title: Effectiveness of an intervention package on knowledge, attitude, and practices of food handlers in a tertiary care hospital of north India: A before and after comparison study.
abstract: BACKGROUND
  Food-borne illnesses have been a recognized hazard for decades. Recent promulgation of Food Safety and Standards Act (FSSA), 2006, indicates the concern of our Govt. for food safety. Research on effectiveness of food safety interventions in our country is remarkably scarce. Hence, the present study was conducted in a tertiary care hospital of north India to create evidence-based results for food safety interventions.
  
  
  METHODS
  The study was before and after intervention trial which was registered with CTRI. Data collection was paperless using a software. All food handlers (n= 280) working inside the hospital were recruited. Intervention package comprised Self-Instructional Manual in Hindi for food handlers, short film for sensitization of food handlers on food safety titled 'Gravy Extra', and a documentary titled 'Food Safety from farm to Fork'. Chi square test, pairedttest, and Wilcoxon sign rank test were used.
  
  
  RESULTS
  The mean age of food handlers was 35 ± 2 years. Majority (61.7%) of food handlers were educated less than 10th standard. Nearly 60% of them had up to five years of experience. At base line majority (68.9%) had a fair knowledge about food safety issues. There was a significant improvement in food safety knowledge and practice score of food handlers after the intervention (p< 0.05). Their attitude toward food safety changed in a positive direction (p< 0.05).
  
  
  CONCLUSIONS
  The intervention package was useful in improving the knowledge, creating a positive attitude and enhancing the food safety practices of food handlers working inside a tertiary care hospital.
authors.affiliation: Associate Professor, Department of Community Medicine, Armed Forces Medical College, Pune 411040, India.
authors.forename: Puja
authors.initials: P
authors.lastname: Dudeja
authors.affiliation: Professor, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
authors.forename: Amarjeet
authors.initials: A
authors.lastname: Singh
authors.affiliation: Dietician, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
authors.forename: Nancy
authors.initials: N
authors.lastname: Sahni
authors.affiliation: Lecturer, National Institute of Nursing Education, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
authors.forename: Sukhpal
authors.initials: S
authors.lastname: Kaur
authors.affiliation: Associate Professor, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
authors.forename: Sonu
authors.initials: S
authors.lastname: Goel
keywords: Food handlers; Food safety; Intervention; Training