Understanding the Underlying Psychosocial Determinants of Safe Food Handling among Consumers to Mitigate the Transmission Risk of Antimicrobial-Resistant Bacteria

Development and assessment of an immobilized bacterial alliance that efficiently degrades tylosin in wastewater

Microbial degradation of tylosin (TYL) is a safe and environmentally friendly technology for remediating environmental pollution. Kurthia gibsonii (TYL-A1) and Klebsiella pneumonia (TYL-B2) were isolated from wastewater; degradation efficiency of the two strains combined was significantly greater than either alone and resulted in degradation products that were less toxic than TYL. With Polyvinyl alcohol (PVA)-sodium alginate (SA)-activated carbon (AC) used to form a bacterial immobilization carrier, the immobilized bacterial alliance reached 95.9% degradation efficiency in 1 d and could be reused for four cycles, with > 93% degradation efficiency per cycle. In a wastewater application, the immobilized bacterial alliance degraded 67.0% TYL in 9 d. There were significant advantages for the immobilized bacterial alliance at pH 5 or 9, with 20 or 40 g/L NaCl, or with 10 or 50 mg/L doxycycline. In summary, in this study, a bacterial consortium with TYL degradation ability was constructed using PVA-SA-AC as an immobilized carrier, and the application effect was evaluated on farm wastewater with a view to providing application guidance in environmental remediation.

How Perspectives on Food Safety of Vendors and Consumers Translate into Food-Choice Behaviors in 6 African and Asian Countries

Background

Consumption of unsafe foods increases morbidity and mortality and is currently an issue, particularly in low- and middle-income countries. Policy actions to ensure food safety are dominated by mitigation of biological and chemical hazards through supply-side risk management, lessening the degree to which consumer perspectives of food safety are considered.

Objectives

This study aimed to provide an in-depth understanding, from vendor and consumer perspectives, of how food-safety concerns of consumers translate into their subsequent food-choice behaviors in 6 diverse low- and middle-income countries.

Methods

Six Drivers of Food Choice projects (2016-2022) provided transcripts from 17 focus group discussions and 343 interviews conducted in Ghana, Guinea, India, Kenya, Tanzania, and Vietnam. Qualitative thematic analysis was used to identify emerging themes important to food safety.

Results

The analysis suggests that consumers constructed meaning about food safety through personal lived experience and social influences. Community and family members contributed knowledge about food safety. Concerns about food safety were influenced by reputations of and relationships with food vendors. Consumers' mistrust of food vendors was amplified by purposeful adulteration or unsafe selling practices and new methods used to produce food. Moreover, consumers were reassured of food safety by positive relationships with vendors; meals cooked at home; implementation of policies and following regulations; vendor adherence to environmental sanitation and food-hygiene practices; cleanliness of vendors' appearance; and vendors' or producers' agency to use risk mitigation strategies in production, processing, and distribution of food.

Conclusions

Consumers integrated their meanings, knowledge, and concerns about food safety to achieve assurance about the safety of their foods when making food-choice decisions. The success of food-safety policies hinges on consideration of consumers' food-safety concerns in their design and implementation, alongside actions to reduce risk in food supply.

Tailoring Can Improve Consumers’ Hygienic Food-Handling Behavior to Reduce the Transmission Risk of Antimicrobial-Resistant Bacteria through Food

Antimicrobial-resistant (AMR) bacteria spread via food to humans and can seriously impair infection treatment. Hygienic food handling is an effective measure to avoid the transmission of bacteria. Therefore, we tested three types of interventions (tailored, generic, and no intervention) for their effectiveness in improving consumers’ hygienic food handling against the spread of antimicrobial-resistant bacteria through foods in a longitudinal randomized control trial. We based the determinants of hygienic food-handling behavior on the Health Action Process Approach (HAPA). The tailored intervention raised self-reported hygienic food handling, self-efficacy, and perceived likelihood of risk compared to no intervention. Moreover, interventions yielded different effects for participants with high vs. low intentions to improve their food-handling behavior. However, there were no differences between the tailored and generic interventions. More research is needed to find out whether including other behavior change techniques in the tailored intervention may increase the effect of tailoring.

Understanding safe water-carrying practices during pregnancy and postpartum: A mixed-methods study in Nepal

Daily carrying of heavy loads of domestic water, especially during pregnancy and postpartum, bears a threat to maternal health in low‐income countries. Using an extended health action process approach (HAPA), we examined women's reasons for and psychosocial determinants of safe water‐carrying during pregnancy and postpartum. In a mixed‐methods study, trained local interviewers conducted 1001 quantitative interviews with women of reproductive age (n = 921 analyzed) and 21 qualitative interviews with women of reproductive age, in‐laws, and spouses in rural Nepal. We analyzed the quantitative data with generalized estimating equations to model the HAPA‐based psychosocial determinants of avoiding water‐carrying during pregnancy and postpartum. Subjective perspectives were investigated with thematic analysis. Outcome expectancies (B = 0.24), self‐efficacy (B = 0.20), and injunctive norms (B = 0.23) were significantly associated with the intention to avoid water‐carrying. Self‐efficacy (B = 0.36) and instrumental support (B = 0.05) are related to behavior (all p < 0.05). Women explained water‐carrying during pregnancy by a lack of family support, a shift of health decision‐making power to in‐laws, and low behavioral control. Overall, the necessity of water, family decision‐making structures, and low support make it difficult for women to discontinue water‐carrying. Additionally to infrastructural improvements, behavioral interventions may increase women's self‐efficacy for safe water‐carrying (e.g. reducing weight) and social support.

Antimicrobial-resistant bacteria in food: which behaviour change strategies increase consumers' risk awareness and preventive food-handling behaviour?

OBJECTIVES

We aimed to identify the potential of behaviour change strategies to effectively increase consumers' risk awareness, behavioural intention, and preventive food-handling behaviour to reduce the transmission risk of antimicrobial-resistant bacteria through food. The applied strategies targeted knowledge and determinants of the health action process approach (HAPA). We tested techniques that are expected to increase knowledge, risk perception, and positive outcome expectancy (Study 1) as well as those that increase planning and coping self-efficacy (Study 2) in two randomised control trials.

METHODS

In Study 1 (N = 328), a 2 × 2 between-subject design was employed to investigate the effects of an educational video about the spread of antimicrobial-resistant bacteria and a personalised risk message on knowledge, risk perception, outcome expectancy and consequently on intention regarding safe food-handling behaviour. In Study 2 (N = 129), we used a 2 × 2 design to examine to what extent goal setting (implemented vs. not implemented) and time (pre- vs. post-test) affected planning, coping self-efficacy, and preventive food-handling behaviour.

RESULTS

In Study 1, we found that the video increased knowledge and the perceived susceptibility of risk compared to the control video. We found no increase on the dependent variables after receiving the personalised risk message. In Study 2, goal setting significantly improved safe food-handling behaviour compared to the control condition. Moreover, participants in the goal-setting condition showed more planning of safe food-handling measures and of dealing with emerging barriers than participants in the control condition.

CONCLUSIONS

These findings demonstrate that the delivery of an educational video on the spread of antimicrobial-resistant bacteria is a useful strategy to increase risk awareness, whereas goal setting presents a promising approach to improve food-handling behaviour. Following the HAPA, an additional effective behaviour change technique is required that decreases negative outcome expectancies and improves coping self-efficacy, thereby further improving intention and behaviour.

Global Trends in Antimicrobial Use in Food Animals from 2017 to 2030

Demand for animal protein is rising globally and has been facilitated by the expansion of intensive farming. However, intensive animal production relies on the regular use of antimicrobials to maintain health and productivity on farms. The routine use of antimicrobials fuels the development of antimicrobial resistance, a growing threat for the health of humans and animals. Monitoring global trends in antimicrobial use is essential to track progress associated with antimicrobial stewardship efforts across regions. We collected antimicrobial sales data for chicken, cattle, and pig systems in 41 countries in 2017 and projected global antimicrobial consumption from 2017 to 2030. We used multivariate regression models and estimated global antimicrobial sales in 2017 at 93,309 tonnes (95% CI: 64,443, 149,886). Globally, sales are expected to rise by 11.5% in 2030 to 104,079 tonnes (95% CI: 69,062, 172,711). All continents are expected to increase their antimicrobial use. Our results show lower global antimicrobial sales in 2030 compared to previous estimates, owing to recent reports of decrease in antimicrobial use, in particular in China, the world's largest consumer. Countries exporting a large proportion of their production are more likely to report their antimicrobial sales data than countries with small export markets.