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The goal of this project is to develop an integrated food safety strategy to effectively reduce the risk of both foodborne illnesses and food allergies. <P>
This project will specifically target independently operated restaurants that often have limited resources to provide their staffs with adequate training in food safety and food allergy separately. Specific objectives of the project are: <OL> <LI> To evaluate knowledge, attitudes, and food handling practices regarding foodborne illness and food allergy in independently operated restaurants using a mixed-methods approach of a nationally representative survey of independently operated restaurants complemented with in-depth interviews. <LI> To develop an integrated strategy of food safety practice to reduce the risk of both foodborne illnesses and food allergies using Delphi focus groups based on the findings from the survey and in-depth interviews. <LI>To develop education materials by employing the integrated strategy to create streamlined and simplified protocols in English and Spanish.<LI> To evaluate the effectiveness of the integrated strategy protocol by assessing the knowledge and behavior toward foodborne illness and food allergy following distribution of the education materials. <LI> To implement the education program through dissemination to stakeholders. </OL> Specific outcomes for each objective of this research project are as follows: <P>
a) Objective 1 - The survey and in-depth interview results will provide understanding of current knowledge, attitudes, and practices on foodborne illness and food allergy at independently operated restaurants. Qualitative analysis will provide information on the willingness and ability of the restaurant owners/operators to adopt the integrated strategies, as well as limitations that will influence the effectiveness of the education program. The quantitative and qualitative results will suggest educational needs and areas of emphasis and may reveal gaps between knowledge and practices; in which case, a variety of strategies will be developed and incorporated in the education program.<P>
b) Objective 2 - An integrated strategy of food safety practices will be developed based on the data collected in Objective 1 and the Delphi focus groups. The integrated strategy will be developed to simplify and streamline the critical control points to reduce the risk of both foodborne illness and food allergic reactions. <P>
c) Objective 3 - The educational materials will employ the integrated strategy of food safety and will be acceptable to and adequate for the general population which has a 6th grade education or more. <P>
d) Objective 4 - The expected outcomes include increased food safety knowledge and improved attitudes toward the importance of safe food handling immediately after learning from the integrated food safety education materials and three months later. <P>
e) Obective 5 - The education program based on integrated strategy will be disseminated to stakeholders. Dissemination will occur through a variety of means depending on the educational medium used.
NON-TECHNICAL SUMMARY: Foodborne illness remains an important public health issue while food allergic reactions are of increasing concern. Since more than a half of all reported foodborne illnesses in the U.S. are associated with restaurants, training restaurant workers for safe food handling practices can be an effective means to improve food safety. Recent Food Code modifications support an inclusive approach to food safety with awareness and training to prevent food allergic reactions particularly in restaurants. However, many of the 945,000 restaurants in the U.S. are small or independently operated with limited resources and access to adequate food safety training programs. Therefore, it is necessary to develop an integrated strategy to reduce the risk of foodborne illness and food allergic reactions at independently operated restaurants. This proposal addresses that need by developing a simple and streamlined education program in English and Spanish for this hard-to-reach audience, i.e. workers at independently operated restaurants. 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 food safety experts will assist with research activities, implementation, and dissemination of this training program to stakeholders.
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APPROACH: All methods for the proposed study will be reviewed and approved by the Institutional Review Board (IRB) at TWU prior to data collection. Objective 1: To evaluate knowledge, attitudes, and food handling practices regarding foodborne illness and food allergy in independently operated restaurants using a mixed-methods approach of a nationally representative survey of independently operated restaurants complemented with in-depth interviews. Objective 2: To develop an integrated strategy of food safety practice to reduce the risk of both foodborne illnesses and food allergies using Delphi focus groups based on the findings from Objective 1. An integrated strategy of food safety practices 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 integration strategy will be developed to simplify and streamline the critical control points to reduce the risk of foodborne illness and food allergy reactions rather than requiring two separate approaches to food safety practice. Objective 3: To develop education materials by employing the integrated strategy to create streamlined and simplified protocols in English and Spanish. Education materials to train employees at independently operated restaurants will be developed based on the results of Objective 2. Appropriate education media will be determined based on the preference identified during the survey. Objective 4: To evaluate the effectiveness of the integrated strategy protocol by assessing the knowledge and behavior toward foodborne illness and food allergy following distribution of the education materials. Objective 5: To implement the education program through dissemination to stakeholders. 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 integrated food safety education program will be sent to National Restaurant Association and other organizations, state and county/parish departments that oversee food safety, Chambers of Commerce, and restaurants in the lists created in Objective 1 for the survey. Depending on the educational medium used, the education program will be sent to the stakeholder upon request or a website will be developed to allow for access to the education program. Evaluation of education materials -The restaurant owner/operators in the experimental group will receive the instructions on the pre-test, treatment group education materials and immediate post-test. The managers will be instructed to give their restaurant employees the pre-test, view the integrated strategy education materials, and then give the employees the post-test at the completion of the education session. In addition, a three-month follow-up visit to each restaurant in the treatment group and control group will be conducted with employees and the owner/operators to measure the retention of knowledge and reported practice with the same questions asked in the post-test.