Food Safety for the Immune-Suppressed/Compromised: A Multimedia Approach

NON-TECHNICAL SUMMARY: There is need for effective messages on food safety for those with suppressed or compromised immune systems. We aim to better understand the food safety attitudes of pregnant women, chemotherapy/organ transplant patients, HIV/AIDS patients and health care professionals, and create a distance education course, patient education materials, and web-cast on food safety for the immune compromised.

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APPROACH: There is a need to examine food safety education programs to assure that messages are aimed at reducing the risk of the most prevalent and/or serious causes of foodborne illness and that the most vulnerable population groups are aware of their greater risk. This project aims to expand information learned in our previous studies to the benefit of three specific populations at high risk for 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. As gatekeepers of information, health care providers also are targeted. Focus groups designed to better understand food safety attitudes and beliefs and food safety education needs will be conducted in Colorado, Ohio and Washington with members and/or support family members of three groups at high risk of foodborne illness (pregnant women, organ transplant/chemotherapy patients, and HIV/AIDS patients). In each state, 10-15 health care professionals (eg., doctors, nurses, dietitians) that work with these audiences will also be interviewed to assess knowledge gaps and education needs regarding food safety and the immune compromised. Information gained will be used to develop and evaluate consumer/patient education materials targeted to each high-risk audience and a multi-media distance education course for health care professionals and graduate/pre-med students on food safety and the immune suppressed/compromised. All materials developed will be formatively and summatively evaluated. Information gained through the project will be further extended to health care professionals, advanced degree students and interested consumers through a web-cast offered in five 1-hour modules. The first two modules will be devoted to the physiology of immune function, pathogens of special importance to the target audiences and behavior change theory. The last three modules will focus individually on specific food safety issues for each of the three high-risk audiences. Following its completion, the web-cast modules and patient education materials will be made available in down-loadable copy through web sites in the three states.
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PROGRESS: 2001/09 TO 2006/09<BR>
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.
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IMPACT: 2001/09 TO 2006/09<BR>
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.