Food Protection Trends - December 2008 - 913

TABLE 1. Hand washing observation checklist: percent of young adultsa observed engaging in each practice Hands were washed Hand washing occasion % Observed 60 14 63 4 Running water was used % Observed 60 14 63 5 Soap was used Hands were rubbed together ≥ 20 seconds % Observed 16 0 10 1 % Observed 54 7 41 4 Before Food Preparation Began After Handling Raw Produce After Handling Raw Poultry As Necessary a b n = 153 b As necessary = hands were washed following: each absence from the food preparation work station (e.g., bathroom breaks, telephone call); touching body parts (e.g., wiping hands on clothes, touching face, hair); coughing/sneezing or blowing nose Evaluating the extent of risky food handling behavior, in particular hand washing during food preparation, is vital to understanding how to tailor and focus food safety education to this population. One purpose of this study, therefore, was to observe young adults’ hand washing behaviors during food preparation and compare their compliance to established guidelines for the prevention and spread of foodborne disease (22). Additional purposes were to determine how observed hand washing behaviors compared to self-reported behaviors as well as to assess young adults’ knowledge of recommended hand washing procedures. METHODS Young adults enrolled at a major US university were recruited via official university student email listservs and campus newspaper advertisements. Interested participants completed a brief screening questionnaire to identify those meeting eligibility requirements [i.e., age 18 to 26 years, did not hold a sanitation certification, had good or excellent health, and were not at increased risk of foodborne disease (i.e., pregnant, immune compromised)]. Of the 167 eligible individuals accepting the invitation, 153 honored their scheduled appointment time. These participants, blinded to the study purpose, followed two simple recipes that involved handling a raw food of animal origin that was to be cooked and one raw vegetable ingredient that was to be chopped and served uncooked. Trained observers recorded participant’s hand washing practices, using a 16-point criterion-based checklist. Specifically, the trained observers observed whether participants washed their hands on these four occasions: (a) before beginning food preparation, (b) after handling unwashed produce, (c) after handling raw poultry, and (d) as necessary (e.g., after touching hair, taking a break to answer the phone, use the restroom). For each occasion on which the participant was observed washing his or her hands, one point was earned, up to a maximum of four points. An additional point was awarded for each of the four hand washing occasions when participants washed their hands with running water, used soap, and/or rubbed their hands for at least 20 seconds (see Table 1) (24). Thus, if a participant washed his or her hands before beginning food preparation, using running water and soap, and rubbed the hands for at least 20 seconds, four points were earned. Ten percent (n = 16) of the observations were randomly selected for independent observation by two researchers; a comparison of the observations indicated a 92% inter-rater reliability. The food preparation protocol, observation checklist validation procedures, and observer training methods have been described previously (7). Following food preparation, young adults completed a 10-item hand washing knowledge test (e.g., most hygienic way to wash hands, when hands should be washed) [Livingston Reliability = 0.83 (5, 11, 20)] and 4-item self-report hand washing practices questionnaire (e.g., when during food preparation participant reports washing hands, whether soap is used) that were part of a comprehensive food safety survey (9, 10, 21). Using standard procedures, experts developed, validated, pilot-tested, and refined these instruments [published previously (7–9)]. Participants earned 1 point for every correct knowledge response and recommended self-reported practice. Thus, scores could range from 0 to 10 and 0 to 4 for the knowledge and self-reported practices questionnaires, respectively. Analysis of variance was conducted using the statistical analysis software program StatView, version 5 (SAS Institute, 2002) to compare observed and self-reported hand washing practices. This study was approved by the authors’ Institutional Review Board. All study participants signed informed consent forms prior to participation. RESULTS Participants had a mean age of 20.73 + 1.30 (standard deviation, SD) with a range of 18 to 26 years and were from a wide array of college majors. The majority (99%) prepared at least one meal weekly and were female (56%), white (67%), and upperclassmen (85%). Most did not believe that they or a house- DECEMBER 2008 | FOOD PROTECTION TRENDS 913
Food Protection Trends - December 2008

Table of Contents for the Digital Edition of Food Protection Trends - December 2008
