Progress 09/15/01 to 09/14/06
Outputs
This project aimed to benefit three populations at high risk of foodborne illness because of compromised immune function: pregnant women, patients on chemotherapy or with organ transplants, and HIV/AIDS patients. Specific objectives included identifying the beliefs, motivators and barriers that affect adoption of safe food handling practices within the 3 population groups, understanding the food safety beliefs of health care professionals that work with these high risk audiences, and using this knowledge to develop and evaluate the effectiveness of patient educational materials, a graduate level distance education course, and an on-line continuing education course on food safety for persons with suppressed or compromised immune systems. All of the objectives were met. Initially, 24 focus groups and 10 in-depth interviews were conducted with members and/or caregivers of targeted population groups. While most focus group participants indicated moderate concern regarding
the safety of food and had made some food handling or consumption changes since becoming pregnant or ill, there was resistance to change habits, especially for more recent food safety recommendations. Common barriers included no prior illness from implicated foods, and the convenience, health benefits of, and personal preference for many risky foods. Participants wanted quick, easy to read, but sufficiently thorough information specifically designed for their population group. In-depth interviews conducted with health care providers revealed they were more likely to discuss long-standing food safety recommendations with their patients than more recent recommendations aimed at emerging pathogens like Listeria monocytogenes. A prominent barrier to discussing food safety issues was limited contact time with clients. The information gained was used to develop food safety education materials for the 3 population groups. We also developed and taught a multi-media graduate-level course, Food
Safety for High Risk Audiences, simultaneously at Colorado, Ohio and Washington State Universities using internet-based video-conferencing. In 2004, we converted the 30-hour distance education course into a 6-hour web-based continuing education course for health care providers who work with high-risk audiences. The web-based course was piloted in fall, 2004 with 106 dietitians, nurses and extension agents. Mean knowledge scores increased from 67 percent pre-course to 92 percent post-course and participants reported satisfaction with the web-based delivery system. In 2005 we modified the course and made it available for a fee through the OSU website. Information about the course is available at: http://hec.osu.edu/highriskfoodsafety/. We also presented a 4-hour workshop on Food Safety for High Risk Populations at the SNE annual meeting. The 12 sets of research-based food safety educational materials developed and evaluated are accessible at
http://www.colostate.edu.edu/orgs/safefood/foodsafety/menuhr.html. In 2006, we developed and pilot tested a class on food safety during pregnancy and presented our work at a national meeting for food safety educators.
Impacts
Consumers vary greatly in their susceptibility to disease from various pathogens based on reproductive status and immune function. It is critical that those at highest risk for foodborne disease receive food safety messages aimed appropriately. This project assessed the food safety education needs of 3 high-risk groups (pregnant women, patients on chemotherapy or with organ transplants, and HIV/AIDS patients) and their healthcare providers, then developed materials and training programs to meet identified needs. The information gained through focus groups and interviews with patients and healthcare providers guided the development of 11 sets of research-based food safety educational materials, all downloadable via the internet. The 33 students participating in the graduate education course on food safety for high risk audiences gained valuable insights on the interrelationships between immune function and risk for specific foodborne pathogens and targeting educational
materials to specific audiences. Conversion of the graduate-level course into a 6-module web-based continuing education course for healthcare providers further extended the outreach of the educational messages. We disseminated our findings through multiple avenues including 8 articles in professional journals, 10 oral or poster presentations at professional meetings, and 13 invited presentations. Our project also resulted in 5 thesis projects and 5 MS students well trained in food safety education. Finally, our work was included as part of the documentation for the 2005 Dietary Guidelines for Americans.
Publications
- Kendall, P, Hillers, V., and Medeiros, L. 2005. Food safety for the immune suppressed/ compromised: A multi-media approach. CSREES-USDA Integrated Projects Seminar, August 30. Washington, DC.
- Wallner, S., Kendall, P.A., Hillers, V., and Medeiros, L.C. Online continuing education course enhances nutrition and health professionals knowledge of food safety issues of high risk populations. 2006. J. American Dietetic Assoc. In press.
- Kendall, P.A., Hillers, V., and Medeiros, L.C. Food safety guidance for older adults. 2006. Clinical Infections Dis. 42:1298-1304.
- Medeiros, L.C., Chen, G., Van Horn, J., Fralic, J., Hillers, V., and Kendall, P. 2006. Essential food safety behaviors for older adults. Food Prot. Trends 26:586-592.
- Hillers, V., Kendall, P., Medeiros, L., and Cates, S.C. 2006. Risk behaviors of target audiences. Invited presentation. 2006 Food Safety Education Conference: Reaching At-Risk Audiences, September 27. Denver, CO.
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Progress 01/01/05 to 12/31/05
Outputs
Persons with compromised immunity are at increased risk for serious foodborne infections. Their health care providers need to be able to explain this increased risk to patients and provide sound information on how to make safe food selection and preparation choices. As a continuation of work accomplished in previous years, a 6-hour web-based continuing education course, Food Safety Issues for High Risk Populations, was developed for health professionals, including dietitians, nutrition educators and nurses, who work with high-risk audiences. This course was pilot tested in fall 2004 with 106 dietitians, nurses and extension agents, with favorable evaluation results for both content and delivery method. Each of the 6 modules included PowerPoint slides, accompanying audio, written script, background information on pathogens being discussed, and references. Pre and post tests were used to measure change in knowledge. Overall mean knowledge score increased from 67 percent
pre to 92 percent upon completion of the course. Participants reported high satisfaction with the web-based delivery system. Responses were positive for every module, with over 80 percent of all participants indicating that objectives were reasonably met. Results of the course evaluation will provide guidance for the development of future courses and may help to advance the growth of online learning. In 2005, the course was modified and made available worldwide for a fee through the Ohio State University website. The course has been approved for 6 hours of continuing education units from each the American Dietetic Association, Ohio Nurses Association, and American Association of Family and Consumer Sciences. To date, 14 persons have enrolled in the on-line course. Information about the course is available at: http://hec.osu.edu/highriskfoodsafety/. Additionally, in summer 2005, we presented a 4-hour workshop, Food Safety for High Risk Populations, at the Society for Nutrition
Education annual meeting in Orlando to 12 pre-conference participants. The 12 sets of research-based food safety educational materials developed specifically for pregnant women, HIV/AIDS patients, cancer patients, solid organ transplant patients and bone marrow transplant patients continue to be accessible through the internet. They can be downloaded directly at http://www.colostate.edu/orgs/safefood/foodsafety/menuhr.html. The materials are being used by extension agents, WIC educators, healthcare clinics, concerned patients and their care givers.
Impacts
Online continuing education courses such as Food Safety Issues for High Risk Populations appear to be a convenient and effective option for healthcare professionals seeking further knowledge related to food safety issues of at-risk populations. Improved scores following content delivery indicate that knowledge was gained, and that the course was effective, which has positive implications for future Web-based courses. Online learning is a promising trend for the future of continuing education in healthcare fields.
Publications
- Hoffman, E.W., Bergmann, V., Shultz, J., Kendall, P., Medeiros, L.C., and Hillers, V.N. 2005. Application of a 5-step message development model for food safety education materials targeting people with HIV/AIDS. J. Amer. Dietetic Assoc. 105:1597-1604.
- Wallner, S. 2005. Evaluation of an Online Continuing Education Course on Food Safety Issues for High Risk Populations. M.S. Thesis. Department of Food Science and Human Nutrition. Colorado State University, Fort Collins, CO 80523-1571.
- Adamson, D., Reyes, P., Morales, S., and Kendall, P. 2005. Assessment of high risk food consumption practices and preferred educational strategies of low-income Hispanic pregnant women. J. Nutrition Educ. Behavior, Abstract O22. 37[Suppl 1]:S34.
- Wallner, S., Kendall, P, Schroeder, M., Hillers, V., and Medeiros, L. 2005. Food safety issues for high-risk populations: a continuing education course for health professionals. J. Nutrition Educ. Behavior, Abstract P23. 37[Suppl 1]:S58.
- Hillers, V. 2005. Food safety education for high risk audiences. 65th Annual Meeting of the Institute of Food Technologists. July 15-20, New Orleans, LA. Abstract No. 91-4.
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Progress 01/01/04 to 12/31/04
Outputs
Pregnant women, solid organ and bone marrow transplant patients, cancer patients and persons with HIV/AIDS are at increased risk for contracting certain foodborne illnesses, such as listeriosis and toxoplasmosis, possibly leading to damaging outcomes. To raise risk awareness and promote prevention of such diseases among these audiences, 22 food safety educational materials prototypes were developed using the Health Belief Model. Five prototypes targeted pregnant women, 5 HIV/AIDS, and 12 bone marrow, solid organ transplant, and cancer patients. Each prototype addressed food safety recommendations differently, using various approaches, formats and writing styles. The materials were formatively evaluated by food safety experts and members of the target audience. Following revisions, 5 groups of pregnant women (n=28), 4 groups of HIV/AIDS patients (n=32), 2 groups of cancer patients (n=7), and 10 solid organ or bone marrow transplant patients evaluated the respective
prototypes. Participants were asked to read through each material individually, write down any thoughts regarding the materials, and complete a material reaction form. After evaluating the materials separately, participants discussed the usefulness of the materials in focus group sessions. Participants generally liked the materials. Overall, they preferred formats with more detailed information to briefer formats. Many of the pregnant women were concerned that they were receiving the information for the first time; other high-risk groups expressed similar concerns. Practical suggestions and tips that helped readers apply the information were attractive features. Most participants expressed willingness to adopt the recommendations provided in the materials. Based on the evaluations, 2 food safety bulletins targeting HIV/AIDS patients, 5 bulletins (one in Spanish) targeting pregnant women and 5 targeting cancer patients, bone marrow transplant patients and solid organ transplant
patients were developed. These materials are available on the web sites of the three universities involved. In another effort, Food Safety for High-Risk Groups, a 2-credit graduate-level academic course, was simultaneously taught via interactive video and web-based technology at three university campuses (Ohio, Colorado and Washington) on three different time zones. Students (n=37) registered for academic credit at their respective universities. Faculty at each university facilitated the class locally and each taught approximately 10 hours of instruction to all campuses. Lectures were delivered via video-conferencing. A central web site established at Ohio State allowed students to receive syllabus and assignment information, email instructors, participate in threaded discussions, view MP3 files of classes presented and submit assignments. Course outcomes were measured as examinations, class participation, an oral presentation, and a research paper. Class evaluations indicated high
acceptance of the course content and methods of delivery. Students agreed their learning was above average compared to other classes and was enhanced by the opportunity to hear experts in the field from across the country.
Impacts
The 12 sets of research-based educational materials developed specifically for pregnant women, HIV/AIDS patients, cancer patients, solid organ transplant patients and bone marrow transplant patients are accessible through the internet. They provide useful educational tools for educators and health care providers who work with these patients. They also can be downloaded directly by concerned patients and their care givers. The 37 students participating in the graduate education course on food safety for high risk audiences gained valuable insights on the interrelationships between immune function and risk for specific foodborne pathogens as well as important lessons on how to target educational materials to specific audiences. The materials developed for the course will be edited and condensed into a 6 module web-based continuing education course on food safety for high risk audiences designed for health care providers.
Publications
- Medeiros, L., Kendall, P., and Hillers, V. 2004. Food safety for high-risk groups: an academic class over three time zones. J. Nutrition Educ. Behavior., Abstract P1. 36[Suppl 1]:S45.
- Hoffman, E., Hillers, V., Bergmann, V., Shultz, J., Kendall, P., and Medeiros, L. 2004. Food safety materials for persons living with HIV/AIDS: Development and evaluation. J. Nutrition Educ. Behavior., Abstract P2. 36[Suppl 1]:S45.
- Dean, J., Kendall, P., Schroeder, M., Medeiros, L., and Hillers, V. 2004. Food safety education materials for pregnant women: a proactive approach. J. Nutrition Educ. Behavior, Abstract P3. 36[Suppl 1]:S45.
- Dean, J.L. 2004. Development and evaluation of food safety educational materials for pregnant women. M.S. Thesis. Department of Food Science and Human Nutrition. Colorado State University, Fort Collins, CO.
- Hoffman, E.W. 2004. Evaluation of food safety education materials for persons with HIV/AIDS. M.S. Thesis. Department of Food Science and Human Nutrition. Washington State University, Pullman, WA
- Dean, J. and Kendall, P. 2004. Food safety during pregnancy. Colorado State University Cooperative Extension Fact Sheet. No 9.372. 4 p.
- Dean, J. 2004. Pregnancy and foodborne illness. Bulletin XCM-229. Colorado State University, Fort Collis, CO
- Kendall, P. 2004. Food safety during pregnancy. Colorado State University, Fort Collins, CO. Available at http://www.colostate.edu/Orgs/safefood
- Dean. P. 2004. Keep your baby safe. Colorado State University, Fort Collins, CO. Available at http://www.colostate.edu/Orgs/safefood/foodsafety/safe_baby.pdf
- Medeiros, L. 2004. Foodborne disease and bone marrow transplants. The Ohio State University, Columbus, OH. Available at http://hec.osu.edu/hn/osue/safe_food/
- Medeiros, L. 2004. Foodborne disease and organ transplant patients. The Ohio State University, Columbus, OH. Available at http://hec.osu.edu/hn/osue/safe_food/
- Medeiros, L. 2004. Foodborne disease and cancer patients. The Ohio State University, Columbus, OH. Available at http://hec.osu.edu/hn/osue/safe_food/
- Medeiros, L. 2004. A guide for cancer and transplant patients on how to control Listeria monocytogenes. The Ohio State University, Columbus, OH. Available at http://hec.osu.edu/hn/osue/safe_food/
- Chen, G. 2004. How do you get a foodborne disease? A guide for cancer and transplant patients and their care givers. The Ohio State University, Columbus, OH. Available at http://hec.osu.edu/hn/osue/safe_food/
- Kendall, P.A., Elsbernd, A., Sinclair, K., Schroeder, M., Chen, G., Bergmann, V., Hillers, V.N., and Medeiros, L.C. 2004. Observation versus self-report: validation of a consumer food behavior questionnaire. J Food Protection. 67:2578-2586.
- Medeiros, L., Chen, G., Kendall, P., and Hillers, V. 2004. Food safety issues for cancer and organ transplant patients. Nutrition in Critical Care. 7:141-148.
- Athearn, P.N., Kendall, P.A., Hillers, V.N., Schroeder, M., Bergmann, V., Chen., G., and Medeiros, L.C. 2004. Awareness and acceptance of current food safety recommendations during pregnancy. Maternal Child Health J. 8:149-162.
- Medeiros, L.C., Hillers, V, Chen, G., Bergmann, V., Kendall, P., and Schroeder, M. 2004. Design and development of food safety knowledge and attitude scales for consumer food safety education. J. Amer. Dietetic Assoc. 104:1671-1677.
- Morales, S., Kendall, P.A., Medeiros, L.C., Hillers, V., and Schroeder, M. 2004. Health care providers' attitudes toward current food safety recommendations for pregnant women. Applied Nursing Research. 17:178-186.
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Progress 01/01/03 to 12/31/03
Outputs
During 2003, focus groups conducted with members and/or caregivers of four populations at high risk for foodborne illness due to suppressed or compromised immune function were analyzed. Researchers at Colorado State University analyzed 10 focus groups conducted with pregnant women. Ohio State University researchers analyzed 6 focus groups and 10 in-depth interviews conducted with cancer and organ transplant patients and Washington State University researchers analyzed 8 focus groups conducted with HIV/AIDS patients and one with caregivers. Although most women in the focus groups with pregnant women indicated moderate concern regarding the safety of food and had made some food handling or consumption changes since becoming pregnant, most were not following 7 of 12 specific recommendations important during pregnancy. Further, there was resistance to change habits, especially for newer recommendations. The women assumed the safety of food, and wanted strong evidence
regarding why they should change current practices. Common barriers included no prior illness from implicated foods, and the convenience, health benefits of, and personal preference for, many risky foods discussed. Participants wanted quick, easy to read, but sufficiently thorough information specifically targeting pregnant women. Focus groups with other high risk audiences indicated similar interests. The information gained in the focus groups were used in developing food safety educational materials for each of the four high-risk groups. Colorado State University took the lead in developing food safety educational materials for pregnant women. Ohio State University developed materials targeting cancer patients and organ transplant patients and Washington State University developed materials targeting HIV/AIDS patients. In-depth interviews conducted with health care providers of each of the high-risk audiences were also analyzed. In Colorado, 23 interviews conducted with doctors,
nurses, nutritionists and social workers that work with pregnant women were transcribed and analyzed for common themes among and between professional groups. Important themes were reported based on strength and frequency of information mentioned. Another researcher analyzed a sample of the transcriptions and a comparison between the two analyses ensured the reliability of the analysis. Results showed that health care providers perceived long-standing food safety recommendations as more acceptable to discuss with clients than more recent recommendations aimed at emerging pathogens like Listeria monocytogenes. Most health professionals felt food safety information for pregnant women should be provided by doctors and nurses. A prominent barrier to discussing food safety issues was limited contact time with clients. Analyses of interviews conducted with health care providers of other high-risk groups found similar results. The results were used in developing Food Safety for High-Risk
Groups, a graduate-level academic course taught simultaneously to 33 students via video and web-based distance education technology on three university campuses (Ohio, Colorado and Washington).
Impacts
The information gained through the focus groups and interviews was useful in developing educational materials on food safety specifically targeting each of four groups at high risk for foodborne illness (pregnant women, HIV/AIDS patients, organ transplant patients and persons on chemotherapy). The 33 students participating in the graduate education course on food safety for high risk audiences gained valuable insights on the interrelationships between immune function and risk for specific foodborne pathogens as well as important lessons on how to target educational materials to specific audiences. The materials developed for the course will be edited and condensed into a 6 module web-based continuing education course on food safety for high risk audiences designed for health care providers.
Publications
- Hillers, V.N., Medeiros, L.C., Kendall, P., Chen, G., DiMascola, S. 2003. Consumer food handling behaviors associated with prevention of thirteen foodborne illnesses. Journal of Food Protection. 66:1893-1899.
- Kendall, P., Medeiros, L.C., Hillers, V., Chen, G., DiMascola, S. 2003. Food handling behaviors of special importance for the pregnant, young, elderly and immune compromised. Journal of the American Dietetic Association. 103:1646-1649.
- Chen, G., Bergmann, V., Schroeder, M. 2003. Research: a collaborative approach. Times Food Processing Journal (Electronic). February-March, pg. 16-21. Available at: www.etfoodprocessing.com.
- Medeiros, L., Chen, G., Kendall, P., Schroeder, M., Hillers, V., Bergmann, V. 2003. Cancer patient beliefs, barriers and motivators to adopting food safety recommendations: a qualitative needs assessment study. Oral presentation at American Dietetics Association, San Antonio, TX. J. Amer. Dietetic Association. 103(9):Supplement 1, A-11.
- Hillers, V., Bergmann, V., Hoffman, E., Kendall, P., Schroeder, M., Medeiros, L., Chen, G. 2003. Attitudes of HIV infected individuals and their health care providers regarding barriers and motivators to adopting food safety recommendations. J. Amer. Dietetic Association. 103(9):Supplement 1, A-36.
- Chen, G., Medeiros, L., Kendall, P., Schroeder, M., Hillers, V., Bergmann, V. 2003. Health care providers' attitudes toward food safety recommendations for cancer and transplant patients. J. Amer. Dietetic Association. 103(9):Supplement 1, A-36.
- Athearn, P.N., Dean, J., Kendall, P., Morales, S., Schroeder, M., Medeiros, L., Chen, G., Hillers, V., Bergmann, V. 2003. Risk assessment: Pregnant women discuss perceptions of food safety recommendations. Abstract: 36th Annual Society for Nutrition Education Conference Proceedings. Vol 36, abstract O10, pg 4.
- Morales, S., Athearn, P., Kendall, P., Schroeder, M., Medeiros, L., Hillers, V. 2003. Health care providers attitudes toward current food safety recommendations for pregnant women. Abstract: 36th Annual Society for Nutrition Education Conference Proceedings. Vol 36, abstract O11, pg 4.
- Morales, Shelly M. Health Care Providers Attitudes toward Current Food Safety Recommendations for Pregnant Women. M.S. Thesis. 2003. Department of Food Science and Human Nutrition. Colorado State University, Fort Collins, CO.
- Athearn, Prudence N. 2003. Risk Awareness: Pregnant Women Discuss Perceptions of Food Safety Recommendations. M.S. Thesis. Department of Food Science and Human Nutrition. Colorado State University, Fort Collins, CO.
- Hoffman, E., Hillers, V., Bergmann, V. 2003. Eating Away from Home and Traveling: Safe tips for avoiding foodborne illness for the person with HIV/AIDS. Misc 530. Washington State University, Pullman, WA.
- Hoffman, E., Hillers, V., Bergmann, V. 2003. Take Control: A Hands-on approach to choosing safe food for persons living with HIV/AIDS. Misc 520. Washington State University, Pullman, WA.
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Progress 01/01/02 to 12/31/02
Outputs
For objective 1, focus groups were conducted with members and/or caregivers of four populations at high risk of foodborne illness due to suppressed or compromised immune function. These populations included pregnant women, persons with HIV/AIDS, patients on chemotherapy and persons with organ transplants. Colorado State University researchers conducted three focus groups with pregnant women and one each with HIV/AIDS and cancer patients. Researchers from The Ohio State University conducted two focus groups with organ transplant patients, and one each with cancer patients, HIV/AIDS patients and pregnant women. Washington State University researchers conducted two focus groups with HIV/AIDS patients, one with cancer patients and one with pregnant women. Participants completed a food safety attitude and practice survey prior to the focus groups and all sessions were audiotaped and transcribed. Focus groups conducted with pregnant women were analyzed by Colorado State
researchers, those with HIV/AIDS patients and their caregivers by Washington State researchers and those with cancer and organ transplant patients by Ohio State researchers. For each population group, common themes among focus groups regarding food safety attitudes and beliefs, motivators and barriers to adoption of recommended food selection and handling practices, current sources of food safety information and preferences regarding methods and format for receiving food safety education were identified. For objective 2, one-on-one interviews were conducted in each state with health care professionals (eg., doctors, nurses, dietitians, case workers, agency directors) that serve the high-risk audience targeted by the state's team for educational materials development. In Colorado, one-on-one interviews were conducted with 23 health care professionals that work with pregnant women. In Ohio, 20 health care professionals that work with cancer and/or organ transplant patients were
interviewed. In Washington, interviews were conducted with 18 health care professionals that work with HIV/AIDS patients. The interviews were designed to assess the importance health care professionals place on food safety, their perceptions regarding high risk behaviors among their patients, patient recommendations they're currently making, types of food safety information they are receiving and/or would find useful, and preferences regarding methods and formats for receiving education and patient materials. The information gathered through the focus groups and interviews will be used to drive the next two phases of the project: development of patient food safety education materials and development of a distance education course for health care professionals and graduate students on food safety issues of concern to high risk audiences. In October, 2002, the project team met in Seattle, WA to review findings from the focus group and interview data, develop an outline for the distance
education course and agree upon an approach to be used in developing and evaluating the patient educational materials.
Impacts
The information gained through the focus groups will be valuable in understanding food safety issues related to food consumption and handling practices of four groups at high risk of foodborne illness (pregnant women, HIV/AIDS patients, organ transplant patients and persons on chemotherapy), along with motivators and barrier to adoption of recommended practices. As gate-keepers of information, it is also important to understand the food safety attitudes and beliefs of the health care professionals that work with high risk audiences and the types and forms of food safety information they would find useful when working with their patients. The insights gained through focus groups with patient groups at high risk for foodborne illness and through interviews with health care professionals will help drive the development of educational materials and training programs designed to meet identified needs.
Publications
- Kendall, P.A., Medeiros, L.C., Hillers, V.N., Chen, G. and DiMascola, S. 2002. Identification of Food Handling Behaviors of Special Importance for the Very Young, Elderly, Pregnant and Immunocompromised. Institute of Food Technologists Annual Meeting, Anaheim, CA, June 17 (Abstract 13710).
- Kendall, P.A. 2002. Food Safety Behaviors of Special Importance to YOPI's. Northwest Food Safety Farm to Table Conference, Mosco, ID, May 29.
- Kendall, P.A., Medeiros, L.C., Hillers, V.N., Chen, G. and DiMascola. S. 2002. Identification of Food Handling Behaviors of Special Importance for the Very Young, Elderly, Pregnant and Immunocompromised. Thinking Globally--Working Locally, A Conference on Food Safety Education, Orlando, FL, September 18-20 (Poster No. 13).
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Progress 01/01/01 to 12/31/01
Outputs
This project aims to benefit three populations at high risk of foodborne illness because of suppressed or compromised immune function: 1) pregnant women, 2) patients on chemotherapy or with organ transplants, and 3) patients with HIV or AIDS. Collectively, these groups represent 4.98% of the American population or about 1.4 million individuals. However, because of their higher risk for contracting foodborne illness and for experiencing complications, they represent a much higher percentage of actual cases of foodborne illness each year in the U.S. The overall project goals are to: 1) better understand the beliefs, motivators and barriers that affect adoption of safe food handling practices among the three targeted populations; 2) understand the food safety attitudes and beliefs of health care professionals that work with these high risk audiences; and 3) use this knowledge in developing and evaluating the effectiveness of: a) a distance education course for health
care professionals and advanced degree students on food safety and the immune suppressed/compromised, b) consumer/patient education materials for each high-risk audience targeted, and c) a 5-module web-cast for professionals, students and interested consumers on food safety and the immune suppressed or compromised. In preliminary work, food safety behaviors of special importance to four high-risk groups (pregnant women, infants and young children, elderly, and the immune-compromised) were identified through the literature and a 4-round, expert-driven web-based Delphi process designed to build consensus, rank order and edit lists of behaviors for their importance to each of four high-risk groups. Nationally-recognized experts in food microbiology, epidemiology, food safety education and food safety policy participated in the process in which behaviors were rank-ordered within 13 pathogens and 5 pathogen control factors and rated for their importance to each high-risk group. For each
pathogen control factor, the top-ranked behavior for general consumers was also considered of special importance for high-risk audiences. For the very young, elderly and immune compromised, over 50% of all highly rated behaviors were from the 'avoid foods from unsafe sources' pathogen control factor; 42% of all highly rated behaviors for pregnant women were from this factor. 'Cook foods adequately' contained the second-highest number of highly rated behaviors, followed closely by 'avoid cross-contamination' and 'practice personal hygiene'. The factor with the fewest highly rated behaviors was 'keep foods at safe temperatures'. The importance experts placed on behaviors did vary by high-risk audience, with those considered highly important for pregnant women differing in several cases from those of high importance to the young, elderly and immune compromised. The results will be useful both in informing the focus groups and interviews to be conducted as part of this project and in
helping us focus our education efforts on those behaviors of greatest importance to each of the audiences being targeted.
Impacts
There is great variability among consumers in their susceptibility to disease from various pathogens based reproductive status and immune function. Thus, there is need to examine food safety messages to assure they are aimed appropriately based on the needs of the target audience. This project (initiated September 15, 2001) will assess food safety education needs of three high-risk groups and their health care providers and then develop materials and training programs to meet identified needs.
Publications
- No publications reported in 2001.
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