Using the Theory of Planned Behaviour to design a food hygiene intervention

Twenty percent of food poisoning annually in Australia is believed to result from consumer food handling behaviour. Research advocates the use of social cognition theories in designing food hygiene interventions, however very few studies have actually done so. Thus, this study investigated the efficacy of a food hygiene intervention based on the Theory of Planned Behaviour (TPB). One hundred and eighty-four participants completed a TPB questionnaire, including questions regarding past behaviour and food hygiene knowledge, and then were randomly allocated to a knowledge and implementation intention group, a combined knowledge/implementation intention/PBC group, or a control group. Behaviour was measured 4 weeks later. The TPB predicted a high proportion of variance in both intentions and behaviour, but neither intervention improved participants’ food hygiene behaviours. However, knowledge and PBC were significantly increased in the PBC group. The implications of this for future research are explored.     

Hygienic food handling intention. An application of the Theory of Planned Behavior in the Chinese cultural context

In China, more than half of all reported cases of food poisoning accidents and deaths cases occur in the household, and it is estimated that 30–40% of these are a result of improper food handling behaviors. In the current study, an extended model of the Theory of Planned Behavior (TPB) and a modified model of the extended TPB for the Chinese cultural context were proposed and proved applicable to predict hygienic food handling intention based on the data from 901 questionnaires from Mainland China. The explanatory power of the two extended TPB models was strong and almost the same, and the eight variables of attitude, habit, past behavior, subjective norm, face consciousness, conformity consciousness, perceived behavior control, and perceived ease were found to be significant predictors of hygienic food handling intention. Furthermore, intention was found to be particularly dependent on perceived behavior control and perceived ease, explaining the phenomenon that consumers have positive attitudes but are less likely to generate intentions. The study examined the adaptability of TPB in different cultures by comparing it with a modified model for the Chinese cultural context. The research results suggest interventions aimed at improving safe food handling intentions should focus on the impacts of attitude, perceived behavior control, perception of ease, normative influences, and habits; in addition, interventions can also take advantage of Chinese consumers' conformity consciousness.     

Food safety training and evaluation of handwashing intention among fresh produce farm workers

Food safety training is mainly focused towards food service establishments. Therefore, this paper aims to develop food safety educational and training materials for fresh produce farm workers. The Theory of Planned Behaviour (TPB) model was used to investigate handwashing intentions among fresh produce farm workers. The findings in this study showed an immediate increase in knowledge gained between pre- and post-training, suggesting that the educational and training programme was successful in improving food safety knowledge of participants. The overall farm food safety knowledge gain was significant at t(41) = −6.95, p < 0.001. Generally, all the participants preferred the You Tube video and hand hygiene demonstration, reiterating the fact that practical and hands-on sessions will create a much more vivid experience for workers. The TPB has provided a useful framework for understanding fresh produce farm workers’ adherence to hand hygiene practices where the multiple regression model explained approximately 57% of the variance in handwashing intention (p < 0.001). Furthermore, perceived behavioural control was identified as the significant predictor of handwashing intention (p < 0.001). This suggests that participants were more likely to wash hands before harvesting or packing fresh produce when they perceived fewer barriers to wash hands. The findings here also suggest that for handwashing behaviour, intention is not considered to be wholly within the fresh produce farm workers’ control as the working environment is different from a food service establishment which have easier access to handwashing facilities and potable water at all times.     

Will capacity building training interventions given to street food vendors give us safer food?: A cross-sectional study from India

Successful food hygiene training and the consent of safe food handling practices learnt during training are critical elements in the control of food-borne illnesses throughout the world. It is true for food handlers and vendors belonging to all sectors. But, it is all the more urgent for street vendors because they are more exposed to environmental hazards and are predominantly from much weaker socio-economic backgrounds and yet cater to the general mass. Using a cross-sectional study design a sample of 80 street food vendors were selected and provided with training to evaluate the existing Knowledge, Attitude and Practice (KAP) regarding food safety and hygiene and the change of the same after training interventions. Responses regarding KAP on food safety and hygiene before and after training revealed that there was a significant change in their perception to food safety knowledge and also practices. The knowledge level of the food vendors increased from an average 24.35%–66.2% after training interventions. The overall performance rating of full adoption of good hygiene practices by the vendors ranged from 37.5% to 50.8% in post-training period.     

Determinants of food hygiene knowledge among youths: A cross-sectional online study

IntroductionA cross sectional study was carried out among 1178 tertiary students (98.2% response rate) at a premier university based in Kuala Lumpur city. This paper specifically deals with knowledge of food hygiene and its determinants.MethodsA web-based questionnaire pertaining to knowledge, attitudes and behavior related to food hygiene was emailed to registered students. Questions on knowledge were related to personal food hygiene (11 items), causes of foodborne diseases (9 items), symptoms of foodborne disease (12 items) and food handling practice (12 items). A score of 1 was given to right answer and 0 to the wrong answer. The students was selected by stratified into three field of studies; Art, Science and Technical.ResultsMean age of students was 23 years old (sd = 3.57), female (65.9%), mostly undergraduates (73.2%), field of study (Arts 42.1%, Science 37.4%, Technical 20.5%), majority of the parents have had secondary education. Overall mean knowledge score = 69.5 ± 6.3 (personal food hygiene 73.0; causes of foodborne diseases 71.9; symptoms of foodborne disease 62.1; food handling practices 70.7). Overall knowledge was significantly associated with gender, level and field of study and father's educational level. Significant association was found between personal food hygiene and field of study with science students being more knowledgeable. Older age and undergraduates were significantly more knowledgeable on causes of foodborne diseases. As for knowledge on symptoms of foodborne diseases, younger pre-university students and father's educational level were significantly associated. In terms of knowledge on food handling, female students and science students were more knowledgeable. Multiple regression analysis showed that gender, level of study, field of study and father's educational level were significant predictors of knowledge on food hygiene.ConclusionThese results warrant the need for further educational programme in creating greater awareness on food hygiene among Malaysian youths.     

Efficacy of the theory of planned behaviour model in predicting safe food handling practices

The majority of food-borne disease outbreaks result from malpractice during food preparation in small food businesses. Effective food safety management, including the adoption of safe food handling practices learnt during food safety training programmes, is thus an important strategy to limit incidences of food poisoning. This study explores the impact of basic or foundation level food hygiene training on the attitudes, and intentions of food handlers to conduct safe food handling practices at every occasion.The Theory of Planned Behaviour was used to evaluate the relative impact of different influences on the intentions and self-reported behaviours of 249 food handlers, in hospitality settings. Interviews were also conducted with food handlers, and their managers to seek further insight into the changes in attitude and intent to conduct safe food handling practices after basic or foundation level food hygiene training.     

Development of conscious food handling in Hungarian school cafeterias

The last steps of food chain are particularly important, because this is when the food products reach the consumer. In the catering sector, the responsibility of food handlers are very high in the prevention of foodborne diseases. In this situation, the food handler's work must be conscious. This paper focuses on the issue of consciousness in food handling, which is the relationship between the level of knowledge and the implementation of right practice. The aim of this study is to establish a special food hygiene training model and measure its efficiency. The essence of the training model is to increase the consciousness of food handlers.Food hygiene training was tested at 33 school kitchens, where 145 staff participated. The program lasted for 6 months. Theoretical knowledge was evaluated, using self-administered tests, and food handling practice was measured through observation. Results before and after the intervention program were compared.Deficiencies in hygienic knowledge and in food handling practice were identified in seven areas. Significant increases were observed in theoretical knowledge in the areas of receiving (33.5%) and food waste (11.7%). With regards to the food handling practice, some remarkable positive changes were observed in the fields of storage (33.3%), dishwashing (24.7%), and cleaning (22.0%). Dishwashing, personal hygiene, and cleaning were the areas where such increases were observed, both in their knowledge and practice, that is, consciousness was increased in these areas.The parallel development of hygienic knowledge and food handling practice increased the consciousness in food handling, which is indispensable for ensuring safe food practices. Increasing consciousness make good practice instinctive in everyday work.     

Process manages and hygienic practices of local beverages producers and sellers in Ouagadougou,Burkina Faso

The trade of local beverages and ice has become popular in many developing countries including Burkina Faso. This study was performed to determine the local beverages safety knowledge of producers and sellers in Ouagadougou. Face-to-face interviews of 233 producers and sellers were conducted. The approach used concerned the process of good hygiene and production. The data were collected following observation checklists and an adapted set of questions: knowledge of risk perception, training, personal hygiene, cleanliness of the selling site, water supply, refreshment condition, packaging materials, food handling practices and foodborne pathogens. Data were analysed by using means, frequencies, standard deviation, 95% confidence interval and t-test. The results of survey showed that women represent 94% of 233 total sellers. Eighty five percent 85.4% did not receive appropriate training about food hygiene and 72.5% of them did not know the reasons of local beverages and ice contamination. Only 35.6% of the sellers used freeze system to store beverages. Poor quality of water and hands implicated to local beverage manufacturing were respectively assigned 8.6% and 7.3%. Statistical analyses revealed significant difference (P < 0.05) between hygiene training and stationary sellers (P = 0.004), hygiene training and source of water (P = 0.02), hygiene training and cold chain (P = 0.013). In view of the socio economic importance of local beverages and their role in the unexpected arrival of food-borne diseases, local beverages sellers should be regularly trained, retrained in order to prevent outbreaks of food-borne illnesses.     

Campylobacteriosis in New Zealand: A new twist to the tale? Part two (the consumer and the regulator)

New Zealand has a much higher rate of reported campylobacteriosis cases than the rest of the developed world. It has been assumed that New Zealanders have worse home hygiene practices during food preparation than the citizens of other developed countries. If this is the case then the study has to address how to educate New Zealanders more effectively about food hygiene practices.A QMRA study using the Bayesian approach has indicated that hygiene has a significant impact on the total probability of illness, as an increase in the poor hygiene percentage by approximately 50% reflected an increase of approximately 50% in the probability of illness. The findings of the QMRA and a review of consumer food handling practice in New Zealand and other developed countries confirm the hypothesis that poor hygiene may contribute to the high rate of campylobacteriosis in New Zealand. There is a lack of New Zealand data and studies regarding consumer knowledge and handling practices. The few studies that were conducted were not comprehensive. The poor hygiene practice of consumers could be linked to demographic, socioeconomic and psychological variables, as well as to personal receptivity to new information, previous knowledge and cultural influence. This study recommends using social marketing as a cost effective option for a future educational or communication strategy aimed at educating New Zealanders and improving their domestic food handling practices.Evidently, the priority for the scientific community, risk managers, policy makers and health professionals is not to celebrate the questionable (for the scientific community in New Zealand and abroad) rapid decline of campylobacteriosis cases but to accurately investigate further the rapid decline, and to think about how to further reduce the current rate as it is still the highest among the developed countries.     

Motives towards traceable food choice: A comparison between French and Italian consumers

Food traceability standards aim to reduce the risk of food-borne disease by facilitating the withdrawal of food and feed products and to provide consumers with targeted information. This paper analyses consumers' attitude and behaviour towards traceable food in two different European countries: Italy and France. A survey has been conducted on two samples of Italian (n = 503) and French (n = 501) consumers, aiming to explain the intention toward purchasing traceable food using the theory of planned behaviour (TPB). The predictive power of the TPB model significantly increases in both countries when new variables are added: habits, trust, past behaviour and socio-demographics. The results show that attitudes drive the intention to purchase traceable chicken and honey in France. Trust affects the intention to purchase traceable chicken and honey in Italy. These findings may serve to target public interventions and private strategies towards food traceability.     

Psychosocial and health-status determinants of safe food handling among consumers: A systematic review and meta-analysis

Consumers often engage in unsafe food handling practices at home, and various psychosocial and health-status constructs have been investigated to attempt to explain the underlying reasons affecting consumers' use of such practices. We conducted a systematic review of these studies to synthesize the associations between psychosocial and health-status constructs and consumer safe food handling behaviours to inform future research and interventions. The review followed standard systematic review procedures including: comprehensive search strategy; relevance screening of references; characterization of articles; data extraction; and risk-of-bias assessment. Meta-analysis was conducted on odds ratio (OR) and Pearson's r measures of association within unique data subgroups that were stratified by eight categories of behavioural determinants, five behavioural constructs, and two outcome types. A total of 66 relevant studies were identified. Knowledge was the most commonly investigated behavioural-determinant category (70%), but was only associated with one of the individual behavioural constructs: prevention of cross-contamination and practicing personal hygiene (adjusted OR = 1.56; 95% CI = 1.17, 2.06; I² = 40%; n = 4 studies). In contrast, attitudes and risk perceptions, the second most commonly investigated category (61%), was significantly associated with all constructs (adjusted ORs ranging from 1.84 to 3.63) except for avoiding the consumption of risky foods. Habits, subjective norm, and measures of self-confidence and control were consistently and strongly associated with various outcomes. Behavioural intentions had inconsistent associations with behaviours, while cues to action and the high-risk health status of consumers and their families were not associated with any outcomes. Most studies (77%) only reported measures of association that were unadjusted for confounding variables, resulting in high risk-of-bias ratings for most outcomes. Stratified analyses indicated that adjusted ORs differed from unadjusted measures. The review findings highlight key psychosocial constructs that could be targeted in future research and interventions to improve consumers' safe food handling behaviours.     

Evaluation of basic knowledge on food safety and food handling practices amongst migrant food handlers in Peninsular Malaysia

This study was aimed to measure the basic knowledge on food safety and food handling practices among migrant food handlers as these information is scarce in Malaysia. A cross-sectional study was conducted face-to-face amongst 383 migrant food handlers from three major cities in Peninsular Malaysia through questionnaire. Socio-demographic information of all respondents was collected. Questions on food safety knowledge (i.e. food cleanliness and hygiene, symptom of foodborne illnesses and foodborne pathogens) and food handling practices were assessed. The compiled data were analyzed by using the Statistical Packages for Social Science (SPSS) 16.0. Overall, migrant food handlers had poor level of knowledge on food safety with an average food handling practice. Significant effects were observed between respondents’ food safety knowledge and socio-demography (country of origin and educational level) and two factors namely; respondents’ nationality and attendance at food training programs showed significant associations with their food handling practices. Multiple logistic regression analyses revealed that attendance at food training programs was a significant and independent predictor of the respondent’s food handling practice. The study’s findings highlighted issues with regards to the extent of knowledge acquisition on food safety and hygiene by migrant food handlers. Therefore, this warrants improvements not only in the better delivery methods of training modules but also tight enforcement of attendance at the programs by the respective authorities.     

Knowledge,attitudes and self-reported practices of food service staff regarding food hygiene in Edirne,Turkey

The purpose of this study was to evaluate the knowledge, attitudes and practices among food service staff with regards to food hygiene in hospitals in Edirne, Turkey, and to provide baseline data for implementing HACCP in hospital food services by carrying out a questionnaire by a face-to-face interview. The current study shows that food service staff in Edirne hospitals have insufficient knowledge regarding the basics of food hygiene. And also revealed a discrepancy between attitudes and practices towards food hygiene. There is an immediate need for continuous training among food handlers regarding safe food handling practices.     

Street-food: The hygiene conditions of hot-dogs sold in São Paulo,Brazil

The present study was carried out with the purpose of identifying the critical points of inspection control for hot-dogs before being sold on the streets. Data were collected from 20 vending sites using interviews, questionnaires, the observation of food handling and storage, the temperature of the meat and the pH measurements of sauce. In 30% of the studied sites, hygiene conditions were rated as regular to extremely poor. Mashed potatoes, chicken and beef preparations were high risk. These findings showed unsuitable hygienic practices for food preparation and a lack of basic knowledge regarding food handling—a public health problem. Given the scarcity of literature and official data about street food in Brazil, further studies are recommended.     

Socio-economic profile and food safety knowledge and practice of street food vendors in the city of Guwahati,Assam, India

Street food is an integral part of society in all countries – underdeveloped, developing or developed. As such the standard of hygiene maintained is a very vital matter. Every region has its sets of factors affecting the hygiene maintain. In the present study a survey was carried out in Guwahati city to determine the existing socio-economic status and food safety knowledge of street food vendors. Data on socio-economic and business profile of 80 vendors were collected using three standardized proformas.A study was also conducted on the existing knowledge of vendors on food safety and hygiene practices and methods of procurement of raw materials. The knowledge and procurement practices of the vendors were assessed for association with some relevant socio-economic factors. From the study it was observed that majority of street food vendors were mobile food vendors (54%) with the remaining being owners of small restaurants and food handlers. Majority of the food vendors were local to Guwahati city (93%). The average daily income of the mobile food vendors were between Rs. 200 to Rs. 600. It also was noted that only 30%–37% vendors were aware of hygienic practices of food handling and a mere 8%–11% of food vendors had knowledge on biological sources of food contamination.It was concluded that there is a high degree of association between procurement practices with the type of vendors, ownership status and average income. But no outstanding association exists with any socio-economic factor with the knowledge of the vendors on food hygiene. The street food scenario in the city was found to be quite dismal and requires stringent steps to improve matters.     

Knowledge,attitudes and practices of food handlers on food safety in food service operations at the Universiti Kebangsaan Malaysia

This study was conducted to determine the level of knowledge, attitudes and practices of food handlers in food service operation at the main campus of Universiti Kebangsaan Malaysia (UKM) regarding food safety. Data were collected from 112 food handlers through questionnaires which consisted of questions about knowledge, attitudes and practices. The results showed that there was significantly positive correlation among the three levels and respondents possess good scores for knowledge (19.68 ± 3.87) about personal hygiene, foodborne diseases and temperature control of food; for attitudes (89.26 ± 8.66) on safe food handling, and for practices (90.02 ± 8.23), specifically for appropriate hand washing, use of gloves in food preparation and prevention of food hazards. About 73.2% of respondents never attend any training related to food safety and majority show poor knowledge of pathogens associated with disease-causing agents as well as critical temperatures for storage of ready-to-eat foods. Therefore, effective and ongoing training on food safety and hygiene must be given to all food service employees to ensure the safety of food provided.     

The evaluation of food hygiene knowledge,attitudes, and practices of food handlers’ in food businesses in Turkey

The purpose of this study was to evaluate knowledge, attitudes, and practices concerning food safety issues among food handlers in Turkey, conducting face to face interview and administrating questionnaire. Of the 764 food handlers who responded, 9.6% were involved in touching or distributing unwrapped foods routinely and use protective gloves during their working activity. A majority of participants (47.8%) had not taken a basic food safety training. The mean food safety knowledge scores was 43.4 ± 16.3. The study demonstrated that food handlers in Turkish food businesses often have lack of knowledge regarding the basic food hygiene (critical temperatures of hot or cold ready-to-eat foods, acceptable refrigerator temperature ranges, and cross-contamination etc.). There is a immediate need for education and increasing awareness among food handlers regarding safe food handling practices.     

Knowledge of food safety and food handling practices amongst food handlers in the Republic of Ireland

Food safety concerns have existed for a long time, as millions of people across the globe suffer from food borne disease every year. Contamination of food owing to limited knowledge of food safety practices primarily increases the risk of food borne illnesses. In the present study, quantitative research was carried out to gauge the level of food safety knowledge amongst people living in Ireland. A total of 1069 participants from all over the Republic of Ireland contributed to the survey (of which 821 were included in this research). Results showed that the residents of Ireland overall had an average level on knowledge of food safety practices (67.0% passing rate). They had an average level of knowledge in food storage (52.8% passing rate), usage and maintenance of the kitchen facilities (59.0% passing rate), and personal hygiene (61.0% passing rate). Conversely, they had a critically low level of knowledge in food handling (10.8% passing rate) and food poisoning (20.1% passing rate). The results of the present study also showed that, the level of knowledge of food safety practices varies amongst the residents based upon their gender, age, place of residence, education level, and marital status, while no significant difference in the knowledge level was observed based upon their per capita income. The study thus, highlights that there is scope for improvement for the residents to advance their knowledge of food safety practices. Therefore, it can be recommended that researchers, educators, food safety communicators, and the media can engage in educating the population, to help the residents advance their food safety knowledge to safer food practices.     

Food safety knowledge and practices of food handlers,head chefs and managers in hotels' restaurants of Salvador,Brazil

This study aimed to assess the knowledge level, attitudes and practices of food handlers, and knowledge and practices of head chefs and managers in hotels' restaurants of Salvador, Brazil. Data collection was done through the application of interviews with 265 food handlers and with 32 head chefs and managers. In addition, the influence of the presence of nutritionist in restaurants was evaluated. The results showed that 88.0%, 96.6% and 76.0% of handlers had knowledge, attitudes and practices appropriate for personal hygiene, respectively. However, some errors were observed such as the non-use of disposable gloves when handling or distributing food (39.6%), tasting food with their hands (28.7%), and usually talking while handling food (52.5%). Statistical analysis did not indicate a significant association between the knowledge, attitudes and self-reported practices by handlers. However, it was found association between handlers that presented good satisfaction with the job and handlers that introduced appropriate practices. Regarding to chefs and managers, the results indicate that the knowledge was unsatisfactory, even 75% of respondents have training certificate in food safety. A significant percentage of respondents were unaware of the legislation adopted in restaurants (37.5%), and only 43.8% of them knew the recommended cooling temperature for food preservation. However, adequate practices to reduce cross-contamination was observed. Still, the presence of the nutritionist in restaurants influenced positively on the adoption of the current legislation in hotels' restaurants, as well as in the participation of the handlers in training, showing in this way the creation of a positive culture among the handlers.