A webinar brought to you by The Partnership for Food Safety Education

Today, we’ll cover:

• Successes of the Consumer Food Safety Education Conference 2014

• Results of the 2014 environmental scan of consumer food safety education efforts

• Preview of a comprehensive Food Safety Education Assessment now underway

• Next steps around measurement and evaluation

Today’s Speakers:

Patricia Borrusso, Ph.D. ORISE Fellow

Division of Education, Outreach and Information

Office of Analytics and Outreach Food and Drug Administration,

Center for Food Safety and Applied Nutrition

Sharmi Das, MHS Director

Division of Education, Outreach and Information

Office of Analytics and Outreach Food and Drug Administration,

Center for Food Safety and Applied Nutrition

Shelley Feist Executive Director

The Partnership for Food Safety Education

Let’s show the world what BAC Fighters and PFSE Partners do for food safety!

Watch for an email from PFSE!

Consumer Food Safety Education Conference Highlights

Consumer Food Safety Education Conference Highlights

97% said the conference provided the tools and knowledge needed to advance Healthy People 2020 food safety behavior change goals 98% said they learned strategies for increasing adherence to safe food handling behaviors among consumers 99% said they would make changes in their practice as a result of the information presented at this conference 98% said they would disseminate information learned to create positive behavior change in consumer food handling practices 100% said the conference provided opportunities to develop a network of professional contacts

Conference Resources Available

Videos

Presentations

www.teamfoodsafety.org > Conference

Have you taken actions since the conference to plan future work or to evaluate your work? A) Yes B) No

Food Safety Leadership: An Environmental Scan

• What are the leaders in consumer food safety education in the public and private sectors doing to reach millions of American consumers?

• PFSE commissioned survey - NCSU

• There has not to date been systematic collection of whom is providing what information to what audiences

• This data collection is a necessary step to a needs assessment to better describe the current population of food safety educators, their programs, and sources of information and materials

• Gaps within food safety messages need to be addressed

Background

• Survey intended to develop short “stories” or case studies from all sectors regarding their food safety education to consumers

• SurveyMonkey was central location for data collection • Participants were able to fill out information for up to

five different food safety education programs • Open for responses from June 2- Aug. 1, 2014 • Reopened Oct. 16-Oct. 31, 2014 to accommodate

other groups that expressed interest in being represented (397 participated in total)

Methods

Academia–Coop Ext - 96%

School System (K-12) - 96%

Public Health - 89%

Channels Educators Use to Reach Consumers

In-person

Channels Educators Use to Reach Consumers

Online

Federal Government - 52%

Academia - 38%

Non-Profits - 34%

Channels Educators Use to Reach Consumers

Television

Federal Government - 12%

Academia - 7%

School System (K-12) - 4%

Channels Educators Use to Reach Consumers

Other Channels

Public Health - 31%

Federal Government - 27%

Non-Profits - 26% Newsletters, mail, phone, posters, displays,

newspaper

Does Your Organization Measure Impacts of the Outreach

Program?

0%

10%

20%

30%

40%

50%

60%

I Don't Know No Yes

10%

38%

52%

Environmental Scan Other learnings:

Federal government is reaching the most people on annual basis (use of television) Children and households w/ children are primary targets for education efforts Must increase engagement of food retail and food industry and better capture this activity

For more info on environmental scan or national consumer food safety education work:

Shelley Feist Partnership for Food Safety sfeist@fightbac.org 202.220.0651

An Examination of Food Safety Research: Implications for Future Strategies

j

Preliminary Findings

Patricia Borrusso and Sharmi Das CFSAN/FDA

Partnership for Food Safety Education Fight BAC! Forward Webinar, February 12, 2015

Outline • Purpose and Background

• Methods – Literature Review

• Findings from Literature Review

• Preliminary Recommendations

• Conclusions

• Plans for Dissemination

Project Goals

• Review consumer food safety campaigns and research

• Evaluate the role of education and other behavioral influences on consumer food-handling practices

• Provide recommendations for the future direction of food safety education and programs

• “Final defense” against foodborne illness

• For the information to have the intended effect (improve behavior), the consumer must: Be exposed to the message, Believe the message applies to them, Feel compelled to listen to the entire message, Understand the message, Agree with the message, and finally, Act as the message suggests.

Many steps between

message creation & consumer action

Why is Food Safety Education So Important… And Sometimes Difficult?

Methods Literature Review Inclusion Criteria: Published food safety research (N=109+) Recent (last 15 years), from similar countries Related to one of the following topics: Consumer knowledge, attitudes, and behavior Communication and behavior theory Design, implementation, and outcomes of education campaigns

+ Interviews with food safety educators and key stakeholders for insight about history, goals, and future of food safety education

Knowledge Consumers are knowledgeable about some food safety topics…

• How and when to wash hands correctly

• How and when to clean/use separate cutting boards and utensils

But not others...

• Recommended temperatures (for cooking, refrigerators)

• How to use a food thermometer • Foods considered “high risk”

References: 1-9

Behavior High Compliance • Avoid cross-contamination via cutting boards – 60-100% correct

Low Compliance • Refrigerator temp. – 30-60% between 41-50oF, 5-14% > 50oF

• Food thermometer use – 0-25%

Compliance Unclear • Correct Handwashing; Before meal preparation

– 5-38% (Observed), 78-97% (Self-Report) • Correct Handwashing; After contact with raw meat

– 20-50% (Observed), 81-92% (Self-Report) References: 2-8, 10-22

Summary of Findings from Literature • Significant progress and improvements to consumer food-

handling over the last 20 years! But…

• Need to improve and vary approach for designing food safety campaigns and interventions

– Consumers fail to follow recommended food-handling behaviors for many reasons

– Strategies that worked 20 years ago, or 10 years ago, or even last week may not work today

Preliminary Recommendations for Educators Do What Works; Stop Doing What Doesn’t Work

• Work at teachable moments, when the target audience is most likely to pay attention – Example: During outbreaks/recalls

• Design campaigns based on needs emphasized by (recent) food safety research

• Conduct rigorous evaluation (all kinds) – Formative: Market research about target audience – Process: Program is up to date and running smoothly – Outcomes: Measurable impact

Designing Need-Based Campaigns – Example 1. Specify target behavior and audience

Target Behavior: Correct (soap & water) handwashing; Target Audience: Consumers who wash hands incorrectly

All steps based on results from literature review, theory adapted from Atkin et al. 2013

Designing Need-Based Campaigns – Example 2. Trace backward: What factors influence the consumer’s decision to perform the behavior? Which have the greatest influence on this decision?

Lack knowledge? Unlikely; 75-100% know correct behavior Low risk perception? Likely; Perceived importance varies by situation; perceived severity is often low Lack resources? Likely for some (low-income); No soap in 8-35% homes Lack awareness? Likely; Unless hands are visibly soiled

References: 1-9, 24

3. Communication perspective: Identify best approach to influence behavior of target audience

Barrier: Underestimate consequences/severity (Low risk perception) Suggestion: Appeal to emotion (fear): Stories about victims of foodborne illness Barrier: Cannot afford soap (Lack resources) Suggestion: Offer coupons for necessary items, Develop donation–based programs Barrier: Forgets to wash hands (Lack awareness) Suggestion: Appeal to emotion (disgust): Graphic picture of hand contamination

Designing Need-Based Campaigns – Example

Preliminary Recommendations for Everyone Form Meaningful Collaborations and Partnerships

• Reach out to organizations who are in the field educating consumers, such as Extension and Health Departments

• Encourage businesses to incentivize safe behaviors: – Food Industry (coupons and promotions on food safety related

items) – Kitchen Designers (more products to make

food safety easy)

Automatic soap dispenser for the home, Bed Bath & Beyond

Conclusion

Here’s the thing about consumer behavior… It’s not simple,

Or random…

But it can be improved.

Future Plans: Dissemination • Invite feedback and suggestions from key stakeholders

– Presentations within FDA, other agencies (USDA, CDC), and to local educators (PFSE, UMD Extension)

• National Conferences – Presenting with Shelley Feist at the Food Safety Summit in April –

“Who's Talking to the Consumer? What We Know About Consumer Food Safety Education”

– Abstracts submitted to NACCHO, IAFP, and APHA

• Peer-reviewed publications?

Acknowledgements

• Thank you to “Committee” at FDA for so much support and guidance on this project– Sharmi Das, Amy Lando, Marjorie Davidson, and Alan Levy

• Interviewees – Howard Seltzer (CFSAN), Louise Dickerson (CFSAN), Marjorie Davidson (CFSAN), Maria Malagon (FSIS), Christine Prue (CDC), and Shelley Feist (PFSE)

We’re very interested in your feedback! Please feel free to contact us at:

g

Patricia.Borrusso@fda.hhs.gov Sharmi.Das@fda.hhs.gov

1. Redmond, E. C. and C. J. Griffith . 2003. Consumer food handling in the home: A review of food safety studies. J Food Prot. 66:130-161. 2. Kwon, J., A. N. Wilson, C. Bednar, and L. Kennon. 2008. Food safety knowledge and behaviors of Women, Infant, and Children (WIC) program participants in the United States. Journal of Food Protection. 71:1651-1658. 3. Byrd-Bredbenner, C., J. Maurer, V. Wheatley, E. Cottone, and M. Clancy. 2007. Observed food safety behaviours of young adults. British Food Journal. 109:519-530. 4. Bruhn, C. M. 2014. Chicken Preparation in the Home: An Observational Study. Food Protection Trends. 34:318-330. 5. Phang, H. & C. M. Bruhn. 2011. Burger preparation: What consumers say and do in the home. Journal of Food Protection. 74:1708-16. 6. Anderson, J. B., T. A. Shuster, K. E. Hansen, A. S. Levy, and A. Volk. 2004. A camera's view of consumer food-handling behaviors. Journal of the American Dietetic Association. 104:186-191. 7. Kennedy, J., V. Jackson, I. S. Blair, D. A. McDowell, C. Cowan, and D. J. Bolton. 2005. Food safety knowledge of consumers and the microbiological and temperature status of their refrigerators. Journal of Food Protection. 68:1421-1430. 8. Nesbitt, A., S. Majowicz, R. Finley, B. Marshall, F. Pollari, J. Sargeant, C. Ribble, J. Wilson, and N. Sittler. 2009. High-Risk Food Consumption and Food Safety Practices in a Canadian Community. Journal of Food Protection. 72:2575-2586. 9. U.S.Department of Agriculture (USDA). 1998. Final report: Focus Groups on barriers that limit consumers' use of thermometers when cooking meat and poultry products. U.S. Department of Agriculture (USDA), Washington, DC. [Final Report Prepared Patrick T. Koeppl, Contract No. 43-3A94-7-1637.] Available from http://www.fsis.usda.gov/oa/topics/focusgp.pdf. Accessed on 12-9-2014. 10. Scott, E. and N. Herbold. 2010. An In-Home Video Study and Questionnaire Survey of Food Preparation, Kitchen Sanitation, and Hand Washing Practices. Journal of Environmental Health. 72:8-13. 11. Kennedy, J., S. Gibney, A. Nolan, S. O'Brien, M. McMahon, D. McDowell, S. Fanning, and P. G. Wall. 2011. Identification of critical points during domestic food preparation: an observational study. British Food Journal. 113:766-783. 12. Kendall, P. A., A. Elsbernd, K. Sinclair, M. Schroeder, G. Chen, V. Bergmann, V. N. Hillers, and L. C. Medeiros. 2004. Observation versus self-report: Validation of a consumer food behavior questionnaire. Journal of Food Protection. 67:2578-2586.

References 1

References 2

13. Hoelzl, C., U. Mayerhofer, M. Steininger, W. Brueller, D. Hofstaedter, and U. Aldrian. 2013. Observational Trial of Safe Food Handling Behavior during Food Preparation Using the Example of Campylobacter spp. Journal of Food Protection. 76:482-489. 14. Dharod, J. M., R. Perez-Escamilla, S. Paciello, K. Venkitanarayanan, A. Bermudez-Millan, and G. Damio. 2007. Critical control points for home prepared'chicken and salad'in Puerto Rican households. Food Protection Trends. 27:544-552. 15. Mazengia, E., C. Fisk, G. Liao, H. Huang, and J. Meschke. 2015. Direct Observational Study of the Risk of Cross-contamination during Raw Poultry Handling: Practices in Private Homes. Food Protection Trends. 35:8-23. 16. Fein, S. B., A. M. Lando, A. S. Levy, M. F. Teisl, and C. Noblet. 2011. Trends in U.S. Consumers' Safe Handling and Consumption of Food and Their Risk Perceptions, 1988 through 2010. Journal of Food Protection. 74:1513-1523. 17. Dharod, J. M., R. Perez-Escamilla, S. Paciello, A. Bermudez-Millan, K. Venkitanarayanan, and G. Damio. 2007. Comparison between self-reported and observed food handling behaviors among Latinas. Journal of Food Protection. 70:1927-1932. 18. Li-Cohen, A. E. and C. M. Bruhn. 2002. Safety of consumer handling of fresh produce from the time of purchase to the plate: A comprehensive consumer survey. Journal of Food Protection. 65:1287-1296. 19. Parra, P. A., H. Kim, M. A. Shapiro, R. B. Gravani, and S. D. Bradley. 2014. Home food safety knowledge, risk perception, and practices among Mexican-Americans. Food Control. 37:115-125. 20. Altekruse, S. F., S. Yang, B. B. Timbo, and F. J. Angulo. 1999. A multi-state survey of consumer food-handling and food-consumption practices. American Journal of Preventive Medicine. 16:216-221. 21. Bermudez-Millan, A., R. Perez-Escamilla, G. Damio, A. Gonzalez, and S. Segura-Perez. 2004. Food safety knowledge, attitudes, and behaviors among Puerto Rican caretakers living in Hartford, Connecticut. Journal of Food Protection. 67:512-516. 22. Cody, M. M. and M. Hogue. 2003. Results of the Home Food Safety - It's in your hands 2002 survey: Comparisons to the 1999 benchmark survey and Health People 2010 food safety behaviors objective. Journal of the American Dietetic Association. 103:1115-1125. 23. Larson, E. and C. G. Duarte. 2001. Home hygiene practices and infectious disease symptoms among household members. Public Health Nursing. 18:116-127 24. Byrd-Bredbenner, C., J. Maurer, V. Wheatley, E. Cottone, and M. Clancy. 2007. Food safety hazards lurk in the kitchens of young adults. Journal of Food Protection. 70:991-996

Moving Forward…

www.teamfoodsafety.org/forward

RTI International's List of Reliable and Valid Food Safety Measures/Instruments

Presentations on Evaluation from the Consumer Food

Safety Education Conference 2014

Questions and Comments

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Ashley Bell, Manager of Programs and Outreach ashley@fightbac.org 202-220-0705