling in a large and exhaustive sample of contacts to a help service by phone or online. As hypothesized, some classes grouped both gaming and gambling, but others illustrated their specificities, both for the profiles of users and for core clinical symptoms.Negative emotions described in class 2 regarded gaming and gambling for users and relatives. This class highlights that users or relatives of gamers and gamblers can experience psychological distress related to these behaviors. Current American Psychiatric Association and World Health Organization classifications mention as a prerequisite for gambling and gaming disorder that these behaviors lead “to clinically significant impairment or distress” ,29, and The difference in the onset of suicidal thoughts also puts into question the commonality between gaming and gambling disorder. In gambling, suicidal thoughts seemed to occur concomitantly to psychological exhaustion and the feeling of being pushed to the wall due to financial damage. These feelings have been consistently described in the literature ,33. In gRelatives of gambling users frequently complained about financial difficulties, grouped in class 6, that often become their shared burden. This result supports previous findings that financial difficulties and familial conflicts were key help-seeking precipitators among gamblers . In contOur study has several limitations. The imbalance between gaming and gambling and the proportion of relatives in the respective subsamples could have influenced the hierarchical classification; however, both gaming and gambling samples were very large compared with those reported in classical qualitative studies. Some contactors could have contacted the help service several times, although the anonymity of the facility prevented documentation of repeat contacts. Moreover, no structured diagnostic or clinical assessments were collected during the calls, and we cannot assume that all contacts regarded people with a clinical addictive disorder. We can only assume that the contactors felt the need to seek help regarding gambling or gaming.In conclusion, negative emotions and shared distress linked to gambling and gaming support their classification as mental disorders in se, but meaningful differences were observed in core symptoms of addiction between gamers and gamblers, beyond specificities related to the behavior itself. Our findings support differences in the development and maintenance of gaming and gambling disorder and should been further explored in a process-oriented approach.