Food Safety Education and Behavioral Changes Among Deaf and Hard-of-Hearing Population: A Model Study

<p>NON-TECHNICAL SUMMARY: <br/>Foodborne illness remains an important public health issue while safety of fresh and fresh-cut produces are of increasing concern. Since cooking or kill steps to reduce pathogenic microorganism are not available, proper food handling practices are particularly important in preparation of fresh and fresh-cut produce. However, such control measures, as simple as hand washing, are not properly excercised among the public as well as food service employees. Therefore, it is important to identify barriers and factors affecting behavioral compliance to prevent foodborne illnesses. In addition, as about 16% of deaf and hard of hearing young adults are employed in food service industry with an increasing trend, it is necessary to provide an up-to-date produce safety education program before this hard-to-reach population enter into workforce. This project
addresses such needs by developing a culturally sensitive education program destined for deaf and hard of hearing while unique strategies to promote behavioral compliance are investigated in this model system. To achieve this goal, mixed method research will be conducted including surveys, in-depth interviews, Delphi focus groups, and observation, followed by development of education materials and evaluation of progam effectiveness. Appointed partner organizations and an advisory board of experts in food safety, behavioral psychology, and deaf education will assist with research activities, implementation, and dissemination of this education program to stakeholders.
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APPROACH: <br/>All methods for the proposed study will be reviewed and approved by the Institutional Review Board (IRB) at University of Idaho (UI) prior to data collection.
<br/>Objective 1: Evaluation of knowledge, attitudes, and handling practices towards fresh and fresh-cut produce using a mixed-methods approach of a nationally representative survey of deaf and hard of hearing complemented with in-depth interviews to understand food safety culture among the target population. To address the first objective, a mixed-method approach will be used to evaluate knowledge, attitudes, and handling practices regarding fresh and fresh-cut produce and foodborne illnesses. The first step will involve a national survey of deaf and hard of hearing between the ages of14-18. This survey will be used to collect quantitative data on the knowledge, attitudes, and self-reported handling
practices among the target population. Results of the in-depth interviews as well as survey data will be used to develop the education strategy for deaf and hard of hearing (Objective 2). Additionally, the data collected will be submitted for presentation at a national meeting such as the International Association for Food Protection and Conference of Education Administrators of Schools and Programs for the Deaf. The results will be published in an appropriate peer-reviewed journal including Journal of Food Protection, American Annals of the Deaf, and Journal of the Rehabilitation for the Deaf. <br/>Objective 2: Development of a culturally sensitive education strategy for deaf and hard of hearing on safe handling of fresh and fresh-cut produce using Delphi focus groups based on the findings from the Objective 1. A food safety education strategy for the target population will be developed
based on the two parts of studies in sequence: (i) the data collected from Objective 1 and (ii) Delphi focus groups. The strategy will be developed to be culturally sensitive for the deaf and hard of hearing so that the science based information on fresh and fresh-cut produce safety can be correctly and effectively understood by the target audience. The focus group is a useful research tool to investigate qualitative factors and to explore opinions and practices of participants towards given circumstances. A Delphi focus group brings together experts to explore specific topics, in this case the fresh and fresh-cut produce safety and effective education strategy for deaf and hard of hearing. The focus groups will be conducted to explore the development of strategies based on the data collected from the surveys and in-depth interviews in Objective 1. The focus groups will be conducted with
the experts in produce food safety, food safety education, and deaf education. <br/>Objective 3: Development of education materials based on the identified education strategy for deaf and hard of hearing population on safe handling of fresh and fresh-cut produce. Education materials to train deaf and hard of hearing will be developed based on the results of Objective 1 and 2. A storyboard plan will be constructed in collaboration with media consultants at the UI Video Production Center and deaf friendly media technology services such as Deaf Empowerment Awareness Foundation, Inc. (DEAF, www.deafinc.org). Appropriate education media will be determined based on the preference identified during the survey. Possible media formats include Digital Versatile Disk (DVD), CD-ROM for computer-based training (CBT), or a web-based training (WBT) module. <br/>Objective 4: Implementation and evaluation of
effectiveness of the education program by assessing the changes in knowledge, culture, and behavior toward fresh and fresh-cut produce following training with the education program. This objective will be achieved by conducting five steps of efforts: (i) Implementation of education program, (ii) Development of evaluation instruments, (iii) recruitment and selection of participants for program evaluation, (iv) Evaluation of education materials, and (v) Follow-up. <br/>Objective 5: Dissemination of the education program to stakeholders including schools for deaf and hard of hearing population in the U.S. Dissemination of the results will occur through a variety of means. A copy of the education materials will be sent to all survey respondents. Additionally, announcements for the fresh produce food safety education program will be sent to educational institutions and programs for deaf and hard
of hearing in the U.S. The research team will also coordinate our effort to acknowledge the importance of fresh produce safety issues and benefits of the program by communicating with the teachers at the schools for deaf and hard of hearing. Depending on the educational medium used, the education program will be sent to the stakeholders upon request or a website will be developed to allow for access to the education program.