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The goal of this project is to identify risk factors for foodborne infections in the child care environment and to develop more effective and targeted interventions for foodborne illness prevention. <P>
We propose four objectives to accomplish this goal: <OL> <LI> To develop a more complete characterization of food handling, hygiene, and sanitation practices that contribute to foodborne illness by conducting observations of child care workers at child care facilities in NC and SC. <LI>To collect and analyze microbiological samples from the hands of child care workers and surfaces at these same child care facilities in NC and SC. <LI>To identify foodborne illness risk factors and effective control strategies using the findings from the observations and microbiological testing results. <LI>To develop, deliver, evaluate, and disseminate training interventions targeting food safety educators based on identified risk factors and control strategies to increase their competency in delivering educational messages to child care workers.
</ol>The proposed research will fill gaps in our current knowledge regarding risk factors for foodborne illness in the child care environment. We will use findings from the observational and microbiological analysis to develop targeted training interventions. Unlike other educational materials that have been developed, the materials will be targeted to food safety educators so that they are equipped with the required knowledge and competency to deliver messages on food safety education to child care workers. Thus, it is expected that child care workers will exhibit safer practices following educational efforts and thus help reduce the risk for foodborne illness among infants and young children in the child care environment.
NON-TECHNICAL SUMMARY: Infants and young children (<5 years) are at greater risk of severe foodborne illness than any other demographic group. Recent research demonstrates that children cared for outside the home are more likely to experience diarrheal disease than those cared for in the home. In the United States, more than half of children < 6 years old (and not yet in kindergarten) spend time in nonparental care. Thus, each year, many infants and children are at risk of contracting foodborne illness, which can be potentially serious and life threatening. Therefore, it is important that more targeted interventions be developed to control for foodborne pathogens in the child care environment. We propose to collect data from 100 child care facilities in North Carolina (NC) and South Carolina (SC) to identify risk factors in the child care environment using two methods: (1) direct observations of food handling, hygiene, and sanitation practices of child care workers and (2) microbiological sampling of the hands of child care center workers and surfaces. This information will form the basis of training interventions (workshops and fact sheets) targeted to educators who provide food safety training to child care workers. Providing food safety educators with information on why engaging in recommended practices is important, not just how to engage in those practices will increase their credibility, and thus increase the likelihood that child care workers will adopt the recommended practices. We will develop, deliver, and evaluate the training interventions and disseminate the final training interventions via the FightBAC! Web site. <P>
APPROACH: <BR> PROJECT ADVISORY PANEL -- We will form an advisory panel to (1) assist in developing the data collection instruments and protocols, (2) review findings and training program content, and (3) assist in disseminating the results. <BR> SAMPLING OF CHILD CARE CENTERS -- We will select a random sample of 100 center-based programs and family child care homes (50 facilities from NC counties and 50 facilities from SC counties) from a list of licensed facilities. <BR> DIRECT OBSERVATIONS -- We will develop a detailed, standardized observation checklist for recording behaviors in three areas: food handling, hygiene, and sanitation. <BR> MICROBIOLOGICAL SAMPLES -- We will obtain 10 to 14 microbiological swabs per child care facility sampled. The samples will be analyzed for several indicator organisms and a variety of pathogens. Microbiological indicators to be included in the analysis are total coliforms, generic E. coli, Listeria spp., Shigella spp., Salmonella spp., E. coli O157:H7, Campylobacter jejuni, Giardia lamblia, noroviruses (both genogroups I and II) and group A rotaviruses. <BR> DATA ANALYSIS -- Specific relationships which we intend to investigate include, but are not limited to the following: (1) the relationship between concentrations of specific microbial indicators and type of facility, sampling site, and/or behavior; (2) the relationship between the presence of specific pathogens and facility type, sampling site, and behavior; and (3) the relationship between groups of pathogens and sampling site and specific behavior. <BR> EDUCATION INTERVENTION FOR FOOD SAFETY EDUCATORS -- We propose to develop a series of backgrounders (i.e., fact sheets) that focus on each risk factor (and corresponding control strategy) identified. The backgrounders will serve as the foundation of the trainings. The training will be delivered using one of two formats: (1) half-day (4 hours) workshops conducted at annual professional meetings or (2) backgrounders delivered to interested individuals via email. <BR> EVALUATION OF EDUCATIONAL INTERVENTION -- We will use a pre-post design to measure outcomes before and after exposure to the training intervention to assess its effectiveness at improving knowledge and practices.