The existence of optimistic bias about foodborne disease by food handlers and its association with training participation and food safety performance

"I'm better than you": assessing the presence of optimistic bias among Italian hunters

According to the latest scientific evidence, consumers appreciate hunted wild game meat (HWGM), but its consumption may expose them to some risks. Hunters produce HWGM, even if they may find it hard to identify themselves as food producers since in Western countries, hunting is practiced mostly as a leisure activity. Thus, hunters may underestimate the risk associated with HWGM handling, failing to preserve its safety during the production process. To test this hypothesis, our study aims to explore the presence of optimistic biases (OB) in a sample of Italian hunters. A sample of 408 hunters was asked to indicate their own risk and the perceived risk of their peers causing a foodborne disease to the final consumer, as well as the practices implemented during the phases of HWGM handling and preparation. Moreover, information about HWGM destinations, hunters' knowledge of basic principles of food safety, and risk perceptions of HWGM preparation were collected. Our results show that hunters generally tend to perceive themselves as "better than their peers" when performing actions to preserve HWGM safety, especially if the peers are unfamiliar to the respondent. Furthermore, OB correlates knowledge of basic principles of food safety with risk perceptions of HWGM preparation-related practices. Finally, hunters perceived themselves as "nature lovers" and "hunting enthusiasts" and did not recognize their role as food producers. Therefore, our findings emphasize the importance of improving hunters' training to preserve public health, addressing the need for more targeted strategies able to enhance hunters' awareness of their role as food producers.

The Impact of Short-Form Video and Optimistic Bias on Engagement in Oral Health Prevention: Integrating a KAP Model

College students are recognized as a demographic particularly susceptible to higher oral health risks due to irregular and unhealthy habits. While previous research has underscored these risks through descriptive studies within this group, a significant gap persists in the literature regarding the impact of contemporary media, specifically oral-health-related content, on the engagement in oral health prevention among Chinese college students. To address this gap, this study, guided by the extended knowledge-attitude-practice (KAP) theory model, explores the direct, mediated, and serially mediated mechanisms through which exposure to oral health short-form videos on Douyin influences their participation in oral health prevention. An empirical cross-sectional online survey was conducted, with valid data (N = 421) analyzed using descriptive statistics and hierarchical regression. Mediation and serial mediation analyses were also performed using SPSS version 25.0. The analysis revealed that exposure to oral health short-form videos had a positive direct effect on both oral health knowledge and the reduction of optimistic bias among Chinese college students. Furthermore, a significant serial mediation effect of oral health knowledge and oral health attitude was identified. The findings underscore the substantial applicability and explanatory power of the extended KAP theory model in understanding engagement in oral health prevention.

Certified Food Safety Management Systems Assessed through the Lenses of Food Safety Culture and Locus of Control: A Pilot Study

The approach to ensure food safety (FS) has evolved, including the concept of FS culture, which has been shaped by both the legislation and the scientific literature. In this study, two companies that produce foods associated with potential risks of cross-contamination (gluten-free foods and frozen pastry, respectively) and are certified according to international voluntary FS standards, such as the British Retail Council Global Standard (BRC) and the International Featured Standards Food Version (IFS), were investigated to assess: (a) if the assessment of FS culture's pillars can uncover unexpected critical areas; (b) if the scores of the FS culture's pillars are related to personal traits, namely, age, seniority in the company and locus of control orientation, i.e., the beliefs that an event is the result of external factors (luck, destiny or superior beings), or the result of internal factors (human behavior). Questionnaires for the survey and the scoring system applied were selected from the literature. Results showed that all food handlers had an optimistic bias, which paradoxically could be the consequence of the rigorous application of hygienic procedures. The younger food handlers had significantly (p < 0.05) lower commitment than the older ones. Moreover, the segment of food handlers having an external locus orientation demonstrated weaker normative beliefs than those having an internal locus of control orientation. Results showed that the FS culture survey, which is related to the shared FS culture, could disclose unknown weakness in third-party certified companies, even if the well implemented principles of voluntary FS standards are aligned with the FS-culture pillars. Moreover, the segmentation of food handlers according to their age and the locus of control assessment could provide additional information on the individual orientation toward FS behavior. Hence these tools could assist the leaders in the management of the dynamic nature of human capital.

Temperature status of domestic refrigerators and its effect on the risk of listeriosis from ready-to-eat (RTE) cooked meat products

Inadequate domestic refrigeration is frequently cited as a factor that contributes to foodborne poisoning and infection, and consumer behaviour in this regard can vary largely. This study provides insight into the temperature profiles of domestic refrigerators in the Netherlands and the impact on the number of listeriosis cases related to ready-to-eat (RTE) cooked meat products. A survey was conducted among Dutch consumers (n = 1020) to assess their knowledge and behaviour related to refrigerators. Out of these participants, 534 measured their refrigerator's temperature, revealing an average temperature of 5.7 °C (standard deviation (SD) of 2.2 °C) with a maximum of 17 °C. Elderly people (65 years and older) had refrigerators with temperatures that were on average 0.6 °C higher than those of younger people (35 years or younger). The 24-hour temperature profiles of an additional set of actively surveyed refrigerators (n = 50) showed that the temperature measured on the upper shelf was significantly higher (mean 7.7 °C, SD 2.7 °C) than the temperature measured on the bottom shelf (5.7 °C, SD 2.1 °C). Quantitative Microbiological Risk Assessment (QMRA) predicted that the primary factors contributing to the risk of listeriosis were the initial concentration and the time and temperature during household storage. Scenario analysis revealed that storing opened RTE cooked meat products at home for either <7 days or at temperatures <7 °C resulted in a significant reduction of over 80 % in predicted illness cases. Among all illness cases, the elderly represented nearly 90 %. When assessing the impact of the disease in terms of Years of Life Lost (YLL), the contribution of the elderly was 59 %. Targeted communication, particularly directed towards the elderly, on the importance of storing RTE cooked meat products at the recommended temperature on the bottom or middle shelf as well as consuming within two to three days after opening, holds the potential to significantly reduce the number of cases.

Do Primary Health Professionals in Brazil Have a Misperception about Food? The Role of Food Literacy as a Positive Predictor

Risk perception is socially constructed; psychological elements control people's reactions to a hazard, and even health professionals may have difficulty determining what healthy food is. This work aimed to measure food literacy and food risk perceptions among primary healthcare professionals in a Brazilian city. In the first phase, 280 health professionals working in primary care in Rio Claro, Brazil, were studied. The Short Food Literacy Questionnaire (SFLQ-Br) and scales of risk and benefit perception of 50 foods were used. In the second phase, 20 professionals were interviewed to investigate the responses to different foods observed in the first phase. In this second phase, 16 users of the health system were also enrolled to understand their perceptions and how the nutrition messages conveyed by the health team reached them. Professionals scored an average of 34.5 on food literacy (for which there is a maximum score of 52). They showed difficulty with dietary guidelines and their interpretation. Food's risk and benefit perception were generally consistent with the recommendations of the Food Guide for the Brazilian Population. However, some processed foods or those with no proven health benefits were considered healthy by the study participants, indicating a biased perception (e.g., gelatin, processed turkey breast, cream crackers, and cereal bars). Less misperception was observed when food literacy was higher, which positively predicted risk perception. The reasons for identifying benefits of these foods ranged from the false impression that they are natural and nutritious foods to the comparative claim that they are better for health than similar foods. The results indicate the need to educate health professionals based on current references to avoid bias in population counseling.

Food handlers' lack of knowledge, and misunderstanding of safe food temperatures: An analysis using the theory of social representations

Comprehension is the ability to understand and be familiar with situations and facts. A critical factor causing foodborne diseases is the inadequate temperature during food storage and handling; food handlers often fail to understand this. Therefore, in this study, we investigated how technical language and everyday knowledge operate in the comprehension of safe food temperatures among food handlers in food services. To achieve this, data collection was carried out in two stages. In the first stage, a survey was conducted to 206 food handlers from 14 food service working in the city of São Paulo. Through this survey, we gathered information to characterize the socio-demographic profile of the sample, details about participation in training, and knowledge of technical terms related to safe food temperatures. In the second stage, individuais interviews were conducted on the same day following the questionnaire administration in each food service. A total of 29 interviews were carried out An interview script was developed containing two storylines based on the Fourth Key: "Keep food at safe temperatures," which is part of the WHO's "Five Keys to Safer Food" manual. Further, the collective subject discourse technique, which is based on the theory of social representations, was employed to analyze each interview and construct a representative collective discourse. Analysis of the results indicated that lack of knowledge about safe food temperatures is mainly a result of the misunderstanding of technical terms. The collective discourses obtained results reinforced that food handlers had diverse and erroneous information about food defrosting, and they exhibited low confidence and clarity about safe food temperatures. Overall, psychological, social, and cultural factors affect the formation of social representations that guide food handlers' decision-making.

Job Crafting and Burnout as Predictors of Food Safety Behaviors in the Foodservice Industry

This study aimed to investigate whether job crafting, burnout, and work engagement predict food safety behaviors in the foodservice industry. It was a cross-sectional study conducted in Cuiabá (Brazil) among foodservice workers. Four instruments were used among foodservice workers for the examination: (a) job demands and resources, (b) job satisfaction, (c) burnout, and (d) work engagement. Food safety practices were measured using a validated risk-based checklist. Partial least squares structural equation modeling was used to test the hypothesis model. In this study, 22 restaurants and 302 foodservice workers were examined. It was found that the “job demands-resources” model was valid for foodservice workers, i.e., burnout was strongly predicted by job demands (β = 0.550; p < 0.001); job resources were a positive predictor of work engagement (β = 0.258; p < 0.001); and burnout was a negative predictor of work engagement (β = −0.411; p < 0.001). Food safety violations were predicted by job crafting (β = −0.125; p = 0.029) and burnout (β = 0.143; p = 0.016). The results indicate that mitigating burnout and increasing job crafting can be important supporting strategies to improve food safety behaviors.

Development, Validation, and Testing of a Self-Assessment Tool to Measure Food Safety Beliefs, Attitudes, and Behaviors in Health Care Food Service Operations

ABSTRACT

The neutropenic diet has long been a dietary prescription for immunocompromised patients. However, its effectiveness and consistency have been constantly challenged. Researchers and health care policymakers call for liberalization of the neutropenic diet, which shifts risk management strategies from excluding "high-risk" food items to focus on safe food handling. The responsibility of food safety falls on food service workers in a health care setting. The objective of the present study was to develop and conduct psychometric testing to determine the validity and reliability of a self-assessment survey instrument tool targeting beliefs, attitudes, and behaviors of health care food service workers regarding safe food handling practices. This survey validation study was conducted in four phases. First, the tool was developed based on the Theory of Planned Behavior. After the initial draft, the survey was tested to establish face validity and test-retest reliability to measure temporal stability. The 40-item survey was then pilot tested to assess internal consistency and construct validity. Pilot testing was conducted over a 16-month period on 211 health care food service workers across six acute care hospitals that serve immunocompromised people. The original survey comprised 46 items. Six items were removed due to low content validity scores and temporal instability. Pilot testing revealed acceptable internal consistency (Cronbach's alpha = 0.79). The linear regression model was a good fit (P ≤ 0.0001) after assumptions were tested and met to predict behavior from attitude. A reliable and valid self-assessment survey instrument tool was developed for use in a health care food service operation. Results of this tool can help organizations pinpoint areas in which they can improve food safety practices of food service workers who serve immunocompromised people.

HIGHLIGHTS

An Evaluation of the Hygiene Practices of Polish Street Food Vendors in Selected Food Trucks and Stands

Today, street food vending is becoming a dynamically developing food industry in Europe, including Poland. Lifestyle changes and socioeconomic factors, especially among young consumers, make it a convenient food alternative, even in countries without this tradition. The aim of the study was to evaluate hygiene conditions and practices in selected street food facilities in Poland. The study was carried out in accordance with an observation checklist developed on the basis of the hygienic requirements of the European Union. The study covered 550 randomly selected street food vendors in Poland in 10 cities. The hygiene of street food outlets was assessed in three aspects: ensuring proper production conditions, hygiene of production and distribution, and hygiene of personnel. The evaluation of street food outlets showed that the level of hygiene was not fully acceptable. A small percentage of the examined objects satisfactorily fulfilled the requirements of the production conditions, production and distribution hygiene, and staff hygiene. The proposed hygienic checklist for quick daily monitoring of street food outlets can be used to perform internal and external inspections. It seems that specific codes of conduct for European street foods facilities are necessary.

The use of food delivery apps during the COVID-19 pandemic in Brazil: The role of solidarity, perceived risk, and regional aspects

This study aimed to evaluate the use of food delivery apps (FDA) during the COVID-19 pandemic in Brazil. A total of 950 questionnaires were collected, covering four Brazilian regions: Southeast, Central-West, Northeast, and South. The data was collected during the peak of the second wave of the pandemic. A questionnaire with 39 measurement items was applied using an online survey. These items were evaluated using a five-point Likert scale covering the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2). The data was analyzed using covariance-based structural equation modeling. About 47% of consumers use FDA weekly. The continuance intention of FDA during the pandemic in Brazil was affected by performance expectancy (β = 0.496; p < 0.001), social influence (β = 0.094; p < 0.001), hedonic motivation (β = 0.068; p = 0.026), price value (β = 0.103; p < 0.001), habit (β = 0.305; p < 0.001), frequency of using FDA (β = 0.051; p = 0.039), and solidarity with the foodservice sector (β = 0.090; p < 0.001). It was also observed that the continuance intention reduces risk perception (β = −0.403; p < 0.001), and risk perception reduces the frequency of using FDA (β = −0.178; p < 0.001). The results indicate that the UTAUT2 strongly explains consumers’ continuance intention. Differences in path estimates among Brazilian regions were observed, indicating some regional differences. It was possible to observe a tendency of using FDA during and after the pandemic, motivated by several factors. The FDA developers and foodservice managers could use this data to improve their services. Policies must be established to increase consumer and employee safety during the delivery service.

Should I stay, or should I go? Consumers' perceived risk and intention to visit restaurants during the COVID-19 pandemic in Brazil

This study aimed to verify how consumers’ intention to visit restaurants during the pandemic is affected by consumers’ risk perception and different types of trust. The sample was composed of 546 consumers from 89 different cities in Brazil. An adapted 43 items questionnaire with 5-point scales was administered, and analyzed using structural equation modeling. The results indicate that consumers' trust in a restaurant and brand, fair price, solidarity with the restaurant sector, disease denial, and health surveillance trust predict intention to visit a restaurant during the COVID-19 pandemic. Age has significant moderated effects, reducing disease denial effects. The trust in restaurants and brands was the factor with the largest effect size. In a multigroup analysis, it was found that solidarity with the sector does not affect the intention to visit restaurants for consumers without formal work. It is discussed the implications of an increased consumers' risk perception, directly affecting their intentions. Special attention to consumers’ trust and fair price perception is fundamental, given consumers’ solidary inclination toward helping the restaurant sector. These aspects must be recognized by restaurant owners and managers to be improved and be used to attract consumers.

An Integrative Review of Hygiene Practice Studies in the Food Service Sector

ABSTRACT

This article reviews the recent literature on studies relevant to hygiene practices of food service workers. A total of 32 articles were chosen for evaluation from a systematic search of the published literature from 2014 to 2019. For the assessment of hygiene practices, hand washing as a measurement item and observation as a method were most frequently used. Factors influencing hygiene practices were categorized as internal and external variables. Internal variables included knowledge; psychological factors, such as attitude, risk perception, self-efficacy, and optimistic bias; and food handlers' sociodemographic characteristics, such as work experience and exposure to hygiene training. External variables included characteristics of food premises, such as the size of the operation and number of people served, and organizational factors, such as training. Regarding the recent training literature, attempts to bring in new methodologies and new technologies were found, such as multimedia case studies, cognitive word association, behavior-focused training, wearable technology, and simulation games. Among the theories utilized, knowledge, attitude, and practices were applied most frequently to explain hygiene practices. In particular, this review highlights the important fact that internal and external factors that affect hygiene practices should be considered to maintain good hygiene practices.

HIGHLIGHTS

The role of Optimistic Bias in safe food handling behaviours in the food service sector

This study evaluates the influences on food handlers' intention to conduct safe handling behaviours in food service settings in Brazil and the United Kingdom, focusing on Optimistic bias (OB). Although OB has been identified in food handlers in other studies, this is the first study evaluating the role of OB in determining behavioural intention. Three hundred participants, from the United Kingdom (n = 150) and Brazil (n = 150), completed a Theory of Planned Behaviour - based questionnaire, including additional questions about OB. For Brazilian food handlers, Attitude had a significant influence on Behavioural Intention followed by Subjective Norm, while Perceived Behavioural Control and OB did not significantly influence Behavioural Intention. For the United Kingdom, Perceived Behavioural Control had the largest influence, followed by Attitude, and then OB. Results suggest that cultural differences may influence predictors of behavioural intention, and that OB can contribute to predicting engagement in safe handling behaviours. Results contribute to a better understanding of the influences on food safety related behaviours.

The Effect of Food Handler Certification on Food Premises in Ontario, Canada

Although health units have implemented food handler certification to operators of food premises, evidence on its effectiveness to improve premise food safety remains inconclusive. Regression models were constructed using inspection data from a health unit in Ontario, Canada, to measure the effect of certification on premise inspection results. We found that premises without certified food handlers at the time of inspection were significantly more likely to fail inspections. The odds of inspection failure were significantly different depending on the premise's cultural cuisine classification. Independently owned establishments had lower odds of inspection failure versus chain operations. Inspector was a significant random effect explaining a small percentage of data variations. These results support the use of food handler certification to improve food safety outcomes at establishments. Further efforts should ensure training programs are accessible and relatable to premise operators, particularly those serving all types of cultural cuisines.

Hygiene and humanization: Breaking the traditional view of food safety

Despite efforts at various levels, foodborne diseases are an extremely relevant global public health issue. This letter emphasizes the differences between the hygienist approach and the concept of sanitary risk in order to stimulate insights for researchers and decision-makers on the necessary changes in the working, training, and education modes of all agents involved in food production in the face of the new and old challenges in the food safety field.

The differences between observed and self-reported food safety practices: A study with food handlers using structural equation modeling

Every year, studies about food handlers' food safety knowledge, attitudes, and practices are published. Some results of these papers have been rather controversial, especially those related to food safety practices. The two most common methods for evaluating food safety practices - self-assessment and observation - are generally treated as interchangeable, but they can have different meanings. The objective of this study was, therefore, to differentiate between the observed and self-reported food safety practices of food handlers, verifying the effect of different variables in these food safety indicators through structural equation modeling, and examining the relationship between cognitive factors and these practices. A questionnaire with 37 questions was given to 183 food handlers to evaluate their food safety knowledge, attitudes, self-reported practices, and risk perceptions. For the observed assessment method of evaluating the food handlers' practices (observed practices), a checklist was developed, and food handlers were observed during one workday. Two models were developed based on the results of these two assessment methods. In the first model a significant positive effect of knowledge and a negative effect of risk perception on self-reported practices were observed. Food handlers with high risk-perception about their practices reported less adequate practices. Positive food safety attitudes acted as a moderator dampening the positive effect between knowledge and self-reported practices. In the second model a significant positive effect of knowledge on observed practices. Attitudes strengthened the positive effect between knowledge and observed practices. On the other hand, a direct effect of attitude on observed practices was not observed. In conclusion, self-reported practices and observed practices are different and should be used and discussed properly.

Knowledge and risk perceptions of foodborne disease by consumers and food handlers at restaurants with different food safety profiles

Food handlers and consumers are responsible for avoiding foodborne diseases (FBD). Considering the meals consumed away from home, can the consumer identify the FBD risk level of the food that he/she consumes in restaurants? This study aimed to evaluate the knowledge, risk perception, and optimistic bias of food handlers and consumers of restaurants and the relationship of these variables with the FBD risk of these establishments. Sixty-four handlers and 265 consumers of 14 restaurants in the city of Limeira - São Paulo, Brazil participated in the study. A validated checklist was used to evaluate the food safety profile of restaurants with a score ranging from zero to 2565.95. A structured questionnaire was employed to assess knowledge of food safety and the risk perception of FBD. The food handlers indicated their own risk and their peers' risk of causing a FBD. Consumers evaluated their own risk and the risk of their peers of contracting a FBD after making their own meals, consuming meals at the studied restaurants and consuming meals in other food establishments. The answers were based on a structured scale with seven options. The difference between their risk perception levels (risk attributed to itself and to a peer) indicated the optimistic bias of FBD risk. The mean food safety risk score of the food service establishments was 105.51. The restaurants were classified into two groups, higher or lower FBD risk. The mean score of knowledge (percentage of correct answers) of food safety was 61.7% for handlers and 59% for consumers, showing a nonsignificant difference (p = .29). Both food handlers and consumers stated that they were less at risk for FBD than their peers (p < .001). A direct effect of consumers' optimistic bias on food service FBD risk was observed through multivariate analysis. Optimistic bias may lead consumers to choose restaurants with a higher FDB risk. A direct negative effect of food handlers' knowledge of food service FBD risk was observed. These results show that consumers may have incorporated a sense of affection and identity to a place, associating it with making their own meals at home. Therefore, the consumer may not differentiate restaurants with regard to food safety. This result reinforces the need for governments and health agencies to protect the health of the population.

Food safety in Brazilian popular public restaurants: Food handlers' knowledge and practices

This study aims to assess food safety knowledge and practices of food handlers in popular public restaurants in Brazil. A questionnaire has been applied with 70 food handlers in different municipalities, with questions related to food safety knowledge and food safety self-reported practices, and observed practices. To check hygienic-sanitary conditions of restaurants, a checklist has been applied. Regarding food safety knowledge, an average of 72.64% of correct answers has been observed. Food safety self-reported practices presented 80.71% of adequacy, while observed practices were 75.40%. A positive correlation has been observed between food safety knowledge and self-reported practices of handlers. The observed food safety practice of handlers presented no correlation with food safety knowledge and self-reported practices. The average adequacy of hygienic-sanitary conditions was 68.08%, classifying the units as "regular." Despite satisfactory results related to the handlers' food safety knowledge and practices, the hygienic-sanitary conditions of the restaurants are of concern.

PRACTICAL APPLICATIONS

The Popular Restaurant Program in Brazil aims to provide proper food from a nutritional and hygienic-sanitary aspect at affordable prices. The assessment of food handlers' food safety knowledge and practices and the assessment of hygienic-sanitary conditions of these units are key in supporting actions aimed at improving the quality of the meals served, as food handlers are the essential agents in the production of meals and can become a source for food contamination if necessary care is not taken. Therefore, conducting this assessment can be an important tool for quality management in these units and can provide improvements in the process of food handling, in addition to ensuring compliance with the objectives proposed by the Popular Restaurant Program.