Assessing Factors Contributing to Food Safety Culture in Retail Food Establishments and Developing Training Tools

<p>NON-TECHNICAL SUMMARY:<br/> Strong evidence suggests that the majority (97%) of foodborne illnesses that affect over 9.4 million Americans annually (Scallan et al, 2011) occur as a result of improper food handling practices by employees in non-manufacturing food establishments (Howe et al, 1996). Training employees on proper food safety practices is one of the more important steps that foodservice establishments can implement in order to reduce the incidence of foodborne illnesses. Although participating in training programs, such as ServSafe®, has been shown to result in increased food safety knowledge, that knowledge has not always translated into improved employee practices since there has not been a detectable decrease in the incidence of foodborne illnesses in foodservice establishments in recent years (Noble et al, 2009). For food safety training to be successful
in changing employee practices, there needs to be an understanding of organizational culture and the "human dimension" of the employees (Yiannas, 2008). This concept of determining what key factors dictate food safety culture in foodservice establishments is in the early stages of development. Because of this, it is extremely important that those key components that are dominant in changing food handling practices be identified. As a consequence, there is a need to develop effective evaluation tools that can be used to identify key establishment-based factors that serve to characterize food safety culture from the perspective of food handler food safety practices (behaviors). In the absence of such tools, employees will more likely continue to receive inadequate food safety training, thereby continuing to contribute to the unacceptable levels of foodborne illnesses with associated
hospitalizations, and even deaths, resulting from such improper practices. The goal of this project is to develop behavior-based food safety training tools that can be implemented in all types of foodservice establishments that in turn, will help to reduce the incidences of foodservice establishment originated foodborne illnesses in the U.S. The objective is to determine what constitutes "best practices" of food safety culture from the perspective of food handlers themselves, and then to use this information to develop assessment tools that can be used to create a training program designed specifically to translate this knowledge into behavior-based practices. The study will target restaurants from several different types of foodservice establishments, such as fast food, casual dining, and non-commercial foodservice (hospitals and schools). The rationale for this project is that the
improvement in food safety culture of an establishment will help to ensure that proper food handling practices will become an integral part of serving safe food.
<p>APPROACH:<br/> Objective #1: Develop instruments to accurately evaluate compliance with standard operating procedures of food safety culture in retail food establishments. Task 1.1: Recruit restaurant operators to participate in the project. A convenience sample of 12 foodservice establishments from different sectors, ex. fast food, casual dining, non-commercial, pre-pared foods, will be recruited to participate in the project. As an incentive to participate, each establishment will be able to keep all behavior-based food safety training tools and each establishment will have the option to receive food safety training. Task 1.2: Conduct assessments of the current food handling practices and food safety systems to determine what constitutes the current food safety culture of the operation. The assessment will be conducted in all participating foodservice establishments
and will include characteristics such as the availability of a current food safety training program, facility layout examining risk-based properties, and other factors. Standard interviews with the Person in Charge (PIC) or contact person for the foodservice establishment will be conducted. Demographic information will be gathered including age, years of experience, and amount of food safety training. The project team will conduct the assessments and interviews. Task 1.3: Conduct a survey of establishment employees to calculate the extent to which employees follow food safety practices and how they feel food safety is being practiced in the establishment. Ball et al, 2010, has identified that work unit factors (influence of peers, monitoring by food safety personnel, and influence of supervisory personnel) and food safety requirements can contribute to the desired food safety behavior.
To do this, Ball et al, 2010, validated a measurement tool to identify the key factors that influenced workers food safety behaviors in meat packaging plants in Canada. This survey, which will be modified for retail foodservice establishments, will be utilized to survey all employees of participating establishments in this study. This survey will be utilized to identify key factors that employees feel influence food safety behaviors Task 1.4: Develop a behavior-based food safety culture card to determine what level of food safety culture is present at each participating establishments. From the results of the employee questionnaire and the assessment, a food safety culture card will be developed that will be used to determine what level of food safety culture is currently present. Task 1.5: Assess the food safety culture of each participating establishment. Using the newly developed food
safety culture card, food safety culture of each participating establishment will be assessed. Assessments will be conducted between 8:00 and 11:00 during preparation hours of the establishments to be able to note if food safety systems are in place and being used. All data collectors will be trained in using all forms involved. Data analysis Data will be analyzed to evaluate trends between types of restaurants (chain vs. independent) and seasonal differences in the data. Expected outcomes and limitations. Although there should not be problem with carrying out the employee questionnaire, I should be recognized that these are self-reported data and there could be a problem with the Hawthorne Effect. The researchers do not foresee this happening since the questionnaire has already been pilot-tested. The development of the food safety culture card and the assessment should be completed
without incident. The assessment will help provide context to the food safety culture practices being used by the operators. This context is important in identifying information gaps and opportunities in creating a model food safety program to help retail foodservice operations create food safety culture. The training results will also allow us to compare practices among different types of restaurants. Objective #2: Develop behavior-based food safety training tools to help retail food establishments improve food safety culture. Task 2.1: Develop and pilot test food safety culture tools. The food safety tools will be developed for one face-to-face delivery. Program content is expected to include ways to effectively communicate and build trust with employees, reinforcement and incentives for positive food safety behaviors, as well as testing the food safety culture tools. These tools will
include posters, information sheets, food safety packets to be given out with paychecks, and food safety culture facts to be used during meeting to help operators change behavior. Task 2.2: Conduct food safety culture implementation workshops for restaurant managers. Topics covered in the workshop, developed in Task 2.1, will be issues and trends in retail food safety, an introduction to behavior-based food safety systems, developing and utilizing a food safety culture scorecard, and developing individualized action plans to improve food safety culture. An action plan will be developed as part of the workshop (to be utilized in Task 2.3) to guide the foodservice managers in discernible changes. To allow for an assessment of the effectiveness of the workshop, the sample will be evenly divided into two groups: a control group and the experimental (workshop) group. After the workshop,
participants will be given a survey to determine their perception of the process and information provided. The results of the survey will be used to make improvements to the food safety culture tools. Task 2.3: Implementation of workshop information and support to participating restaurants. After participating in the food safety culture workshop, managers will be required to initiate their action plan in their establishments. Data analysis The data analysis for this objective will be limited. Expected outcomes and limitations Workshop participants (foodservice managers) are expected to be conceptually knowledgeable about food safety and would have already attained food protection manager certification. Objective #3: Determine the effectiveness of positive food safety culture training tools on standard operating procedures is participating establishments. Task 3.1. Conduct on-site
assessments of changes in food safety culture and survey employees to calculate the extent to which employees follow food safety practices. The employee survey, as described in Task 1.2., will be given to all employees at each restaurant to see if any changes can be detected concerning the thoughts of employees on food safety behaviors being practiced in each restaurant. The assessments will also be conducted again. Scores for the food safety culture scorecard will also be gathered with each visit. Task 3.2. Develop final food safety culture card and food safety training tools to prepare for dissemination. The results of all surveys, assessments and scores on the food safety culture card will be used to finalize the food safety culture card and the food safety training tools that can be used in workshops for establishments throughout the foodservice industry. Data analysis Pre/post
comparisons will be completed with the food safety culture card score. To assess the effectiveness of the training (Task 2.2) comparisons will be made between the control and the experimental group using the food safety culture card scores, and the employee survey scores. T-tests will be used to demonstrate whether the intervention was successful. Expected outcomes and limitations We expect to see changes over time and after the training for scores on the culture card and the questionnaire. By focusing on changes in the restaurant's culture, we expect that increases could be sustained over time.