title: Food Safety Instruction Improves Knowledge and Behavior Risk and Protection Factors for Foodborne Illnesses in Pregnant Populations.
abstract: Objective This study compared knowledge and food-handling behavior after pathogen-specific (experimental treatment) versus basic food safety instruction (active control) presented during nutrition education classes for low-income English- and Spanish-language pregnant women. Methods Subjects (n = 550) were randomly assigned to treatment groups in two different locations in the United States. Food safety instruction was part of an 8-lesson curriculum. Food safety knowledge and behavior were measured pre/post intervention. Descriptive data were analyzed by Chi-Square or ANOVA; changes after intervention were analyzed by regression analysis. Results Knowledge improved after intervention in the pathogen-specific treatment group compared to active control, especially among Spanish-language women. Behavior change after intervention for the pathogen-specific treatment group improved for thermometer usage, refrigeration and consumption of foods at high risk for safety; however, all other improvements in behavior were accounted for by intervention regardless of treatment group. As expected, higher pre-instruction behavioral competency limited potential gain in behavior post-instruction due to a ceiling effect. This effect was more dominant among English-language women. Improvements were also linked to formal education completed, a partner at home, and other children in the home. Conclusions for Practice This study demonstrated that pathogen-specific food safety instruction leads to enhance knowledge and food handling behaviors that may improve the public health of pregnant women and their unborn children, especially among Spanish-language women. More importantly, food safety instruction, even at the most basic level, benefited pregnant women's food safety knowledge and food-handling behavior after intervention.
authors.affiliation: Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, 80523-1571, USA. Patricia.Kendall@colostate.edu.
authors.forename: Patricia
authors.identifier: http://orcid.org/0000-0001-7103-2921
authors.initials: P
authors.lastname: Kendall
authors.affiliation: Department of Human Sciences, The Ohio State University, 1787 Neil Avenue, Columbus, OH, 43210, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Scharff
authors.affiliation: Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, 80523-1571, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Baker
authors.affiliation: Food Animal Health Research Program, Ohio Agricultural Research and Development Center, The Ohio State University, 1680 Madison Ave, Wooster, OH, 44691, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: LeJeune
authors.affiliation: Animal Sciences, Colorado State University, Fort Collins, CO, 80523-1171, USA.
authors.forename: John
authors.initials: J
authors.lastname: Sofos
authors.affiliation: Food Animal Health Research Program, Ohio Agricultural Research and Development Center, The Ohio State University, 1680 Madison Ave, Wooster, OH, 44691, USA.
authors.forename: Lydia
authors.initials: L
authors.lastname: Medeiros
mesh_terms: D000328:Adult; D005260:Female; D005511:Food Handling; D059022:Food Safety; D005517:Foodborne Diseases / Q000517:prevention & control* / Q000523:psychology; D006266:Health Education / Q000379:methods* / Q000592:standards; D007722:Health Knowledge, Attitudes, Practice; D006630:Hispanic or Latino / Q000193:education / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D010043:Outcome and Process Assessment, Health Care; D011203:Poverty; D011247:Pregnancy; D037841:Pregnant People / Q000208:ethnology*; D011446:Prospective Studies; D065840:Protective Factors; D012307:Risk Factors; D012309:Risk-Taking; D011795:Surveys and Questionnaires; D014481:United States
keywords: Education; Food safety; Pregnancy; Randomized intervention