Beyond self reporting: Exploration of food safety behaviours through observation

1. Beyond self reporting: Exploration of food safety behaviours through observation Dr. Ben Chapman Food safety extension specialist North Carolina State University benjamin_chapman@ncsu.edu

2. What is safe food?

3. Retail and food service Transport In-the-home Processors Farmers

4. WHO factors contributing to foodborne illness • Improper cooking procedures • Temperature abuse during storage • Lack of hygiene and sanitation by food handlers • Cross-contamination between raw and ready-to-eat foods • Foods from unsafe sources • All human factors, behaviour based • WHO, 2002

5. Background - communication • “If you think the 10 commandments being posted in a school is going to change behavior of children, then you think “Employees Must Wash Hands” is keeping the piss out of your happy meals. It's not.” • Source: Jon Stewart, Saturday Night Live monologue, 2002

6. Food safety communication philosophy • Anyone who tries to make a distinction between education and entertainment doesn`t know the first thing about either • Marshall McLuhan, 1967 • Disconnect between knowledge and food handler practices • Green et al., 2006; Green and Selman, 2005; Pragle et al., 2007; Redmond et al., 2004

7. Where it all began • MSc project (on-farm food safety) • Put information into context (Chapman, 2004) • Began to shift to food service food handlers (restaurant inspection interest) • Post at urinals? From Chapman, MacLaurin and Powell, 2009. BFJ (in press) and Chapman, Eversley, Filion, MacLaurin and Powell. JFP (in review)

9. www.foodsafetyinfosheets.com

13. Sample • 8 sites in Ontario (out of 13 possible) • Stations • Grill/fryer • Deli and salad • Preparation areas • Similar menus • Burgers, chicken, sandwiches, salads, specials • 47 food handlers

14. Methodology • Baseline practices recorded • Food safety infosheets were designed (to be current) and provided weekly for 7 weeks • Posted by researcher/assisstants • 5 highly visible areas • May have been integrated into on-going training • Rerecorded

15. Data collection • 174 hours of video on each occasion (pre and post food safety infosheet introduction) • 348 total hours • On-camera for a mean of 13.43 hours of actual food handling pre-food safety infosheet introduction and • 13.55 hours post-infosheet introduction. • Recording commenced 30 minutes prior to the first scheduled employee’s start time and end 30 minutes after

16. Results: Mean events per food handler *Significance level (p <.05, 95% CI)

18. Did your microwave nuke the bacteria? DeDonder, S., Wilkinson, C., Surgeoner, B., Phebus, R, Chapman, B. and Powell, D. 2009. Direct Observation of Meal Preparation by Consumers. British Food Journal (in press). Source: NYT (14.oct.07

19. Cause for consumer confusion? Product packaging of fully cooked vs. uncooked products Similar appearance of fully cooked and uncooked breaded products

20. N.Y. Times, May 15, 2009

22. Methods • Convenience sample • 21 Primary meal preparers • 20 Adolescents • Direct Observation • Meal preparation in model kitchen • Trained scorers and predetermined scale • Self-report survey • Data analysis • Descriptive and frequency statistics (SPSS 15.0)

23. Handwashing

24. Read/apply label instructions • Reading: Little time spent reading • Applying: Only 7% of all participants followed directions precisely

25. Food Thermometer Use

27. Objectives • To investigate compliance to hand hygiene at the peak of an outbreak investigation • To assess cognitive factors related to hand hygiene From Surgeoner, Chapman and Powell, University Students’ Hand Hygiene Practice During a Gastrointestinal Outbreak in Residence: What They Say They Do and What They Actually Do. Journal of Environmental Health, September 2009, Volume 72, No. 2.

28. Methodology • Combination of different research methodologies • Provides more illuminating evidence of intervention impact and/or effects • Covert observations (n=357) • Self-report surveys (n=100) • Long interviews (n=6)

29. Covert observations

30. Observation results

31. Key survey results cont’d Beliefs toward hand hygiene • Most respondents considered they knew recommended guidelines on hand hygiene (mean = 5.8) Perceived adherence: • 64% of respondents ALWAYS perform hand hygiene as recommended (another 20% usually did) • But…only 20% of their peers ALWAYS performed hand hygiene as recommended

32. Conclusions • Human behavior is key • Education alone ≠ application of knowledge gained • Re-evaluate sanitized messages • Providing easy access to tools does not necessarily improve desired practices • Improving safety culture at societal level, merits emphasis

33. “Prayer is antiseptic”

34. Methods • June and July 2007 • 3 Communities • Region of Waterloo, City of Toronto, Haiburton Kawartha Pine Ridge • Catalogue practices • Trained to write down everything, risk or not, • gleaned from past studies with food handlers, health inspections • Exploratory • sense of frequency

35. Observation results • Proper handwashing was problematic • Not consistent, tools not there in one dinner • Cross-contamination • Tongs and platters: raw meat to RTE burgers • Dirty equipment used • No thermometer usage at any of the CMEs • Despite participants’ discussions • Refrigerators over-packed, out of temperature • To conserve energy, fridge not turned on until morning of event

36. Observation results

37. Have the tools

38. Dishwashing (hand towels -- everyone uses towel dry)

39. So What? • Measuring behaviour methodologies • What do people actually do? • Observation has limitations, but better than self report or others • Secret peers/shoppers • Understanding and tailoring information to target audiences • Moms-to-be • Menu builders at long term care homes • On-farm

40. So What? (cont) • Learning from outbreaks • Storytelling • Moving beyond traditional training • Risk identification, other dialogue enriching tools • Food safety culture creation, evaluation and enhancement

42. bites.ksu.edu

43. Dr. Ben Chapman benjamin_chapman@ncsu.edu Follow me on twitter @benjaminchapman 919 809 3205 www.foodsafetyinfosheets.com www.bites.ksu.edu www.barfblog.com