Identification and classification of consumer food-handling behaviors for food safety education

Objective To identify key behaviors associated with major food safety pathogen control factors. Design World Wide Web-based descriptive study with 4 tasks: compile a list of food-handling behaviors from the literature; use Delphi process to build consensus, rank order, and edit lists of behaviors; assess content and construct validity; and review results of Delphi process at a summit meeting of selected experts to make final recommendations for a food safety behavior list. Subjects/setting A convenience sample of 10 epidemiologists, 11 food microbiologists, 10 food safety educators, and 10 food safety policy makers was recruited from lists of nationally known experts. Twenty-four experts completed 4 rounds of surveys presented to them via a Web site. Six experts attended a face-to-face meeting to finalize behavior lists. Statistical analyses performed Descriptive statistics and sum of observation data were used to determine rank order and validity. Results Twenty-nine key food-handling behaviors for maintaining the safety of food and reducing the number of cases and outbreaks of foodborne illness were identified. These were rank-ordered within 5 pathogen control factors: practice personal hygiene, cook foods adequately, avoid cross-contamination, keep foods at safe temperatures, and avoid foods from unsafe sources. Applications/conclusions Thus list of rank-ordered behaviors grouped by pathogen control factor should help dietitians and educators confidently teach food safety, guidance that will be most effective in preventing illness.