Even with longer breakfasts, McDonald's could be hard-pressed to regain their once-strong consumer base. In fact, even with changes the company is considering to boost decreasing sales, almost half of Americans say they would not consider increasing their visits to the fast-food chain.

According to a new study conducted by the Chicago-based research group 8Sages, the chain, which is still the most dominant fast-food restaurant in the country, has largely fallen out of favor with American consumers who find the food low-quality, unhealthy, or not even tasty. The study's findings suggest that the company's "problems are deep and pervasive and will not be easy to fix."

Some initiatives, including all-day breakfast and moving away from antibiotic-laden chicken meat, were among consumers' top concerns, and could boost some numbers, the report says. Still, the fast-food giant has taken hits from the success of competitors, and a shifting public awareness of healthful eating.

"Competitors have leaped ahead not just in food healthfulness, quality and tastiness, but also in the overall experience of ordering and dining," the study's lead researcher, Leo Shapiro, told Crain's Chicago Business, which commissioned the survey. "Is McDonald's fixable? Yes. Is the fix in? It doesn't look that way yet," Shapiro said.

The study's key findings point to a discrepancy between the company's still-dominant placeholder among fast-food chains in the United States, and comparatively low customer-satisfaction ratings when set against other fast food restaurants. That number was lower still for customers who only ordered inside the restaurant instead of at the drive-through. Many respondents also complained about taste, rating it lower than the average of its competitors.

Strikingly, the survey found that almost half of respondents reported visiting the chain less compared to five years ago, with nearly half of that segment citing health and quality of food concerns. According to the study, "the arena of healthfulness [is where] McDonald's has a real challenge." For respondents whose last restaurant visit was to a McDonald's, for example, the chain ranked only 5.56 out of 9 for healthfulness—almost a full point below the average for other competitors.

The report concludes that if the restaurant were to find a way to satisfy consumers' needs for food that is both healthier and possessing of the accompanying "gusto" factor, which it describes as "the pleasure of eating and the food that achieves that pleasure," the company could "see significant growth in the coming years."

But even if McDonald's does implement some consumer-driven changes, the company carries a tarnished reputation for reasons that possibly go deeper than aesthetic or nutritional shortcomings.

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h/t Crain's Chicago Business