The Abuela Project : A Community Based Food Safety Intervention

1. The Abuela Project:A Community Based Food SafetyIntervention

2. Project Background • In 1997, over 90 cases of Salmonella typhimurium DT 104 were reported in Yakima county, Washington • Symptoms included diarrhea, fever, abdominal pain, bloody stool,vomiting • Median age was 4 years old

3. Project Background • Majority of cases involved children of Hispanic heritage • A CDC study implicated unpasteurized-milk queso fresco as the source of S. typh. DT104 • CDC emphasized the need for an intervention

4. Project Background -CDC Recommendations- Adapt interventions to convey health & safety messages with educational programs to improve the safety of popular traditional foods

5. Pre-Intervention Salmonellosis Cases

6. Raw-Milk Cheeses • Highly valued in many cultures (Tavaria and Malcata) • Have unique taste characteristics (Tavaria and Malcata) • Popular in Latin American (Torres and Chandon, 1981)

7. Intervention Goals • Decrease consumption/production of unpasteurized-milk queso fresco • Increase knowledge of hazards associated with raw milk • Maintain/Encourage a nutritious food in the Hispanic diet • Maintain a traditional food custom

8. Pre-Intervention • Collection of preliminary data via survey • Design of a safer, pasteurized-milk QF recipe • Design of a flyer to illustrate the recipe • Acquisition of funding • Design of a program to introduce the new recipe

9. Pre-Intervention Survey • Designed July 15 - August 1, 1997 • Implemented August 2 - August 15, 1997 • Outdoor community events • Face-to-face interview style • Spanish or English • n=86

10. Pre-intervention Survey Data ~ 50% get QF from family member, neighbor, vendor ~ 50% did not know if QF made from raw milk ~ 40% did not believe raw-milk QF could cause illness (~25% unsure) ~ 60% had not heard of Salmonella.

11. Safe Queso Fresco Design • Preliminary pasteurized-milk recipe obtained from Julia Herrera • Modification of the recipe by WSU dairy scientists Lloyd Luedecke and Mike Costello • Decreased pH • Increased shelf-life • Improved ease-of-preparation • Maintained acceptable taste/texture

12. Julia, Mike and Lloyd

13. Abuela Project Pamphlet • Heat treatment of unpasteurized milk • Sanitization of cheese-making implements • Step-by-step instructions in Spanish and English • Graphical illustrations for low literacy audience

14. Project Funding • $5,000 gift obtained from the Washington State Dairy Products Commission • Used to purchase Abuela Educator incentive package

15. “Abuela” Educators • Older Hispanic “grandmothers” • respected • hold positions of authority • carry on traditions

16. Abuela Educators • 15 volunteers from the community • learned the new recipe • learned hazards of raw milk • learned sanitization methods • Trained at 3 locations • Agreed to teach 15 others

17. Training Abuela Educators

18. Educators (15) Colander 5-quart mixing bowl Thermometer Cheese cloth Apron Tote bag 8-cup mixing bowl 6-quart stock pot Participants (225) Tote bag Thermometer Cheese cloth Measuring spoons 8-cup mixing bowl Incentive Packages

19. Educator Incentives

20. Safe Cheese Workshop Results

21. Will People in the Community Eat Pasteurized-Milk Queso Fresco?X2 = 29.9 (Significant/p<.01)

22. Are there Health Risks Associated with Eating Unpasteurized Milk and Cheese?X2 = 1.5 (no significant change)

23. Community Survey People who did not participate in safe cheese workshops

24. Does Raw-Milk QF Cause Illness?X2 = 25.3 (significant/p<.01)

25. Post Intervention Salmonella Cases