Mary Schroeder

Observation versus self-report: validation of a consumer food behavior questionnaire

A reliable and validated set of food safety behavior questions that could be used with confidence when evaluating food safety education programs was identified in this study. A list of 29 food-handling and consumption behaviors rank-ordered within five pathogen control factors by nationally recognized food safety experts was the basis for the development of the behavior questions. Questions were evaluated for reliability and several forms of validity. During a kitchen activity session, 70 graduates of a nutrition education program completed four food preparation tasks while being observed and videotaped. The individuals also participated in an in-depth interview to validate behaviors that could not be observed during the food preparation activity, e.g., refraining from preparing food for others when experiencing diarrhea. Criterion validity was established by comparing questionnaire responses to observed behavior and interview responses. Twenty-eight questions met the validity criterion (> or = 70% agreement between observed and interviewed responses and self-reported responses), with three or more questions from each of five pathogen control factor areas. Observation assessments revealed that hand washing was more likely to be performed prior to beginning food preparation than between working with raw meats and fresh produce. Errors in methods of washing hands, utensils, and preparation surfaces between food preparation tasks were common. Most participants did not use thermometers to evaluate doneness but still cooked to safe internal temperatures. The results provide a tool that educators can use to evaluate food safety programs and will help guide the development of more effective food safety education programs targeting needed improvements in behavioral skills.

Awareness and Acceptance of Current Food Safety Recommendations During Pregnancy

Objectives: To better understand pregnant womens food safety attitudes and beliefs that affect food selection, preparation and handling behaviors, sources of food safety information, motivators and barriers to adopting current recommendations, and preferences for receiving food safety materials. Methods: Eleven focus groups were conducted with 69 women (57 pregnant and 12 less than 6 months postpartum). The Health Belief Model guided development of the moderators guide. In the presence of each focus group, participants completed a food safety attitude/behavior questionnaire. Sessions were audiotaped, transcribed, and analyzed for common themes across and within groups. Results: Most participants indicated moderate concern about food safety and had made some food handling or consumption changes since becoming pregnant; however, many were not following 7 of the 12 specific recommendations discussed. Further, there was resistance to change habits, especially for less well-known recommendations. The women assumed their food is safe, and wanted strong evidence regarding why they should change current practices. Common barriers included lack of prior awareness of most recommendations, no prior illness from implicated foods and the convenience, perceived health benefits of, and personal preference for many risky foods discussed. Participants wanted food safety information that was quick and easy to read, sufficiently thorough, and specifically targeted to pregnant women. Conclusions: The women studied had not internalized the connection between risky food consumption during pregnancy and risk to the unborn child, but expressed interest in valid information that might cause them to change their behaviors. The information gained will be useful in developing food safety educational materials for pregnant women.

Health professionals' knowledge and understanding about Listeria monocytogenes indicates a need for improved professional training.

Listeria monocytogenes causes listeriosis, an uncommon but potentially fatal disease in immunocompromised persons, with a public health burden of approximately

Healthy Baby, Healthy Me Food Safety Curriculum

2 billion annually. Those consumers most at risk are the highly susceptible populations otherwise known as the immunocompromised. Health professionals have a considerable amount of interaction with the immunocompromised and are therefore a valuable resource for providing appropriate safe food handling information. To determine how knowledgeable health professionals are about Listeria monocytogenes, a nationwide Web-based survey was distributed targeting registered nurses (RNs) and registered dietitians (RDs) who work with highly susceptible populations. Responses were received from 499 health professionals. Knowledge and understanding of Listeria monocytogenes was assessed descriptively. Parametric and nonparametric analyses were used to detect differences between RNs and RDs. The major finding is that there are gaps in knowledge and a self-declared lack of understanding by both groups, but especially RNs, about Listeria monocytogenes. RDs were more likely than RNs to provide information about specific foods and food storage behaviors to prevent a Listeria infection. Notably, neither group of health professionals consistently provided Listeria prevention messages to their immunocompromised patients. Pathogens will continue to emerge as food production, climate, water, and waste management systems change. Health professionals, represented by RNs and RDs, need resources and training to ensure that they are providing the most progressive information about various harmful pathogens; in this instance, Listeria monocytogenes.

Design and development of food safety knowledge and attitude scales for consumer food safety education

Pregnant women are at increased risk for developing certain types of foodborne illness due to hormonal changes necessary during pregnancy to promote the survival of the fetus. Pathogens of special concern to pregnant women and their fetuses include Listeria monocytogenes, Toxoplasma gondii, Salmonella species, and Campylobacter jejuni. Nutrition education curricula for pregnant women typically focus on basic food safety concepts, which may not address the pathogen-specific information pregnant women need to understand why they are at higher risk for certain foodborne illnesses, potential health risks to their fetus, and what foods and/or food preparation styles they should avoid to protect themselves and their unborn child.