Food Protection Trends - March/April 2021 - 218

bacteria and viruses happens rapidly when handling, chilling,
cooking, and cleaning foods, and the causes of foodborne
illnesses in the home can be difficult to determine because
food is consumed across different settings (13). In some
studies, experiments and observations have been used to
assess food safety behaviors in the home (25, 41). Although
the majority of study participants used safe cooking
practices in the home setting, some did not follow safe
practices concerning reheating and stored food at improper
temperatures. Researchers also determined that indirect and
direct cross-contamination while preparing foods was the
most significant unsafe practice (41). Wills, Meah, Dickison,
and Short (40) argued that foodborne illness is a public
concern and that it is caused by food prepared and cooked at
home. Despite this concern, U.S. consumers perceive their
personal risk associated with home cooking as low (24). Due
to these perceptions and optimistic bias, consumers believe
they are in control of any exposure to foodborne illness
(22, 23). However, Neff et al. (26) found that consumers
misunderstand the meaning of food date labels, which leads
to frequent food discards (26). As these findings indicate,
education is needed to improve consumers' food safety
knowledge in the United States.
According to a recent study on consumer food safety,
consumer perceptions of food safety differ among individuals
(10, 39). U.S. consumers make decisions based on their past
experience, knowledge, and convenience when handling
foods (22). For this reason, consumers perceive different
levels of risk associated with foods. In the United States, more
than half of foodborne illnesses are associated with foods
prepared in the home (22). Food safety knowledge, attitudes,
and behaviors differ across demographic and socioeconomic
groups (17, 41). Terpstra, Steenbekkers, Maertelaere, and
Nijhuis (33) found that older people lacked food safety
knowledge about such issues as food storage times. Evans
and Redmond (9) found that older adults believed they
were at lower levels of risk than were other individuals,
suggesting perceptions of personal invulnerability. Thus,
older people may be more likely to practice unsafe food
handling, food consumption, and cooking behaviors (34).
Improper food storage leads to cross-contamination, and
the consequence of handling and consuming contaminated
food may be the increased likelihood of foodborne illnesses
(41). Because poor food handling practices may result in
foodborne outbreaks (34), it is essential to educate and
inform consumers about proper food handling practices. One
group of researchers noted no relationship between food
safety knowledge and practice; a significant number of study
participants reported unsafe food practices even though they
had a high awareness of food safety (26). Thus, actual food
safety practices may not be effectively transferred from food
safety knowledge.
According to the American Camp Association (ACA)
(2), a camp may be in a rural location where an ambulance

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Food Protection Trends March/April

might be restricted from easily access in a timely manner.
As a result, prior to going camping, campers need to
ensure available transportation and prepare for necessary
medications in case of emergencies due to foodborne illness.
In addition, campers should plan what equipment will be
used during the camping trip (35). The U.S. Department of
Agriculture (USDA) (35) also recommended bottled water;
otherwise, water should be boiled before drinking. The
number of foodborne illness outbreaks at camps increases
every summer (30). Although most cases are minor, they
can turn into serious outbreaks. Schirick (30) stressed
the importance of also educating camping staff members
to enhance the food safety knowledge and follow safe
food handling practices to effectively prevent foodborne
outbreaks. The results of their investigation found that the
number one cause of foodborne illness outbreaks among
campers was cross-contamination, especially when viruses
transfer from person to person (7). Therefore, more attention
should be given to educating campers on how to prevent
cross-contamination during outdoor activities. Additionally,
campers might suffer from a food allergy if cross-contact is
not prevented. The ACA (2, 3) emphasized that campers
are twice as likely to become ill due to foodborne diseases
as opposed to getting physically injured. For this reason,
the USDA (35) suggested that campers should keep all
perishable foods at the appropriate hot or cold temperatures.
More specifically, food safety guidelines suggested that
campers bring frozen gel packs to keep meals cold. Bacteria
are likely to grow rapidly at temperatures between 40 and
140°F on perishable foods because this range is considered
the temperature danger zone (37). Cross-contamination can
be best prevented by washing hands before and after handling
food (37). The juices from raw poultry and other meats can
also cause cross-contamination (7). For this reason, raw
foods should be placed in plastic bags. A food thermometer is
an important piece of camping equipment used to determine
when cooked food is safe to consume (37). It is critical to
understand that a food thermometer is the only way to ensure
that foods are adequately cooked and safe to consume (35,
37). Nevertheless, training materials such as those that are
available through the ACA and USDA do not seem effective
in preventing foodborne outbreaks among campers. In fact,
the increasing number of annual foodborne illness outbreaks
indicated a gap between the food safety guidelines and the
current knowledge and practices among U.S. campers.
MATERIALS AND METHODS
Approval to use human subjects in this research was
obtained from the University Institutional Review Board
prior to the initiation of research.
Instrument and validation
Based on the literature review, a survey questionnaire was
developed that comprised three sections. The first section
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