Conference Proceedings

A Conference on 

Food Safety 

Education 

U.S. Department of Health and Human Services 

• Centers for Disease Control and Prevention 

• Food and Drug Administration 

September 18-20, 2002 

Orlando, Florida 

Sponsors: 

• Food Safety and Inspection Service 

• Cooperative State Research, Education and 

Extension Service 

Conference 

Proceedings 

In cooperation with the Partnership for Food Safety Education www.fsis.usda.gov/Orlando2002 

Thinking Globally–Working Locally 

U.S. Department of Agriculture 
U.S. Department of Health and Human 

Services 

“As risk communicators, educators, public 

the men and women to whom we turn to make 

sure what we eat is not contaminated and what 

we drink is pure... 

supplies safe... millions of men, women, and 

children depend on what you do. I use the word 

front lines in the defense against illnesses 

transmitted by food.” 

information we share with consumers, food 

understand basic food safety practices. They 

also must be kept apprised of the many changes 

and advances being made with technology and 

in other areas that are strengthening the food 

“All of us understand the immense challenges 

great strides, but much work remains to be 

our programs, examine closely the best science, 

and work with all interested parties...to move 

forward and make progress in a responsible and 

Tommy Thompson, Secretary, 

health officials, and industry leaders, you are 

“You share the best ways to keep our food 

‘depend.’ I use it deliberately...You are on the 

Ann Veneman, Secretary, U.S. Department 

of Agriculture 

“We can never do too much when educating 

people about the importance of food safety. 

That’s why we must continually improve the 

handlers, and the food sector, so that they 

supply. 

we face. We share the ultimate goal of protecting the food supply. Together we have made 

accomplished. We need to continuously review 

aggressive manner.” 

Conference Proceedings


Thinking Globally—Working 

Locally: A Conference on Food 

Safety Education 

From September 18 through 

September 20, 2002, more than 600 

food safety educators from around the 

United States and the world gathered 

in Orlando, Florida, to attend Thinking 

Globally—Working Locally: A Conference on Food Safety Education. 

It was sponsored by: 

U.S. Department of Agriculture 

•	 Food Safety and Inspection Service 

•	 Cooperative State Research, 

Education and Extension Service 

U.S. Department of Health and Human

Services 

•	 Centers for Disease Control and 

Prevention 

•	 Food and Drug Administration 

In cooperation with the Partnership for 

Food Safety Education 

Conference speakers covered the 

gamut of topics, addressing global 

issues, updating attendees on the status of food safety in the U.S., discussing 

food safety communications in a world 

confronting bioterrorism, summarizing 

the latest findings in consumer 

research, and highlighting educational 

initiatives from around the country 

and the world. 

Thinking Globally– Working Locally: A Conference on Food Safety Education 
September 18: 

•	 Keynote speaker Sir John Krebs, Chairman, Food Standards Agency, the United Kingdom, explored the 

dilemma of building public trust when that trust has been shaken following that nation’s crisis with 

bovine spongiform encephalopathy (BSE) contamination in cattle. 

•	 Leaders of U.S. Federal agencies responsible for food safety reported on progress and the challenges 

ahead. A number of experts noted new concerns from evolving microbiological threats. But while the 

war on microbes may never be won, as one expert said, it’s also not lost because “we can learn and 

transfer knowledge. Food safety education folks will always have a job to do.” 

•	 Consumer researchers from national and local levels pointed to thought-provoking trends: they noted 

that knowledge of safe food handling does not necessarily translate to behavior. Consumers, they said, 

tend to be overconfident and unaware of the mistakes they make. 

•	 The last session of the first day provided a glimpse of the many food safety education programs at 

work throughout the country and the world, showcasing five innovative programs. 

September 19: 

The morning general session focused on crisis communication and biosecurity. Communicators and public


health officials drew from their experiences dealing with anthrax. Their stories illustrated why, as one said,


“preparation is a journey, not a destination.”


After the general session, concurrent sessions offered participants information on writing grants; establishing 

research programs; local, regional, and national partnerships; and food safety education projects. 

On both the first and second days of the conference, more than 80 poster presentations were 

showcased, addressing topics as diverse as training programs for Arab homemakers to Internet-based training 

for food service workers. 

September 20: 

The final morning of the conference evidenced the energy and enthusiasm of food safety educators as they


participated in an Interactive Collaborative Planning Process—a session specifically designed to assess


educators’ goals and target future directions.


The Planning Process utilized information collected from educators during the previous 2 days of the confer­


ence. Attendees had logged on to a special Web site at computer kiosks to voice their thoughts regarding


their goals and food safety education needs and provide information on their budgets and organizations.


Eighty-two percent of the conference attendees provided input.


On the last day of the conference, this data—along with the knowledge and experiences gleaned from the 

conference itself—were used to create an Interactive Collaborative Planning Process. Everyone’s knowledge, 

experience, and best ideas were brought to the fore as regional teams gathered to put theory into action—to 

think globally and act locally. 

It was high energy, said one participant. “I’m ready to go home and get going!” 

The following conference proceedings present: 

•	 benchmark information presented at the conference’s general sessions, 

•	 results of the Interactive Collaborative Planning Process, and 

•	 summaries of a selection of the poster presentations. 

Conference Proceedings 1 
“So there are lots of 

opportunities out there 

for us, as educators, to 

have seen first hand your 

commitment to spreading 

food safety messages. 

While I enjoy getting 

educate folks on food 

deserve our thanks for 

being there on the front 

lines day in and day out.” 

make a difference. And I 

out of Washington to 

safety, I certainly can’t do 

that every day. You truly 

Dr. Elsa A. Murano 

Wednesday, September 18, 2002 

Welcome and Opening Remarks 

Dr. Elsa A. Murano, Under Secretary for Food Safety, 

U.S. Department of Agriculture

Dr. Elsa A. Murano was sworn in as Under Secretary for Food Safety for 

the U.S. Department of Agriculture (USDA) on October 2, 2001. In this 

position, she oversees the policies and programs of the Food Safety and 

Inspection Service. 

Dr. Murano has extensive public and private experience in the field of 

food safety as both a manager and educator. From 1995 until 2001, she 

held several positions with Texas A&M University at College Station, TX. 

Since 1997, she served as director of the University’s Center for Food 

Safety. During this time, she also served on the University’s Department 

of Animal Science Research Advisory Committee and the Food Safety 

Response Team of the Texas Agriculture Extension Service, and served 

from 1999 to 2001 as the Chair of the Food Safety State Initiative 

Committee of the Texas Agriculture Experiment Station. 

A native of Havana, Cuba, Dr. Murano holds a B.S. degree in biological 

sciences from Florida State University in Miami. She also holds an M.S. 

degree in anaerobic microbiology and a Ph.D. in food science and technology, both from Virginia Polytechnic Institute and State University in 

Blacksburg, VA. 

USDA Under Secretary for Food Safety Dr. Elsa A. Murano welcomed 

conference attendees and noted that she’s been on the road herself 

with the educational messengers BAC! and ThermyTM, visiting senior 

centers and schools. 

And while she’s been teaching food safety, she said, she’s also been 

learning. “I’ve learned there are many eager students out there—of 

all ages and from all backgrounds. At the senior center I visited in 

San Antonio, I was surprised at how many basic questions people had 

about handling and storing food safely. At a grilling event, people 

were surprised to learn that they could use a food thermometer to 

check the doneness of burgers, and that cooking them to 160 0

F is a 

much better way than by checking color to ensure that harmful 

E. coli organisms have been destroyed. 

“So there are lots of opportunities out there for us, as educators, to 

make a difference. And I have seen first hand your commitment to 

spreading food safety messages. While I enjoy getting out of Washington to educate folks on food safety, I certainly can’t do that every 

day. You truly deserve our thanks for being there on the front lines 

day in and day out.” 

As the top public health official at USDA, Murano’s primary role is to 

oversee the safety of meat, poultry, and egg products. “The majority 

of USDA’s regulatory authority is focused on slaughter and processing 

2 Thinking Globally– Working Locally • A Conference on Food Safety Education 
plants, and my job is to ensure that policies are in place to reduce, to


the greatest extent, pathogens that can cause foodborne illness.


“We have seen many successes,” Murano said. “Testing in plants


reveals that Salmonella levels in a variety of products are down, for


instance, and that corresponds to a reduction in illnesses reported by


the Centers for Disease Control and Prevention.


“But, as Secretary Veneman said, ensuring food safety is a farm-to-


table job. Food safety education is certainly not a substitute for, but


a complement to, science-based food safety policies. I would like


nothing better than to tell people that they don’t need to worry


about how they handle and prepare their food because the govern­


ment has taken care of the problem. I wish I could say that, but I


can’t. We will continue to strive for greater reductions in harmful


pathogens within plants. But regardless of what we can accomplish,


consumers always will have an important role in keeping food safe.”


“Many of us in the food safety business like to talk in terms of a risk


analysis framework—that is, risk assessment, risk management, and


risk communication. Education is a critical element of this


framework...because educating consumers is an important way to


reduce the risk of foodborne illness. This is very clear, for example, in


the work we have all done in educating high-risk population groups


about Listeria monocytogenes. Education is also a risk communica­


tion function, because it serves to alert the public about a hazard


that exists and can be addressed by safe food handling and food


choices.


“As we continue to examine emerging and existing food safety


problems, it is important that we remember that reducing


foodborne illness requires numerous interventions all along the


farm-to-table chain. We must consider all the strategies available to


us—including education—to make the food supply safer,” she


added.


Today’s educators, Murano noted, face many challenges. The data


presented at the conference will reveal, for instance, that what


consumers say they do and what they really do when handling food


“may be miles apart.” The data will also report on the current state


of foodborne illness in the U.S., “and there is room for improvement


in the prevention of illness,” she pointed out.


And education today, Murano said, “is not just about the basics of


safe food handling, although this certainly remains our greatest


need. There are many new products in the marketplace and tech­


nologies being used that people need to know about, such as bio­


technology, organic foods, and irradiation. The job will fall on you,


as leaders in education, to help us give the public the most accurate


and up-to-date information on these new and evolving products and


technologies.


“And of course, the increasing diversity of the population is another


hurdle we face. Our strategies must reach the many diverse cultures


and languages.”


Abstracts 

“As we continue to 

examine emerging and 

existing food safety 

problems, it is important 

that we remember that 

reducing foodborne 

illness requires numerous 

interventions all along 

the farm-to-table chain. 

strategies available 

to us—including 

education—to make the 

We must consider all the 

food supply safer.” 

3 
Murano recognized the difficulties inherent in changing behaviors as 

well as dealing with diverse populations. “Despite these challenges,” 

she said, “I am an optimist at heart. I believe we can truly make a 

difference in changing behavior. 

“I think it is very exciting to see how the science of food safety 

education is evolving in terms of developing messages and targeting 

audiences. Just as we are learning in medicine that not all medications work the same for all people...we know that one size does not 

fit all in education. We cannot reach all people with the same 

messages and the same methods of delivery. 

“I want to assure you,” she continued, “that we are committed to 

helping you meet these food safety education challenges, because 

we are all in this together....We are your partners, and we will 

continue to be your partners. 

“We have provided you with educational materials, and we will 

continue to do so. And we will continue to facilitate discussions, just 

as we are doing here today, to keep everyone up to date on the 

latest in food safety education.” 

Dr. Rodney J. Brown, Deputy Under Secretary for Research, 

Education, and Economics, U.S. Department of Agriculture 

Dr. Rodney J. Brown was appointed Deputy Under Secretary for Research, 

Education, and Economics for the U.S. Department of Agriculture (USDA) 

on February 8, 2002. His responsibilities include working with the four 

agencies of USDA’s research mission area that include the Agricultural 

Research Service; the Cooperative State Research, Education, and Extension Service; the Economic Research Service; and the National Agricultural 

Statistics Service. 

Dr. Brown served as professor and dean of agriculture at Utah State 

University for 8 years before accepting this appointment. He recently 

chaired the Board on Agriculture of the National Association of State 

Universities and Land Grant Colleges. 

Dr. Brown received his Ph.D. in food science in 1977 from North Carolina 

State University in Raleigh. He was awarded his M.A. in nutrition and 

food sciences in 1973 from Utah State University in Logan. In 1972, he 

earned his B.S. at Brigham Young University in Provo, UT. 

Dr. Rodney J. Brown, Deputy Under Secretary for Research, Education, and Economics, USDA, told conference attendees, “I commend you. You are in a field that saves people’s lives by teaching 

food safety.” Observing how the world has changed in the past 

100 years, Brown called for extending the farm-to-table food 

safety concept to the whole world. 

“It’s a tremendous challenge and we are determined to accomplish 

it,” he said. “The extension service is one of the strongest and most 

capable outreach organizations in the world.... 

4 Thinking Globally– Working Locally: A Conference on Food Safety Education 
“Eating should not be a hazardous activity, and, on a numerical risk


basis, it isn’t,” he said. “Many things we do every day have much


higher risks. But it is not acceptable to have risks from eating. The


public isn’t as convinced of the safety of our food supply today as


they have been in years past. This uncertainty stems from several


sources, including concerns about the global food supply and the


uneasiness caused by the September 11 terrorist attacks,” according


to Brown.


“Our citizens increasingly worry about things such as food safety


and the nutritional content of their food,” he said. Brown noted


that food imports have increased steadily in the last 25 years, and


that most imports are fresh or minimally processed fruits and veg­


etables.


“Indeed, technological revolutions in transportation, communica­


tion, and information have created a global food network in which


our food is produced, preserved, processed, prepared, transported,


and handled by a series of people, potentially from around the


world, before it reaches our tables. From this modern food system,”


Brown noted, “we derive many benefits, not the least of which is


the variety and the high nutritional content of our food supply. The


tradeoff, however, is our dependence on markets in other countries,


and the competition from around the world facing local businesses


engaged in growing, producing, and distributing food in the United


States,” Brown asserted.


“U.S. government agencies, professional groups, academia, and


industry have adopted a farm-to-table approach to food safety,” he


said, “addressing food quality problems with science-based solu­


tions. Our efforts to extend this system, in cooperation with other


countries, is a tremendous challenge,” according to Brown, “but one


the United States is determined to meet.”


“The September 11 terrorist attacks were an additional assault on


our food system,” he said, noting that, “immediately after the


attacks the focus was on air traffic control systems, military pre­


paredness, and other activities designed to protect the country.


Now,” Brown said, “concerns have shifted to food.”


“The largest shift in my mind,” he said, “has been in the direction of


food—food security, food safety, and food availability for the Ameri­


can people—and the things that need to be done to protect our


food. Now we must be concerned with intentional as well as unin­


tentional threats,” he said. “Only a few years ago, when we said


‘food security’ we meant ‘enough food available for everyone.’ Now


when we say ‘food security,’ it has an entirely different meaning.”


“To deliver our food safety messages, government agencies are


working to educate food processors, food producers, news media,


and a multitude of other groups, while risk communicators and food


safety educators reach out to the public,” Brown added. “Food


safety education efforts must help people understand that they


need to feel and be responsible for themselves in the area of food


safety. We even have to find ways to reach outside of our own food


Conference Proceedings 

“Eating should not be a 

on a numerical risk basis, 

things we do every day 

have much higher risks. 

But it is not acceptable 

to have risks from 

as convinced of the 

safety of our food supply 

today as they have been 

in years past. This 

uncertainty stems from 

several sources, including 

concerns about the 

global food supply and 

the uneasiness caused by 

the September 11 

terrorist attacks.” 

hazardous activity, and, 

it isn’t,” he said. “Many 

eating. The public isn’t 

Dr. Rodney J. Brown 

5 
“Food safety is a compelling public health 

issue. What we do in 

single person, every 

what could be more 

important than that. 

The singular goal we 

want to accomplish is to 

keep getting the word 

This is the kind of work 

that has just begun.” 

Joseph A. Levitt 

food safety affects every 

single day. I don’t know 

out about food safety. 

system to ensure food safety within our system,” he said, noting that, 

“risks for foodborne illnesses occur everywhere that food is handled 

and eaten.” 

Citing USDA’s 140-year history of food safety research, Brown called 

for the addition of behavioral research. “One of the biggest problems is learning how to encourage people to change their behavior. 

Many times people know what to do, they know the hazards, but 

their behavior doesn’t change.” 

“Food safety educators have done a lot to educate the public,” he 

said, thanking conference participants. “I encourage you, however, as 

much as possible, to broaden and deepen the things you are doing, 

to concentrate harder on the hardest parts of your work—and to 

keep on keeping at it.” 

Joseph A. Levitt, Director, Center for Food Safety and 

Applied Nutrition U.S. Food and Drug Administration 

On February 1, 1998, Joseph A. Levitt was appointed Director of the 

Center for Food Safety and Applied Nutrition (CFSAN) at the U.S. Food and 

Drug Administration (FDA). In this capacity, Mr.Levitt provides executive 

leadership to the Center’s development and implementation of programs 

and policies regarding the composition, quality, safety, and labeling of 

foods, food and color additives, dietary supplements, and cosmetics. 

These products account for nearly 80 percent of the nation’s food supply. 

Mr. Levitt began his FDA career in 1978 in the Office of the General 

Counsel. He later joined the FDA Commissioner’s Office and held various 

positions. His FDA position prior to becoming CFSAN Director was Deputy 

Director for Regulations and Policy at FDA’s Center for Devices and 

Radiological Health. 

Mr. Levitt has received numerous awards for his contributions and 

achievements, including three Presidential Executive Rank Awards. 

Mr. Levitt’s B.A. degree is from Cornell University in 1975 where he 

graduated magna cum laude. He graduated cum laude from Boston 

University in 1979, where he was a member of the law review. Mr. Levitt 

is a member of the Massachusetts Bar Association and the Phi Beta Kappa 

Society. 

“Food safety is a compelling public health issue. What we do in food 

safety affects every single person, every single day. I don’t know what 

could be more important than that. The singular goal we want to 

accomplish is to keep getting the word out about food safety. This is 

the kind of work that has just begun,” said Joseph A. Levitt in his 

opening remarks. The numbers the Centers for Disease Control and 

Prevention (CDC) has issued—76 million foodborne illnesses; 325,000 

hospitalizations, and 5,000 deaths annually—are compelling figures, 

he said, and it is what draws us to note that we need to “press on 

and do more.” 

6 Thinking Globally– Working Locally: A Conference on Food Safety Education 
Levitt identified several of the reasons why foodborne illness is 

occurring: 

•	 Diets that include more fresh, often imported produce; 

•	 Fewer meals prepared at home; and 

• Vulnerable populations that comprise 25 percent of the U.S. 

population—the very young, the elderly, pregnant women, 

and people with weakened immune systems. 

The FDA, the U.S. Department of Agriculture (USDA), and their sister 

agencies are actively addressing the challenge of reducing foodborne 

illness, he said. “Together,” Levitt added, “we have created newer 

surveillance systems, stronger prevention programs, and faster outbreak response. We need to continue and strengthen these programs 

still further.” 

Levitt cited a number of Federal surveillance systems now in place. 

FoodNet, established at sentinel sites across the country, monitors 

and tracks the progress of foodborne illness. PulseNet uses a DNA 

fingerprinting system to pinpoint the causes of foodborne illnesses, 

resulting in rapid outbreak response. Another surveillance system is 

used for identifying antimicrobial resistance and a collaborative 

laboratory network, called E-LexNet, now under development. 

We have, across the board, strong prevention programs, he said. A 

food safety system called Hazard Analysis and Critical Control Point 

(HACCP) has been expanded to include fruit and vegetable juices, as 

well as seafood, meat, and poultry. Good agricultural practices are in 

place for produce, the Food Code is being adopted at the State level 

for the retail sector, and the import inspection program is growing. 

Finally, he said, “We have faster outbreak response—the surveillance 

system was designed to be an early warning network. The warning is 

good only if you do something about it. Just as they say, all politics is 

local, a lot of food safety is local. The outbreaks start at the local 

level. Local, State, and Federal governments are all in this together.” 

“Where does the role of food safety education fit in?” Levitt asked. 

“It is central and it is critical.” Levitt went on to say that education 

programs need to be “ongoing and enduring.” He identified some 

examples of recent food safety education initiatives: 

•	 Fight BAC!® for the general consumer; 

• FDA’s Science and Our Food Supply for teens; 

•	 Programs targeted to vulnerable populations—seniors and 

pregnant women, for example; 

• Materials in various languages; 

•	 Product specific campaigns on juice and egg safety; 

•	 Vibrio vulnificus education for Hispanic men in California; 

•	 Physician education including identification of systems, treatment, and reporting of foodborne illness; and 

•	 Food handler education for food service and retail employees. 

break response—the 

surveillance system was 

designed to be an early 

warning network. The 

warning is good only if 

you do something about 

politics is local, a lot of 

food safety is local. The 

outbreaks start at the 

local level. Local, State, 

and Federal governments 

“We have faster outit. Just as they say, all 

are all in this together.” 

Conference Proceedings 7 
Levitt explained that FDA has also taken its food safety message on 

the road. Known as the “International Road Show,” teams from FDA, 

CDC, and USDA have traveled to Central and South America, Africa, 

Asia, the South Pacific, the European Union, and Eastern Europe. 

They presented training sessions designed to educate foreign producers about U.S. food safety requirements, foodborne illness surveillance programs, and U.S. education programs for both 

producers and consumers. 

Regarding food bioterrorism, Levitt said that food safety education is 

central and critical to a safe food supply. “We have made changes 

after the September 11 attacks,” he said. “We are trying to apply the 

same type of analytical thinking and science-based approach to this 

problem that we do to food safety in general, while looking through 

the lens of homeland security. We are looking at how to identify the 

risks, how to prevent them when we can, and how to respond quickly 

when we must. 

“We have to be thinking about new educational messages that 

address this issue. We need to encourage greater vigilance by consumers in looking at the foods they eat,” he said. “We also have to 

look more carefully at risk communication in a time of uncertainty. 

The September 11 attacks demonstrated that ‘public credibility’ in 

times of crisis is critical,” he said, “and more important than 

providing specific information about ‘what to do.’” 

Everyone’s help is needed to do this, he said, thanking participants 

for their work. “I hope that this week provides a little bit of a booster 

shot so we can all go back to our communities and stand up and 

make our food safer,” he encouraged. 

General Sessions: 

Keynote Address:


Educate Locally, Improve Food Safety Globally:


The Global Nature of Our Food Supply


Professor Sir John Krebs, Chairman, Food Standards Agency, 

United Kingdom 

Sir John Krebs has held a Royal Society Research Professorship in the 

Department of Zoology, Oxford University, where he also has been a 

Fellow of Pembroke College since 1988. He has held posts at the University of British Columbia and the University of Wales, Bangor. Sir John is 

an internationally renowned scientist for his research on the behavior and 

ecology of animals. Between 1994 and 1999, Sir John was Chief Executive 

of the Natural Environment Research Council. Sir John is a Fellow of the 

Royal Society, a member of Academia Europaea and of the Max Planck 

Society, an Honorary Foreign Member of the American Academy of Arts 

and Sciences, and a Foreign Member of the American Philosophical 

Society. He has received numerous awards and honorary degrees for this 

scientific work. 

8 Thinking Globally– Working Locally: A Conference on Food Safety Education 
“I do not answer questions of the kind – ‘Is food “x” safe?’ – in 

absolute terms because there is no such thing as absolutely safe 

food,” said Sir John Krebs. Questions such as this can’t be answered 

in absolute terms, he said, because the science of food safety very 

often is incomplete and uncertain. “Science is a way of knowing and 

the facts evolve as knowledge evolves,” he said, adding that government must tell the people what it knows and be willing to change its 

policies as the evidence changes. 

Sir John is the Chairman of the Board of the Food Standards Agency 

(FSA), a non-ministerial government department established in 2000, 

partly in response to the bovine spongiform encephalopathy (BSE) 

crisis of the 1990’s. 

When the FSA was announced, public confidence in the government’s 

handling of food safety issues was low, according to Sir John. The 

new Agency’s goal was to “do away with the old climate of secrecy 

and suspicion surrounding the way in which food standards were 

handled in the United Kingdom and replace it with modern, open 

arrangements that will deliver real improvements in standards,” Sir 

John said. 

To change the public’s perception, Sir John said that considerable 

time was spent defining a system that would engage the interested 

parties and the general public early in the decision-making process— 

and build trust. 

“When we set out to try to move along this road of earning public 

trust and confidence, we realized that we had to be very different 

from the past,” he said. “We recognized that we needed to be 

different both in what we were going to do and how we were going 

to do it,” he added. “We are there solely to protect the consumer’s 

interest. We are not there for industry or to make politically expedient decisions. We are about openness and honesty and involving the 

public,” he explained. 

As a result, Sir John said, the FSA is independent of influence from 

industry, government, and pressure groups. The Agency is led by a 

Board that is detached from the political process. The Board meets 

every 6 weeks and makes policy decisions in public. “We base our 

decisions on objective and impartial analysis of the evidence. It may 

be scientific evidence, it may be economic evidence, or it may be 

other kinds of evidence, but we are evidence-based.” 

“As educators, we realize that education isn’t a one-way process. It’s 

a two-way process,” he said. “It involves people telling you, as well as 

you telling them. So as part of our program of openness, engagement, and involvement, we have developed a clearly defined system 

of bringing stakeholders from industry, consumer groups, health 

professionals, and the general public into the early development 

phase of our policies on food safety issues. 

“We have a series of debates or discussions that may take place 

completely in public or may be a mixture of public and closed-session 

debates with stakeholders. It helps make the decisions more robust 

“When we set out to try 

to move along this road 

of earning public trust 

and confidence, we 

realized that we had to 

recognized that we 

both in what we were 

going to do and how we 

were going to do it,” he 

added. 

Sir John Krebs 

be very different from 

the past,” he said. “We 

needed to be different 

Conference Proceedings 9 
expect, through these 

debates, to reach an 

absolute consensus. Not 

everyone is going to be 

able to agree. But what 

we do expect is for 

people to have confidence in the process by 

which we reach a decision....“ 

“We don’t naturally 

than if they had been made just by us and then announced. It also 

gives us a way of challenging ourselves and allowing stakeholders to 

challenge each other,” he explained. 

“We don’t naturally expect, through these debates, to reach an 

absolute consensus. Not everyone is going to be able to agree. But 

what we do expect is for people to have confidence in the process by 

which we reach a decision. We also don’t expect to reach a decision 

after just one meeting, so we put a lot of effort into having a series 

of meetings on a particular issue and build a dialogue of trust and 

debate amongst the different points of view.” 

Public trust and confidence in the FSA is growing. In 2000, only 25 

percent of the public felt they could trust the FSA. In 2001, that 

figure rose to 44 percent. 

More people also believe the FSA’s information is reliable. In 2000, 75 

percent felt their information was reliable. By 2001, that figure had 

risen to 93 percent. 

Sir John said that another component of building trust rests on the 

FSA’s approach to education. “For me, an important part of improving people’s appreciation of food safety policies is understanding risk 

and uncertainty,” he explained. 

In the old days, he said, the government’s automatic response to food 

safety issues was to proclaim the food absolutely safe. It was a claim 

they could not always support. Following the BSE crisis, the government commissioned an inquiry into what went wrong with the 

handling of the crisis. The report emphasized the importance of 

honesty and not overstating reassurances. 

Sir John summarized three additional lessons from the BSE crisis: 

• When scientists offer advice, the government should challenge 

that advice. 

•	 Science is an evolving body of knowledge and, therefore, as 

the facts change and as evidence changes, the government 

should be willing to change its policies. 

• When government does develop a policy, it must make sure 

that it is effectively enforced. 

“In reality, food, like everything else in life, is not risk free,” Sir John 

said. Assessing risks—and remedies—is complex, he said. Policy 

makers frequently start off with incomplete science. They also need 

to consider the cost and feasibility of implementing particular regulations. And, he said, “we need to consider public opinion. The public is 

much less likely to accept risks in relation to food. All of these elements inform our judgment and policy making,” he explained. In the 

end, he said, “we might decide to do nothing, we might inform 

people, or we might introduce new restrictions.” 

What is very important, he said, is that throughout the process 

decisions are discussed in a very public way. “Our approach is to 

acknowledge that we don’t necessarily know all the facts, and to 

10 Thinking Globally– Working Locally: A Conference on Food Safety Education 
bring people in—the public and interested parties—to develop our 

thinking as it goes along,” he said. 

This process illustrates a new relationship between scientific knowledge and public policy, he explained. In the past, “we felt that if we 

educate people about the science behind our policies, their resistance 

would fade. We now realize that we need to learn what people think 

and respond to their concerns. We need to think of science within 

society,” he said. “It’s a different model than the linear relationship 

between assessment, management decision, and then communication that was followed 10 years ago. It is a more sophisticated 

message and one that the public is more comfortable living with,” he 

added. 

Sir John pointed out that people’s attitudes towards risk and scientific evidence don’t always match up. Science will say one thing and 

people will persist in believing another. “For example,” he said, “the 

experts that assess pesticide residues in food would say that the 

presence of pesticide residues at very low levels poses no significant 

threat to human health. But there are many members of the public in 

Britain who don’t like the idea of eating vegetables with minuscule 

levels of pesticides on them and are very anxious about it. When you 

say the scientific experts report that it is all fine, they say, ‘Well, we 

don’t trust those guys and, in any case, we don’t like it.’” 

Genetically manufactured (GM) food is another example of the 

discrepancy between what the scientists say and what the public 

believes. The scientists who assess GM food safety in the U.K. say the 

foods are as safe as their conventional counterparts. The public says, 

“we don’t like it,” Sir John reported. 

“So although consumer rejection of GM can be portrayed as a triumph of fear and ignorance over rationality and enlightenment,” he 

said, “it can also be seen as a perfectly rational response to risk.” 

From the consumers’ point of view, Sir John explained, “Science 

cannot be 100 percent confident that there is no risk to human 

health. The foods are not cheaper and don’t taste better. The public 

asks, ‘Why should I take the risk?’” 

A voluntary moratorium on growing GM food crops in the U.K. is due 

to expire. The FSA is beginning the process of engaging consumers 

and interested parties in a debate to raise public awareness about 

the science, the economic implications, and the choice aspects of GM 

foods. “This is really a debate that is not about simply educating the 

public,” he said, “but about engaging the public in a dialogue and 

reaching beyond the well-known views of pressure groups to the 

views of the ordinary consumer.” 

Another public policy area that stirs debate concerns globalization. 

Activists within the U.K. are calling for food to be produced and 

prepared within the U.K, although the country now imports 50 

percent of the food supply. In addition, Sir John said, surveillance 

data doesn’t show imported food poses greater safety risks than 

domestically produced food. “The answer is not to prevent global 

“Our approach is to 

acknowledge that we 

all the facts, and to 

bring people in—the 

public and interested 

parties—to develop our 

thinking as it goes 

along,” he said. 

don’t necessarily know 

Conference Proceedings 11 
think of the battle 

against foodborne 

illnesses not in terms of 

winning or losing, but as 

something that we have 

to do day in and day 

out, and do well— 

can lose the battle.” 

“We are not losing the 

war. But, unfortunately, 

it’s probably a war we 

can’t win. We need to 

because if we don’t, we 

Dr. Arthur Liang 

trade, but to develop the correct systems to control problems when 

they arise,” he said. 

In addition to working to build public trust, the FSA has committed 

significant resources to educating food service employees, as well as 

consumers at home. The Agency has introduced a food hygiene 

campaign which mirrors the four Fight BAC!® messages—clean, don’t 

cross-contaminate, cook, and chill. Using television ads and educational materials distributed through schools and local environmental 

health offices, the campaign focused initially on the food service 

trade and the public. Six months into the campaign, Sir John reported 

that 37 percent of respondents spontaneously recalled the campaign. 

But the impact is uncertain: 40 percent of food service staff still 

admitted to not washing their hands. 

Regardless of the topic being debated—GM, globalization, safe food 

handling instruction—Sir John pointed out that “I think one of the 

challenges for all of us as educators is to find a way to allow a wider, 

genuine participation in the debates that lie behind policy making in 

the food area so that we can include and reach beyond the knowledge of the small expert elite.” 

Setting the Stage for Food Safety Educators: The Current State of 

Foodborne Illness in the United States 

Arthur Liang, M.D., M.P.H., Centers for Disease Control and 

Prevention 

Currently Director of the Centers for Disease Control and Prevention’s 

(CDC) Food Safety Office, Dr. Liang previously served as Associate Director 

for Public Health Practice, Division of Applied Public Health Training, 

Epidemiology Program Office, where he directed CDC’s Preventive Medicine Residence. He is the Southeast Regent of the American College of 

Preventive Medicine, Accreditation Council for Graduate Medical Education, and a member of the Preventive Medicine Residency Advisory 

Committee for the Walter Reed Army Institute of Research. From 1987­

1993, he was the Assistant Director for Science in the Division of Public 

Health Systems, Public Health Practice Program Office, CDC. He is a former 

State Epidemiologist, Chief, Communicable Disease Division, Hawaii 

Department of Health, and a member EIS of Class of 1980. He is board 

certified in General Preventive Medicine and Public Health. He has an 

M.P.H. from the University of Hawaii (1980), an M.D. from the University 

of Maryland (1974), and a B.A. from Oberlin College (1970). 

In his “state of the union” report on foodborne illness, Dr. Art Liang 

said, “We are not losing the war. But, unfortunately, it’s probably a 

war we can’t win. We need to think of the battle against foodborne 

illnesses not in terms of winning or losing, but as something that we 

have to do day in and day out, and do well—because if we don’t, we 

can lose the battle.” 

At the same time, he said, we have made progress, noting that 

infectious diseases were major causes of mortality and morbidity in 

the U.S. in the early 1900’s. At that time, the leading cause of death 

12 Thinking Globally– Working Locally: A Conference on Food Safety Education 
was tuberculosis, primarily from unpasteurized milk. The third leading cause of death was diarrhea. Today, neither of those illnesses 

appear in the top 10 in this country. 

While many of the infectious diseases of concern in the 1900’s are 

now controlled, he cautioned that others have made their presence 

known, most notably HIV. The same dynamic also has happened with 

foodborne illnesses and the pathogens that cause them, according to 

Dr. Liang. “By the 1970’s,” he said “we were adding a lot of different 

names to the list of known pathogens.” 

So why has the list of pathogens increased? Dr. Liang pointed out 

that we are more aware of pathogens today because of better 

surveillance systems and detection methods. Most significantly, he 

said, “a lot of the simple problems have been solved when it comes 

to foodborne pathogens. The complex issues are ahead of us.” 

In the past, Dr. Liang pointed out, we had limited perceptions about 

the various causes of foodborne illness. Today, “we recognize that 

foodborne illness turns out to be a complex interaction between host 

and environment,” he said. This recognition has allowed us to identify additional factors in the foodborne illness equation: the evolving 

nature of microbes, the increasing number of susceptible 

populations, and changes in the food production environment. 

As an example, Dr. Liang said, when people think of foodborne 

illness, they normally think of bacteria. But, he pointed out, the 

Norwalk virus is the single most common cause of identified 

foodborne illnesses, actually causing more illnesses than all the major 

bacteria combined. The Norwalk virus is very hardy and very low 

doses can produces illness, and it can be transmitted from person to 

person, as well as through food. 

As another example of new challenges, he said, “We also used to 

think that acid foods were not high-risk foods, that the acidity inhibited bacterial growth or was anti-microbial. But it turns out that 

E. coli O157:H7 actually does well in some acid foods, like apple cider, 

salami, and mayonnaise.” 

We now realize that refrigeration, which inhibits the growth of most 

bacteria, may not be as effective an intervention against certain 

pathogens, Dr. Liang pointed out, noting that Listeria doesn’t stop 

growing until the temperature gets close to 0 degrees Centigrade. 

We are increasingly aware of problems posed by pathogens that are 

resistant to antibiotic treatments, he said. And we are more aware 

that some people face special risks from foodborne disease: the very 

young, the elderly, pregnant women, and people with weakened 

immune systems. 

People are also changing their eating habits and risks of illness can 

rise with increased reliance on foods prepared by others, including 

convenience foods, salad bars, and fast foods. “Basically,” he said, 

“we are eating more and more foods that have been prepared or 

processed at some level before they get to us. We are also eating out 

said, “a lot of the 

simple problems have 

been solved when it 

comes to foodborne 

pathogens. The complex issues are ahead 

of us.” 

Most significantly, he 

Conference Proceedings 13 
”The world is counting 

on you,“ he added. ” 

and once you start, you 

can‘t stop. Because the 

‘bugs‘ will catch up with 

you. Are you up to the 

challenge?” 

more and bringing food into the home that has already been 

prepared.” 

Environmental factors affecting the risk of contracting foodborne 

illness in the U.S. include centralized food production and changes in 

food production methods. Because of mass production and distribution, increasing numbers of large multi-State outbreaks of foodborne 

illness were recorded in the past decade. 

Another factor is globalization of the food supply. While testing 

programs don’t show widespread contamination of produce, a 

significant percentage is imported: 35 percent of fresh fruits and 10 

percent of fresh vegetables. In addition, 62 percent of fish, fish 

products, and shellfish are imported. 

Another environmental factor of concern is safe handling of animal 

manure. Dr. Liang noted that there are real problems dealing with 

the glut of animal manure produced in the U.S. CDC’s FoodNet casecontrol data shows that E. coli O157 and Campylobacter have been 

transmitted through contact with farm animals, and by living on or 

visiting a farm. In addition, E. coli O157 has been transmitted 

through gardening and direct and indirect contact with manure. 

“Direct contact with manure can be a problem,” Dr. Liang said. 

But in spite of these challenges, significant progress is being made in 

the war on pathogens, Dr. Liang maintained. “We are getting better 

at recognizing outbreaks and what causes them. We are improving 

surveillance and our ability to detect these problems. To some extent, 

these problems were out there and invisible, and we are just getting 

better at recognizing them,” he said. 

Dr. Liang described CDC’s PulseNet, which provides DNA “fingerprinting” of pathogens. “It is allowing us to see the invisible. If you have a 

common organism like Salmonella, you can actually fingerprint the 

Salmonella so you can recognize a cluster of activity that might 

otherwise have been missed behind all the other background. It also 

aids in the investigation. You actually can match the patient’s isolates 

to the food, and then find the same Salmonella in the factory,” he 

explained. 

The CDC is also exporting technology to State labs to aid in the 

identification of Norwalk virus and enable more rapid response to 

outbreaks. “The Norwalk virus is one of the hard problems because 

there is no industrial fix,” he said, noting that, “if there is no industrial fix, then educators are the fix or final barrier preventing illness.” 

Real progress is also being made in improving food safety as a result 

of improvements in Federal inspection and regulations, as implementing Hazard Analysis and Critical Control Point systems, innovative technologies, hygienic processing, water chlorination, and food 

safety education. 

Even with the decline in the number of foodborne illnesses, Americans continue to suffer from foodborne pathogens. The CDC esti14 Thinking Globally– Working Locally: A Conference on Food Safety Education 
mates that 76 million cases of foodborne illness occur annually, 

resulting in 323,000 hospitalizations and 5,000 deaths. That means 

that 1 in 4 Americans develops a foodborne illness every year and 1 in 

1,000 is hospitalized. The overall cost to society is $6.5 billion a year, 

equivalent to the CDC’s annual budget, Dr. Liang said. 

While Norwalk-like viruses are the most common cause of foodborne 

illness, bacterial pathogens remain the leading cause of death. 

Salmonella is the leading cause of death from foodborne illness, 

31 percent. It is followed by Listeria, 28 percent; Toxoplasmosis, 

21 percent; Norwalk-like viruses, 7 percent; Campylobacter, 5 percent; 

E. coli O157:H7, 3 percent; and Other, 5 percent. 

“Food is produced, distributed, and prepared in a very complex 

web—and we are always exposed,” Dr. Liang said in conclusion. “So 

even if a single meal is of a relatively low risk, over a lifetime you 

have to consider how many meals you eat. Basically, everyone has to 

do everything right every time.” 

In the “war” with microbes, Dr. Liang said, microbes have unique 

advantages. “We need to respect the microbes. They can rapidly 

adapt, even by the hour. And they have a 3.5 billion year head start 

on people. But that’s where you come in,” he said, because “the 

unique human adaptability is the transfer of information and 

learning from the past.” 

“The world is counting on you,” he added. “And once you start, you 

can’t stop. Because the ‘bugs’ will catch up with you. Are you up to 

the challenge?” 

Panel: What They Say They Do...What They Actually Do: New Data 

About Consumer Behavior and Food Handling and What It Means for 

Educators 

Introduction 

Christine Bruhn, Ph.D., University of California, Davis, 

Moderator 

“One of the factors I have always considered when communicating to 

the public is that the first step in communicating is listening. Listening to hear what consumers have to say; listening to hear what they 

think. I believe after this program we are going to find that listening 

isn’t enough. Actually we need to watch, also, to see what consumers 

do. And we need to try to understand what has led to their actions.” 

Alan Levy, Ph.D., Center for Food Safety and Applied Nutrition, Food and Drug Administration—Cognitive Antecedents 

of “Good” Food Safety Practices 

Dr. Alan Levy is the senior scientist in the Consumer Studies Team at the 

Center for Food Safety and Applied Nutrition at the Food and Drug 

“One of the factors I 

have always considered 

when communicating to 

the public is that the 

first step in communicating is listening. Listening 

to hear what consumers 

have to say; listening to 

hear what they think. I 

believe after this 

program we are going 

to find that listening 

we need to watch, also, 

to see what consumers 

do. And we need to try 

to understand what has 

led to their actions.” 

Christine Bruhn 

isn’t enough. Actually 

Conference Proceedings 15 
“Consumers practice 

safe food behavior 

when they perceive a 

direct risk to themselves. 

General risk information 

is not enough,” he said. 

Dr. Alan Levy 

Administration (FDA), where he works on labeling, education, and consumer communication issues. Prior to coming to FDA, he taught Social 

Psychology at Duke University and conducted public policy research for 

other government agencies. He is currently working on a number of food 

safety projects, as well as dietary supplement labeling issues. 

“Trends in reported safe food handling behaviors on the part of 

consumers are remarkable both in the magnitude of improvement 

and because of their sudden onset,” reported Dr. Alan Levy. He bases 

his conclusion on the FDA/USDA Food Safety Surveys of 1988, 1993, 

1998, and 2001. 

The data is based on answers to a detailed questionnaire administered through a nationwide telephone survey to 4,500 adult 

consumers. 

“Consumption and handling practices began to improve greatly in 

1993. Since then, improvement has continued for consumer handling 

practices and has been sustained for consumer consumption 

practices,” he said. 

These improvements, according to Levy, are evidence that the average person has a greater understanding of food safety. “This in turn 

must be due to the effectiveness of the information, messages, and 

the coverage of food safety stories that have inundated the public in 

the past few years,” he said. 

At the same time, research also indicates that knowledge doesn’t 

necessarily translate into action, Levy reported. The single most 

important factor affecting consumer behavior, he said, is consumers’ 

perception of risk. “Consumers practice safe food behavior when 

they perceive a direct risk to themselves. General risk information is 

not enough,” he said. 

Another thought-provoking conclusion Levy offered: Consumer 

knowledge and awareness of foodborne illness and pathogens can 

work against them. Why? Because consumers can become overconfident. They have mistaken ideas about risks and remedies and 

erroneously believe they can manage the risks, Levy explained. They 

also have erroneous ideas about how to execute safe food handling 

practices—for instance, how to correctly wash hands or surfaces like 

countertops. 

In light of these findings, Levy advised educators to ”challenge 

consumer complacency, emphasize individual risks, and provide 

‘practice specific‘ information about how to handle food safely.“ 

In his presentation to conference attendees, Levy explained the 

survey design, as well as details of the survey’s results and assessments. Levy noted that the data allow for the interrelationships 

among all the different measures to be controlled during the analysis 

to determine those factors most directly responsible for whether a 

person reports good food safety practices. As a result, the data allow 

researchers to identify the “cognitive antecedents of good food 

safety practices”—in other words, the factors that influence behavior 

change. From that, educators can develop more effective messages. 

16 Thinking Globally– Working Locally: A Conference on Food Safety Education 
The survey measured a number of specific food safety practices and 

obtained information on the respondents—including demographic 

characteristics, food choices, cooking experience, food safety knowledge, attitudes, risk perceptions, and sources of food safety 

information. 

Levy reported that the survey included questions on three separate 

measures of good food safety practices: 

•	 Clean and separate: Questions asked respondents how they 

washed their hands and cutting boards before starting meal 

preparations or after handling various kinds of raw foods. 

•	 Cook: Respondents were questioned concerning eating raw or 

undercooked protein food—including shellfish, hamburger, 

and eggs. 

•	 Chill: Several questions were asked regarding cooling practices 

including how long, if at all, respondents left certain foods out 

of the refrigerator. 

In addition, survey questions covered other variables. Consumers were 

asked about their: 

•	 Status as a meal preparer in the home, whether there are 

young children under 5 years old in the home, and whether 

respondents report that someone in the home had a 

foodborne illness experience in the past year; 

•	 Knowledge of six microbial pathogens; 

•	 Perceptions of risk of foodborne illness in today’s world, and 

how much risk they believe they personally take when they fail 

to follow specific food safety practices; and 

•	 Information sources concerning foodborne illness. They were 

also queried on their awareness of the USDA safe handling 

label on meat and poultry products, whether they could correctly remember any of the messages from the label, and if 

they had changed their behavior after reading the message on 

the label. 

The survey results, Levy explained, control for demographic characteristics, respondents’ patterns of food choices, and the joint effects of 

all the other cognitive variables on the dependent variables. “What 

remains,” he said, “is the direct effect, due to a given cognitive 

variable, on the specific good food safety practice. This is the pure, 

direct effect, unmediated by any other variable in the analysis.” This 

allows researchers to identify factors that directly influence consumer 

behavior. 

The results, according to Levy, support the conclusion that the key 

factor influencing consumer behavior is their individual perception of 

risk. Survey questions regarding behavior and risk were the most 

likely to yield a strong link to good food safety practices. 

For example, he said, how consumers answer the question “How 

likely are you to get sick if you forget to wash your hands before you 

begin cooking?” is a good predictor of respondents’ food handling 

practices. 

In light of these findings, 

Levy advised educators 

to ”challenge consumer 

individual risks, and 

provide ‘practice specific‘ 

information about how 

complacency, emphasize 

to handle food safely.“ 

Conference Proceedings 17 
On the other hand, knowledge about foodborne illness and pathogens was inversely related to safe food handling, Levy said. In fact, 

Levy pointed out, the profile of the consumer least likely to worry 

about their safe food handling practices matches the consumer who 

is most knowledgeable. “They have more experience in the kitchen, 

are more educated, and more knowledgeable about food safety. 

They are confident they are handling their food safety risk. These 

people express complacency, not because they don’t know about the 

risk, but because they feel confident they are effectively managing 

the risk,” he said. 

Other surprising results: • Views about foodborne illnesses as a general problem in 

society are not predictive of safe food handling behavior. 

•	 Having children does not positively relate to safe food


handling practices.


•A recent foodborne illness experience does not lead to good 

food safety practices and, in fact, these respondents appear 

more likely to eat raw or undercooked protein foods. 

•	 Knowledge of the most common pathogens also does not 

translate into safe food handling practices. 

Levy said the research clearly shows that, “Consumers practice safe 

food behavior when they think about it. They think about it when 

they perceive a risk, but may not perceive a risk if they are confident 

they are controlling their risk. And, they may have mistaken ideas 

about which practices are effective at reducing risks.” 

The implications of this research provide direction to educators. “We 

need effective education that challenges undue complacency,” Levy 

said. “Practice-specific information is likely to work better than 

general information. And we need to challenge consumers’ assurance 

that they know what they are doing.” 

Panel: What They Say They Do...What They Actually Do: New Data 

About Consumer Behavior and Food Handling and What It Means for 

Educators 

Patricia Kendall, Ph.D., R.D., Extension Specialist, Colorado 

State University—Food Safety Behavior of Nutrition Program Graduates: Do They Do What They Say They Do? 

Dr. Patricia Kendall’s research and outreach work focuses on communicating with consumers about health risks, particularly risks associated with 

the safety of the food supply. The author of more than 100 publications 

for scientific and lay audiences and more than 2,000 newspaper columns 

on food and nutrition topics, she has held a variety of positions at the 

Department of Food Science and Human Nutrition at Colorado State 

University. For the past few years, as an Extension Specialist at Colorado 

State University, she has collaborated with Extension Specialists in Ohio 

and Washington to research projects designed to better understand food 

safety behaviors of importance to targeted audiences and evaluation 

processes that can be used with confidence. Dr. Kendall holds a Ph.D. in 

Nutrition Education from Colorado State University. 

18 Thinking Globally– Working Locally: A Conference on Food Safety Education 
Patricia Kendall, professor and extension specialist at Colorado State 

University, reported on a unique research project designed to develop valid instruments for assessing the impact of food safety instruction on actual food handling. To do that, the researchers provided food safety instruction followed by observational research— 

and then measured how consumers’ actual food handling compared 

to their self-reported 

behaviors. 

The research was part of a larger study supported by a grant from 

the Cooperative State Research, Education, and Extension Service of 

the U.S. Department of Agriculture. One of the goals of their research was to identify high risk behaviors that should be targeted for 

future food safety education efforts. 

Working with Lydia Medeiros from Ohio State University and Val 

Hillers from Washington State University, Kendall and colleagues first 

surveyed food safety experts to achieve a consensus on the behaviors 

to be studied. Based on those behaviors, instruction was then provided to 50 low-income consumers enrolled in nutrition education 

classes. These consumers were then tested on their knowledge and, 

finally, observed while preparing food at a community kitchen. 

So, after having been provided instruction on safe food handling, 

how safe were these consumers’ food handling practices? How well 

did their self-reported behaviors correlate to their actual behaviors? 

And what were their riskiest food handling behaviors? 

“This group did very well,” noted Kendall, pointing out that the 

participants knew they were being videotaped. “Ninety-two percent 

of them did wash their hands and did do it correctly before they 

began food preparation.” Participants also knew that they needed to 

clean utensils and cutting boards to avoid cross-contamination. 

And while most participants did not use a thermometer, almost all 

cooked the foods to adequate temperatures: 90 percent cooked 

chicken breast to 160 0

F. However, knowledge about how to use food 

thermometers was definitely lacking, Kendall reported. 

But, the riskiest behaviors involved cross-contamination. More skills 

are needed in this area, Kendall said. Consumers aren’t aware of the 

importance of correctly washing their hands after handling raw 

foods, like poultry and meat. For instance, when observed, 74 percent 

of consumers did not wash their hands correctly after handling raw 

chicken. 

Consumers also need more information about cleaning countertops 

before and after food preparation—98 percent didn’t clean the 

countertops before food preparation and 76 percent didn’t clean 

correctly after preparing food. 

In explaining the research project to conference attendees, Kendall 

noted that their first step was to reach consensus on risky food 

handling behaviors. To do this, the researchers worked with 40 food 

safety experts, including food microbiologists, food epidemiologists, 

food safety educators, and food safety policy makers. With input 

from the food safety experts, researchers identified 29 behaviors and 

“This group did very 

well,” noted Kendall, 

pointing out that the 

participants knew they 

were being videotaped. 

“Ninety-two percent 

of them did wash their 

hands and did do it 

correctly before 

they began food 

preparation.” 

Patricia Kendall 

Conference Proceedings 19 
prepare a chicken breast 

to their own recipe and 

to their desired doneness, 

then slice an apple to go 

with the chicken,” she 

said. “Then they were 

asked to cook a hamburger to their desired 

doneness and slice a 

tomato to go with the 

“We asked them to 

hamburger.” 

then developed survey questions designed to shed light on these 

behaviors. 

The questions were grouped as follows: 

•	 practice personal hygiene (5 questions), 

•	 cook foods adequately (12 questions), 

•	 avoid cross-contamination (7 questions), 

•	 keep foods at safe temperatures (12 questions), and 

•	 avoid foods from unsafe sources (16 questions). 

Kendall and her project team then targeted 30 to 60 minutes of food 

safety education to low-income consumers already enrolled in food 

and nutrition programs. About a week after completing the training, 

the participants answered the food safety questionnaire to test their 

knowledge. 

Fifty class members who were the primary food preparers were then 

recruited to take part in a cooking methods study, according to 

Kendall. Participants were provided with food, equipment, and 

recipes and then observed as they prepared the food in a community 

kitchen. 

“We asked them to prepare a chicken breast to their own recipe and 

to their desired doneness, then slice an apple to go with the 

chicken,” she said. “Then they were asked to cook a hamburger to 

their desired doneness and slice a tomato to go with the 

hamburger.” 

The specific behaviors monitored during the observational study 

were: 

• washing hands before food preparation, avoiding


cross-contamination;


•	 thoroughly rinsing fruits and vegetables; 

• washing hands and utensils with soap and water during


preparation;


•	 cleaning food preparation surfaces; and 

•	 cooking food adequately. 

Following the cooking session, participants then participated in an indepth interview during which researchers queried them on their food 

handling at home. 

Additional specific findings from the study include: 

•	 92 percent correctly washed their hands before preparing 

food, 4 percent did not wash their hands correctly, 4 percent 

did not wash their hands—this correlates to their self-reported 

practices and responses to the questionnaire with a 92 percent 

agreement. 

•	 24 percent correctly washed their hands after handling raw 

chicken; 74 percent wiped or rinsed their hands, but did not 

wash them correctly—this represents 94 percent agreement 

with the responses to the questionnaire if incorrect 

20 Thinking Globally– Working Locally: A Conference on Food Safety Education 
handwashing attempts were included and 18 percent 

agreement if they were not. 

•	 76 percent washed the cutting board used for the chicken 

before cutting the apple—this represents 83 percent 

agreement with the responses to the questionnaire. 

•	 74 percent thoroughly rinsed the fresh fruit and vegetable 

under running water—this represents 68 percent agreement 

with the responses to the questionnaire. 

•2 percent cleaned the countertops with hot, soapy water 

before preparing food; 98 percent did not clean at all—this 

represents 

12 percent agreement with responses to the questionnaire. 

•	 76 percent incorrectly cleaned the countertops after preparing 

food; 18 percent didn’t clean at all; 6 percent cleaned correctly 

—this represents 76 percent agreement with responses to the 

questionnaire. 

•	 18 percent used the thermometer to determine if the chicken 

breast was cooked adequately; many that did try to use a 

thermometer stopped when they realized they did not know 

how to use the thermometer—67 percent agreement with the 

questionnaire. 

•	 90 percent cooked the chicken breast to 160 

0

F even without a 

thermometer. 

Panel: What They Say They Do...What They Actually Do: New Data 

About Consumer Behavior and Food Handling and What It Means for 

Educators 

Janet Anderson, M.S., R.D., Utah State University—What 

Consumers Say They Do...What They Actually Do: A 

Comparison 

A Clinical Associate Professor in the Department of Nutrition and Food 

Sciences at Utah State University, Ms. Janet Anderson’s primary duty is 

teaching in the Coordinated Program in Dietetics where she is responsible 

for teaching quantity foods production and food service management 

courses, with an emphasis in school food service and health care food 

service. A Registered Dietitian with experience in managing food service 

operations, she has expertise in retail food safety and teaches the Utah 

State University Extension Food Safety Manager Certification courses via 

satellite to food service managers throughout the state of Utah. Ms. 

Anderson also is the Director of the Safe Food Institute, the mission of 

which is to research consumer behavior and develop effective 

educational messages and materials based on scientifically valid data. 

“From our research, consumers are not doing what they say they do 

in terms of handling food safely,” said Janet Anderson, Clinical 

Associate Professor in the Department of Nutrition and Food Sciences 

at Utah State University. Working with support from the Food and 

Drug Administration, Anderson is one of the first U.S. researchers to 

use observational techniques to see how consumers are actually 

handling food in their kitchens—and to compare those results to the 

behaviors consumers report on surveys. 

Conference Proceedings 21 
“From our research, 

consumers are not doing 

what they say they do in 

terms of handling food 

Janet Anderson 

safely.” 

According to Anderson, the discrepancy may exist for a number of 

reasons: consumers are simply not aware of how they are handling 

food, they forget what they do, or they answer surveys in “ways they 

think are appropriate.” 

Anderson’s insights are the result of research that she has been 

conducting for the past several years. 

Anderson enlisted 122 consumers in a 2-phase project purportedly 

designed to “test recipes” in their homes. “The consumers were 

unaware of the food safety purpose of the study,” said Anderson, 

noting that participants were told the purpose of the study was to 

conduct market research on food preparation practices. In fact, that 

was the original intent of the study, she said, until researchers saw 

the videotapes and the lack of food safety practices. 

Participants received a bag of groceries and recipes for a salad and 

either a beef, chicken, or fish entrée, explained Anderson. They were 

asked to put the groceries away as they normally would and then to 

prepare the recipes. Three small wireless cameras strategically placed 

in the participants’ kitchens recorded the actions of participants’ 

hands. After the meal was prepared, a survey was administered to 

the participants asking them about their safe food handling practices. The videotapes were coded for food safety behaviors using the 

four steps of the Fight BAC!® recommendations—clean, separate, 

cook, and chill. 

Comparing consumers’ survey responses to the videotapes revealed 

some significant discrepancies between what people reported they 

did in the kitchen and what they actually did. As Anderson noted, 

“Surveys are good for assessing consumer food safety knowledge and 

attitude, but we need observational methodologies to really assess 

consumers’ food safety behavior.” 

Before highlighting the results, Anderson cautioned her listeners to 

“keep in mind that if someone is going to come into your home with 

video cameras, you are going to be on your best behavior. And your 

kitchen is going to be clean. We even had people dusting their 

refrigerator as we walked up to the front door. So, keep in mind they 

are on their best behavior.” 

Some of the highlights of discrepancies between what consumers say 

and what they do: 

How often do you wash your hands with soap before

 preparing food? 

Sixty percent of consumers say they wash their hands all of the time. 

But what do consumers really do? 

Fifty-two percent did wash their hands. “But,” says Anderson, “how 

many of these were actually effective? To some extent, many were 

just putting their hands in water.” Thirty-two percent washed with 

22 Thinking Globally– Working Locally: A Conference on Food Safety Education 
cold water and soap. Only 2 percent actually washed correctly, with 

hot water, soap, and agitation. 

How long should you spend washing your hands before 

preparing food? 

On average, consumers said almost a whole minute: 56 seconds. 

But what did they actually do? The average time actually spent 

“washing” was 7 seconds. 

What do you know about cooking ground beef and chicken? 

Some issues just continue to confuse consumers, like final cooking 

temperatures. 

Only 9 percent reported the correct temperature of 160 0

F for ground 

beef. Only 3 percent reported the correct temperature of 170 0

F for 

chicken breasts. Their responses ranged from 100 to 500 0F. 

And the results of that confusion showed up in the cooked entrees. 

Forty-six percent of consumers undercooked the ground beef; 82 

percent undercooked the chicken entree. 

Other disturbing observations: the dad who wiped up a spill from a 

raw chicken and then turned around and wiped the baby’s face with 

the same towel; and consumers who tasted the ground beef entree 

to see if it was “done.” 

One bright spot: 99 percent of consumers correctly reported that it 

was risky to serve the cooked entree on the same platter that had 

been used for raw meat or poultry. And—none of the observed 

subjects served the cooked food on the same plate that held the raw 

food. Also on the positive side: while only 29 percent of consumers 

said they stored cooked food in shallow containers, when observed, 

48 percent actually put their food in shallow containers. 

Some additional discrepancies highlighted by comparing consumers’ 

survey responses to behavior observed on the videotapes: 

Is NOT washing your hands after handling raw eggs a risky 

behavior? 

Survey: 75 percent said this is risky behavior. 

Observation: 60 percent failed to wash their hands after handling 

raw eggs in the preparation of recipes. 

How do you know when hamburgers are done? 

Survey: 64 percent reported they cut the meat, 19 percent used the 

color of the juice, 8 percent looked at the outside, 3 percent cooked 

for a certain time, 1 percent used a thermometer. 

Observations: 30 percent cut the meat with a knife, 34 percent used a 

utensil on the surface to extract juice, 58 percent looked at the 

outside, 0 percent cooked for a certain time, 3 percent used a 

thermometer, 7 percent tasted the meat. 

Fifty-two percent did 

wash their hands. “But,” 

says Anderson, “how 

many of these were 

actually effective?” 

Conference Proceedings 23 
How often do you use a thermometer when cooking? 

Survey: 10 percent reported always, 10 percent often, 

35 percent occasionally, 41 percent rarely, 3 percent never. 

Observations: Only 3 percent used any temperature indicator device 

and only 1 person used the thermometer properly. 

To what internal temperature should ground beef be cooked? 

Survey: responses ranged from 100 to 500 0

F. Only 9 percent accurately reported 160 0

F. 

Observations: 46 percent undercooked the ground beef entrée and 

the final cooked temperature of entrees ranged from 129 to 197 0

F. 

To what internal temperature should chicken breast be 

cooked? 

Survey: responses ranged from 100 to 500 0

F. Only 3 percent reported 

the correct temperature of 170 0

F. 

Observations: 82 percent undercooked the chicken entrée and the 

final cooked temperature of entrees ranged from 132 to191 0

F. 

What do you use most often to clean your countertops in your 

kitchen? 

Survey: 76 percent dishcloth, 14 percent sponge, 10 percent paper 

towels. 

Observations: 46 percent contaminated cloth, 26 percent cloth, 

10 percent contaminated sponges, 7 percent sponges, 

7 percent paper towels, 2 percent scrub brushes. 

How would you store a large pot of soup or stew? 

Survey: 35 percent reported they would store in a large, deep container with a cover; 33 percent said original pot; 25 percent said 

small, shallow containers with covers; 4 percent said small shallow 

containers without covers; 3 percent said a large, deep container 

without cover. 

Observations: 23 percent stored leftover entrée in original cooking 

container; 7 percent in a large, deep container; 48 percent in shallow 

container; 23 percent with a cover. (A third of the refrigerators in the 

study had temperatures over 40 0

F.) 

Panel: What They Say They Do...What They Actually Do: New Data 

About Consumer Behavior and Food Handling and What It Means for 

Educators 

Sheryl Cates, Research Triangle Institute International— 

Changes in Consumer Knowledge, Behavior, and Confidence 

Since the 1996 PR/HACCP Final Rule 

Ms. Sheryl Cates is a Research Business Analyst in the Food and Nutrition 

Policy and Consumer Behaviors Program at RTI International where she 

24 Thinking Globally– Working Locally: A Conference on Food Safety Education 
manages studies funded by the USDA, FSIS, and FDA on food safety issues. 

She conducts research to design and evaluate consumer education 

programs and labeling messages, and to evaluate changes in consumer 

practices as a result of education initiatives and food safety labeling. Ms. 

Cates employs both qualitative and quantitative research methods, 

including focus groups, in-depth interviews, telephone surveys, and webenabled panel surveys. Ms. Cates has published in the Journal of Food 

Protection and Resource and Energy Economics. 

How have consumers’ food safety knowledge and behavior changed 

since 1996? 

Sheryl Cates of the Research Triangle Institute (RTI) tackled this 

question for the U.S. Department of Agriculture’s Food Safety and 

Inspection Service (FSIS). In searching for answers, Cates surveyed a 

wide variety of existing consumer research conducted from 1993 

through 2000 and conducted a series of new focus group research. 

Her research specifically sought to assess changes in consumer knowledge and reported use of safe food handling practices and confidence in the safety of meat and poultry since the 1996 FSIS Pathogen 

Reduction/Hazard Analysis and Critical Control Point rule. 

One reason this research is significant is because it tracks changes in 

consumer behavior over a period of years and summarizes research 

conducted by a wide variety of organizations, including Federal 

agencies, industry, and academe. Research methodologies included 

surveys, focus groups, and observational studies. 

In addition, Cates’ research included new focus group research, which 

was “very valuable in helping us understand the ‘why’ behind 

changes in consumer knowledge and confidence. It also raised questions about just how well people were following through on their 

actions,” she explained. 

Cates’ findings echoed concerns voiced by other researchers: Consumers are more confident in the safety of meat and poultry. They are 

also more confident in themselves. But despite knowledge and good 

intentions, consumers may still be making some significant mistakes 

when it comes to handling food safely. 

Her examination of existing research confirmed that consumers are 

more knowledgeable about pathogens. In fact, 93 percent of 

consumers are aware of Salmonella and 88 percent of consumers are 

aware of E. coli O157:H7. Consumers also understand that pathogens 

can be destroyed by cooking. 

At the same time, observational studies and focus group research cast 

doubt on the impact of this knowledge. 

“In focus groups, consumers tell us they are very concerned about 

food safety, so they take precautions when cooking at home to 

protect their family from foodborne illness. They also express confidence in their ability to safely handle meat and poultry,” Cates said. 

In addition, Cates’ 

research included new 

focus group research, 

which was “very valuable 

in helping us understand 

the ‘why’ behind 

changes in consumer 

knowledge and confidence. It also raised 

questions about just how 

well people were following through on their 

actions,” she explained. 

Sheryl Cates 

Conference Proceedings 25 
“But in discussions about their actual practices, they reveal that they 

sometimes follow some unsafe practices.” 

In addition, focus group research revealed that consumers are frequently confused about who faces increased risk of foodborne illness. 

Most people are not aware that pregnant women are a high-risk 

group, Cates reported. Many seniors also did not recognize their 

risks. In a focus group made up of seniors 60 and older, “they didn’t 

see themselves as high risk. They felt people at risk were seniors 80 

and older,” Cates revealed. 

Consumers also continue to believe, mistakenly, that most foodborne 

illness originates in food processing plants or restaurants, as opposed 

to their own homes. 

And while consumer awareness of most pathogens has increased 

significantly, awareness of Listeria remains low. (At the same time, 

awareness of Listeria has nearly tripled from 1993 to 2001, increasing 

from 9 percent to 31 percent.) 

And how do consumers rate the government’s performance? While 

they feel the government is doing an adequate job, they don’t think 

it has improved its performance in the past 5 years. They do feel that 

media scrutiny, however, is effective. 

“Consumers tell us that they get a lot of information on food safety 

from the media, from local television news, and from television news 

shows and cooking programs,” said Cates. “They report that hearing 

about food safety in the media has made them more knowledgeable, 

so they have improved their safe food handling practices.” In addition, consumers say that media coverage of food safety problems, 

such as recalls or re-wrapping and re-dating meat products encourages manufacturers to “clean up their acts,” making consumers feel 

more confident in the safety of the products, according to Cates. 

Also on the plus side, while regular use of food thermometers 

remains relatively low, more consumers own them and use them. 

While consumer use of food thermometers to check small cuts of 

meat remains low, it also doubled between 1998 and 2001. Approximately 12 percent of consumers now regularly use a food thermometer to check small pieces of chicken; 6 percent use it to check their 

hamburgers. Thirty-two percent use a food thermometer to check a 

roast. And, the number of people owning a food thermometer has 

increased from 46 percent to 60 percent. 

In general, Cates reported, her research indicates consumers need 

more guidance concerning: 

• 	 using food thermometers, 

• 	 safely storing leftovers, and 

• 	 safely thawing meat and poultry. 

Specifically, 

•	 Consumers report that they cook meats longer, particularly 

hamburgers, because of safety concerns. They rely on a variety 

Thinking Globally– Working Locally: A Conference on Food Safety Education 

“In focus groups, 

consumers tell us they 

are very concerned 

they take precautions 

when cooking at home 

to protect their family 

from foodborne illness. 

They also express 

confidence in their 

ability to safely handle 

Cates said. “But in 

discussions about their 

actual practices, they 

reveal that they 

sometimes follow some 

unsafe practices.” 

about food safety, so 

meat and poultry,” 

26 
of methods for testing the doneness of the meat and poultry, 

with color mostly used as an indicator of doneness. In focus 

groups, consumers indicate they are not generally aware of the 

quality, as well as safety, benefits of using a food thermometer. 

• Only about 25 percent of consumers safely store large amounts 

of leftovers within 2 hours in shallow containers, she reported. 

Focus group findings also suggest that consumers are unaware 

that perishable foods should be refrigerated or frozen within 2 

hours. About half of consumers still thaw meat and poultry on 

the countertop. 

• Only 33 percent of consumers own a refrigerator thermometer 

and only 40 percent are aware of proper refrigerator 

temperature. 

•	 According to surveys, consumers seem to have a good understanding of cross-contamination and are following practices 

that keep raw meat and poultry separate from food that will 

not be cooked. They also are more careful to use separate 

cutting boards. Focus group research, however, suggests that 

in reality, consumers may not always follow these practices. 

Consumers are also not as conscientious about keeping meat 

and poultry products separate from other foods while grocery 

shopping or storing foods in the refrigerator. 

Panel: What They Say They Do...What They Actually Do: New Data 

About Consumer Behavior and Food Handling and What It Means for 

Educators 

Christopher Griffith, Ph.D. University of Wales Institute 

Cardiff, United Kingdom 

Professor Christopher Griffith has lectured on aspects of medical and 

food microbiology for more than 20 years and been involved in food 

safety research for 18 years, including 12 years of consumer-based research. As Head of the Food Research and Consultancy Unit and Director 

of Enterprise and Development for the School of Applied Sciences at the 

University of Wales Institute, Cardiff, he is involved with food safety at all 

points within the food chain. He has authored/co-authored more than 150 

books, book chapters, scientific papers, and conference proceedings 

related to food safety, including the How To series of books, the most 

recent of which is How to Clean—A Management Guide and How To 

HACCP, 3rd Edition. Dr. Griffith has received a number of international 

awards, including a New Zealand ESR international research fellowship in 

1999 and a Welsh National Assembly Award in 2002. 

Dr. Christopher Griffith, professor in food safety at the University of 

Wales Institute, Cardiff, observed that, based on his research, “the 

most important tool in the kitchen is the human brain—and the best 

advice to consumers may be to think more about their actions.” 

In addition, Griffith suggested that future consumer research needs 

to address new issues, such as the microbiological risks associated 

with specific behaviors. 

“The most important 

tool in the kitchen is the 

human brain—and the 

best advice to consumers 

may be to think more 

about their actions.” 

Dr. Christopher Griffith 

Conference Proceedings 27 
Griffith noted that about 85 percent of the studies concerning consumers’ food handling practices have taken place since the mid1990’s, primarily in the United States and the United Kingdom. “At 

that time, we suddenly realized that consumer food safety does 

require some attention,” he said, adding that conferences on food 

safety give credibility to consumer studies and aid in the establishment of consumer food safety research as an appropriate scientific 

discipline. 

From a recently published review analyzing 88 consumer research 

studies, Griffith noted that surveys were the most popular form of 

research. Most data has been collected “on consumers’ knowledge 

about various aspects of food safety and how consumers practice 

food safety based on self-reporting. There has been less work done 

on people’s attitudes toward particular elements of food safety and 

the actual practices they use,” he said. 

“At first we needed to study consumers because we didn’t know 

what their beliefs were. Now we are getting a body of knowledge 

and can identify trends. Our next step is to take the research forward 

to quantitative risk assessment—what really happens in the kitchen 

and what are the consequences? This needs then to be linked to costbenefit analysis and educating the consumer to achieve behavioral 

change. In Cardiff, we are currently using social marketing to try to 

achieve this,” he said. 

“The United States is carrying out some very large studies on quantitative risk assessment, but one of the weaknesses in these studies is 

incorporating what happens in the kitchen of either the food establishment or the home into the risk assessment. I think this is an 

important issue for us to address.” 

Based on his observational research and exposure assessment, Griffith 

cited cross-contamination as a major risk factor, for certain pathogens, that needs to be emphasized. For pathogens such as 

Campylobacter (the most commonly reported cause of bacterial food 

poisoning in the U.K.), it is likely to be more important than 

undercooking or poor storage. 

“It is likely to be an underreported risk factor. In outbreak investigations, people may remember that the meat was undercooked,” he 

said, “but they won’t remember if a cloth that wiped the surface 

where the raw meat had been was subsequently used to wipe the 

surface where cooked food was handled.” 

Another challenge facing educators, according to Griffith, is that 

most consumer research shows that consumers frequently misunderstand safe food handling advice. “If you talk to people and ask why 

they think they can have a steak rare but not a burger, they do not 

precisely understand the ‘whys.’” 

In general, Griffith observed, people may be unaware of their own 

actions and the risks they face. For instance, he said, “if you are 

trying to persuade people to improve their food handling practices, 

they need to be convinced that you can acquire foodborne illnesses 

28 Thinking Globally– Working Locally: A Conference on Food Safety Education 
in the home. Unfortunately, that is the last place most people think 

they are going to get food poisoning.” 

The home is an important location for contracting foodborne illness, 

he said, making consumer food preparation practices critical. Like his 

American counterparts, Griffith concluded that there is a poor correlation between knowledge and actual behavior. Some of his other 

findings: 

“Most people know to wash their hands,” he said, and that is a 

positive finding. “But when you work with focus groups, things start 

to change. You get statements like: ‘I just rinse them under the 

water’ or ‘I wipe them on the towel.’ They know what to do, but they 

don’t always understand how to do it, why they should do it, or 

when.” 

Another problem is hand-towels. “We have actually picked up 

that hand-drying towels are one of the better places to recover 

pathogens in the kitchen. People handle raw poultry and then put 

their hands under the tap. They get their hands nice and wet and 

then they rub them with the towel, applying mechanical pressure. So 

these pathogens have moisture and mechanical energy—a beautiful 

way to transfer pathogens from the hands to the towel.” 

Cleaning is a related area where consumers have good intentions, 

but lack knowledge and skills—and end up facing risks of foodborne 

illness, he said. “People base cleanliness on a visual assessment. But if 

you use a microbiologically contaminated wet cloth (i.e., the average 

dishcloth) to wipe a visually dirty surface, you might make the surface 

look cleaner, but you increase the microbial contamination level very 

significantly. It’s not uncommon for surfaces to be more contaminated after cleaning than before.” Griffith noted that part of the 

problem with cleaning habits is that many people get instructions on 

cooking from their parents, but few get instructions about cleaning— 

either surfaces or food products. 

Another example: Griffith questioned a common consumer practice 

of rinsing out the carcass of poultry before cooking. “They put it 

under the tap,” he said, “which spreads pathogens around the sink 

and kitchen areas. When you ask them why they do it, they say it is to 

get the ‘muck’ out. They think they are doing something right, but in 

my view, it is counterproductive and the wrong thing to do.” 

To read more about Griffith’s research projects in Cardiff, see Journal 

of Food Protection, “Consumer Food Handling in the Home: A Review of Food Safety Studies,” January 2003; and International Journal 

of Consumer Studies, “A Comparison and Evaluation of Research 

Methods Used in Consumer Food Safety Studies,” January 2003. Both 

of these were written in conjunction with Dr. E. Redmond. 

Panel: What They Say They Do...What They Actually Do: New Data 

About Consumer Behavior and Food Handling and What It Means for 

Educators 

Following the presentations, two designated “reactors” summarized 

their impressions: 

“At first we needed to 

study consumers because 

their beliefs were. Now 

we are getting a body of 

knowledge and can 

identify trends. Our next 

step is to take the research forward to quantitative risk assessment— 

what really happens in 

the kitchen and what are 

the consequences?...” 

we didn’t know what 

Conference Proceedings 29 
“Our challenge as 

educators is two-fold: 

incorporate messages 

within our educational 

programs that motivate 

people to handle 

food safely and find 

evaluation tools that 

we can stand behind so 

we can say our programs 

are making an impact.” 

Angela Fraser 

Val Hillers, Ph.D., R.D., Washington State University 

Val Hillers acknowledged that the consumer behaviors educators are 

trying to change are complex. “I think that we have tended to think 

of these behaviors as fairly simple,” she said. Educators have given 

consumers simple messages, “when clearly consumers don’t understand how to perform these behaviors properly. I think we need to 

get much more detailed,” she said. 

Hillers said she was “interested in Dr. Levy’s remarks that risk perceptions are important to understanding why consumers do what they 

do. My next challenge area is [finding] an appropriate message 

where people understand the risk and how they can control the risk 

without getting complacent. I need to think about this a lot.” 

She also noted that the research points to two behaviors as “the most 

important: personal hygiene and cross-contamination. These are also 

probably the hardest behaviors to teach.... We have lots of work 

collectively to do.” 

Noting the large to-do list facing educators, Hillers also called on 

food equipment engineers and manufacturers to pitch in and build in 

food safety tools. One example, she suggested, is refrigerators. “Why 

can’t refrigerators have built-in thermometers? Then people could set 

the thermometer at the correct temperature and we wouldn’t have 

to go to all the work of telling people to buy a thermometer. And 

consumers wouldn’t have to figure out what a ‘7’ means on the 

refrigerator dial!” 

Angela Fraser, Ph.D., North Carolina State University 

“It is very evident that people are not handling food safely,” said 

Angela Fraser, referring to the findings of the consumer panelists 

that revealed problems with consumer handwashing, cooking, and 

cleaning skills. “We have to realize that simply sharing a message 

about what to do is not necessarily going to lead to a decreased 

incidence of foodborne illness. We have to figure out ways to motivate consumers to apply appropriate safe food handling practices,” 

she said. 

Fraser also suggested that educators need to focus more on making 

consumers aware that they are at risk for foodborne illness. “A lot of 

times they will say, ‘I am not at risk. Prove it. Prove to me that I am at 

risk,” she said referring to her work with older adults. “We need to 

do a better job of convincing the public that they are at risk. I think 

this is probably our first step.” 

Fraser also challenged her fellow educators to improve the quality of 

the tools they use to evaluate the impact of their education programs. “A lot of us develop tools that are not sound, that are not 

valid, and that are not reliable. I recommend to all educators that 

when you evaluate your program, consider the soundness of your 

instrument. The more credible your evaluation instrument, the more 

confident you will be that the information you share with 

stakeholders about program effectiveness is true. 

30 Thinking Globally– Working Locally: A Conference on Food Safety Education 
“Our challenge as educators is two-fold: incorporate messages within 

our educational programs that motivate people to handle food safely 

and find evaluation tools that we can stand behind so we can say our 

programs are making an impact.” 

Food Safety Education: The Victims’ Perspective 

Nancy Donley, Safe Tables Our Priority 

Safe Tables Our Priority (STOP) was founded by Ms. Donley in 1994 

following the death of her son, Alex, from illness caused by eating a 

hamburger contaminated with E. coli O157:H7. Members of STOP have all 

had personal encounters with foodborne illnesses. Ms. Donley described 

STOP members as “actionists” who work with government and industry 

to prevent needless tragedies from foodborne illness. 

“Education alone is not the answer to preventing foodborne illness. 

The answer is to keep pathogens out of the food to begin with. 

Everyone in this room has had an episode of foodborne illness,” said 

Nancy Donley, President of Safe Tables Our Priority (STOP). “Even the 

most knowledgeable still get sick,” she said. 

While Donley feels that education by itself isn’t the answer, she feels 

it has a role. In fact, STOP has recently added an outreach 

coordinator. 

But Donley objects to a concept that she believes can accompany 

education: “If you get sick, it’s your own fault.” Food needs to be 

uncontaminated in the first place, she said. “And we need to apply 

the Hazard Analysis and Critical Control Point approach to the whole 

farm-to-table continuum. The fact that there are no on-farm controls 

is a serious oversight,” she said. 

Donley also noted that consumers face mixed messages from government agencies. “We tell them we have the safest food supply in the 

world, so they don’t see a problem. They have a false sense of security. Another example: Why should consumers cook hamburger to 

160 0

F at home when the restaurants tell them they’ll cook it any way 

they want it. It’s confusing to consumers. And we still haven’t beaten 

the ‘pink’ message. People still mistakenly think they can judge the 

safety of their food by the color.” 

Another problem that Donley sees is that consumers still don’t understand who faces special risks from foodborne illness. “The public is 

unaware of who is at risk—young children, pregnant women, the 

elderly, and the immune-compromised. They have no idea of their 

added vulnerabilities. All education messages should reinforce who is 

especially vulnerable,” she said. 

Donley strongly supports education campaigns, such as Fight BAC!® 

and the Food Safety and Inspection Service’s campaign to promote 

the message that behind 

every dry statistic, there 

are real people, real 

faces, and real stories. 

you. Use them as an 

education tool, if you 

want to put STOP out of 

business.” 

Nancy Donley 

“We want to reinforce 

Take our stories with 

think it can help. We 

Conference Proceedings 31 
the use of food thermometers. Programs for school curriculums, she 

said, are especially important and can help educate parents as well. 

“The messages need to be consistent and truthful,” she said. 

Explaining her organization’s approach, Donley said “we want to 

reinforce the message that behind every dry statistic, there are real 

people, real faces, and real stories. Take our stories with you. Use 

them as an education tool, if you think it can help. We want to put 

STOP out of business.” 

Panel Discussion: Making It Real—Highlights from Successful 

Education Programs 

Science and Our Food Supply: A Food Science Curriculum for 

Middle and High School Students 

Laura Fox, Food and Drug Administration 

Ms. Laura Fox is a member of the Food Safety Staff at the Food and Drug 

Administration (FDA) Center for Food Safety and Applied Nutrition where 

she develops food safety programs for producers, consumers, and the 

media, as well as education campaigns targeted at the general population, those at risk for developing foodborne illnesses, and productspecific initiatives. Ms. Fox is the project manager for two new schoolbased initiatives developed in partnership with the National Science 

Teachers Association: a middle and high school supplementary food 

science curriculum, Science and Our Food Supply, and a week-long professional development program in food science for middle and high school 

teachers. Ms. Fox is an FDA representative to the Partnership for Food 

Safety Education, a national organization dedicated to educating consumers about the importance of food safety. 

Science and Our Food Supply is a public health education program 

that uses food science to teach students about reducing foodborne 

illness through safe food handling and introduces them to careers in 

food science, according to Laura Fox. Middle level and high school 

students were selected as the target audience for the curriculum 

because they often are responsible for preparing food for themselves 

and others and often work in the food service industry. 

The curriculum program, developed jointly with the National Science 

Teachers Association (NSTA), is being distributed for free to science 

teachers throughout the country. 

The unique science curriculum includes an Emmy-award winning 

video and teachers’ guides for middle and high school students. The 

guides include dozens of lab experiments and classroom activities. 

The package also includes an 88-page publication, Food Safety 

Reference A-Z Guide. Because the program is also designed to promote interest in science careers, the Guide includes 16 profiles of 

food science professionals. 

32 Thinking Globally– Working Locally: A Conference on Food Safety Education 
In developing successful science-oriented curricula, Fox stressed the 

importance of partnering with an organization with expertise in 

science education. In developing this program, FDA partnered with 

the NSTA and worked with an advisory group of middle level and 

high school science teachers to ensure that the curriculum was 

academically challenging. 

The advisory teachers and FDA scientists created inquiry-based lab 

experiments and classroom activities to demonstrate that microbiological properties that allow foodborne bacteria to grow and spread 

can be effectively reduced through safe food handling practices. 

The award-winning video component of the program, “Dr. X and the 

Quest for Food Safety,” introduces and reinforces the science 

concepts featured in the activities and experiments. 

Fox said ”teachers are reporting that the Science and Our Food 

Supply curriculum package is an excellent vehicle for teaching science, capturing the students’ interest, and helping teachers meet the 

National Science Education Standards.“ Teachers say the bottom line 

for students completing the curriculum is acquiring better food safety 

habits, Fox reported. 

A complementary professional development program created by FDA 

and NSTA for middle level and high school teachers is being offered 

to encourage teachers to use Science and Our Food Supply. 

Beginning in 2000, 25 middle level and 25 high school teachers came 

to Washington, D.C., for a week-long training program that provided 

them with the opportunity to hear the latest developments in food 

science from FDA scientists, visit research and food processing facilities, practice the lab experiments and classroom activities contained 

in Science and Our Food Supply, and exchange teaching strategies. 

In exchange, the teachers agree to teach a 1-day workshop for other 

teachers in their local area. As of September 2002, Fox reported that 

150 teachers had participated in the program and, in turn, trained 

another 3,750 teachers. 

The program for teachers has been so successful in stimulating interest in food safety that Albertsons grocery store chain agreed to 

sponsor workshops for teachers in California, Washington, and 

Chicago. 

Making It Real—Highlights of Successful Education Programs 

Diagnosis and Management of Foodborne Illnesses: 

A Primer for Physicians 

Julia Smith, M.P.H., Centers for Disease Control and 

Prevention 

Fox said ”teachers are 

reporting that the 

Science and Our Food 

Supply curriculum 

package is an excellent 

vehicle for teaching 

science, capturing the 

students’ interest, and 

helping teachers meet 

the National Science 

Education Standards.“ 

Laura Fox 

Conference Proceedings 33 
“The purpose behind 

the Primer is to assist 

physicians in recognizing 

and managing 

foodborne illness—and 

to facilitate the flow of 

food safety education 

information to high-risk 

patients,” 

Julia Smith 

Ms. Julia Smith is the Associate Director of Health Education in the 

Centers for Disease Control and Prevention’s (CDC) Food Safety Office. 

Her responsibilities include coordination of health education, training, 

and communication activities. Ms. Smith works with other Federal agencies, industry, consumer, and professional organizations to promote food 

safety among consumers, industry, and health professionals. Ms. Smith 

received her Masters in Public Health from the Rollins School of Public 

Health at Emory University and her B.S. in Biology from the University of 

South Carolina. 

With studies showing that physicians are key potential partners in 

food safety education, the American Medical Association partnered 

with Federal agencies to produce Diagnosis and Management of 

Foodborne Illness: A Primer for Health Care Providers, according to 

Julia Smith of the Centers for Disease Control and Prevention. 

More than 15,000 full-color versions of the Primer have been distributed, and the Primer has been distributed to approximately 600,000 

readers as a special supplement to an issue of the CDC’s Morbidity 

and Mortality Weekly Report. 

Physicians are ideally positioned to serve as food safety educators, 

especially with at-risk populations, Smith reported. Physicians have 

contact with approximately 80 percent of the U.S. population during 

a given year. And research indicates that people seeing physicians 

may be more open to changing their behavior because they see 

themselves at risk. 

A CDC survey of physicians serving patients at greatest risk of 

foodborne disease indicates that the physicians are concerned about 

foodborne disease. Eighty percent of the surveyed physicians perceive 

foodborne illness as a serious problem in immunocompromised 

patients and want to be aware of those risks. Fifty-one percent 

perceive their own patients at risk for foodborne illness. 

These physicians also reported that they see themselves as educators. 

Fifty-four percent of the physicians see educating patients about 

foodborne illness as part of their role. Thirty percent already provide 

foodborne information to patients. And the remaining 70 percent of 

physicians want to provide information to their patients. 

Studies also show that consumers value physicians over other health 

professionals as key sources of educational information, she said. “A 

nutrition study showed that education programs involving 1- to 3­

minute pep talks by physicians, followed by the provision of self-help 

materials, are as effective as 30-minute counseling sessions from 

other health professionals in changing behaviors,” Smith reported. 

The Primer provides clinical considerations, patient scenarios, fold-out 

tables of foodborne illness information, clinical vignettes for selfevaluation, suggested reading, and a patient education handout. 

Physicians completing the Primer can take the Continuing Medical 

Examination (CME) for credits. An updated version will have new 

patient scenarios and offer CME and Certified Health Education 

Specialist credits. The material is available in print, or online, at 

http://www.cdc.gov/foodsafety. 

34 Thinking Globally– Working Locally: A Conference on Food Safety Education 
Private practice physicians and those who practice in hospital clinics, 

along with State and local health departments and other public 

health officials are most likely to use the materials, according to 

Smith. The majority of the participants use the Primer as health 

education materials and local practice guidelines. 

As of September 2002, 1,502 physicians had completed the Primer for 

CME credits and 685 have completed it for Continuing Education Unit 

credits. 

Making It Real—Highlights from Successful Education Programs 

Smart Kids Fight BAC!® A Program for Grades K-3 

Judy Harrison, Ph.D., University of Georgia 

Dr. Judy Harrison is an associate professor and extension food specialist 

in the Department of Foods and Nutrition at the University of Georgia. 

She supports the outreach mission of the College of Family and Consumer 

Sciences in the areas of food safety and home food preservation. She 

trains and supports County Extension Family and Consumer Sciences 

Agents, and also develops, implements, and evaluates educational programs for a variety of audiences, including materials and videos for 

training food handlers in child and elder care environments. Dr. Harrison 

also is involved in applied research examining the efficacy of various 

home food dehydration procedures in eliminating the risk of foodborne 

illness from E. coli O157:H7, Salmonella, and Listeria. 

“Smart Kids Fight BAC!® is a complete food safety curriculum for 

grades K through 3, when kids are like sponges,” explained Dr. Judy 

Harrison of the University of Georgia. 

The curriculum program features: 

• an award-winning animated video, 

• activity booklets, 

• teaching guides, and 

• a 4-color storybook. 

A clip from the animated video was aired for conference participants 

and confirmed the program’s high fun quotient—guaranteed to 

appeal to the Saturday morning cartoon set. 

The program was supported in part by a grant from USDA’s Cooperative State Research, Education, and Extension Service. Other partners 

in developing the program included Mississippi State University and 

North Carolina State University. 

Like all the curriculum materials, the 15-minute animated video, 

titled Smart Kids Fight BAC!®, demonstrates the 4 key safe food 

handling concepts in action: “clean, separate, cook, and chill.” In the 

video, the elementary school’s drama class puts on a play with ani-

“Smart Kids Fight BAC!® 

is a complete food safety 

curriculum for grades K 

through 3, when kids are 

like sponges.” 

Dr. Judy Harrison 

Conference Proceedings 35 
storybook to be 

something the kids 

could take home and 

that parents would have 

to read 50 million 

times.” 

“We wanted the 

mated characters representing each of the 4 concepts and fighting 

BAC! 

The activity books that accompany the video are separated for grades 

K-1 and 2-3. The books present a variety of activities that teach 

children about safe food handling while utilizing math, language 

arts, and science skills. The teaching guides show a step-by-step 

approach for delivery and use of the program. 

The package also includes a four-color storybook, He’s BAC! A 

Children’s Guide to Keeping Food Safe. According to Harrison, the 

storybook can be used with the video or as a stand alone book. “We 

wanted the storybook to be something the kids could take home and 

that parents would have to read 50 million times,” Harrison said. 

The curriculum was tested with school children in three States— 

Georgia, Mississippi, and North Carolina. Cooperative extension 

agents worked with local teachers who presented the program to 

1,200 children in grades K through 3. 

Comparing these children to a control group of 1,000 students, 

Harrison found a positive impact for children exposed to the 

curriculum. 

•	 Children in kindergarten showed a highly significant increase 

in knowledge of the “cook” concept and significant increases 

in knowledge of the “separate” and “chill” concepts. 

•	 Children in first and second grade showed significant increases 

in their knowledge of all four food safety concepts, with highly 

significant increases in their knowledge of the “separate” and 

“cook” concepts. 

•	 By the third grade, a “ceiling” effect was taking place, 

Harrison noted. Children already knew the correct 

handwashing procedure. They also knew the importance of 

“chill.” They did, however, show a highly significant increase in 

their knowledge of the “cook” concept and a significant 

increase in their knowledge of the “separate” concept. 

Making It Real—Highlights of Successful Education Programs 

Food Safety Education Campaign in New Zealand 

Sandra Daly, New Zealand Food Safety Authority 

Ms. Sandra Daly is the Director of Communications and Business Services 

for the newly established New Zealand Food Safety Authority. In this role, 

she is responsible for the development and implementation of communication planning, with a particular focus on providing information to 

consumers on food safety issues. Ms. Daly has played a leading role in the 

Foodsafe Partnership established in New Zealand in 1998. The partnership 

36 Thinking Globally– Working Locally: A Conference on Food Safety Education 
is a collaboration between health providers, industry organizations, 

consumers, and regulators to promote food safety messages to New 

Zealand consumers. 

“I am here working globally—with every intention of stealing your 

best ideas and copying your programs—thinking locally!” said Sandra 

Daly, Director of Communications and Business Services for the New 

Zealand Food Safety Authority (NZFSA). 

Daly observed that her country tended to see itself as a bit different 

from other nations. New Zealand has a population of only 4 million 

and, as Daly said, “is a long way from...well...almost anywhere! 

“We see ourselves as clean, green, and unpolluted. Most significantly, 

we have never had a serious food safety incident. To suggest that we 

might need a major food safety program seemed 

unnecessary...somewhat like suggesting woolies in Florida!” 

However, in the 1990’s, she reported, perceptions began to change. 

“We saw the headlines from overseas. We also saw increases in 

foodborne illness in New Zealand. We saw that geographic isolation 

was not enough to protect us,” she explained. 

New Zealand exports approximately 80 percent of the food it produces, and 50 percent of income from exports comes from food. 

“One serious incident in New Zealand would mean consumers in 

trading partner countries might avoid New Zealand products. In 

addition, we recognized that consumers could easily destroy the 

good work of our producers in their homes. We had to mitigate the 

risks in their homes,” Daly said. 

The New Zealand Food Safety Authority was formed in July 2002. It 

was charged with providing consistent, clear, and appropriate messages to consumers. This has been a welcome move and the Authority 

is now able to provide considerable support to the work of the 

Foodsafe Partnership. Prior to this, with no dedicated funding and 

few people to do the work, Daly said, the Partnership had relied on 

“Kiwi ingenuity and found lots of low-cost ways to give people a 

sense of ownership of the programs.” 

The first thing the Partnership did, according to Daly, was to look at 

the best way to deliver the message. “Shock and horror aren’t successful with New Zealand consumers,” she said. “Quirky, irreverent, 

simple messages do appeal. So we adopted the four Fight BAC!® 

concepts and altered them to fit our humor.” 

To date, they have run four campaigns that were funded by the 

member groups within the Partnership. The campaigns included 

brochures and posters that were put in student packs and carry bags, 

grocery stores, and camping grounds. The campaign messages also 

appeared as radio, television, and newspaper ads, as well as magazine articles. The campaigns ran during the summer months, which, 

in New Zealand, is the Christmas season. 

Daly reported that program evaluations showed 85 percent of consumers recalled at least one message from the campaign and that 60 

percent reported a behavior change. 

clean, green, and 

unpolluted. Most 

never had a serious food 

suggest that we might 

need a major food 

safety program seemed 

like suggesting woolies 

in Florida!” 

Sandra Daly 

“We see ourselves as 

significantly, we have 

safety incident. To 

unnecessary...somewhat 

Conference Proceedings 37 
The newest program, Foodsafe Week, was launched December 2002 

with a picnic on the Parliament grounds with the Minister of Food 

Safety Annette King. 

Most significantly, according to Daly, they are now drafting a 5-year 

strategy. “After a sluggish start,” Daly said, “we are on our way!” 

Making It Real—Highlights of Successful Education Programs 

“It’s Safe to Bite When the Temperature is Right!”: A Food 

Thermometer Education Campaign 

Holly McPeak, M.S., Food Safety and Inspection Service 

(FSIS), USDA 

Holly McPeak is a Public Affairs Specialist with the USDA/FSIS Food Safety 

Education Staff. She is the project coordinator for the national consumer 

education campaign designed to promote the use of food thermometers, 

popularly known as the ThermyTM campaign. Ms. McPeak has been with 

FSIS for four years. Prior to her work in food safety, she was a nutritionist 

for the USDA’s Food and Nutrition Services for 14 years, working with Team Nutrition initiatives and implementing nutrition guidance for the 

Child Nutrition Programs. Ms. McPeak has a M.S. in Nutrition from Drexel 

University, Philadelphia, PA, and a B.S. in Biology from LeMoyne College, 

Syracuse, NY. 

ThermyTM Campaign Success Stories 

In 1998, consumer and scientific research indicated consumers were 

risking foodborne illness by failing to use food thermometers to 

check the doneness of their foods, according to Holly McPeak. 

A 1998 national consumer survey revealed that less than 50 percent 

of American cooks owned a food thermometer. And, significantly, 

only 3 percent of them used a food thermometer to check the 

doneness of small cuts of meat, like hamburgers. 

At the same time, research conducted by Kansas State University and 

the USDA’s Agricultural Research Service showed that one out of four 

hamburgers turns brown before it’s been cooked to a safe internal 

temperature. The bottom line: cooking by color is misleading. 

As McPeak explained to conference participants, the health consequences of undercooking can be serious. Undercooked hamburger 

can be a leading factor in illness caused by E. coli O157:H7. Children 

are especially susceptible to this illness, which can cause lifelong 

health problems, even death. As a result, the FSIS Food Safety Education Staff embarked on a campaign to educate consumers, using 

social marketing concepts to actually change consumer behavior. 

According to McPeak, focus groups were convened to identify barriers and to test strategies for overcoming them. “The research 

revealed that behavior change is possible. It suggested that we target 

parents of young children as an audience most open to our message. 

“We also found that behavior change was most likely to occur if we 

emphasized that using food thermometers improved food quality,” 

38 Thinking Globally– Working Locally: A Conference on Food Safety Education 
she said. “You don’t have to turn hamburgers into hockey pucks to 

achieve safety,” she explained. The second reinforcing message, she 

said, was that thermometers are easy to use and accurate. 

This research, as well as additional research, formed the foundation 

of the educational materials for the campaign, including the 

ThermyTM messenger. The campaign was kicked off in May 2000 with 

a media event featuring a chef demonstrating the use of food thermometers in everyday foods. Public service announcements featuring 

an animated video were distributed via satellite and mailed to 600 TV 

stations. Ten thousand promotional kits were distributed to 

educators nationwide. 

Since 2000, the ThermyTM messenger and message have appeared in 

venues across the country, supported by a wide array of partners and 

partnerships. The ThermyTM messenger has marched in the Macy*s 

Parade greeting 2 million spectators and 60 million TV viewers, 

popped into view on the Today Show, and turned up at fairs and 

schools from New York to New Mexico. 

New research shows encouraging results. The 2002 Food Safety 

Survey reveals that thermometer usage by main meal cooks increased 

from 3 percent to 6 percent. The goal, said McPeak, is to reach 10 

percent by the year 2010. 

Thermometer sales have also increased. Since 2000, average sales 

have increased about 10 percent each year. And thermometers are 

turning up everywhere with new looks and new applications: on 

digital-read forks, remote sensors, and as thermometer probes. “They 

are more accessible and user-friendly,” McPeak explained. 

National, State, and local initiatives have all contributed to these 

results. Here’s just a sample of the campaign’s wide reach: 

•	 Since 2000, FSIS has distributed more than 100,000 ThermyTM 

kits in English and Spanish nationwide. 

•	 The ThermyTM Web site provides a vast array of resource materials including consumer research, artwork, reproducible 

materials, campaign materials, and more, McPeak reported. All 

information is available in both Spanish and English. 

•	 The thermometer industry has embraced the campaign, 

McPeak said. To date, 10 thermometer manufacturers use 

ThermyTM and his safe food handling message on their 

packaging and in product information. In addition, they have 

been active partners, McPeak said, donating food thermometers to communities and supporting educational campaigns. 

• Grocery stores also have joined the campaign. Wegmans was 

the first grocery store to promote safe cooking temperatures 

and embraced the ThermyTM campaign since its beginning, 

McPeak said. Dozens of other grocery chains around the 

country—including Jewel-Osco, Giant, and Wal-Mart—have 

promoted the campaign, complete with in-store 

demonstrations and promotions. 

•	 The costumed ThermyTM messenger and campaign materials 

have been utilized by cooperative extension and local public 

“The research 

revealed that behavior 

change is possible. It 

suggested that we 

target parents of young 

children as an audience 

most open to our 

message.” 

Holly McPeak 

Conference Proceedings 39 
health staff in fairs throughout the country, making dozens of 

appearances each year—including Puerto Rico. 

•	 Local educators have supplied their own initiative and creativity. Cooperative extension agents in New York created a 

puppet show featuring ThermyTM. 

•	 In 2002, FSIS expanded the ThermyTM campaign to include FDA 

Food Code 2001 temperatures for retail and food service. A 

new line of educational materials using these temperatures 

includes posters and refrigerator magnets. Working with the 

USDA’s Food and Nutrition Service, FSIS has provided these 

materials to nearly 100,000 schools throughout the country. 

Looking ahead, McPeak said new steps for the campaign will focus 

on refining the use of social marketing to target the campaign to the 

audience most likely to change behavior: a sub-set “trend-setting” 

segment of parents of young children. 

Thursday, September 19, 2002 

Panel Discussion: Communicating Food Safety in a World 

Confronting Bioterrorism 

When Food’s Not Safe to Eat: Public Health Communications 

Challenges in the Age of Bioterrorism 

Sandra Mullin, Associate Commissioner, New York City 

Department of Health and Mental Hygiene 

Ms. Sandra Mullin directs the New York City Department of Health’s communication activities as an associate commissioner. Along with responsibility for 

media relations, Ms. Mullin oversees health media and marketing, cross 

cultural communications, community relations, and the agency’s Web site. 

Skilled in both crisis and risk communication, she manages the development 

of numerous multi-media campaigns on infectious and chronic disease 

control and prevention, environmental health promotion, and mental 

health concerns. She has made numerous presentations on topics related to 

risk communication and social marketing. Ms. Mullin is a columnist for the 

Journal of Urban Health and teaches community organizing at City College. 

“I think we all tend to learn from events as we look back at them,” 

Sandra Mullin said, recalling her involvement in both the September 

11 terrorist attacks and the anthrax events as Associate Commissioner 

for the New York City Department of Health and Mental Hygiene. 

Of the two events, the anthrax cases created the greater challenge to 

her department, she said. Describing New York City as one of the 

most prepared cities in the nation, Mullin said the anthrax incidents 

still caught the city by surprise. 

Immediately following the attacks on September 11, 2001, New York 

City public health officials issued a broadcast alert to hospitals asking 

them to report anything unusual. But in this instance, they weren’t 

40 Thinking Globally– Working Locally: A Conference on Food Safety Education 
looking for illnesses in the right places, Mullin reported. Anthrax 

didn’t turn up in emergency rooms. Instead, it turned up in a doctor’s 

office where a patient appeared in early October with an unusual 

skin condition. 

“We are always asking if we are prepared,” Mullin said, “but preparation isn’t a static point. It’s always changing. We need to remember 

that preparation is a journey, not a destination.” 

Dealing with the anthrax crisis was a lesson in reverberating impact 

and risk communication. As Mullin noted, there were 2 anthrax 

letters, 8 cases, 1 death, 600 reported cases, and “8 million anxious 

New Yorkers.” 

“You need to recognize that even though the risks are small, people 

will worry. And you need to figure out how to meet the mental 

health needs of a terrified population,” she said. 

The impact on the public health infrastructure was also tremendous. 

“While there were few cases,” Mullin said, “there was so much to do. 

It was particularly difficult on our labs because of the number of 

samples submitted for testing.” 

While the perpetrator terrorized the public, Mullin said, her focus 

was on getting the media to talk to the public about what citizens 

could do to reduce the risk. While people wanted to know what to 

do about the anthrax threat, knowledge was changing early on, 

Mullin said. 

To deal with the public’s need for information and the media crush, 

Mullin outlined a number of “tools to facilitate the flow of 

information”: 

• a public hotline operating 24 hours a day, 7 days a week and 

Web site updates; 

•	 daily media briefings in conjunction with the mayor and health 

commissioner; 

• regular contact with elected officials, community organizations, and hospitals’ public information officers; and 

•	 critical inter-agency communications. 

Drawing on her experiences during this crisis, Mullin said there were 

a number of important lessons: 

•	 During a crisis, don’t overload the public with data. “During 

uncertain times, what you communicate and how you communicate are both critical,” Mullin said, referring to the challenges associated with risk communication. “During a crisis, or 

when an issue is highly controversial, the public doesn’t expect 

a dissertation that compares one risk to another. This makes 

people feel patronized or cornered. Data do not impress 

people when they are upset.” The public views some risks as 

more acceptable than others, although those that are imposed 

on us tend to frighten us even more, she added. 

that even though the risks 

are small, people will 

figure out how to meet 

the mental health needs 

of a terrified population.” 

Sandra Mullin 

“You need to recognize 

worry. And you need to 

Conference Proceedings 41 
Mullin recommended 

that spokespeople be 

able to “model being 

able to bear fear” and 

a terrifying situation. 

uncertainty. “Let people 

be afraid,” she said. “It’s 

Don’t tell people they 

shouldn’t be afraid.” 

•	 Get messages ready in advance. “We need to fine-tune public 

health messages now,” Mullin said, noting that New York is 

preparing fact sheets, putting them on the Web, and disseminating them so key agencies and individuals know in advance 

the instructions that would be given in the event of an 

emergency. 

• Prepare staff. Cross-train staff for crisis activities, check contracting requirements for setting up emergency hotlines, 

prepare media lists, update phone numbers and e-mail list 

serves, and keep the batteries fresh in two-way radios. 

•	 Build trust beforehand. Mullin advised agencies to build trust 

with the public and with crisis partners before an emergency 

occurs. These partners are varied and can include other 

government agencies, industry, and the media. 

• Empathize with the public. Mullin recommended that 

spokespeople be able to “model being able to bear fear” and 

uncertainty. “Let people be afraid,” she said. “It’s a terrifying 

situation. Don’t tell people they shouldn’t be afraid.” 

•	 Don’t use reassurance to minimize concern. “The principle of 

straight talking is never more critical than during a crisis,” 

Mullin said. False reassurances have a potent kick-back effect. 

Once credibility is lost, it may not be regained, she said. 

•	 Don’t be afraid to say you don’t know, Mullin advised. “We 

don’t do this enough,” she said, “and I think it’s a critical thing 

to remember. It’s better to irritate people by saying you don’t 

know than to loose credibility later.” 

Agencies also need to realize that a crisis may be around the corner, 

Mullin said. “It is important for government agencies to say what 

they are doing so the public knows they are trying to be as prepared 

as possible.” Now is the time to share preparation plans and information with the public, to improve agency communication skills, and to 

meet with stakeholders, such as citizen’s groups, unions, environmental groups, and elected officials, she said. 

Finally, she noted, in the event of a crisis, the public wants to take 

action. Channel that, Mullin advised. Agencies should help the public 

be more informed and involved in disaster planning and communications response. “In a crisis situation,” she added, “people tend to be 

brave and more tolerant of uncertainty than we realize.” 

Panel Discussion: Communicating Food Safety in a World 

Confronting Bioterrorism 

Kay Golan, Special Assistant to the Deputy Director, formerly Director of Media Relations (1997-2002), Centers for 

Disease Control and Prevention 

Kay Sessions Golan is the former Director of Media Relations for the 

Centers for Disease Control and Prevention (CDC). She has over 20 years 

experience in media relations, public affairs, crisis communication, and 

42 Thinking Globally– Working Locally: A Conference on Food Safety Education 
public policy. Ms. Golan directed the strategic planning and response to 

the print and electronic media, which was mentioned over 30,000 times 

in 1 year in print. CDC is frequently in the news as the expert scientific 

agency on public health issues such as emerging infectious diseases like 

West Nile visus, flu, ebola, and hanta virus—as well as chronic disease 

prevention and environmental health. Ms. Golan had a pivotal role in 

oversight of the crisis communication team at CDC during the anthrax/ 

bioterrorism event. 

“Our world changed on September 11—and it changed again on 

October 4 when headlines about anthrax hit every newspaper in the 

country,” said Kay Sessions Golan. 

Golan knows. She was director of media relations for CDC in October 

2001. 

For Golan, the moment of change came when she was moving 

through an ordinary October evening. 

“I was in the car coming from seeing my son’s high school play—for 

the fourth time that weekend,” she said. As Golan drove, she listened 

in to a conference call from CDC investigators reporting on the first 

reported anthrax case in Florida. The investigators dropped a bombshell—they had found anthrax on the victim’s computer keyboard. “I 

knew then. I knew it wasn’t naturally occurring. Golan turned her car 

from its track home and headed to the press office, which she didn’t 

leave until 2 o’clock the following morning. “One of the most memorable moments was later in the evening on the call to Florida—I could 

hear police sirens as they came to seal the AMI building,” Golan said. 

While there was no way to be “prepared” for the coming crisis, CDC’s 

media staff had a clear understanding of their role—and that understanding helped guide them through the many uncertainties that 

were ahead. 

The CDC, best known to many people as the “Disease Detectives,” is a 

national public health agency employing 8,500 people covering 170 

disciplines. With today’s increased focus on science, the CDC has 

moved to the forefront of popular interest. 

But science, as Golan explained, is frequently a work in progress. 

“Science is constantly changing, therefore it has many gray areas; it is 

a complex subject. Our job is to help scientists explain the complexities of their work in understandable terms and to help journalists sort 

through the complexities of science and report these responsibly.” 

CDC’s increased news visibility was easy to track, Golan reported. In 

1990, CDC was in the news 6,330 times. By 2001, the number had 

rocketed to 17,205. Calls to the press office had increased from 8,000 

a year in 1989 to over 20,000 a year. Clearly, usual media scrutiny was 

intense. 

For the next 3 months following October 4, 2001, nothing was as 

usual. Normal volume of press calls at CDC ran 25 to 75 calls a day. 

“Our world changed on 

September 11—and it 

changed again on 

October 4 when headlines about anthrax hit 

every newspaper in the 

Kay Session Golan 

country.” 

Conference Proceedings 43 
“Science is constantly 

changing, therefore it 

has many gray areas; it is 

a complex subject. Our 

job is to help scientists 

explain the complexities 

standable terms and to 

help journalists sort 

through the complexities 

of science and report 

of their work in underthese responsibly.” 

Now they were running 350. As Golan explained, “we needed to feed 

the beast,” the virtually insatiable media need for information on a 

daily basis. 

Managing that need is no small task, especially when the question is: 

“What’s happening?” And the answer is: “We’re not sure.” 

How did Golan manage? What was key? 

“We knew we needed to stick to basics. From earlier work we had 

done concerning public expectations of CDC, we knew that people 

were looking for two things from us: timeliness and accuracy. 

“Now, these two concepts can be in conflict—that was our most 

critical problem—balancing the two.” That balancing act was also 

their core function, Golan realized. 

To achieve that balance, they followed a straight-forward formula: 

“Tell people what you know. Tell them what you don’t know. Tell 

them what you’re going to do next,” said Golan. 

Because timeliness and accuracy are equally important in the formula, Golan would not provide public statements that went beyond 

the science. But she also needed to let the public know they were 

looking for the answers and Golan tried to channel the public’s desire 

to take action. 

For instance, people wanted to know how they could protect themselves and what they should do with their mail, she said, particularly 

after the death in Connecticut was attributed to cross-contamination. 

“We told people: Be careful handling your mail. Don’t rip it up into 

little shreds where it could aerosolize the possible anthrax spores. 

Wash your hands after handling your mail. Those were things people 

could do. They certainly weren’t going to hurt people, and they 

might have helped people. But there was no guarantee that they 

were absolutely going to prevent people from contracting anthrax.” 

Other keys for people involved in crisis communication: 

• CDC had two teams operating, and “that was a lifesaver. We 

needed to rotate staff and that included me. We worked 4 

days on and 3 days off,” Golan said. Press officers were also 

deployed with investigation teams. 

• CDC used a multi-channel approach to get news out—but the 

single most effective tool was the daily telebriefing. “It gave 

the media information it needed every day—and it allowed us 

to manage the time of the science experts. They didn’t have 

the time to answer media questions all day—they needed to 

try to solve the problem. We took their time for an hour and 

then they got back to the task at hand—looking for answers to 

questions never before asked,” she said. Other channels of 

communication included video, audio, and press releases; 

satellite training for public health professionals; Web 

information; and individual interviews. 

•	 Stay in your niche, stick with your core functions, and don’t 

speculate. “When there are so many players in an emergency 

44 Thinking Globally– Working Locally: A Conference on Food Safety Education 
situation, it’s important not to speak to issues outside your 

area,” Golan said. 

•	 Set up emergency teams in advance and let them work together. 

•	 Pay attention to little things—such having a database of names 

and phone numbers on your hand-held computer. 

•	 Get talking points on topics in advance of a crisis. Difficult to 

do, but important. 

•	 Stay calm and set the tone for your staff. 

•	 Rotate staff, including the leadership role. “This was hard to 

do, but important,” Golan said. 

•	 Don’t take criticisms personally, “let it go.” 

•	 Be flexible. 

•	 Ask for help. 

Meeting the needs of the media and the public in times of crisis 

always comes down to a balancing act between timeliness and 

accuracy, Golan concluded. 

Panel Discussion:Communicating Food Safety in a World 

Confronting Bioterrorism 

Communicating About Food Terrorism 

Irene. E. van Geest-Jacobs, Food and Nonfood Authority, 

Ministry of Agriculture, The Netherlands Formerly Director of Communications and Information for the Ministry of 

Health, Ms. van Geest-Jacobs currently is Director of Communications and 

Information for the newly formed Food and Nonfood Authority of the 

Netherlands. As a consultant, Ms. van Geest-Jacobs has specialized in the 

development and implementation of communications strategies, including crisis communications and internal communications during reform 

processes. 

The events of September 11, 2001, “were obviously headline news in 

the Netherlands. We naturally felt for the United States,” said Ms. 

van Geest-Jacobs, director of communications for the recently formed 

Food and Nonfood Authority (FNA). “The attacks also made us realize 

just how vulnerable an open society is. They showed how easy it is to 

destabilize society. And they highlighted the importance of taking 

precautions,” she said. Van Geest-Jacobs encouraged the international community to move 

quickly to improve communications that would be vital in the event 

of bioterrorism and food terrorism. “So far, however, there is hardly 

any international coordination, even though we all know that foods 

are produced and sold worldwide and, in Europe at least, food 

problems are often cross-border problems. The European Food Safety 

Agency is in the process of being set up and one of its primary areas 

of attention will be communication. Perhaps we should not wait that 

long and should start exchanging knowledge now,” she advised. 

Conference Proceedings 45 
“Our concern centered 

on deliberate infection 

with smallpox and 

considered the possibility 

tried to envisage a 

situation in which we 

needed to communicate 

and what the community 

would expect us to do in 

such a situation.” 

Irene E. van Geest-Jacobs 

anthrax. We also 

of food terrorism. We 

Van Geest-Jacobs’ recommendations are the result of her work in the 

Netherlands identifying the risks of bioterrorism prior to the 2001. 

“Initially,” she said, “our concern centered on deliberate infection 

with smallpox and anthrax. We also considered the possibility of food 

terrorism. We tried to envisage a situation in which we needed to 

communicate and what the community would expect us to do in such 

a situation.” 

To help assess what needed to be done, they projected two hypothetical scenarios, one involving rat poison contaminating bottled 

beer, the second involving a more wide-spread threat of an unidentified contaminant in milk. By running through these exercises, they 

identified “just how important communication is,” van Geest-Jacobs 

said. 

Her advice, she said, can best be summarized as: P, A, and R: 

• Prevent 

• Prioritize

• Prepare 

• Alert

• Respond

“It all starts with the three P’s,” she explained. “Preventing food 

terrorism begins by making it difficult for people to gain access to 

the places foods are produced. We can make it more difficult to 

perpetrate attacks and also discover them quickly by having a good 

system of controls throughout the supply chain. This requires good 

communication with the food industry and retail organizations. At 

the Food Inspection Agency in the Netherlands, this is a major point 

of attention.” 

It’s also important to Prioritize the foods most at risk, van GeestJacobs explained. “It is unrealistic to think that you can prevent and 

control everything. To combat food terrorism effectively, you must set 

priorities. You need to identify the foods most vulnerable to acts of 

terrorism and focus on those products. So, what foods are we talking 

about?” 

They identified several features that could increase risk: 

• large quantities of food, 

• liquids, and 

• high velocity sales. 

They also identified certain products more at risk: 

• dairy products, 

• edible oils, 

• beer, and 

• water. 

The next step, she said, is to identify how you Prepare to deal with 

these risks. “In this phase, preparations center around gathering 

46 Thinking Globally– Working Locally: A Conference on Food Safety Education 
knowledge. Who possess knowledge of these products? From whom 

can we get information about bacteria and viruses? Who has knowledge of the market, distribution, and use of the product among 

consumers? What government agencies are involved? You have to 

get the best possible picture of all of these matters,” she explained. 

From this knowledge, van Geest-Jacobs continued, you begin to build 

a system that allows you to move to the next phase: Alert. The 

Netherlands has two alert/notification systems. The Food Inspection 

Agency has an “incident desk” for the public to report items of 

concern. Businesses, as well as the public, utilize the incident desk, 

which in 2001 received 40,000 notifications. Of these, 5,000 were 

investigated. “Last year we had an advertising campaign to make 

people more aware of the function of the incident desk. Our messages was simple: If you notice something strange in food, let us 

know,” she said. 

The second notification system in place is for physicians, hospitals, 

and other health professionals. They work through local health 

authorities to report infectious diseases, including food infections. 

In light of new concerns, the Netherlands has introduced a new 

criteria for those screening reported incidences: malice. “The person 

who assesses the notification now always examines whether there is 

any indication of a conscious or deliberate act,” she explained. 

The final step, van Geest-Jacobs explained focuses on Respond. “My 

golden rule for crises response is: communicate and coordinate. The 

Netherlands is a very small country, so it is easy for us to coordinate 

action,” she said. 

International coordination should begin immediately, she recommended. “Because the fight against food terrorism requires intelligent preparation, early warnings, broad-based coordination, and 

honest communication. All in the hope that you’ll never need to put 

your preparations into practice!” 

Friday, September 20, 2002 

Interactive Workshop: Planning the Future of Food Safety 

Education, facilitated by Tom Kornbluh, Feola & Kornbluh 

Associates 

The following material includes: 

1. Summary of the Workshop’s Purpose, 

2. Description and Overview of the Process,

3. Results of the Data Collection,

4. Summary of Interactive Collaborative Planning Process, and

5. Summary of Suggested Regional Initiatives.

“Because the fight 

against food terrorism 

requires intelligent 

preparation, early 

warnings, broad-based 

coordination, and 

honest communication. 

All in the hope that 

you’ll never need to 

put your preparations 

into practice!” 

Conference Proceedings 47 
1 • Summary of the Workshops Purpose 

“The process was 

designed to strengthen 

the conference 

experience and promote 

collaborative action at 

the regional level.” 

Tom Kornbluh 

More than 600 people attended the national conference on food 

safety education, representing 48 U.S. states and educators from all 

over the world. By entering responses to an online Planning Tool at 

kiosks throughout the conference center, attendees voiced their 

thoughts regarding their goals, food safety education needs, and 

provided information on their budgets and organizations. 

On the last day of the conference, this data – along with the knowledge and experiences gleaned from the conference itself – were used 

to create an Interactive Collaborative Planning Process. Everyone’s 

knowledge, experience, and best ideas were brought to the fore as 

regional teams gathered to put theory into action – to think globally 

and act locally. 

From the information gathered, participants drew knowledge about 

overall objectives, target audiences, education gaps, and budget 

parameters. As teams, they then merged the information with knowledge drawn from conference sessions to identify actions they could 

take. 

The following section describes the process, summarizes results from 

input to the Planning Tool, identifies conference attendees’ priorities, 

and provides a list of some of the initiatives suggested during the 

regional teams’ brainstorming. 

2 • Description and Overview of the Process 

Purpose 

According to facilitator Tom Kornbluh, the Interactive Collaborative 

Planning Process was created to provide an opportunity for participants of the conference to immediately put into action new ideas and 

to support the theme of the conference – Thinking Globally–Working 

Locally. “The process was designed to strengthen the conference 

experience and promote collaborative action at the regional level,” 

Kornbluh explained. 

Creating the Planning Tool 

The online web-based Planning Tool was created through the involvement of the Conference Planning Committee and the feedback of 

many food safety educators and administrators from around the 

country. The questions were developed to collect data that would be 

useful in the development of future food safety products and services, as well as helping to improve the performance and quality of 

current practices. Questions were developed as “forced choice” 

priorities and “open response” text formats to maximize the 

usefulness and coherence of the resulting data. 

The Planning Tool contained the following questions: 

•	 Please rank your top five food safety education priorities for 

the next year. 

48 Thinking Globally– Working Locally: A Conference on Food Safety Education 
•	 Rank your top three primary target audiences. • Which five tools or resources would best help you accomplish 

your food safety education goals? 

•	 Rank the top five sources you most often use to obtain food 

safety education information, tools, and resources. 

•	 Rank the three most significant gaps in food safety education 

materials or research. 

•	 How can we best continue communication among food safety 

educators after this conference ends? 

•	 Is your organization a member of a food safety partnership 

whose structure includes members from industry, academia, 

government, and consumer organizations? 

•What is the name and contact information for one


partnership?


•	 At what level is the partnership? 

•	 How much of your professional time is spent developing and 

conducting food safety education programs? 

•What is your organization’s average annual budget for food 

safety education programs? (Please include external funding.) 

•What is your professional affiliation? 

•	 Please indicate the state or country where you work. 

Collecting the Data 

The Planning Tool was available online during the conference and 

was heavily publicized to encourage participation. Through the use 

of incentives and regular reminders, 82 percent of the attending 

participants completed the tool before the end of the third day. 

Attendees could complete the tool through the use of kiosks available at the conference facility or through their own computers and 

Internetconnections. 

Presenting the Data 

Once the data were collected at the conference, the Conference 

Planning Committee analyzed the information to establish important 

highlights and extract whatever key priorities were suggested by the 

responses. The summary of the data was presented to the entire 

plenary session in the Collaborative Planning segment on the final 

day of the conference. 

Regional Discussions 

For the final regional planning session, attendees were seated at 

tables by region so that new relationships could be established and 

potential actions and initiatives could be discussed in a regional 

context. 

Once the data had been presented, attendees were led through a 

series of discussions by volunteer facilitators who had been briefed 

and trained by the Conference Planning Committee. The facilitators 

were responsible for capturing key themes and contacts that 

emerged from the discussions. The facilitators asked the following 

questions to initiate and focus the conversations: 

Conference Proceedings 49 
•	 “As you reflect on the conference, where do you think we, as a 

food safety community, need to focus? What should be our todo list?” 

• “What is a high-impact initiative on which you can collaborate 

regionally?”

 At the conclusion of these regional conversations and planning 

session, selected groups reported their results and proposed action 

plans to the entire conference as examples of the work that had been 

done. The results of regional conversations were captured and are 

summarized in this document.

 3 • Results of the Data Collection 

The Planning Tool collected 511 responses during the course of the 

conference (82 percent of conference participants). The Planning Tool 

yielded the following results: 

Significant Demographics 

Professional Affiliations 

•	 23.7 percent work with a Federal Agency 

•	 23.3 percent work with a University Extension Service 

•	 12.4 percent work with local or State health departments 

(6.4 percent local, 6 percent State)

•	 8.5 percent work with a College or University 

•	 7.8 percent work with the Food Industry 

Time Allocated 

Respondents were asked to designate an approximate percentage of 

their work hours dedicated to food safety education. 

• Over 30 percent spend less than 25 percent of their time on 

food safety education. 

•	 Approximately 25 percent spend from 25-50 percent of their 

time on food safety education. 

•	 Approximately 15 percent spend 50-75 percent of their time on 

food safety education. 

•	 Approximately 15 percent spend 75-100 percent of their time 

on food safety education. 

Size of Annual Food Safety Budgets 

Respondents were asked to estimate the total annual budget of their 

organization allocated to food safety education. 

•	 Approximately 40 percent have annual food safety education 

budgets of over $25,000. 

• Over 20 percent have an annual food safety budget of less 

than $5,000. 

•	 Slightly over 10 percent have annual food safety budgets of 

over $1 million ($1,000,000). 

50 Thinking Globally– Working Locally: A Conference on Food Safety Education 
Of those with budgets over $1 million, 65 percent are Federal agencies, 12 percent are university extension, 12 percent are other State 

and local agencies, about 4 percent are food service industry related, 

and about 2 percent are health care establishments. 

Geographical Representation 

Respondents represented 48 U.S. states and educators from all over 

the world. Foreign representation included: Australia, Argentina, 

Bermuda, Brazil, Cameroon, Canada, China, Columbia, Ecuador, 

Guam, Hong Kong, Indonesia, Ireland, Japan, Mexico, the 

Netherlands, New Zealand, Nigeria, Puerto Rico, and the United 

Kingdom (and Wales). 

Food Safety Partnerships 

Sixty-five percent of conference attendees are members of food 

safety partnerships. These partnerships are formed under Federal, 

national, or State auspices and include members from industry, 

academia, government, and consumer organizations. A significant 

number of these partnerships – 38 percent – are organized at the 

State level. 

Sources of Food Safety Information and Resources 

The respondents look primarily to the Federal agencies (USDA/FSIS, 

FDA, and CDC) as sources to obtain food safety education information, tools, and resources. Many respondents cited the Cooperative 

Extension Service as their primary source. 

The Internet has become a major vehicle for food safety information 

according to the respondents. Many Web sites and other sources of 

information where identified by respondents, particularly for specific 

material and information requirements. There is extensive use of the 

www.foodsafety.gov Web site. 

Food Safety Education Priorities 

One of the most important questions posed by the planning tool 

asked about the respondents’ greatest food safety education 

priorities for the coming year. Among all respondents: 

•	 The highest priority among respondents overall was that of 

training food service workers and managers. Over 42 percent 

of all respondents selected this as their first or second highest 

priority. 

•	 The next highest priority was that of promoting hand washing. 

•	 Educating children ranked third. 

•	 The fourth highest priority for the respondents as a group was 

promoting the principles of Fight BAC!®. 

• Many respondents also indicated that educating the public 

about specific pathogens and evaluating existing food safety 

education programs were high priorities. 

Conference Proceedings 51 
•	 For the subset of respondents who work for the food industry, 

their highest priority by far was the food safety education of 

culturally diverse audiences. Approximately 64 percent of 

industry representatives selected this as their highest priority. 

Other goals mirrored those of the group as a whole. 

•	 For those representing Federal agencies, the most significant 

priority was addressing food biosecurity. Almost 40 percent of 

Federal agency respondents selected this priority as their first 

or second highest priority. 

•	 Several priorities emerged as particularly high priorities in 

individual regions. For example, respondents from the Northwest region selected the priority of educating higher risk 

populations as one the most important in the coming year. 

Respondents from the Western region indicated that 

increasing food science literacy was a very high priority – 

higher than that suggested by those from other regions and 

the respondents as a whole. 

Target Audiences for Food Safety Education 

Once again the data showed food service workers as the highest 

priority target audience for the coming year. Over 52 percent of 

respondents indicated that food service workers were their first or 

second highest priority target audience. 

Other target audiences identified included the general public, educating children, educating the school community, educating parents 

of young children, and educating seniors – in that order. 

Those in the Northwest region also identified public health officials 

as a principal target audience. While those in the North Central 

Region added the target group of caregivers to their highest priority 

list. 

Tools and Resources 

Respondents were asked to identify those tools and resources that 

would be most helpful to them in their work. 

The most important tool according to respondents is print publications for consumers. This is followed by a desire for materials and 

programs on video and materials on CD-ROM. Many respondents are 

looking for Web-based materials that can be downloaded through 

the Internet. And, of course, many respondents are looking for food 

safety education materials designed for food service workers. 

Material and Research Gaps 

Respondents were asked to identify the gaps in food safety 

education materials, material availability, and food safety research. 

• Respondents overall indicated that that biggest gap was in 

food safety education materials in languages other than 

52 Thinking Globally– Working Locally: A Conference on Food Safety Education 
English. About 35 percent of all respondents identified this as 

their first or second highest priority. Some of the language 

gaps identified: Spanish, Chinese, Korean, Japanese, Haitian 

Creole, Vietnamese, and Navaho. 

•	 Approximately 37 percent of respondents identified low 

literacy materials as their first or second highest priority gap. 

• Other gaps included the lack of evaluation tools for food 

safety education programs and the lack of sufficient consumer 

behavior research findings. Respondents also suggested more 

timely release of foodborne illness data. 

Continued Communication 

When respondents were asked how they would suggest the food 

safety community stay connected and in communication after the 

conference was over, a variety of responses were received. 

Most respondents suggested the use of focused listservs and E-mail 

newsletters. Other suggestions included regularly scheduled “meet 

me” conference calls, regular State and national conferences, the use 

of Web-site forums, as well as creating special sessions for food safety 

educators at professional meetings.

 4 • Summary of Interactive Collaborative Planning Process 

On the last day of the conference, more than 500 attendees 

participated in the final session and planning process. Conference 

participants were grouped with other attendees from the same 

geographical region to create teams and were joined by a volunteer 

facilitator. 

“Thinking Globally” 

The regional discussion began with the question of what the food 

safety community, thinking globally as a whole, should be working 

on in 2003. These conversations were wide ranging and covered 

many more topics than can be summarized adequately here. The 

conclusion of many of these conversations, however, led to the 

following themes, which emerged across regions. 

•	 Develop more effective mass media communication strategies 

to promote food safety. 

•	 Increase focus on educating children through the school


curriculum, their parents, and teachers.


•	 Create more aggressive standards for food safety certification 

and procedures. 

•	 Increase focus on training food service workers and


supermarket handlers.


•	 Build greater emphasis on educating culturally diverse and low 

literacy groups. 

•	 Develop more effective and user-friendly evaluation of food 

safety education – find out what really works to change 

behavior. 

Conference Proceedings 53 
•	 Support much greater national and, particularly, international 

collaboration and coordination. 

Several themes emerged strongly in the regional conversations that 

did not show as prominently in the Planning Tool data. The consensus 

from the regional teams revealed an emphasis on developing more 

effective mass media communication strategies – a concept not 

highlighted in the Planning Tool data. Another example was the 

group’s strong emphasis on developing much greater collaboration 

and coordination across regions. 

“Working Locally” 

For the second half of the Interactive Planning Process, facilitators led 

the regional teams to discuss how they might “work locally” with 

specific initiatives that would most benefit from regional collaboration. These conversations among the regional teams produced 

outcomes that ranged from simply exploring ideas to developing 

action plans and time lines for implementation of proposed 

initiatives. 

Most suggested regional collaboration initiatives fell into one or 

more of the following categories: 

•	 Creating more effective and formal regional partnerships to 

share resources and information. 

•	 Collaboration on mass media promotional ideas. 

• Opportunities for industry, supermarket, and government 

collaboration on specific educational initiatives. 

•	 Customizing promotional and educational approaches to 

regional audiences.

 5 • Summary of Suggested Regional Initiatives 

The following represents a summary of the action outcomes suggested by the regional teams. These initiatives were developed in 

response to the question: “What is a high-impact initiative on which 

you can collaborate regionally?” The suggested initiatives are 

organized by region. 

Southeast Region 

Suggested Initiatives: 

•	 Develop a collaborative, regional hand washing campaign 

using materials that are culturally and age appropriate with 

strong attention to innovative design. 

•	 Institute a campaign to increase food safety awareness/messages on television cooking shows and media outlets. 

•	 Begin work with restaurants/fast food/supermarkets to coordinate with vendors and increase food safety messages on 

take-out packaging using existing and new educational 

materials. 

•	 Create enhanced coordination and interaction between Florida 

54 Thinking Globally– Working Locally: A Conference on Food Safety Education 
and Alabama extension specialists on specific project initiatives. Communication network will be established with each 

member by E-mail. 

•	 Create high-impact food safety education programs in


elementary schools with strong focus on kindergarten.


•Work with local supermarkets and grocery stores to provide a 

disposable thermometer with packaged meat and poultry 

products. Include enhanced video training for store employees. 

•	 Develop more complete database of existing food safety 

education materials available through Web and catalogs. 

Mid-Atlantic Region 

Suggested Initiatives: 

•	 Strengthen local coordination through regular regional meetings and enhanced electronic communication, including 

listservs/Internet/Alert System. 

•Work with local media (radio) and local health departments to 

do a “food safety minute” in partnership with local sponsor 

(e.g., Giant Food, McDonald’s, local restaurants, etc.). 

•	 Develop a video for PTA (Parent and Teacher Association) 

regional meetings. Schedule presentations for the first meeting 

of the year. Build local capacity by enhanced “train the 

trainer” programs for school presenters. 

•	 Identify the main health communication need of the regional 

area and focus intense efforts on that issue. Examples include 

seafood and wild game in the local region. Create symbols 

(such as irradiation symbol) that will help in the communication effort. Identify specific audiences and communication 

channels. Tie in efforts to State and national professional 

associates to open the dialogue. Have annual regional food 

safety meetings to exchange information and other resources. 

Gaps will be identified so that education efforts do not miss 

anyone. Identify critical audiences that need to be targeted 

(legislators, health inspectors, immigrants who are not 

residents, and other closed communities). 

•	 Develop communication effort focused on local food safety 

managers. Emphasize customer impact of proper handling and 

specific local requirements. Include public service announcements (PSA’s) to drive the message home. 

•	 Build school-based education initiative. Include a Sesame 

Street-style sing-a-long and youngsters becoming “ambassadors” for proper hand washing. Use PSA’s. Begin with pilot 

study with a few schools – target parents – “Did your child tell 

you...?” 

•	 Initiate a regional conference to focus on culturally diverse 

audiences. The conference will lead to a campaign to reach 

managers and establishment owners with specific guidelines 

and recommendations. 

Conference Proceedings 55 
Northeast Region 

Suggested Initiatives: 

•	 Use existing major meetings to encourage regional planning 

and coordination. Initiate a strategy to create an inspector 

certification program. 

• Work through regional grocery chain to provide shopper 

education. Involve Federal government partnering with the Ad 

Council to get Fight BAC!® oven mitts, aprons, etc., in popular 

stores, e.g., Wal-Mart. Collaboration through the Food Safety 

Training and Education Alliance Web site: www.fstea.org. 

Midwest Region 

Suggested Initiatives: 

•	 Develop a strategy to provide greater credibility, accuracy, and 

accessibility to food safety education materials. Selected 

committee members will serve as reviewers of new materials. 

•	 Develop programs and support systems to increase monitoring 

of sanitarians. 

•	 Develop and promote a national single source for immediate 

food safety information. 

•	 Develop State-level coordination to address and manage 

potential turf issues, minimize duplication of efforts, and keep 

people informed of available resources. 

•	 Establish a regional food safety conference. 

Rocky Mountain Region 

Suggested Initiative: 

•	 Build strengthened coordination through the Rocky Mountain 

Food Safety annual conference. Increase information sharing 

through enhanced E-mail communication. 

Western Region 

Suggested Initiatives: 

•	 Create work group for sharing resources and information flow 

across FDA, USDA, Extension Service, and industry. 

•	 Focus on creating innovative programming for seniors in Los 

Angeles County, including coordination of Fight BAC!® activities. 

•	 Create a food safety “media advisory committee” to better 

understand and utilize the media in coordinated regional 

strategy. 

•	 Expand Fight BAC!® messages to include Choose Food for 

Safety. Annually award a nationally known chef with a multiorganization funded award (e.g., FDA, USDA, American Di56 Thinking Globally– Working Locally: A Conference on Food Safety Education 
etetic Association, National Restaurant Association, etc.). Give 

award at a chef’s event, followed by continuing publicity and 

press releases. At the local level, contact specific cooking shows 

and other local initiatives (e.g., county fair, Made in Hawaii 

Festival, etc.) to incorporate food safety practices. 

Southwest Region 

Suggested Initiatives: 

• Work with local legislature and city council to support food 

safety in schools and local restaurants. Include Fight BAC!® 

bandages and basket of hand washing supplies for school 

administration. 

•	 Develop regional (Texas) collaboration venues and conferences 

on regular basis. 

•	 Develop a coordinated “source” for all food safety training 

resources statewide. 

• Work with Department of Health to establish “training schedule” listing all certification programs on a local and State basis. 

•	 Develop coordinated strategy to teach food safety in childcare 

centers. 

International 

Suggested Initiative: 

•	 Develop a listserv for enhanced international coordination and 

resource sharing. Integrate with current Web-based organizations. Report on international education initiatives and share 

Web-based materials. 

Conference Proceedings 57 
Abstracts of Poster 

Presentations: 

The following abstracts represent just a sample of 

the more than 80 poster presentations at the 

national conference, Thinking Globally—Working 

Locally: A Conference on Food Safety Education. 

While they don’t represent all of the poster presentations, these abstracts do capture the enormous 

diversity of people working in food safety 

education—and the ingenuity, innovation, and 

commitment that they demonstrate as they work to 

improve the health of their community, their 

country, and the world. 

1. Development of HACCP

Principle Training Materials for 

Front-line Food Service Workers 

Southern Illinois University at Carbondale/Illinois 

Department of Public Health 

Hea-Ran L. Ashraf, E. Endres, T. Welch, T.C. Girard; J. 

Bloom D. Blaise, S. Atwood 

Academicians and public health officials have collaborated in developing HACCP-based food handling 

training materials suitable for front-line food service 

workers. This training method emphasizes identification of hazards in the foods that one handles and 

taking appropriate precaution or handling procedures to eliminate or reduce the hazards. This type 

of basic training is recommended for HACCP 

implementation at food service establishments. A 

training kit was produced that included an award 

winning video, a workbook with recipe exercises, a 

thermometer, several color posters, and other job 

aids. 

The efficacy of these materials was evaluated by pre 

and post on-the-job HACCP behavioral observation 

on a sample of food service workers who attended a 

training workshop. The results showed a significant 

reduction (p<.001) in food code violations 8 weeks 

after the training session. 

Frequent employee turnover and shortage of time 

seem to be the primary obstacles in effective sanitation training. In this study, out of 60 workers invited 

to attend a training session, only 3 volunteered to 

participate, 34 attended after personal encouragement by local health department inspectors. Out of 

the 37 who attended, 28 were holding the same job 

8 weeks after the workshop. 

This study has produced effective HACCP training 

materials suitable for front-line food service workers. 

Collaboration between university faculty members 

and public health officials created a team with 

various expertise to develop training materials that 

are practical, up-to-date, and instructionally 

appropriate. 

future activities. 

Existing written educational material has been 

selected for health professionals and new material 

developed for consumers. Additionally, a consumeroriented videotape describing the irradiation process 

and the role of irradiation in enhancing food safety 

has been prepared by Purdue University. 

2. Food Safety and Food Irradiation 

University of California / Food Science & 

Christine M. Bruhn, Julie Albrecht, 

Britta Thompson, William 

n 

The goal of this multi-state project is to enhance 

consumer food safety through increasing their 

knowledge of factors that lead to foodborne illness 

and increasing their knowledge of science-based 

information on food irradiation. This is a multistage, 

on-going project. The poster reviews the project 

plan, covers successes and challenges, and describes 

The first stage of the project is to increase the 

knowledge of those experts consumers and the 

and cooperative extension educators—received 

updated information regarding the extent of 

foodborne illness, common consumer handling 

errors, the safety of irradiated foods, and the role of 

food irradiation to reduce foodborne disease. AlEducation: A Multi-State Project 

Technology 

Lynne Brown, Jim Chalfant, Philip Crandall, Sean Fox, 

April Mason, Karen Penner, 

Schafer, Ronald Schmidt, Peggy C. Van Laane

media consult regarding food safety. Health professionals—such as dietitians, public health officials, 

most all States have completed efforts in this area. 

The next stage is to present information directly to 

consumers, especially in areas where irradiated food 

is available in the marketplace. While many states 

have presented information to consumers, irradiated 

foods are only available in a limited number of 

states. 

58 Thinking Globally– Working Locally • A Conference on Food Safety Education 
Researchers are working within their state to reach 

supermarkets and meat and poultry producers to 

increase availability of irradiated foods. When foods 

are available, consumer information on safe food 

handling and food irradiation will be presented to 

consumers through community group meetings. 

Finally, economists will conduct an economic analysis 

of the response to irradiated foods in two states 

where foods are in the supermarket. 

This project focuses on consumer education; however, information gained may help increase use of 

irradiation in the food service industry. This project is 

supported by a grant from USDA. 

3. The Pan American Health

Organization Food Safety


Education Project Pan American Institute


for Food Safety – Pan American Health


Organization/World Health Organization


Maria José Ravalli 

The Pan American Institute for Food Safety (INPPAZ) 

is a specialized center of the Pan American Health 

Organization – World Health Organization (PAHOWHO). INPPAZ provides technical cooperation to 

increase the institutional and technical capacity of 

food safety system in the Americas. 

To accomplish this aim, the Institute developed three 

integrated projects: Modernization of Food Safety 

Systems, Social Communication and Education, and 

Promotion of Food Safety Policy. 

The Social Communication and Education Project


purpose is to promote consumers’ safe food han­


dling practices. To achieve this aim, we developed


different products and educational materials:


Main target: Children in elementary school


Product developed: Educational kits with games,


posters, stickers, and other materials.


Secondary Target: Kids in junior and high school


Secondary Target: Mothers


Product developed: Public service announcements


(TV and radio) and educational kits with calendars


and brochures.


“Thinking globally, working locally” describes perfectly our job. Since we have a hemispheric 

mandate, we use different resources for information, 

validation, and distribution of our material. The first 

resource is PAHO representatives and consultants (32 

Abstracts 

offices in the Americas). By means of electronic 

conferences, we discuss our messages in order to 

adapt them to the local conditions and solve the 

multi-lingual audiences problem. The second resource is governments (municipalities, states or 

provinces, and federal) and governmental food 

safety and public health agencies. The third resource 

is alliances with the media to promote food safety 

consumer-orientated messages. 

Last, but not least, the Education Project uses information from the Regional Epidemiological Surveillance System of Foodborne Diseases (SIRVETA) that 

compiles data from 24 countries of the Americas to 

define the population at risk. This system showed, 

for example, that 40 percent of the reported 

outbreaks in the Americas occurred in homes. 

4. The West Virginia School Food 

Safety Pilot Program 

WV School Food Safety Program 

Scottie M. Ford 

In an effort to address the issue of emerging infections and the continuing rise in the number of 

annual cases of foodborne illnesses, the Division of 

Adolescent and School Health of the United States 

Department of Health and Human Services, Centers 

for Disease Control and Prevention, awarded a grant 

to the West Virginia Department of Education. This 

grant initiated the development and implementation in 2001 of a State-level model for a coordinated 

school food safety program. 

This on-going program is being designed as a 

uniquely comprehensive, integrated school food 

safety program that addresses: (1) instruction; (2) 

staff development for school personnel; (3) State and 

local policies; (4) school environment and facilities; 

(5) parent and community involvement; and (6)

surveillance and evaluation. 

An assessment instrument is being designed on both 

the State and Federal levels to measure the schools’ 

capacity to address food safety issues and respond to 

foodborne illnesses. Using input from States that are 

participating in this grant project, a Federal action 

guide is being developed to aid in the implementation of a coordinated food safety program in the 

nation’s schools. 

Within West Virginia, a main goal of the program is 

to increase the State’s capacity to ensure that all 

59 
schools meet high standards of food safety as set 

forth in the WV 1999 Food Code. The program also is 

designed to help prepare children and families to 

take an active role in the prevention of foodborne 

illnesses. 

5. Communicating Food Safety

Across Cultures 

Michigan State University 

Cathy Pisano 

This study addresses the need to consider culturespecific concepts of trust to communicate food safety 

messages. Failure to know, understand, and implement safe food practices causes illness. Communicating food safety messages, which are science based, 

sets in motion campaigns designed to heighten 

public awareness and motivate people to take 

action. Preparing effective messages for different 

segments of the population, however, requires 

determining what recipients think, what is relevant, 

and what their lifestyle and living conditions are like. 

Two variables that impact risk communication, trust 

and sociocultural orientation, are the focus of this 

paper. The process of risk communication with 

minority communities has perhaps the greatest 

benefit. Yet this area is the least understood due to 

limited research defining what is important within 

cultural groups. The study reported in this paper was 

designed to improve our understanding of who 

Arab-Americans trust and perceive as credible 

messengers of food safety information. The data 

collected and its impact on education can advance 

the delivery of food safety material to the 

Arab-American community. 

6. Identification of Consumer

Food Handling Behaviors 

Associated With Prevention of 

Specific Foodborne Illness 

Washington State University – 

Food Science and Human Nutrition 

Department 

Val Hillers 

To be most effective in reducing the incidence of 

foodborne illness, educational messages must 

address factors most likely to result in illness. 

Nationally recognized experts in food microbiology, 

epidemiology, and food safety education were 

surveyed using the Delphi technique to develop 

consensus on food handling behaviors associated 

with major foodborne pathogens. The food safety 

experts participated in 4 rounds of Delphi via 

Internet and edited and rank-ordered lists of foodhanding behaviors associated with 13 pathogens. 

They also rank-ordered the food handling behaviors 

within five major pathogen control factors: a) practice personal hygiene, b) cook foods adequately, 

c) avoid cross-contamination, d) keep foods at safe 

temperatures, and e) avoid foods from unsafe 

sources. 

Results: 

•	 The experts ranked behaviors related to 

‘personal hygiene’ as most important to 

prevent infections from Shigella species and 

Staphylococcus aureus and second most 

important for Norwalk virus. 

•	 For Campylobacter, Salmonella, and Yersinia 

enterocolitica, “cook foods adequately” was 

top-ranked, followed by “avoid cross-contamination.” 

• Top-ranked behaviors related to Toxoplasma 

gondii were related to “hygiene” and “adequate cooking.” For Escherichia coli 

O157:H7, “adequate cooking” and “avoiding 

unsafe foods” received the highest ratings. 

•	 The food safety experts ranked behaviors 

related to “safe temperatures” most important to prevent illness from Bacillus cereus, 

Clostridium perfringens, and of secondary 

importance for Staphylococcus. 

• Avoiding specific risky foods were the topranked behaviors associated with Listeria 

monocytogenes, Norwalk virus, Salmonella 

Enteritidis, and Vibrio species. 

The expert’s rank ordering of food-handling behaviors associated with major foodborne pathogens 

provides a framework for food safety educators to 

use in educational programs. 

7. Food Handling Behaviors of 

Special Importance for the Very 

Young, Elderly, Pregnant, and 

Immunocompromised 

Colorado State University Department 

of Food Science and Human Nutrition 

Patricia Kendall, Lydia Medeiros, 

Val Hillers 

Consumers vary greatly in their susceptibility to 

disease from various pathogens based on age, 

reproductive status, disease state, and immune 

60 Thinking Globally– Working Locally • A Conference on Food Safety Education 
function. Thus, there is a need to examine food


safety messages to assure they are aimed appropri­


ately based on the needs of the target audience.


Nationally-recognized experts in food microbiology, 

epidemiology, food safety education, and food 

safety policy were surveyed using a four-round 

Web-based Delphi process to develop consensus 

concerning consumer behaviors most associated with 

reducing the risk of foodborne illness among young 

children, elderly persons, pregnant women, and 

persons with compromised immune systems due to 

disease or pharmacological therapy. 

Behaviors were rank-ordered within 13 pathogens 

and 5 pathogen control factors for general consumers and then rated for their importance to each of 4 

high-risk groups. 

For each pathogen control factor, the top-ranked 

behavior for general consumers was also considered 

of special importance for high-risk audiences. 

Results: 

•	 For the very young, elderly, and immune 

compromised, over 50 percent of all highly 

rated behaviors were from the “avoid foods 

from unsafe sources” pathogen control factor; 

42 percent of all highly rated behaviors for 

pregnant women were from this factor. 

•	 “Cook foods adequately” contained the 

second-highest number of highly rated behaviors, followed closely by “avoid cross-contamination” and “practice personal hygiene.” 

•	 The factor with the fewest highly rated 

behaviors was “keep foods at safe 

temperatures.” 

The importance experts placed on behaviors varied 

somewhat between the four high-risk audiences. The 

results should help food safety educators focus their 

efforts on those behaviors of greatest importance to 

targeted audiences. 

8.A Case Study in Risk

Communication–the


Walkerton Story


University of Guelph, Ontario,


Food Safety Network


Bonnie Lacroi 

A “Boil Water Advisory” was in effect from May 21


to December 5, 2000 in Walkerton, Ontario, Canada


Abstracts 

because of a contaminated municipal water supply. 

A series of unfortunate circumstances occurred in 

May 2000, causing the largest multi-bacterial waterborne outbreak (including Escherichia coli O157:H7 

and Campylobacter). It was the first documented 

outbreak in a municipal water supply in Canada. As 

it turned out, consuming the water in Walkerton in 

any form was a clear and present danger to local 

residents and visitors during this time. 

Top-line results of several sets of focus group interviews are presented illustrating the impact on daily 

life of a boil water advisory. The participants included some high-risk groups within the community 

who shared how they dealt with home water and 

food handling practices during the emergency. 

A brief chronology of events from May 18-24, 2000, 

the pathogens involved and an overview of issues to 

consider during a foodborne or waterborne outbreak are provided. Also included is a checklist for 

communication messages prepared during a crisis. 

This presentation will be of particular interest to 

those in the community delivering foodborne or 

waterborne risk reduction messages to consumers. 

9. A Food Safety Educational

Program for Small Farmers 

Federal University of Parana, Brazil 

A. M. Oliveira, M. L. Masson

This study was done with small farmers of a southern 

Brazilian town who manufacture traditional food 

such as jams, pickles, salami, cookies, pasta, candy, 

milk, and canned fruits. These farmers work the 

products from planting to selling. They have traditional familiar habits of production: poor financial 

resources, lack of information, and a large variation 

of raw material in their small scale production. 

The main objective of this study was to learn the 

prevention practices of contamination employed by 

the farmers on production and to give them conditions to learn about Good Manufacture Practices 

(GMP), according to Basic Texts on Food Hygiene 

from the Codex Alimentarius Commission. 

Therefore, using semi-structured interviews, a general diagnosis was made of their knowledge about 

current Brazilian food laws, food safety, and the 

farmers’ characteristics. After the interviews, a 

10-month course about GMP was planned. 

61 
During the course, each topic of GMP was specifically 

discussed, with oral interviews and objective questions. The classes were planned using brainstorming, 

group discussion, lectures with dialogue, games, and 

panel expositions. Students were evaluated during 

the class and through homework. After the course, 

the situation was evaluated on the production area. 

The farmers’ participation was very satisfying, making it possible to design a plan according to what 

they already do and to define, with their help, what 

can be changed and what must be changed to adopt 

GMP. The effectiveness of the program rests on the 

farmers’ participation and their learning about 

contamination and its prevention. 

10. Web-Based Food Safety 

Education and Resources 

Success Story—What Makes 

it Work? 

Iowa State University 

Daniel Henroid, Jr., Jim Huss 

Since 1995, the Iowa State University Food Safety 

Web site project (http://www.extension.iastate.edu/ 

foodsafety/) has provided resources for consumers 

and the food industry. The site is used frequently 

with over 904,000 page views recorded in 2001 and 

an average of 10-1/2 minutes per visit. The frequently used site features are information about 

common foodborne pathogens, daily food safety 

news stories, food irradiation information, the “Ten 

Steps to a Safe Kitchen,” and the “Consumer Control 

Point Kitchen.” A set of 4 Web-based food safety 

lessons called “Safe Food...It’s Your Job Too” is also 

frequently used with 90,000 scores registered on the 

end of lesson online exams. 

Other resources are available for food safety and 

Hazard Analysis and Critical Control Point (HACCP) 

education. A companion site at 

http://www.iowahaccp.iastate.edu provides a full set 

of HACCP procedures with examples for small meat 

processors. 

This site also provides training resources to Iowa’s 15 

Nutrition and Health Field Specialists to teach the 

ServSafe® sanitation certification programs. 

Additional online training resources are under 

development for food service operators as Iowa 

restaurateurs indicated they would use them to 

educate their employees (survey March 2001). 

The site has received numerous awards from the 

National Science Teachers Association’s SciLinks 

program, Restaurants and Institutions Magazine, 

Tufts Nutrition Navigator, BBC OnLine, Lightspan, Big 

Chalk, U.S. News and World Report Online, Golden 

Web Award from the International Association of 

Web Masters, Best of the Food Internet by 

FoodNavigator.com, Links2Go, Food and Wine 

Online, and the Gourmet Spotlight Award. 

Elizabeth Bugden 

food safety messages. 

organization. 

11. School Food Safety Developed 

at the University of Rhode Island 

University of Rhode Island/Cooperative 

Extension Food Safety Education Program 

Martha Smith Patnoad, Lori Pivarnik, 

Preventing foodborne illness in schools requires a 

multifaceted approach. This approach includes the 

development of a “blueprint” for food safety education that includes every member of the school 

existing partnerships and is building collaborations 

safety behavior change through delivering consistent 

The Rhode Island School Food Safety Pilot Project 

was funded in August of 2000 by the Centers for 

to reduce the risk of foodborne illness in the school 

setting through educational interventions. The 

project builds upon the existing Coordinated School 

Health Model. The partners in the project are the 

Rhode Island State Departments of Health and 

Education, the University of Rhode Island Cooperative Extension Food Safety Education Program, and 

Kids First, a community based nonprofit educational 

community. This “blueprint” utilizes the strengths of 

with new partners in an effort to affect positive food 

Disease Control and Prevention. The project’s goal is 

Activities of the project to date, implemented by the 

various partners, include an analysis of current 

Rhode Island food safety education materials, a 

survey of teachers and administrators to determine 

what and how food safety educational materials are 

being used in schools, and development of a project 

evaluation. 

Currently, six pilot schools are developing needs 

assessments and establishing long and short-range 

goals to integrate food safety into all aspects of the 

schools’ activities. Educational interventions will be 

62 Thinking Globally– Working Locally • A Conference on Food Safety Education 
developed based on these needs assessments and 

their effectiveness evaluated. Finally a model that 

can be utilized by other states will be developed. 

12. A Meta-analysis of International 

Consumer Food Safety Studies 

University of Wales Institute, Cardiff, 

United Kingdom 

E.C. Redmond, C. J. Griffith 

Illness resulting from foodborne disease has become 

one of the most widespread public health problems 

in the contemporary world. Underreporting, particularly of sporadic cases, suggests that the number of 

individuals who have suffered from foodborne 

disease maybe significantly higher than actually 

reported. Internationally, 12-62 percent of reported 

foodborne disease outbreaks are believed to be 

associated with food prepared/consumed in the 

home. 

The importance of the home as a location for acquiring foodborne disease has prompted numerous 

studies that have evaluated consumer perceptions, 

knowledge, and behavior pertaining to food safety 

in the domestic environment. 

Electronic searches of Internet and library databases, 

personal communication with food safety professionals, and attendance at international conferences 

has facilitated the collection of 88 studies carried out 

over 27 years. Analysis of when studies were published showed increased interest in consumer food 

safety has corresponded with increased incidence of 

foodborne disease. 

The majority (52 percent) of the studies were published between 1995-1999, and a further 27 percent 

of studies were published 2000-2002. Many studies 

were carried out in the UK (48 percent) and North 

America (42 percent), as well as New Zealand, Australia, Italy, and Eire. A variety of research methods 

were used to collect information, including interviews (49 percent), self complete questionnaires (26 

percent), direct observations (17 percent), and focus 

groups (8 percent). 

Analysis of survey contents showed 92 percent of the 

studies investigated self-reported practices, 76 

percent assessed knowledge, and 53 percent assessed 

attitudes/beliefs. Although consumers generally have 

a high level of concern for food safety issues, key 

areas where knowledge is lacking were apparent 

and substantial proportions of consumers fail to 

implement important food safety practices. Additionally, knowledge and self reported practice of 

specific behaviors did not correlate with actual 

observed practices. Results will be discussed in the 

context of government targets for reducing 

foodborne disease and development of future 

consumer food safety initiatives. 

13. Assessment of Consumer

Food Safety Behaviors 

University of Wales Institute, Cardiff, 

United Kingdom 

E.C. Redmond, C, J. Griffith, J. Slader, 

T. J. Humphey

The potential spread and persistence of foodborne 

pathogens in domestic kitchens has been recognized 

as an important food safety issue. Actions related to 

cross-contamination as a risk factor have been 

implicated in 39 percent of general outbreaks in the 

United Kingdom. The aim of this research was to 

correlate observed cross-contamination actions with 

actual pathogenic contamination of Campylobacter 

and Salmonella after food preparation. 

Consumers from three target audiences were 

observed via closed circuit TV whilst preparing a 

poultry-based meal involving high-risk practices in a 

model domestic kitchen. Cross-contamination actions 

were recorded and analyzed using a risk-based 

scoring system. Microbiological samples from potentially contaminated kitchen surfaces, materials, and 

food products were taken after each meal preparation and analyzed for Campylobacter and Salmonella 

contamination. 

Observation results indicated that consumers 

handled food with a considerable number and 

variety of food handling errors. For example, 43-57 

percent of consumers used the same unwashed/ 

inadequately washed utensils for preparation of raw 

chicken and then salad vegetables. 

Microbiological analysis showed that 80 percent of 

raw chicken portions used for meal preparations 

were contaminated with Campylobacter and 6 

percent with Salmonella. Seventeen percent of 

consumers who handled Campylobacter-positive 

chickens contaminated the kitchen and a further 17 

percent contaminated the end product. In total, 33 

Abstracts 63 
percent of meal preparations involving a 

Campylobacter-positive chicken resulted in cross– 

contamination. 

These and other results will be discussed in terms of 

comparisons between target audiences. It can be 

concluded that implementation of food safety 

malpractices during food preparation does result in 

pathogenic contamination of end products and the 

kitchen environment. Provision of observation and 

microbiological data will enable a more accurate 

evaluation of cross-contamination practices and 

enable informed development of risk communication strategies to improve food safety practices in 

the home. 

14. Identification of Factors for

Successful HACCP Implementation 

in School Foodservice 

Iowa State University – Food Safety Project 

Daniel Henroid, Jeannie Sneed 

Food safety is of primary importance in school food 

service, yet many school districts have not implemented prerequisite food safety programs for 

preventing foodborne illness. Even fewer school 

districts have implemented Hazard Analysis and 

Critical Control Point (HACCP) programs due to 

constraints of time, money, and labor. 

A focus group consisting of a national sample of 

school food service directors (n=10) who had already 

implemented HACCP was conducted. These directors 

were selected based on recommendations of the 50 

State directors of child nutrition programs. Questions 

were asked about best practices for developing 

HACCP programs and strategies for school food 

service directors to develop HACCP programs. Participants were asked questions about their HACCP 

programs, such as the motivation for beginning the 

program, necessary resources, recommendations for 

developing and delivering materials, challenges to 

implementing, advantages of HACCP, and strategies 

to motivate employees to follow HACCP programs. 

Participants reported that liability concerns about 

foodborne illnesses, strong interest in food safety, 

and desire to serve children safe food were major 

reasons to begin a HACCP program. They recommended taking an integrated approach to implementing HACCP procedures into current operating 

practices and using a slow but steady progression. 

They stressed that documentation of procedures 

must be made part of employees’ daily responsibilities and part of the work environment. Educating, 

motivating, and empowering staff were identified as 

keys to successful implementation. Directors reported integrating HACCP procedures into their 

systems helped improve customer satisfaction, 

contributed to making the operation more efficient, 

and saved money. 

15. A Diamond Engagement:

An Innovative Food Safety Tool 

Allegheny County Health Department 

Michael J. Diskin 

What would you think if you heard that the health 

inspector was giving out diamonds? You’d probably 

think it was pretty strange, but what if those diamonds represented an exceptional rating in a critical 

food safety category. What if the diamonds meant 

that a food operator was using a HACCP-based 

systems approach to food safety? And what if it 

made your community a safer place to eat...That 

would be really cool. 

Thousands of times each year food safety specialists 

from the Allegheny County Health Department get 

the opportunity to engage food operators. An 

innovative “assessment” tool that determines the 

food safety status of an operation has been developed. A diamond rating can be awarded in specific 

categories such as cooking, cooling, reheating, hot/ 

cold holding, protection from cross-contamination, 

and sanitization to operators who demonstrate 

control of food safety hazards. 

The objective of the assessment process is three-fold: 

1. to increase the number of food operations 

using a systems approach to food safety, 

2.	 to more accurately depict the food safety 

status of an operation, and 

3.	 to recognize businesses for exemplary food 

safety work. 

The program is unique in that it breaks through the 

traditional inspection model, provides incentives for 

food operators, and shifts the emphasis from identifying violations to educating operators on how to 

implement a HACCP-based systems approach. A 

two-page assessment form and an accompanying 

Guide to Food Safety Assessments are available. An 

evaluation of the program will measure a change in 

64 Thinking Globally– Working Locally • A Conference on Food Safety Education 
the number of facilities implementing food safety 

systems, feedback from the industry, and trends on 

contributing factors to foodborne illness. 

16. Voices and Visions in Food 

and Food Safety in Michigan 

Michigan State University 

L. D. Bourquin, T. A. Ten Eyck, M.A. 

Uebersax, L. G. Occeña-Po, E. C. Mather 

Effective food safety education must be developed 

through linkages among consumers, academia, and 

the public and private sectors. Recent work at Michigan State University has focused on constructing and 

sustaining these linkages through the cultivation of 

a self-directed Area of Expertise (AOE) team consisting of campus scientists and extension agents, 

county extension agents, government policy makers 

and regulators, and food industry personnel. The 

main focus of this group has been to protect the 

health of people in Michigan and abroad through 

the execution of research, educational programs, 

and the provision of reliable information to policy 

makers. 

The AOE team has three primary work groups– 

training, consumer education, and the social dimensions of food safety. The training work group has 

offered training sessions on such topics as HACCP, 

good agricultural practices, and food handler 

certification. The consumer education work group 

has developed materials to be disseminated to 

consumers and the popular mass media, and the 

social dimensions work group has been focusing on 

consumer and industry perceptions of topics such as 

biotechnology, irradiation, and general food safety. 

A Web site has been constructed to serve as an 

informational source for all audiences concerned 

with food, and while heavily focused on Michigan 

issues, information is available for national and 

international audiences. The Web site is envisioned 

as a tool for forging collaborations among various 

centers of Michigan State University and others in 

the food industry and consumers engaged in some 

aspect of the food system. The Web site can be 

found at http://fooddomain.msu.edu. Funding for 

this project was provided by the W. K. Kellogg 

Foundation and Michigan State University. 

17. Internet-based Multimedia 

Food Worker Training: 

Development and Evaluation 

Oregon Center for Applied Science, Inc. 

Lynne H. Grilley Swartz 

This project developed and evaluated a unique 

video-based Internet foodhandler training program. 

Funded by the Centers for Disease Control and 

Prevention, the program is theoretically grounded in 

behavior change principles (Theory of Reasoned 

Action and Social Learning Theory) and proven 

instructional design principles. 

Unlike the many programs targeted for food 

managers, this program is designed to include entry 

level, lower literacy workers and contains unique 

features to evaluate worker knowledge and attitudes. Video-based motivational testimonials and 

positive message framing attempt to impact the 

users’ attitudes, intentions, and self-efficacy towards 

performing safe food handling techniques. No prior 

computer experience is required to navigate the 

program. Internet access with intensive server logic 

allows for central administration and dissemination 

of testing materials for certification purposes, and 

simplified customization and updates. The program 

is ideal for public health departments or large work 

sites that need to inexpensively and consistently 

train and/or certify workers. 

Based on the 1999 FDA Food Code, the program 

consists of video, animation, and graphics covering 

principals of food safety, proper hygiene, temperature controls, avoiding cross-contamination, and 

proper storage. Graphic-based interactive learning 

activities reinforce the critical skills for each section. 

The final skill-building section consists of a “real 

world challenge,” where the user identifies food 

handling errors made in a realistic workplace. 

The program was evaluated with over 500 food 

workers seeking certification in Oregon. Results 

indicate that the program was quite efficacious with 

both experienced and inexperienced food workers. 

Workers showed gains in knowledge and increased 

positive attitudes, intentions, and self-efficacy in 

performing food safety tasks. 

Abstracts 65 
18. Food Safety Assessment

Work of the National Association 

of County and City Health 

Officials 

National Association of County and 

City Health Officials 

Becki Shapac 

It has been estimated that each year 76 million 

persons experience foodborne illnesses and that 

5,000 food-related deaths occur in the United States. 

In localities across the country, ensuring safe food 

stands out as a principle environmental health 

responsibility of the Local Public Health Agency 

(LPHA). According the National Association of 

County and City Health Official’s (NACCHO) 1992­

1993 National Profile of Local Health Department 

and a subsequent 1997 survey, food safety activities 

are most commonly cited among the “environmental 

health services” which the LPHA provides. Most 

often, the LPHA is responsible for inspections and/or 

licensing of restaurants and food and milk control. 

Recognizing the need for improving local environmental health effectiveness, the Centers for Disease 

Control and Prevention’s (CDC) National Center for 

Environmental Health (NCEH) partnered with 

NACCHO to conduct a 5-year project. The first 2 

years have focused on assessing current activities, 

abilities, and needs at the local level around food 

protection. The assessment consisted of a mailed 

survey to randomly selected LPHAs and focus group 

discussions with health officials. The key findings 

included the needs and weaknesses of LPHA’s food 

safety programs. They consisted of lack of training, 

funding, staff, staff retention, technology, and 

equipment. The findings also identified issues with 

regulatory loopholes and complexities. 

The coming 3 years will build on research findings 

and will focus on addressing gaps and implementing 

programs to build local capacity for reducing 

foodborne illness. Primarily, NACCHO will provide 

resources, technical support, and expertise to enhance LPHA’s food safety programs in the identified 

areas. 

19.Food Safety Certification 

Training for Chinese-American 

Food Service Workers in 

South-Central Pennsylvania 

Penn State Cooperative Extension 

Nancy Wiker, Margaret Malehorn,


Karen Karnes,


Larry Sulpizio


Penn State Cooperative Extension, Penn State Continuing Education, and the Pennsylvania Department 

of Agriculture Bureau of Food Safety collaborated to 

implement food safety certification training for 

Chinese-American food service workers in southcentral Pennsylvania. The purpose of this outreach 

effort was to assist Chinese food service managers 

to comply with the Pennsylvania Food Employee 

Certification Act, which went into effect on July 1, 

2003, requiring all licensed food service establishments to employ one certified employee. 

This exceptional program employs a Chinese-American instructor, qualified with the National Restaurant 

Association, to teach the course in Chinese, using a 

Chinese text and exam. A brochure in Chinese was 

prepared and direct marketed to Chinese food 

establishments. Because local sanitarians identified 

specific cultural practices indigenous to this population and language barriers, a field trip to a Chinese 

restaurant for hands-on training/demonstration was 

incorporated. In addition, a Chinese cultural diversity 

training for staff of all collaborators was held to 

facilitate cultural understanding. 

Four 16-hour classes were conducted using 

ServSafe® Chinese curriculum materials. Corresponding handouts and posters were translated into 

Chinese. Ninety-seven percent of the participants 

(n=89) qualified for certification. Sanitarians inspecting Chinese food establishments indicated 

participants were more likely to practice safe food 

handling techniques. 

Materials and processes developed for this program 

provide a training model for additional diversity 

programming in Chinese and other languages. 

66 Thinking Globally– Working Locally • A Conference on Food Safety Education 
20. Handle With Care: Keeping


Your Child’s Formula,


Expressed Breast Milk &


Food Germ-Free


Rutgers Cooperative Extension of 

Somerset County 

Daryl L. Minch 

Objectives: Participants will: 

1.	 Gain knowledge about key food safety 

practices for infants and young children. 

2.	 Describe a behaviorally focused approach to 

teach parents and child care providers about 

food safety for infants and young children. 

3.	 Gain practical ideas to implement this


program.


Description: 

Handle With Care is a multi-faceted food safety 

educational program using behaviorally focused 

messages in a creative and engaging manner to 

reach at-risk audiences. Presenter will: 

•	 Summarize research on food safety and 

feeding practices of parents with children, 

ages birth to 5 years. 

•	 Present results from a needs assessment 

conducted with WIC personnel and focus 

groups of WIC clients. 

•	 Demonstrate the multi-county intervention 

using the Handle With Care curriculum which 

includes: 

• A food safety curriculum - educator overview, two behaviorally focused lessons, 

activity sheets, and an evaluation questionnaire; 

• 3 multi-cultural fact sheets on keeping 

expressed breast milk, formula, and food 

germ-free; and 

• 2 posters to create awareness of key food 

safety practices. 

•	 Review results of the program and discuss 

implementation strategies. 

21. Working Together to Improve 

Food Safety in Indonesia 

Cormorant Technical Services P/L, 

Australia 

Carole Theobald 

If you are passionate about food safety and get the 

chance to help a neighboring country – you jump at 

it! Well, that is what I did! Jakarta, the capital of 

Indonesia is closer to Perth, than Sydney. Our neighbor, the fourth largest country in the world, was 

having a hard time economically and saw that 

through improving food safety, trade could be 

improved. Since 2000, I have been involved on a 

number of projects funded by the Australian Government through its Aus-AID program. The projects 

have involved training Indonesian officers in 

advanced chemical and microbiological laboratory 

techniques for analyzing food, laboratory quality 

management programs, and also food safety 

auditing. 

Besides trialling basic and more advanced food 

safety programs in a number of food premises in 

Java, Bali, and Sumbawa, the team has also developed a CD-ROM package to facilitate the understanding of Australian food labeling legislation by 

Indonesian exporters to Australia. 

Finding a practical approach to introducing a workable system of food safety reform in a land of food 

safety extremes is challenging. However, our binational team has recently developed an integrated 

national food safety management system and, 

during 2002, further work is planned that will put 

the policy document into practice. This will involve 

developing suitable food safety training materials, 

establishing a system to integrate and synergise 

current food monitoring activities, and developing a 

suitable foodborne disease notification system. 

22. Communicating New Food

Safety Legislation in Australia – 

Overcoming the Fear Barrier 

Cormorant Technical Services P/L, Australia 

Carole Theobald 

Two national projects sponsored by the Commonwealth Government of Australia have been undertaken to facilitate the introduction of new national 

Abstracts	 67 
Food Safety Standards in Australia. Previously every 

state and territory in Australia had its own food 

safety legislation. 

1) Leveling the Playing Field. This is a set of training 

materials for food safety enforcement officers that 

was developed in consultation with State and Territory Health Departments throughout Australia. It is a 

2-day professional development workshop designed 

to facilitate the consistent interpretation and application of the new Australian Food Safety Standards 

by Environmental Health Officers. The project involved surveying EHOs throughout Australia to 

identify their needs, developing draft materials, 

piloting them in three states, and producing the 

final resources. 

2) National School Canteen Food Safety Project ­

Looking After Our Kids. School canteens in Australia 

are “school-based takeaways” with one paid staff 

member and parent volunteers. Menus consist 

mainly of pizzas, rolls, sandwiches, pies, stuffed 

potatoes, hot chicken pieces, etc. This 30-minute 

video and 60-page handbook package has been 

designed in consultation with School Canteen Associations and Health Departments in all states/territories. It explains the new legislation to school principals, parent bodies, paid school canteen staff, and 

volunteers – so they understand their responsibilities 

under the legislation. (The Commonwealth Government will distribute the package, without charge, to 

all 10,000 schools in Australia.) 

23. To Reduce Rates of Foodborne 

Illness, Let’s Target Handwashing 

(and Drying)—A Most Effective 

Means of 

Reducing Disease Transmission 

Georgia-Pacific Corp 

Barry Michaels 

The following is a complete review of the 

handwashing (and drying) paradigm. It consists of a 

series of metanalyses identifying what is known 

about handwashing effectiveness (in vivo laboratory 

testing and group handwashing intervention studies), compliance, and education (successes and 

failures). 

A metanalysis of 16 different in vivo investigations 

supports claims of high efficacy and allows construction of a hygienic efficiency model for each stage of 

the handwashing process (washing, rinsing, and 

drying). Data from 21 group studies show an 

average of 40 percent reduction in rates of both 

diarrheal and respiratory diseases when active 

handwashing education programs were implemented. 

However, handwashing compliance data from 25 

studies covering a variety of venues shows that 

handwashing compliance (HWC) is relatively low and 

that there is generally an inverse relationship between education and compliance. Over the years, 

of WIC Participants 

order to improve HWC. In an analysis of over 40 

studies, many produced improvement, but after 

initial improvement, drop back to baseline. An 

extensive list of barriers to handwashing were 

identified and catalogued for targeting with social 

marketing approaches. 

In a study of self-perceived HWC, it was found that 

there is often a wide variance between self-perception and actual compliance. This and other 

behavioral aspects of the handwashing paradigm 

explain why educational programs so often fail to 

to change and require multimodal intervention 

programs (as outlined) in order to overcome the 

psychological impediments to compliance. 

24. Food Safety Education Needs 

Nutrition & Food Sciences 

Participants in The Special Supplemental Food 

frequently at high risk for foodborne illness. The 

purpose of this study was to assess food safety 

many different approaches have been trailed in 

different handwashing compliance intervention 

improve handwashing rates. Poor habits are difficult 

Texas Woman’s University/ Dept of 

Carolyn Bednar, Junehee Kwon 

Program for Women, Infants, and Children (WIC) are 

education needs of WIC participants and appropriate 

dissemination methods. A questionnaire was developed by the researchers, validated by 10 food service 

professionals, and pilot tested. The final survey, 

mailed to a stratified random sample of 500 WIC 

directors nationwide, received 219 responses 

(43.8 percent return rate).

The highest priority topics for food safety education 

were handwashing (81 percent), infant formula 

handling (80 percent), leftover baby food (68 percent), cross-contamination (63 percent), and food 

preparation practices (57 percent). A majority (91 

68 Thinking Globally– Working Locally • A Conference on Food Safety Education 
percent) of WIC agencies indicated that most clients 

spoke English, but 9 percent had a majority of 

Spanish-speaking clients. A chi-square test revealed 

that WIC directors at sites where Spanish is the 

prevailing language perceived a higher need for 

educating clients on safe thawing of frozen foods 

(p <0.05). Infant formula handling was perceived as 

a greater educational need (p <0.05) at agencies 

with mainly English-speaking participants. 

Director respondents chose the most effective education methods for WIC participants as: game/activity 

(26 percent), video with discussion (23 percent), 

video with interactive materials (23 percent), and 

brochures/handouts (15 percent). 

Eighty-seven percent of the WIC agencies currently 

offered food safety education, usually provided by a 

WIC nutrition educator or dietitian. Information 

gained from this study will be used as background to 

develop bilingual (English and Spanish) educational 

materials aimed at low-income, low-literacy 

consumers. 

25. Disparities in Foodborne 

Disease Education Among 

Physician pecialties That Treat 

At-Risk Populations 

Georgia Division of Public Health 

S. Thomas, K. McCombs, S. Lance-Parker

Background: 

Because of the higher risk of illness in 

immunocompromised and pregnant individuals and 

the inherent lack of food safety education, physicians whose specialties are intimately involved in the 

treatment or management of at-risk individuals are 

essential in the education of these populations 

about foodborne disease. 

Methods: 

In 2000, the Georgia Emerging Infections Program 

conducted a survey on foodborne disease risk and 

prevention targeting four physician specialties that 

treat immunocompromised or pregnant individuals: 

obstetricians, oncologists and hematologists, 

infectious disease (ID) physicians, and nephrologists. 

Results: 

Three hundred nine surveys were distributed to 

these 4 specialties; 87 of the 134 questionnaires 

returned were used in the analysis. Among the four 

specialties, no difference was found in the proportion of physicians surveyed that treat at-risk individuals or in the proportion of physicians that reported 

that their patients requested information regarding 

foodborne disease. Thirty-eight percent of physicians 

reported that their practice provides information 

about foodborne disease to patients. ID physicians’ 

practices were more likely to provide information 

than both nephrology (p=0.001) and obstetric 

(p=0.004) practices, while oncology practices were 

more likely to provide information than nephrology 

practices (p=0.043). 

Conclusions: 

There is a disparity in foodborne disease education 

of patients among the four different physician 

specialties. In Georgia, ID physicians and oncologists 

are more likely to ensure that their patients receive 

education on foodborne disease risk and prevention. 

26. Bilingual Food Detectives

Fight BAC!® 

New Mexico State University Leading 

Object Media Group 

Jeanne Gleason, Barbara Chamberlin 

New Mexico State University Cooperative Extension 

Service has produced a variety of multilingual food 

safety educational materials including those distributed through video, print, and multimedia. Their 

Food Detectives Web site (http:// 

www.fooddetectives.com) reachs kids ages 8-12 with 

engaging learning games, while videos have been 

successful in reaching bi-lingual and multi-lingual 

adult audiences. At-risk populations are also targeted through specific materials including salsa 

processing, HAACP procedures, child care food 

safety, and safety for food service providers. 

This educational exhibit will highlight the materials 

available, with versions available for preview and 

demonstration. Producers will also be available for 

discussion of instructional design and evaluation 

procedures of the educational tools. 

Abstracts 69 
27. USDA Fight BAC! ® Campaign 

Delivered in Inner City of Hartford 

Targeting Low Income Latinos 

University of Connecticut 

Jigna Morarji Dharod,


Rafael Perez-Escamilla,


Angela Bermudez-Millan,


Sophia Segura-Millan, Grace Damio


The Fight BAC!® food safety campaign was delivered 

for 6 months in English and Spanish through 

culturally appropriate media channels in inner-city 

Hartford. Pre- and post-campaign household-tohousehold surveys (N=250 each) were conducted to 

determine coverage, satisfaction, and changes in 

food safety knowledge, attitudes, and behavior of 

low-income Latinos. 

Seventy-three percent of respondents were exposed 

to at least one campaign media (TV, radio, newspaper, and/or posters). Highest campaign exposure 

(p<0.05) was among those: a) 46 and above, b) 

unemployed, c) with cable TV at home, and d) 

attending food pantries. Recognition of the Fight 

BAC!® logo increased from 10 percent to 42 percent 

between surveys (p<0.001). The vast majority (92 

percent) were satisfied/very satisfied with the campaign. Thirty-nine percent of exposed and 17 percent 

of the non-exposed group were aware of the term 

“cross-contamination” (p<0.001). The percentage of 

those properly defrosting their meats increased from 

16 percent to 22 percent between surveys (p=0.09). 

Results indicate good targeting, a high degree of 

satisfaction, and positive food safety knowledge and 

behavioral changes associated with this campaign. 

Funded by the USDA Food Safety and Quality 

Initiative. 

28. International Electronic 

Newsletter Offering 

Convenience to Nutrition and 

Food Safety Educators 

National Food Safety Educator’s 

Network (EdNet) 

Kathy Bernard, Julia Smith, 

Robyn Douglas, Susan Conley, 

Barbara O’Brien, Juanita Yates 

Despite continued progress in improving the quality 

and safety of foods produced in the United States, 

food-related illness remains a serious public health 

problem. However, most cases of food-related illness 

can be prevented if consumers recognize the important role they play in ensuring the safety of the 

foods they eat as well as prepare. 

To help address that need, the National Food Safety 

Educator’s Network (EdNet), an electronic newsletter 

from the Departments of Health and Human Services 

and Agriculture was launched in order to communiFood Safety 

Providers 

cate regularly with food safety educators and 

cooperators. EdNet provides updates on food safety 

activities to public health, nutrition, food science 

EdNet also delivers the latest information on government food safety initiatives to public and private 

sector organizations and individuals who disseminate this information to the public. This electronic 

disseminate information and assures awareness and 

information dissemination activities. 

Since its October 1997 premiere, 53 issues of the 

monthly 3-6 page electronic EdNet newsletter have 

been disseminated. The number of subscribers is 

join the one-way direct mail food safety education 

Archives of past EdNet updates are available. See 

29. A Spanish Multimedia 

New Mexico State University 

Martha Archuleta, Jeanne Gleason, 

Kari Bachman, Anita Rodriguez 

educators, and others concerned about food safety. 

newsletter utilizes cost effective communication to 

coordination of each agency’s food safety 

approximately 3500, representing 32 countries. To 

network, send the message: SUBSCRIBE EDNET-L 

firstname lastname to LISTSERV@FOODSAFETY.GOV. 

http://www.foodsafety.gov/~fsg/ednet.html 

Program for Child Care 

A Spanish language “Home Child Care Providers’ 

Food Safety Program” curriculum was developed by 

New Mexico State University Extension in collaboration with the New Mexico Child and Adult Care Food 

Program. The program was developed using the 

health belief model, specifically that the threat of 

foodborne illness in children under the care of 

participants would be a motivating factor for 

behavior change. 

Prior to development of the curriculum, focus groups 

were conducted with home child care providers that 

70 Thinking Globally– Working Locally • A Conference on Food Safety Education 
spoke primarily Spanish to ensure that information 

was relevant and culturally appealing. The curriculum focuses on the four areas of the Fight BAC!® 

campaign. Proper techniques for diapering and safe 

handling of bottles and baby food are also included. 

The curriculum consists of a Spanish telenovela-


(soap opera) style video, participant booklet,


facilitator’s guide, behavior change evaluation tool,


and certificate of completion.


The social-learning theory was used in designing the 

implementation of the curriculum. Specifically, the 

video is used to teach food safety concepts but also 

to stimulate discussion among participants so they 

can learn from each other. Activities included in the 

teachers’ guide provide opportunities for participants to practice appropriate behavior and observe 

others. Further, the evaluation component of the 

curriculum allows participants to set goals for behavior change. Workshops were conducted with 100 

Spanish-speaking home child care providers. 

Following participation in training, statistically 

significant improvement was observed in 8 of the 12 

food safety practices measured. This project was 

funded by the USDA Food Safety and Quality 

Initiative. 

30. Egg Safety Education for

Children


SGA Associates 

Jill A. Snowdon, Christine M. Bruhn,


Marcia Greenblum


The Egg Nutrition Center, the research and education center on nutrition and food safety for the egg 

industry, identified the need for food safety education among children. Few materials are available for 

helping children understand the subject and 

FoodNet data indicate that about 25 percent of the 

cases of salmonellosis from Salmonella Enteritidis, a 

bacterium that can be present in the interior of an 

egg, occur in children. 

The California Egg Commission, in collaboration with 

public health officials in southern California, had 

previously identified changes in consumer behavior 

that would block transmission of disease through 

eggs. The Commission also funded a research project 

to identify egg safety messages that could be communicated effectively on the label of an egg carton. 

The research included focus groups to generate label 

Abstracts 

information and a study among California consumers 

to test the efficacy of the messages. 

The results of the collaboration with the public 

health officials and the consumer research were 

combined with consumer education experience from 

the American Egg Board and formed the basis of the 

Egg Nutrition Centers project. The Center developed 

a colorful poster in English and Spanish for children 

and their parents that used pictures as well as words 

to help consumers understand basic egg safety 

concepts. The poster has been well received and over 

12,000 copies have been distributed. This work 

shows the results of combining the opinion and 

experience of the realms of food technology, public 

health, epidemiology, consumer research, and the 

food industry to promote food safety education. 

31. Science-based Research and 

Education About Safe Home Food 

Processing Practices 

University of Georgia /National Center 

for Home Food Processing and 

Preservation 

E. L. Andress, B. A. Nummer, 

M. A. Harrison, W. L. Kerr, J. A. Harrison 

The National Center for Home Food Processing and 

Preservation is a multi-institutional collaboration 

funded by CSREES-USDA with The University of 

Georgia as the primary institution. Scientists from 

Alabama A&M University and the University of 

California-Davis are partners. Experts in home food 

preservation from eight other U.S. universities and 

industry comprise an advisory committee. 

Interest in home food preservation and processing 

remains high in the U.S., but methods must be 

continually evaluated against updated information 

in food safety. It is critical to provide educators and 

consumers with access to current science-based 

information concerning safety and quality issues 

regarding home processing of food, and to encourage adoption of new practices. Therefore, the Center 

is creating, gathering, evaluating, and disseminating 

science-based recommendations and conducting 

research as needed in support of those 

recommendations. 

Multiple strategies for making safe food preservation recommendations available are being used: 

critical literature reviews and publishing of results; 

original research; updating of existing USDA and 

71 
Extension consumer publications; and establishing 

additional distribution channels for dissemination of 

guidelines, including a new Web site: http:// 

www.uga.edu/nchfp/ 

The Center’s Web site is the place to find information about the Center’s projects and its findings, 

USDA home food preservation publications, Center 

publications, links to other Cooperative Extension 

System publications, multimedia (graphics, animations, slides, and video), and how-to guides. 

Other programs in development through the 

collaboration of the Center include a model volunteer-based Master Food Preserver Program, an 

instructional video series, and an original Web-based 

curriculum on home food preservation. Evaluation 

strategies have been implemented to assess 

effectiveness. 

32. The Literary Classics: A New

Kind of Reading Material for 

Public Restrooms 

Allegheny County Health Department 

Michael Diskin, Christy M. Glenda 

The Allegheny County Health Department has 

released three new posters for public restrooms in a 

continuing campaign to promote handwashing as a 

way to combat the spread of infectious diseases. 

Displayed inside stall doors and above urinals to 

provide convenient reading material for a captive 

audience, the posters contain parodies of classic 

literature which communicate the importance of 

handwashing in an interesting and amusing way 

that people are likely to remember. 

The new posters, volume III of a series titled The 

Literary Classics – A New Kind of Reading Material 

for Public Restrooms, are parodies of The Adventures 

of Tom Sawyer by Mark Twain, The Hound of the 

Baskervilles by Arthur Conan Doyle, and Emma by 

Jane Austen. 

The first two volumes were released in 1997 and 

1998. They have been shown to significantly increase handwashing rates. A 1997 survey found that 

67 percent of women and 50 percent of men washed 

hands with soap and water in restrooms displaying 

the posters, compared to 52 percent and 20 percent 

respectively in restrooms with no posters. 

In a survey in 2001, the Health Department found 

that handwashing rates remain appallingly low in 

restrooms with no posters. Only 40 percent of men 

and 56 percent of women were observed washing 

hands with soap and water, 23 percent of men and 

28 percent of women used no soap and only water, 

while a shocking 36 percent of men and 11 percent 

of women walked right by the handwash sink and 

didn’t even bother trying. 

Quantity Cook 

Extension 

ment will pay particular attention to whether the 

people using no soap and only water is significantly 

lower in restrooms displaying the new posters. 

Marc Advertising donated its creative services and 

wrote the text for the new posters. The first set won 

local, regional and national Addy awards for excellence in public service advertising. The posters also 

gained national recognition for the Health Department, which received the 1999 J. Howard Beard 

local level from the National Association of County 

33. Food Safety for the Occasional 

University of Nebraska Cooperative 

foodborne illness outbreaks in Nebraska. Most 

confirmed cases did not occur in commercial food 

service establishments, but in foods prepared by 

community groups. A team of extension educators 

from central Nebraska checked into the problem and 

In a planned follow-up survey, the Health DepartAward for excellence in public health practice at the 

and City Health Officials. 

Cheryl Tickner, Sue Brown, 

Carol Schwarz, Cami Wells 

News articles in the mid-1990’s reported a number of 

discovered community workers have little food 

safety training and are unaware of health regulations because their facilities are seldom inspected. 

In 1997, the team developed “Food Safety for the 

Occasional Quantity Cook” targeting volunteers and 

part-time caterers who prepare and/or serve food at 

banquets, soup suppers, barbecues, food stands, etc. 

This comprehensive program includes an introductory skit, 56-set screen show, pre/post test, hands-on 

activities, participant and background materials, 

evaluation, marketing information, and completion 

certificate. 

72 Thinking Globally– Working Locally • A Conference on Food Safety Education 
More than 250 people, representing several hundred 

community groups, have completed the training 

during the last 5 years. Pre/post tests show a 23 

percent average increase in participants’ knowledge. 

Follow-up surveys and visits to community events 

indicate a number of proper food safety practices 

have been implemented. 

34. Using Distance Technology


for Food Safety Education


The Ohio State University 

Kristin Best, Lydia C. Medeiros 

Developing a technology enhanced, comprehensive 

food safety class for undergraduate and graduate 

students can provide innovative ways for students to 

learn. 

University Technology Services (UTS) of the Ohio 

State University has a special classroom designed for 

distance learning that is composed of video cameras, 

computer equipment, and microphones placed near 

students. UTS provided a technology expert who was 

knowledgeable with using the equipment. 

Distance learning provided two unique aspects to 

classroom education. This technology allowed 

students from a branch campus to attend class in 

real-time and guest speakers from all over the 

country to be able to contribute their knowledge 

without having to travel. Students had the opportunity to speak directly to distant students and guests. 

They also had the opportunity to use WebCT to 

access the syllabus and class updates and to participate in a threaded discussion and weekly chat 

session during the professors’ online office hours. 

Graded assignments were received via the Internet. 

The class earned 3 hours of graduate credit. 

Continuing education students were able to register 

on a pass/fail basis. 

Invited speakers were from universities, the Colum­


bus Health Department, industry, and the State and


Federal government. Topics focused upon laws and


regulations, retailer and consumer food safety


responsibilities, cost of foodborne illnesses, food


processing technologies, risk communication,


environmental impact, and social marketing.


Developing a similar class may help educators provide distance teaching about food safety to students, 

extension specialists, health professionals, and 

secondary education teachers who otherwise may 

not have the opportunity. 

Abstracts 73 
Thinking Globally– Working Locally • A Conference on Food Safety Education