Food Protection Trends - October 2009 - 627

INTRODUCTION It has been estimated that more than 20% of foodborne illnesses may occur because of food-handling errors by consumers (17). Several studies have emphasized the importance of the consumer as the “final line of defense” in the prevention of foodborne illness because they comprise the final step in the food preparation process (9, 20, 30). Concern about the consumer’s role in food protection has increased attention to food safety education. As a result, the Healthy People 2010 initiative, which reports that 71% of meals and 78% of snacks are prepared by consumers, has identified increasing the proportion of consumers who follow key food safety practices as one of its seven food safety objectives (8). This emphasis on improving consumer food safety practices has prompted considerable research in food safety education interventions focused on consumer knowledge and behaviors. Researchers suggest that for effective food safety education and risk communication to encourage safe food-handling practices, behavioral differences between various subpopulations must be understood (15). Several studies have found that food-handling practices differ by gender, ethnicity, age, income, and other demographic characteristics (2, 13, 19). Overall, studies find that safer food practices are reported by women than men (4, 13, 14, 18). While results of differences among ethnic groups between studies have varied greatly, overall, research suggests that race may play some role in determining food safety knowledge and behaviors of consumers (17, 21, 24, 27). Several studies have reported an inverse relationship between safe food-handling behaviors and education, with the most highly educated consumers engaging in the riskiest behaviors, especially with regard to consumption of adequately cooked meats (13, 14, 19, 22, 24). Some researchers have observed the relationship of food safety knowledge, attitudes, and behaviors to socioeconomic status or income levels of consumers. Many studies have found that high-income adults (> $50,000 annual household income) reported greater consumption of unsafe foods, less knowledge of hygiene, and greater likelihood of engaging in crosscontamination practices (13, 14, 19, 29). The effect of geographic location of residence on food-safety knowledge and behaviors has received little attention in research. Patil et al. (19) found that individuals residing in metropolitan areas or cities reported the highest consumption of raw or undercooked ground beef and that use of preventive cross-contamination practices was poorest in the rural mountain area. Other studies report that consumers from urban areas tend to have lower food safety knowledge scores than those from rural areas (1, 24). The association of frequent food preparation and gender with safe practices suggests that food-handling skills may be acquired through factors related to training, experience preparing food, or maturation (25). Many studies found that unsafe practices were reported more often by adults 18 to 29 years of age, particularly with regard to implementation of preventive cross-contamination practices (2, 14, 19, 22). Interestingly, Altekruse et al. (2) reported that while safe practices did increase with age, knowledge of food hygiene practices did not. The disparity between knowledge and self-reported practices may relate to food-handling experience, which may be lacking in young adults (25). Throughout food safety knowledge and behavior research, no demographic group consistently outperformed another in every safe-handling practice. Overall, food safety behavior differences among gender, race, socioeconomic level, and other demographic characteristics do exist and can be helpful in tailoring education and risk communication efforts to target groups. Recently, studies have begun to focus on young adults, mostly college or high school students. Many of the same gaps in knowledge and disconnects between behaviors that are found with adult consumers in the areas of good hygiene, adequate cooking, and preventive cross-contamination practices were found among young consumers (5, 10, 26). These studies concluded that some exposure to food safety or experience in food-handling practices may lead to increased safer behaviors. Also, research with college students reveals that some of the differences among demographic groups with adult consumers have already been established by the college years. Despite a consensus in the public health community that learning safe food-handling habits at an early age benefits health in the short and long term, many adolescents (fifth to eighth grade) have not received adequate education on the topic of food safety (3, 28). Some researchers contend that with increased contamination of food with pathogenic microbes (5) and changes in eating habits of Americans, today’s youth are more at risk of experiencing a foodborne illness than previous generations (7). Adolescents are targeted for food safety educational research because many have begun or will soon begin preparing meals or working in food service, and they are currently an understudied population in food safety knowledge and behaviors. Richards et al. (21) suggest that middle school is an ideal time to teach food safety, because adolescents are in the process of establishing life-long behaviors and, therefore, are more likely to synthesize new food safety knowledge in a way that will lead to the development of safer life-long behaviors. Effective educational interventions for adolescents can lead to improved food safety habits, but the success of these interventions depends upon alignment of educational strategies with specific needs of the targeted demographic group. Research suggests that without baseline data, it is difficult to develop and implement effective education efforts (6). Constructing a baseline of food safety knowledge, attitudes, and behaviors for various demographic groups is vital for determining the specific educational strategies that will motivate adolescents to practice safer food-handling. The objectives of this study were to: (1) develop a rigorous statistical sampling method to allow for the collection of data on the food safety knowledge, attitudes, and behaviors of seventh grade students in East Tennessee; (2) analyze that data to construct a baseline and identify gaps in food-safety knowledge, attitudes, and behaviors; and (3) ascertain the relationship of variables such as geographic location, socioeconomic status (SES), gender, and food-handling experience with food-safety knowledge, attitudes, and behaviors. OCTOBER 2009 | FOOD PROTECTION TRENDS

Food Protection Trends - October 2009

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