# Presentation: 099898

## Food Safety Behavior of Nutrition Program Graduates:Do They Do...What They Say They Do?

- Patricia Kendall, PhD, RD
- Colorado State University
- Lydia C. Medeiros, PhD, RD
-  The Ohio State University
- Virginia N. Hillers, PhD, RD
- Washington State University

## Context of Data

- Part of larger study to:
- Gain consensus among food safety experts on most important behaviors to reduce risks of foodborne illness from home food preparation
- Develop and validate a food safety behavior questionnaire
- Identify high risk behaviors that should be further targeted for food safety education
- Medeiros, Hillers, Kendall 1999-2001
- USDA grant #99-35201-8126

## Identification of Food Safety Behaviors Most Important in Preventing Foodborne Illness

- Using web-based Delphi process, food safety experts (n=24) identified 29 food safety behaviors as being most important in home food preparation
- Behaviors ranked within 13 pathogens and 5 pathogen control factors and for importance to high risk audiences
*Medeiros, Hillers, Kendall*
*J. Amer. Dietetic Assoc., 101:1326;2001*

## Development & Validation of a Behavior Questionnaire

- Expert Panel led process:
- Panelists (n=6) reviewed results of Delphi process & made final recommendations for behavior list.
- Worked in small groups to develop questions to assess the 29 behaviors
- Evaluated content & face validity of questions
- Questionnaire further shortened & revised based on feedback from target audience and project team

## Behavioral Question Bank

- Reliability and validity testing performed on 52-item question bank:
- Practice personal hygiene (5 questions)
- Cook foods adequately (12)
- Avoid cross contamination  (7)
- Keep foods at safe temperatures (12)
- Avoid foods from unsafe sources (16)

## Recruitment

- Targeted EFNEP/FSNEP classes with 30-60 minute food safety education component
- Classes took food safety behavior questionnaire, then recruited to take part in a cooking methods study
- Primary food preparer
- Limited income household

## Kitchen Activity Session

- Cooking observation in Community Kitchen:
- Cooked a chicken breast to desired doneness
- Sliced an apple to garnish the chicken
- Cooked a hamburger to desired doneness
- Sliced a tomato to go with the hamburger
- In-depth interview
- Asked same questions on  questionnaire in conversational, open-ended manner
- 50 graduates completed sessions

## Observable Behaviors

- Wash hands before food preparation
- Avoid cross contamination:
- Thoroughly rinse fruits and vegetables
- Wash _hands_ and _utensils_ with soap and hot water after contact with potentially hazardous foods
- Clean food preparation _surfaces_ with hot soapy water _before_ and _after_ meal preparation
- Cook foods adequately:
- Use a thermometer to ensure meat/poultry are adequately cooked

## How Safe are their Practices?Do they do what they say they do?

## Wash hands with soap and water before preparing food(n=50)

- Observation
- 92% did correctly
- 4% did incorrectly
- Included rinse only, wipe with dishcloth or paper towel
- 4% did not do
- Validation with Questionnaire
- 92% agreement

## Wash hands with soap & water between working with raw chicken and continuing cooking

- Observation
- 24% did correctly
- 74% did incorrectly
- Included rinse only, wipe with dishcloth or paper towel; clean as part of dishwashing
- 2% did not do
- Agreement with Questionnaire
- 94% agreement (correct & incorrect behaviors)
- 18% agreement (correct only)

## Wash cutting board after preparing  chicken and before cutting apple

- Observation:
- 76% did correctly
- 21% did incorrectly
- 2% not at all
- Validation with Questionnaire:
- 83% agreement (correct & incorrect behaviors)
- 64% agreement (correct only)

## Thoroughly rinse fresh vegetables under running water before eating 

- Observation
- 74% rinsed tomato before slicing
- 26% did not
- Validation with Questionnaire
- 68% agreement

## Clean countertops with hot, soapy water Before preparing food

- Observation
- 2% did correctly
- 98% not at all
- Validation with Questionnaire
- 12% agreement

## Clean countertops with hot, soapy water After preparing food

- Observation
- 6% did correctly
- 76% did incorrectly
- Included wiping with sponge,  cloth or paper towel
- 18% not at all
- Validation with Questionnaire
- 76% agreement (correct & incorrect behaviors)
- 28% agreement (correct only)

## Use thermometer to determine if a chicken breast has been cooked enough

- Observation:
- 18% used thermometer
- 82% did not
- Still, 90% cooked to 160°F
- Validation with Questionnaire:
- 67% agreement
- Results similar for hamburger patty

## Conclusions

- Handwashing:
- Message learned
- Skills need improving, esp. to prevent cross-contamination
- Cleaning utensils/cutting boards to prevent cross-contamination:
- Message learned
- Skills need improvement

## Conclusions

- Cleaning food preparation surfaces before/after food preparation:
- Message not well learned
- Skills lacking
- Use thermometer to ensure adequate cooking:
- Message not learned, but most cooked to adequate temperatures
- Skills lacking in use of thermometer

## Recommendations

- Emphasis should be placed on:
- Correct handwashing after contact with potentially hazardous foods
- Cleaning of countertops *before *meal preparation
- Correct methods for cleaning countertops *after *meal preparation
- Correct methods for cleaning utensils, cutting boards
- Thermometer use

## Acknowledgments

- Ohio State University
*Dr. Gang Chen*
- Colorado State University
*Mary Schroeder*
*Anne Elsbernd*
*Kelly Sinclair*
- Washington State University
*Verna Bergmann*

## Thinking Globally -- Working Locally

**Thinking Globally -- Working Locally**

**A Conference on Food Safety Education**