Moving Forward to the Future: A Review of Microbial Food Safety Education in China

Knowledge, attitude, and practice toward foodborne disease among Chinese college students: a cross-sectional survey

Background

More than 200 diseases are caused by eating food contaminated and the burden of foodborne disease is considered to be high worldwide. Foodborne diseases are an important public health issue, and the knowledge, attitudes and practices among college students are crucial in preventing outbreaks.

Objective

This study aimed to evaluate the current knowledge, attitudes, and practices (KAP) toward foodborne diseases among Chinese college students and to identify the factors influencing practice actions.

Methods

A cross-sectional study was conducted from April to November in 2023. A cluster random sampling method was used to enroll participants at Xihua University. The questionnaire including 47 items was used to collect the foodborne diseases information. An offline questionnaire was used to generate the surveys. Multiple linear regression was used to analyze the factors associated with foodborne disease knowledge, attitudes and practices.

Results

A total of 445 college students with a mean age of 19.76 ± 1.24 years were included in the study. The majority of participants were female (59.1%), of Han Chinese (95.1%), and nearly two-thirds were lower-year undergraduates (66.7%). Most participants (78.9%) were non-medical students, and 64.7% of participants were from rural areas. The KAP score of foodborne diseases was 79.21 ± 6.84. The knowledge, attitudes, and practices scores toward foodborne diseases were 8.76 ± 0.95, 10.50 ± 1.63, and 59.94 ± 6.48, respectively. In particular, there was a notable decrease in practice scores toward foodborne diseases among male students, ethnic minority students, and non-medical students. The significant predictors of practices were included gender (β = 0.11, p < 0.05), nationality (β = -0.12, p < 0.05), specialization type (β = -0.13, p < 0.05), residence (β = -0.11, p < 0.05).

Conclusion

These results revealed gaps in knowledge, attitudes, and practices regarding foodborne diseases, and the knowledge was at an insufficient level, the attitude was positive and practice was at a moderate and acceptable level. In general, the level of KAP was at a moderate and acceptable level. Gender, nationality, education level, specialization type, and residence were identified as crucial influencers on practices toward foodborne diseases. It is necessary to provide foodborne disease health education targeting this population in western areas, which can help improve students' knowledge, attitudes, and practices.

Combating foodborne disease through household food handling behavior improvement: A comparison between education and price interventions

Foodborne disease cases are increasingly occurring in home kitchens because of improper food handling behavior. Human factors are considered major determinants of such behavior, although economic factors, which have attracted little attention, may also be important influencers. Taking the service time of kitchen towels as an example, we construct a theoretical model to analyze food handling behavior under an economic framework and empirically explore its economic determinants. Empirically, we use a randomized controlled trial (RCT) coupled with pre- and postsurveys in rural China. The RCT intervention includes information with tips for proper kitchen towel use and in-kind subsidies of one, two, or three packs of kitchen towels, which is regarded as a price intervention. We find that information alone and information plus one pack of towels are not enough to stimulate behavior improvement, whereas information plus two or three packs is sufficient. This implies that the quantity of kitchen towels used increases only as the towel price drops below a certain threshold. As an early attempt, we indicate that food handling behavior is economically driven, suggesting that a well-designed policy should combine educational campaigns and appropriate economic incentives to improve such behavior to reduce the risk of foodborne disease.

Status and associated factors of food and nutrition literacy among young adults aged 15-44 years in Shenzhen City, China

Background

Food and nutrition literacy (FNL) plays an important role in young adults' dietary habits and nutrition. This study aimed to investigate FNL status and its associated factors among young adults aged 15-44 years in Shenzhen.

Methods

A cross-sectional survey of 5,390 participants was conducted in June 2021. FNL was measured using the Food and Nutrition Literacy Questionnaire for Chinese Adults (FNLQ). A generalized linear model was employed to analyze the factors associated with FNL.

Results

The median FNL score (total score = 100) was 68.00, which was below the adequate level of 80. FNL was divided into the two different domains of knowledge and skills, with significantly different scoring rate of 85.30 and 67.77%, respectively. The overall proportion of respondents with adequate FNL was 19.52%. The FNL score was significantly higher among the participants who were female (β = 2.665; 95% confidence interval [CI]: 2.031-3.299) and with higher education levels (β ranging from 5.632 [CI: 3.845-7.419] to 10.756 [CI: 8.973-12.538]), healthcare-related work experience (β = 4.197; CI: 3.557-4.837) and a higher economic status (β ranging from 0.753 [CI: 0.079-1.426] to 6.217 [CI: 5.208-7.227]). Those who were divorced or with an unknown marital status (β = -8.438; CI: -9.701, -7.175), abnormal body mass index (thin [β = -2.115; CI: -3.063, -1.166], overweight [β = -1.427; CI: -2.254, -0.600]), and suffering from chronic diseases (single disease [β = -3.483; CI: -4.485, -2.480], multimorbidity [β = -5.119; CI: -5.912, -4.327]) had significantly lower FNL scores.

Conclusion

Generally, the level of FNL among young adults in Shenzhen, China, was relatively low. Thus, nutrition education programs targeted at promoting improved FNL status call for additional emphasis, especially in subgroups with lower scores.

Effects of Governmental Intervention on Foodborne Disease Events: Evidence from China

Foodborne disease events (FDEs) endanger residents’ health around the world, including China. Most countries have formulated food safety regulation policies, but the effects of governmental intervention (GI) on FDEs are still unclear. So, this paper purposes to explore the effects of GI on FDEs by using Chinese provincial panel data from 2011 to 2019. The results show that: (i) GI has a significant negative impact on FDEs. Ceteris paribus, FDEs decreased by 1.3% when government expenditure on FDEs increased by 1%. (ii) By strengthening food safety standards and guiding enterprises to offer safer food, government can further improve FDEs. (iii) However, GI has a strong negative externality. Although GI alleviates FDEs in local areas, it aggravates FDEs in other areas. (iv) Compared with the eastern and coastal areas, the effects of GI on FDEs in the central, western, and inland areas are more significant. GI is conducive to ensuring Chinese health and equity. Policymakers should pay attention to two tasks in food safety regulation. Firstly, they should continue to strengthen GI in food safety issues, enhance food safety certification, and strive to ensure food safety. Secondly, they should reinforce the co-governance of regional food safety issues and reduce the negative externality of GI.