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GEM No. 529

‘‘Food Safety on the Go’’: A Course for Home-Delivered

Meal Programs

Amy L. Anderson, PhD1; Linda L. Netterville, MA, RD, LD2; Nadine R. Sahyoun, PhD, RD1

INTRODUCTION

The goal of home-delivered meal programs is to help homebound adults

maintain their health and stay in

their homes. Roughly 1 million older

adults in the US rely on homedelivered meals, and the demand

continues to increase.1,2

Home-delivered meal clients are

especially vulnerable to foodborne

illness, as they have a high prevalence of health conditions that can

weaken the immune system.3 Homedelivered meals can be a source of

foodborne illness if staff, volunteers,

or clients of home-delivered meal

programs do not follow proper food

safety practices.

The approximately 5,000 homedelivered meal programs across the

US have lacked a standard food safetycourse that addresses issues such as

maintaining safe meal temperatures

during delivery. In response to this

need, ‘‘Food Safety on the Go’’ was developed. The goal of this course is to

improve the food safety knowledge

and practices of home-delivered

meal program staff, volunteers, and

clients, and thereby decrease the

risk of foodborne illness among

clients.

CURRICULUM

To gather information for the course,

a survey was administered to the

State Units on Aging in all 50 states

about their food safety policies, and

a second survey was administered to

Module 1 

Food safety basics 

Module 6 

Clients (magnets) 

Figure 1. ‘‘Food Safety on the Go’’ modules. Module 1 is an overview of food safety 

for all staff and volunteers. Modules 2 through 5 are for specifc individuals within a program; for example, a program director should complete Modules 1 and 2. Module 6 

entails drivers giving out refrigerator magnets to clients. 

Module 2 

Program director 

approximately 360 home-delivered

meal programs about their food

safety training and meal delivery

procedures. Focus groups of homedelivered meal program directors

and dietitians from across the country were also convened. In addition,

the US Food and Drug Administration Retail Food Protection Team

reviewed the initial version of the

course and provided recommendations.

‘‘Food Safety on the Go’’ includes

6 modules from which program staff

can select according to their training

needs (Figure 1). Module 1, food

safety basics, is for all staff and volunteers. It explains why food safety is

essential when providing meals to

1

Department of Nutrition and Food Science, University of Maryland, College Park, MD 2

Meals On Wheels Association of America, Alexandria, VA

Address for correspondence: Nadine R. Sahyoun, PhD, RD, University of Maryland,

Department of Nutrition and Food Science, 0112 Skinner Building, College Park, MD

20742, USA; Phone: (301) 405-8774; Fax: (301) 314-3313; E-mail: nsahyoun@umd.edu

J Nutr Educ Behav. 2014;46:148-150

2014 SOCIETY FOR NUTRITION EDUCATION AND BEHAVIOR

http://dx.doi.org/10.1016/j.jneb.2013.09.002

older adults. Module 2, for the program director, emphasizes the importance of food safety training for all

staff and volunteers, and it describes

the adverse consequences of a foodborne illness outbreak. It also outlines

federal, state, and local food safety

requirements for home-delivered

meal programs. Module 3, for the

food service management staff, discusses recommended food safety

policies and procedures, from food

purchasing through meal delivery. It

describes a sample policy on food

product recalls, as well as a policy

on cases of foodborne illness. Module

4, for food service workers, focuses on

how to safely handle food, as well as

the importance of good health and

personal hygiene when working

with food. Module 5, for drivers,

also stresses the importance of good

health and personal hygiene during

meal delivery, and it outlines procedures for delivering safe meals. Each

of these modules takes between 15

and 45 minutes to complete and

includes an activity such as a crossword puzzle, scenario for discussion,

148 Journal of Nutrition Education and Behavior Volume 46, Number 2, 2014

Module 4 

Food service workers 

(staff and volunteers) 

Module 5 

Drivers (staff and 

volunteers) 

Module 3 

Food service 

management staff 
 

Journal of Nutrition Education and Behavior Volume 46, Number 2, 2014 Anderson et al 149

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

KEEP FOOD SAFE MANTENGA LOS 

','>', 

ALIMENTOS SEGUROS 

,.,.. ','>', 

,.,.. ❖ EAT meals RIGHT AWAY or 

REFRIGERATE/FREEZE ❖ COMA alimentos INMEDIATAMENTE 

THROWAWAY food left out for o REFRIGERELOS/CONGELELOS 

more than 2 hours ❖ TIRE alimentos dejados afuera del 

refrigerador por mas de 2 horas 

❖ REHEAT food until STEAMING ❖ RECALIENTE alimentos hasta que HOT EMITAN VAPOR 

❖ WASH YOUR HANDS before ❖ LAVE SUS MANOS antes de tocar 

touching food alimentos 

❖ KEEP your kitchen CLEAN ❖ MANTENGA SU cocina LIMPIA 

~~ M"e~s On Wheels f'I .. M"e~s On Wheels 

~- ,.._, .... _ ·~-~k UIICIO!•W .. UCi 

~ ¢ ~--r""ro IOUS--ty-~ 

'<YL!'~ 'f/(yl,J•~ 

10 

8.3 

~ 

e "' 

0 6.0 0 

"' .!: 

., 5 

"' C: 

"' 3.0 ,: 

0 

C: 

"' ., 

:. 

0 Module 1 Module 2 Module 3 Module 4 Module 5 

Food safety basics Program director Food service Food service Drivers 

(n = 174) (n=4) management staff workers (n=87) 

(n=52) (n=105) 

Figure 2. Magnet for clients (Module 6), in English and Spanish. 

‘‘Fill in the blanks,’’ or ‘‘What's wrong

with this picture?’’ Each of these

modules also includes a pretest and

an identical posttest, with 5–10

true/false questions on the main

points covered in the module.

Module 6, for clients, is in the form

of refrigerator magnets for drivers

to distribute to clients. The magnets

display 5 key food safety messages

(Figure 2).

EVALUATION

‘‘Train-the-trainer’’ pilot tests of ‘‘Food

Safety on the Go’’ were conducted

in Kansas and California. Attendees,

who represented a variety of homedelivered meal programs, were asked

to train staff and volunteers within

their programs over the following

4 months. They were also asked

to complete a written course evaluation at the end of the pilot tests,

and an online evaluation 4 months

later.

In the 4 months after the pilot

tests, Kansas trainers trained over

380 staff and volunteers and California trainers over 1,200 staff and

volunteers, for a total of over 1,580

individuals. Trainers provided preand posttests from 422 staff and

volunteers they trained. Of this number, 308 (73%) either increased their

scores from pretest to posttest or had

perfect scores on both the pretest

and the posttest; 35 (8%) decreased

their scores; and 79 (19%) did not

show any change. Figure 3 shows the

mean percent change in staff and volunteer scores from pretest to posttest

by module.

Trainer responses in the initial

course evaluation were similar to

those in the 4-month evaluation. In

the evaluations, trainers were asked

to read a number of statements and

check one of the following options:

‘‘strongly agree,’’ ‘‘agree,’’ ‘‘disagree,’’

‘‘strongly disagree,’’ and ‘‘no opinion.’’ In the initial evaluation, all

55 trainers strongly agreed or agreed

that the course would be useful to

their programs; that the information

in the course was relevant to their programs; that the course was clear and

easy to understand; and that the

course was at the right level of difficulty for staff and volunteers in their

programs. Fifty-four of the 55 trainers

strongly agreed or agreed that they

would recommend the course to other

home-delivered meal programs, and

one gave no opinion. Trainers were

also asked to rate the overall course

and various parts of the course according to the following scale: ‘‘excellent,’’

‘‘very good,’’ ‘‘good,’’ ‘‘fair,’’ and

‘‘poor.’’ In the initial evaluation, 85%

of trainers rated the overall course

as excellent or very good, 14% as

good, and 1% as fair. Trainers gave

similar ratings to individual components of the course, including the

PowerPoint slides, the trainer guides,

the activities, and the magnets for

clients.

Forty percent of trainers stated

that the most important information

they learned in the course pertained

to meal delivery or client handling of

meals. These subjects included training drivers in food safety, keeping

meals at safe temperatures, and checking that clients' refrigerators were at

safe temperatures. In the 4-month

evaluation, half of trainers reported

that they had made changes to the

food safety practices of their programs

in the 4 months after the pilot tests.

Changes included: training all

volunteers and drivers in food safety;

ensuring that meals were kept at

appropriate temperatures; checking

Figure 3. Mean percent change in staff and volunteer scores from pretest to posttest 

by module (n 1⁄4 422). 
150 Anderson et al Journal of Nutrition Education and Behavior Volume 46, Number 2, 2014

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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clients' refrigerator temperatures; adding labels with reheating instructions

and a use-by date to home-delivered

meals; ensuring that drivers had

hand sanitizer in their vehicles; and

instructing drivers not to leave meals

at clients' doors.

FUTURE APPLICATIONS

‘‘Food Safety on the Go’’ was disseminated through a webinar with representatives of State Units on Aging, as

well as at national conferences. Future

plans include providing the course

on DVD and on the Internet, as

focus groups expressed an interest in

having the course available in these

formats.

ACKNOWLEDGMENTS

This study was approved by the University of Maryland Institutional

Review Board. It was funded by

the National Institute of Food and Agriculture within the US Department of

Agriculture and by the University of

Maryland. Course materials and a recording of the webinar are available

online at http://www.nfsc.umd.edu/

programs/foodsafety.

REFERENCES

1. Administration on Aging. Nutrition Services (OAA Title IIIC). http://

www.aoa .gov/AoARoot/

AoA_Programs/HCLTC/

Nutrition_Services/index.aspx. Accessed

March 4, 2013.

2. Government Accountability Office. Nutrition Assistance: Additional Efficiencies

Could Improve Services to Older

Adults. http://www.gao.gov/assets/130/

126478.pdf. Accessed March 4, 2013.

3. Kleinman R, Foster L. Multiple Chronic

Conditions Among OAA Title III

Program Participants. http://mathematicampr.com/publications/PDFs/health/vulnerable

seniors_IB4.pdf. Accessed March 4, 2013.