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5030-039, all restaurant managers and employees must be
familiar with the definition of a food allergy, the top eight
food allergens, and describe common symptoms of an allergic
reaction (11).
Sample
The restaurants identified for this project were obtained
from an initial listing of 1,123 independently owned
establishments in Metro Orlando, FL, from the Florida
Department of Business & Professional Regulation, Division
of Hotels and Restaurants. The COVID-19 pandemic
resulted in 78 permanent and 88 temporary restaurant
closures in Metro Orlando (30, 47), resulting in 957
independently owned restaurants. The list was reviewed
and revised by restaurant type and cuisine. The principal
investigator called the restaurants and talked to an owner or
manager, explaining the reason for the phone call, purpose
of study, data collection procedures, and eligibility criteria.
Owners and managers that agreed to participate in the
study provided email addresses to receive the questionnaire.
Two hundred fifty-five restaurants did not answer or return
telephone calls, and 41 restaurants refused to participate
in the study. Six hundred and sixty-one email addresses
remained, with 60 undeliverable email addresses, for a final
restaurant listing of 601 that participated in the study.
Survey instrument
The questionnaires developed by Rajagopal and Strohbehn
(33) and Choi and Rajagopal (8) were adapted for this study
based on guidelines by Dillman et al (14). The questionnaire
consisted of 10 food allergy knowledge questions, 19 food
allergy attitude items (1 = strongly disagree; 5 = strongly
agree), and 10 demographic questions. Correct answers to
knowledge questions earned one point, with zero points
for incorrect answers. According to the U.S. Census Bureau
of Labor Statistics (41, 42) 25.6% of Metro Orlando, FL,
residents are native Spanish speakers, and Spanish is the
most common non-English language in the region. The
questionnaire was translated into Spanish and translated back
into English to ensure the accuracy of the translation. Experts
in food safety, foodservice, and research design reviewed the
questionnaire before the pilot test.
Pilot study
The questionnaire was sent to 20 owners and managers
of independently owned restaurants in Metro Orlando, FL.
Four participants (n = 4) completed and returned study.
Participants received two reminder emails at 1-week intervals
prompting them to complete the questionnaire.
Data analysis
Data were analyzed by using IBM SPSS software (version
27.0, IBM Corporation, Armonk, NY). Descriptive statistics
(frequency, percentage, mean [M], and standard deviation
206 Food Protection Trends May/June
[SD]) were computed. Cronbach's alpha coefficient was
measured to assess the reliability of the questionnaire
(17). Chi-square tests examined the differences between
independent variables and the relationship between two
nominal variables (29). Analysis of variance (ANOVA)
examined the relationship between food allergy attitudes and
knowledge and participant demographic variables (39).
RESULTS
Demographic characteristics
One hundred eleven questionnaires were received; 9 were
incomplete, resulting in 102 valid questionnaires (Table
1). More than half of the participants were male (n = 65,
63.7%). The average participant age was 26 to 33 years (n
= 33, 32.4%). English was the most spoken language (n =
63, 61.8%), followed by Spanish (n = 35, 34.3%). Less than
half of the participants (n = 42, 41.2%) were Hispanic or
Latino, followed by Caucasian or White (n = 39, 38.2%).
Forty-three (42.2%) participants had 1 to 5 years of work
experience in foodservice. Fifty-nine (57.8%) participants
had 1 to 5 years of experience as the owner or manager at
the current restaurant. Participants reported an average of
41 to 50 hours worked per week (n = 56, 54.9%). The most
common cuisines represented were American cuisine (n
= 41, 40.2%), followed by Latino cuisine (n = 31, 30.4%).
Participants worked at casual full-service (n = 40, 39.2%)
and quick-service restaurants (n = 35, 34.3%). Sixty (58.8%)
participants had received formal food safety training. Fiftythree
(52.0%) participants had not received any food allergy
training. Eighty (78.4%) participants did not have food
allergy training certification.
Food allergy knowledge of owners and managers
The average food allergy knowledge score was 7.68 ± 2.11
of 10 possible points (Table 2). Eighty (78.4%) participants
correctly identified eggs as a food allergen. Over half of the
participants (n = 59, 57.8%) recognized that proteins in
some foods trigger food allergies. Seventy-three (71.6%)
participants recognized the symptoms of food allergic
reactions, and 85.3% (n = 87) knew that identifying food
allergens in menu items can prevent an allergic reaction. Most
participants (n = 89, 87.3%) knew they should wash their
hands before preparing allergen-free foods and after wiping
surfaces on which allergen-containing foods were prepared or
consumed. Over 91.2% (n = 93) of participants recognized
cross-contact practices that can transfer an allergen from
one food to another. In contrast, over three-quarters (n = 85,
83.3%) identified practices to prevent an allergic reaction
and avoid cross contact. More than half of the participants
(n = 59, 57.8%) were familiar with the state of Florida
rule requiring all foodservice employees to know the most
common food allergens. Sixty (58.8%) participants knew
restaurants in Florida were not required to provide allergenfree
menu options for customers with food allergies.
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