Progress 09/01/08 to 08/31/13
Outputs
Target Audience: Through broad dissemination by publication of the results in the Journal of Environmental Health, the information from our study became available to health department personnel, food safety professionsals, and other stakeholders. The results were also presented at the IAFP meeting in Charlotte thus exposing additional food safety professionals to the results. Changes/Problems:
Nothing Reported
What opportunities for training and professional development has the project provided? The project provided MPH, MS, and PhD level students with training and practice of food safety research. How have the results been disseminated to communities of interest? The results have been and will be published in scientific journals (two articles are in press), presented to public health professionals at meetings including regional environmental health practitioners, and presented at scientific meetings such as the annual IAFP conference. The results have also been shared with the state health department. What do you plan to do during the next reporting period to accomplish the goals?
Nothing Reported
Impacts
What was accomplished under these goals?
The project met all of its goals. The project determined gaps in food safety knowledge among restaurant food handlers that work in suburban restaurants (including examining the influence of lack of English fluency among Spanish speaking food handlers), creating evidence-based educational interventions for these food handlers and assessing which is superior (a comic book versus a brochure) on its impact on knowledge and on restaurant inspection score results as well as determining if the comic book or brochure is more acceptable to each of the two language groups.
Publications
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2013
Citation:
Manes M, Burke A, Liu L, Dworkin M. 2013. Effective evidence-based food safety materials for restaurant food handlers: Interventions designed to target knowledge gaps. IAFP Program and Abstract Book, Annual Meeting, Charlotte, South Carolina (P1-136)
- Type:
Journal Articles
Status:
Published
Year Published:
2013
Citation:
Baseline knowledge survey of restaurant food handlers in suburban Chicago: do restaurant food handlers know what they need to know to keep consumers safe? Journal of Environmental Health 2013;76:18-26; quiz 67.
- Type:
Journal Articles
Status:
Awaiting Publication
Year Published:
2014
Citation:
Manes M, Liu L, Burke A, Dworkin MS. Food for thought: Effective evidence-based brochure and comic book interventions designed for restaurant food handlers. Food Protection Trends (in press)
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2012
Citation:
Dworkin M. 2012. Development of a food safety educational comic book for restaurant food handlers in English and Spanish. Programme, European Symposium on Food Safety, Warsaw, Poland (P1-19).
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Progress 09/01/10 to 08/31/11
Outputs
OUTPUTS: The report outputs described in this section reflect the study for Year Three. The study methods and timeline compliance have been met in accordance to the research protocol for the third year. December 2010 through February 2011- Educational interventions (comic book and brochure) designed to target food safety knowledge gaps determined in pre-intervention survey were disseminated to 90 restaurants in Suburban Cook, Lake, Kane and DuPage Counties in Illinois. Materials were distributed to restaurants in-person by the researchers and restaurant managers were asked to provide the educational materials to their staff. Managers were also informed that reading the materials was an eligibility requirement to participate in the upcoming post-intervention survey. February 2011- IRB approval for the English and Spanish post-intervention consent forms and surveys was obtained. March 2011- Analysis of pre-intervention food handler surveys was completed and analysis of the pre-intervention restaurant inspection scores began. March 2011- Analysis of food handlers pre-intervention scores for DuPage County was completed. August 2011- IRB Continuing Review approval was obtained. August 2011- Pre-intervention survey results were presented as a poster at the USDA/NIFA Principal Investigators meeting in Milwaukee, Wisconsin. August 2011- Lessons learned from the study methods were presented as a poster at the annual International Association of Food Protection (IAFP) meeting in Milwaukee, Wisconsin. September 2011- Analysis of pre-intervention restaurant inspection scores was completed. September 2011- 345 post-intervention food handler surveys were completed at 135 participating restaurants; the remaining post-intervention surveys are expected to be complete by December 2011. Data entry is complete for all post-intervention surveys performed thus far and analysis will begin once all post-intervention surveys are complete. PARTICIPANTS: Nothing significant to report during this reporting period. TARGET AUDIENCES: Nothing significant to report during this reporting period. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.
Impacts
The pre-intervention results of this project demonstrate substantial and important knowledge gaps among suburban restaurant food handlers that can place restaurant patrons at increased risk of food poisoning. Substantial knowledge gaps related to cross contamination, cooking, and holding and storage of food were identified. The mean overall knowledge score for the food handlers was only 72%. Spanish-speaking food handlers scored significantly lower than English-speaking food handlers (p<0.05). Although certified food managers scored significantly higher than non-certified food handlers, their score was only 79%. Because, the overall restaurant participation rate was low in this study (33%), a sub-study was performed in DuPage County to assess whether willingness to participate in the study differs when the survey is administered by research personnel or by the local health department sanitarians. In the DuPage County study, there were 96 interviews conducted in total. Of the 84 interviews analyzed, 42 were performed by the sanitarians and 42 were performed by research personnel. Participation was much greater when restaurants were approached by public health sanitarians (65%) compared to university research assistants (27%). When comparing the Suburban Chicago study to the DuPage County study, there were no differences in mean and distribution of food handler knowledge scores (72% and 71%, respectively), and there were no differences in mean and distribution of food handler knowledge scores when the survey was administered by a university research assistant versus a public health sanitarian (71% and 71%, respectively). This sub-study revealed best practices for recruiting restaurants and food handlers to participate in food safety research. Collaboration between local health departments and food safety researchers may maximize restaurant participation in future studies. Examination of recent health department inspections of participating restaurants revealed that Suburban Chicago restaurants had an overall mean inspection score of 90.6 and the number of violations ranged from 0 to 19. Among the most commonly reported violations, two were critical; one for the failure to maintain temperature requirements of potentially hazardous food (29%) and the other for inadequate food protection from potential cross-contamination (28%). No significant correlation was observed between overall inspection score and certified food manager knowledge score as a result of regression analysis. In general, knowledge gaps were not directly correlated with food safety citations in practice. However, there was a significant association between an inspection with a violation related to food handler hygiene and employing at least one certified food manager who missed at least one hand hygiene question, on the knowledge survey (RR=1.96, p=0.05). The results of this study suggest that restaurant inspection reports do not correlate well with certified food manager knowledge. Interpretation of these results should consider that some violations may be corrected during the inspection and not recorded on the report form.
Publications
- Manes, M., Burke, A., Liu, L., and Dworkin, M.S. 2011. Lessons Learned Recruiting Restaurant Food Handlers to Participate in a Food Safety Survey. IAFP Program and Abstract Book Annual Meeting, Milwaukee, Wisconsin (P3-90).
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Progress 09/01/09 to 08/31/10
Outputs
OUTPUTS: The report outputs described in this section reflect the study for Year Two. The study methods and timeline compliance have been met in accordance to the research protocol for the second year. February 2010-729 pre-intervention food handlers surveys were completed at 211 restaurants in the suburbs in Northern Illinois. April 2010- Preliminary analysis of the pre-intervention surveys began. May 2010-A Stakeholder's meeting was convened and representatives that attended included persons from local health departments (Kane, Lake, Cook, DuPage) including urban, suburban, and rural jurisdictions' Environmental Health managers, sanitarians, and communicable disease outbreak investigation staff, the Illinois Department of Public Health including the Division of Food, Drugs, and Dairies, the artist who is illustrating the educational comic book, and the Survey Research Laboratory from the University of Illinois at Chicago School of Public Health. The agenda for this meeting included an overview of preliminary results of restaurant food handler demographics and food safety knowledge, the project's objectives and methods, and review of a draft of the restaurant food handler educational intervention materials (brochure and comic book). The educational materials were modified based on comments provided by stakeholders. June 2010- An additional 96 restaurant food handler surveys were completed in DuPage County and data entry and analysis are currently being performed. July 2010- The preliminary study results were presented as a poster at the USDA/NIFA Principal Investigators meeting in Chicago, Illinois. August 2010- The preliminary study results were presented as a poster at the annual International Association of Food Protection (IAFP) meeting in Anaheim, California. October 2010- The evidence-based educational materials were completed, translated into Spanish and approved by the IRB. PARTICIPANTS: The following key personnel have worked on this project: Mindi Manes, PhD Epidemiology candidate is acting as the research study coordinator. Palak Panchal, MPH and PhD candidate and Anne Burke, MS candidate are current research assistants. In accordance with the Research Protocol, staff from the Survey Research Laboratory at the University of Illinois at Chicago, with the assistance of the research assistants, helped to perform the pre-intervention surveys. DuPage County santarians Maria Ruiz, Mary Jo Keinzle and Rachael Browning helped complete the food handler interviews in DuPage County. TARGET AUDIENCES: Suburban Chicago restaurant food handlers are the target audience for this project. Evidence-based educational materials (comic book and brochure)were developed based on the food safety knowledge gaps determined by the pre-intervention survey for this population. These materials were completed in October 2010 and will be distributed to the target audience in November 2010. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.
Impacts
The preliminary results of this project demonstrate substantial and important knowledge gaps among suburban restaurant food handlers that can place restaurant patrons at increased risk of food poisoning. Memory of the minimum and maximum temperatures that germs grow most easily was very low in this population. There were also substantial knowledge gaps related to cross contamination, cooking temperatures, defrosting of food and storage of food. The mean knowledge score was only 72% and although, certified food managers scored significantly higher than non-certified food handlers, their mean knowledge score was still below 80%. Based on these preliminary findings, an educational intervention is needed to target the food safety knowledge gaps. Evidence-based educational materials (a comic book and brochure) that target the most substantial knowledge gaps are currently being created and will be distributed to the participants of this study in December 2010. This study also found that Spanish language food handlers had lower knowledge scores overall than English language food handlers (66.5% and 72.8%, respectively). In addition, the overall restaurant participation rate was low in this study (33%), however, within the participating restaurants, food handler participation was high. Based on a review of the few published studies of restaurant food handler interviews, the investigators noted that response rate was higher when the interviews were conducted by health department sanitarians. To validate these findings, a small sub-study was performed in DuPage County to assess whether willingness to participate in the study differs when the survey is administered by research personnel or by the local health department sanitarians. In the DuPage County side study, there were 96 interviews conducted in total. Of the 94 interviews, 42 were performed by the sanitarians and 42 were performed by research personnel and analysis is currently being performed using the DuPage data. The preliminary findings for this sub-study suggest that participation rate is much higher among restaurants approached by sanitarians (65% ) than by those approached by research staff (27%). In addition, the DuPage study also found that Spanish language food handlers had lower knowledge scores overall than English language food handlers (69.5% and 73.3%, respectively), similar to the results obtained for the other participating Illinois counties.
Publications
- Manes, M., Liu, L., and Dworkin, M.S. 2009. Preliminary results of a food safety knowledge survey of suburban Chicago restaurant food handlers. IAFP Program and Abstract Book Annual Meeting, Anaheim, California (P1-90).
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Progress 09/01/08 to 08/31/09
Outputs
OUTPUTS: The report outputs described in this section reflect the study for Year The study methods and timeline compliance have been met in accordance to the Research protocol for this first year. Initial IRB approval for the study was obtained September 24, 2008. September 2008- Cognitive interviews at the University of Illinois at Chicago School of Public Health were performed with restaurant food handlers including 5 that are fluent in English and 5 that are fluent in Spanish to explore the suitability of survey questions as written. These interviews involved asking the survey questions with oral responses and asking interviewees to explain why they chose their responses and what the terms in the questions meant to them. These responses helped to finalize the pre-intervention survey. October 2008- A Stakeholder's meeting was convened and representatives that attended included persons from local health departments (Kane, Lake, Cook, and Chicago) including urban, suburban, and rural jurisdictions' Environmental Health managers, sanitarians, and communicable disease outbreak investigation staff, the Illinois Department of Public Health including the Division of Food, Drugs, and Dairies, the artist who will be illustrating the educational comic book, and the Survey Research Laboratory from the University of Illinois at Chicago School of Public Health. The agenda for this meeting included an overview of data available on restaurant food handler knowledge, the project's objectives and methods, and review of a draft restaurant food handler knowledge survey. The survey was modified based on comments provided by stakeholders. March 2009- IRB approval of the final revised pre-intervention survey. April 2009- Survey Research Lab conducted pilot interviews to ensure survey feasibility in the field and to test appropriate methods to approach restaurant managers. June 2009- Survey Research Laboratory and UIC student research assistants began interviewing food handlers. As of August 31, 2009 there were approximately 280 pre-intervention interviews completed. The pre-intervention interviews are projected to continue into March 2010, however with the current completion rate, interviewing may be completed up to 6 weeks ahead of schedule. September 2009- IRB Continuing Review approval was obtained. October 2009- Survey Research Laboratory plans to begin data entry of the completed surveys. PARTICIPANTS: Key personnel have been added to this project. Mindi Manes, PhD Epidemiology candidate is acting as the research study coordinator. Palak Panchal, MPH and PhD candidate and Suzanne Brown, MPH candidate are current research assistants. In accordance with the Research Protocol, staff from the Survey Research Laboratory at the University of Illinois at Chicago, with the assistance of the research assistants, are currently preforming the pre-intervention surveys. TARGET AUDIENCES: Nothing significant to report during this reporting period. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.
Impacts
This is the first year of the study and in compliance with the research outline there are no findings, results, techniques or information dissemination to report at this time. The outcomes and impacts of this research are projected for Years 2 and 3.
Publications
- No publications reported this period
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