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Overall Study Objectives. This study focuses on a highly vulnerable group, pregnant women and their unborn children. An intervention is developed and implemented with two specific target audiences: low income English speaking pregnant women and low income Spanish speaking pregnant women. Educational outcomes will be verified by microbiological assessment for general sanitation (aerobic and coliform counts) and presence of foodborne pathogens in the environment (Listeria monocytogenes (LM) and Salmonella spp.). Research findings and educational materials are then communicated to consumers and health professionals using a variety of outreach educational methods.
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Specific Aim 1. Development, implementation and evaluation of a food safety education intervention among pregnant women. (Research Aim) <Br> Objective 1.1. Development of intervention phase <Br> Objective 1.2. Educational intervention<Br> Expected Outputs. It is expected that a method and plan will be developed that will provide the validity and precision needed to detect changes that result after the educational intervention. These studies are further expected to demonstrate that intensive food safety education can result in 1) improved knowledge and attitudes, 2) improved food consumption and handling behaviors related to risk of exposure to LM, 3) improved general food and environmental hygiene, and 4) decreased exposure to LM among Spanish-and English-speaking pregnant women. <P>
Specific Aim 2. Formal and outreach education, publications. (Education, Extension and Outreach Aim) <Br> Objective 2.1: Revise, publish and disseminate the materials developed through this study to targeted audiences<Br> Objective 2.2: Incorporate research findings into academic courses <Br> Objective 2.3: Develop manuscripts for health professionals and educators that serve pregnant women and mothers of young infants <Br> Expected Outputs: Pregnant women, undergraduate and graduate students, and continuing education participants will demonstrate knowledge of foodborne pathogen contamination and control after reading the publications developed for this study. This will enable participants to institute or promote changes in their food handling habits for themselves or their clients. Even though it is beyond the procedures of these studies, the ultimate outcome of these studies is decreased incidence of infections of listeriosis and salmonellosis, which will be evident in public health statistical data in future years.
NON-TECHNICAL SUMMARY: This study focuses on a highly vulnerable group, pregnant women and their unborn children. An intervention is developed and implemented with two specific target audiences: low income English speaking pregnant women and low income Spanish speaking pregnant women. Educational outcomes will be verified by microbiological assessment for general sanitation (aerobic and coliform counts) and presence of foodborne pathogens in the environment (Listeria monocytogenes (LM) and Salmonella spp.). Research findings and educational materials are then communicated to consumers and health professionals using a variety of outreach educational methods. Despite marked reductions in the incidence of illnesses from many foodborne pathogens, there remains a concern that the most vulnerable population groups continue to suffer foodborne illnesses disproportionately to the general population. My research has focused on educational needs of consumers for the last 10 years, and more recently on population groups at greatest risk of foodborne illnesses due to suppressed or compromised immune function. Although we who conduct research in food safety have sharpened our understanding of the educational needs of consumers, there are still many unknowns. We have yet to prove the efficacy of our work through educational intervention. We have yet to document improved health because of food safety education. And, we have yet to focus our work on the food safety issues of a high risk group who is highly susceptible to the consequences of foodborne illnesses - pregnant women. In these proposed studies, pregnant women are the beneficiaries of the formative studies, educational interventions and outreach education.
<P>APPROACH: Specific aim 1. Low income English- and Spanish-speaking pregnant women will be recruited for participation in this phase of the study (n=300). The control and will receive a low-contact education treatment consisting of typical food safety education. The experimental group will receive high-contact food safety education. A peer educator will schedule a home visit with each participant to conduct the pre-assessment, assessment of refrigerator temperature, and collection of environmental and food samples. Two food items prepared or stored in the home (ready-to-eat and home-prepared) and two environmental samples (refrigerators, kitchen sink) will be collected from the homes. Pre-moistened sterile sponges will be used to swab surfaces. For foods, 25 g samples will be collected. Specimens will be transported to the Wooster campus lab on ice. The education evaluation will be repeated with both treatment groups at 2 months post intervention. Two sets of food safety educational materials and related curricula will be developed and will be evaluated for content and face validity by 6-8 key informants. Evaluation instruments will be developed based on food safety attitude and knowledge surveys, food behaviors surveys, and survey questions used by the FDA to assess trends in risky food handling and consumption practices. <P>
Specific aim 2. The materials developed in this project will be revised as needed and published in print and web-based form for dissemination to pregnant women. These materials will include consumer publications in English and Spanish targeting pregnant women with food safety information, 2 sets of curricula specifically tailored for food safety educators to use with low-income English and Spanish speaking audiences, one targeting food safety educators and paraprofessionals and the other targeting clients of USDA-funded programs such as WIC, EFNEP, and FSNE. The availability of these materials will be marketed through trade publications and web sites, mailings to memberships of professional organizations, and through health clinics and physician's offices. Printed materials will be made available for cost; free materials will be available for download from the research study web site. Lesson plans and educational materials based on research findings will be developed to incorporate into undergraduate and graduate academic courses in colleges and universities. Lesson plans will be made available to other educators through a web site established to communicate the progress and findings of this research project. Research manuscripts will be developed for dissemination to health professionals based on the findings of these studies. The manuscripts will be submitted to journals offering continuing education opportunities to health professionals.