Improving Food Safety Practices of Restaurant Employees Using the Theory of Planned Behavior

NON-TECHNICAL SUMMARY: The identification of a training program to overcome existing barriers and improve food handling practices of employees in restaurants should ultimately result in decreased foodborne illness in the retail sector of the food chain. The ultimate goal is enhanced consumer confidence in the safety of the food served in retail establishments and provide directions for future food safety research.
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APPROACH: A pre-test post-test research design will be used to evaluate the effectiveness of the initial training program at different time periods. Prior to the initial knowledge training, a survey will be administered to determine the prior knowledge and attitudes of employees about food safety. Researchers will then observe the employees while they work to determine which practices are or are not being followed prior to the training session. The ServSafe training sessions will be offered for all employees and managers at each operation in two-one day, 8 half hours, training sessions. The employees will then be given the norm-referenced ServSafe examination. To assess retention of knowledge and change in attitude, half the sample will be surveyed immediately following the training session with the remaining half being surveyed two months following the training. The content of the instrument will be the same as the pretest. Researchers will then conduct post observations to determine the specific practices that are or are not being followed after the training session. A within group, multiple baseline design will be used to evaluate behaviors related to food handling practices prior to and following the two training programs. A criterion measure instrument and observation times will be based on research conducted by Johnson. Focus groups will be conducted to determine barriers that may be preventing employees from applying the knowledge they gained from the training program. Atlas, Inc., a software program designed to analyze qualitative data, will be used to summarize the results from the focus group discussion. Once barriers to implementing food safety practices are identified in the focus groups, researchers will categorize them into one of the three areas within the Theory of Planned Behavior: attitudes, subjective norms, or perceived behavioral controls. A new training program based on the three areas within the Theory of Planned Behavior will be developed, implemented, and evaluated. Two sections to specifically measure subjective norms and perceived behavioral control will be added to the questionnaire that was administered following the initial knowledge training (ServSafe). The results will be compared prior to and after the second training session. After the second training session is complete, researchers will again observe employees to determine if this second intervention increased the frequency of the utilization of safe food handling practices. Descriptive statistics, including means, standard deviations, and frequencies, will be computed for all closed-ended items on the questionnaire. Additionally, inferential statistics, such as, within subject t-tests and analysis of variance will be used to compare pre- and post-test means to determine if there is a significant change. Regression analyses will be conducted to examine which factors (attitudinal, subjective norms, or perceived control) most influenced behaviors in the observation part of the study.
<p> PROGRESS: 2004/09 TO 2008/09<BR>
OUTPUTS: Food production employees (n = 368) from randomly selected restaurants within a 300-mile radius of Kansas State University participated in the longitudinal study. The research focused on the three behaviors of handwashing, use of thermometers, and proper handling of food and work surfaces because they are known to contribute significantly to the incidence of foodborne illnesses. Three data collection phases involved participants completing a survey assessing knowledge and beliefs about food safety and being observed during peak hours (i.e., a lunch or dinner shift) for compliance with the three food safety behaviors. When comparing if training all production employees in an operation or just training a shift manager in food safety made a difference in employees' knowledge and compliance, the results of the baseline data in Round 1 suggested there was no distinction. Attitudes were found to be a consistent predictor of intentions to perform the behaviors. Prior to Round 2 data collection, the researchers provided participants with four-hour ServSafe food safety training. Training improved knowledge and behavioral compliance, though there was still need for improvement. The foodservice employees identified barriers to food safety (e.g., lack of time, lack of equipment, and lack of incentive) during focus group interviews conducted following the training sessions. An intervention encouraging perceived control over and more positive attitudes about complying with the food safety practices was designed which included an employee food safety competition, providing thermometers to the operations, and posting reminder signs which focused on persuasive arguments for performing the behaviors. The researchers implemented the intervention program prior to Round 3 data collection. Among the few employees (n = 33) who completed all phases of the study, compliance with the behaviors was best after receiving both the intervention and training (compared to receiving training only or no treatment). When participants were divided into four treatment groups, including a group receiving ServSafe training (n = 94), the intervention (n = 83), a training/intervention combination (n = 51), or no treatment (n = 140), the ServSafe training or intervention alone was better than no treatment, but a training/intervention combination was most effective at increasing behavioral compliance and perceptions of control over the behaviors. Results indicate, when offered in conjunction with training, the simple, relatively inexpensive intervention offers significant benefits over food safety training alone. Foodservice managers may improve the food safety compliance rates of their foodservice employees by ensuring they receive ServSafe training and an intervention targeting their perceived barriers to food safety, including messages convincing employees of the importance of performing the behaviors.<BR> PARTICIPANTS: Restaurant employees in 31 restaurants in Kansas, Iowa, and Missouri within a 300-mile radius of the research institution. Team Members: Kevin Roberts, Amber Howells, Valerie Pilling, David Olds, Laura Brannon, Betsy Barrett, Carol Shanklin, and Woomi Phillips. Undergraduate assistants: Michele Galindo, Holly Campbell, Shane Frownfelter, Adam Horner, Luke Oplinger, and Julie Pierce.<BR> TARGET AUDIENCES: Managers and employees in retail and institutional foodservice, Food sanitarians, Extension professionals, Educators <BR> PROJECT MODIFICATIONS: Due to recruitment challenges, the researchers expanded the proposed 250-mile recruitment radius to 300 miles. The researchers encountered major challenges in terms of recruitment and retention. Proposed statistical analyses focused on within-subjects, repeated-measures analyses. While these analyses were pursued with employees retained through all three research phases (N = 33), alternate analyses (i.e., between subjects analyses) also were pursued to maximize participant inclusion in analysis.
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IMPACT: 2004/09 TO 2008/09 <BR>
ServSafe training was provided to 144 food production employees in 19 restaurants in Kansas, Missouri and Iowa within 300-mile radius of Kansas State University. Posters that included persuasive and how-to messages related to handwashing, using thermometers, and proper handling of food and work surfaces were developed. The posters addressed 1) barriers to performing safe food handling practices identified by employees and 2) the behaviors that were observed to have the lowest compliance rates among employees' food safety practices. These posters were available both in English and Spanish; the messages emphasized the importance of performing the three targeted behaviors. The posters were found to increase employees' compliance with food safety practices alone or in combination with food safety training. Increasing employees' compliance with food safety practices will decrease the number of foodborne outbreaks and the associated annual costs of $6.5 to $34.9 billion.