Food Protection Trends - July/August 2019 - 307

met for a debriefing session, and additional information was
added to the notes as needed.
A moderator's guide was used to ensure consistency for
all focus groups. The moderator greeted participants as they
arrived, thanked them for joining the discussion, and asked
them to complete the consent form and a demographic
questionnaire. Each session began with the moderator
describing the focus group process and goals. Participants
were asked to use pseudonyms for confidentiality and for
promoting a safe, inviting environment. Each participant
received a copy of the discussion questions and behavior
definitions as a reference to use during the focus group
meeting. Next, the moderator explained the food safety
behaviors, providing detailed descriptions of how each
practice is properly performed in the work environment.
The respondents were then asked a series of open-ended
questions designed to capture participants' beliefs about
the practices under the TPB constructs. Participants were
encouraged to indicate as many factors as possible for each
question. The moderator allowed ample time for responses,
and each question was repeated multiple times. Followup questions were asked, when needed, to ensure that
the moderator and assistant moderator understood the
participants' perspectives. The elicitation process continued
until saturation was achieved.
Data analyses
Demographic information was entered into Microsoft
Excel (Version 2013), and descriptive statistics (frequencies, percentages, and means) were calculated. Focus group
recordings were transcribed verbatim. Transcripts of focus
group responses were pooled for analysis of key TPB
themes, using a hybrid deductive and inductive method.
Three researchers independently analyzed transcripts
through manual, free, and line-by-line coding to generate
an initial list of themes, which were categorized by use of
the TPB constructs. The researchers subsequently met to
validate the themes until agreement was achieved. A theme
book was developed to be used in NVivo 11 (QSR International Pty Ltd. Version 11, 2015), a qualitative data analysis
software program.
Transcripts were entered into NVivo 11. Analysis was
conducted using a template coding method to generate
visual representation of the data. Primary nodes were established to represent the three food safety practices. Secondary nodes corresponded to TPB constructs addressed
by the salient belief-elicitation questions. Sub-categories
of "advantages" and "disadvantages" were established for
behavioral beliefs and "facilitators" and "barriers" for
control beliefs. Three researchers then independently
coded into NVivo the lowest sublevel, using the previously constructed theme book. Interpretation of the coding
process was conducted by multiple meetings among the
researchers, during which researchers discussed whether

the coding process was conducted line-by-line, by sentence, or by entire paragraphs. Discussions also included
descriptions, meanings, and interpretation of the terms
in the theme book. After agreement had been reached,
themes were finalized. Beliefs were rank ordered, and the
most frequently mentioned beliefs were selected as the
salient set (2).
RESULTS
The four focus groups conducted in three states contained
a total of 43 child nutrition professionals from four school
districts. A summary of demographic information is provided
in Table 1. Most of the employees were 40 years or older
(n = 33), worked full-time (n = 33), and had food safety
certification (n = 29).
Based on data generated by the NVivo analysis, a visual
representation of the frequency with which participants
referred to these constructs for all three practices is presented
in Fig. 1. Overall, proper handwashing generated the most
quotes (n = 183), followed by use of a thermometer to check
the temperature of food (n = 177) and proper handling of
food and work surfaces (n = 130).
Proper handwashing
The frequency of themes related to behavioral and
control beliefs identified by participants for proper
handwashing is presented in Table 2. Control beliefs (n
= 102) were referred to more frequently than behavioral
beliefs (n = 81).
To establish behavioral beliefs, participants were asked
to list good and bad things that they believed could result
from proper handwashing and reasons employees would
want and not want to follow this practice. These advantages and disadvantages of performing the behavior help to
determine an individual's attitude toward proper handwashing. Advantages (n = 40) and disadvantages (n = 41)
were mentioned with nearly equal frequency.
Themes that emerged from the category of advantages
for proper handwashing included food safety (n = 32) and
pride (n = 8). The theme "food safety" was mentioned in
all four focus groups while the theme "pride" was mentioned in three of the four focus groups.
The food safety theme included topics such as preventing the spread of bacteria, preventing cross-contamination, and preventing illness. For instance, an employee
stated proper handwashing is good because "you don't
spread germs if you wash your hands."
The pride theme included topics such as enjoying clean
hands, setting a good example, and sharing knowledge.
One employee mentioned enjoying properly washing their
hands because it provides "a clear conscience of knowing
that your hands are clean; that you're not going to crosscontaminate, spread [germs,] ... [and] knowing you're
[following] safe-handling practices."

July/August Food Protection Trends

307

Food Protection Trends - July/August 2019

Table of Contents for the Digital Edition of Food Protection Trends - July/August 2019