Compelling food safety messaging

I am always fascinated with the garbage hygiene/food safety messaging that I come across during my travels. The same boring food safety posters over and over again and yet there they are, plastered on the wall doing absolutely nothing. Have we lost complete creativity or are some organizations convinced these actually work?  They don’t, they are not compelling and people are not going to pay attention.  The intention is admirable but we need to do better.

Ben and Doug devised infosheets as a means to grasp people’s attention and these were tested for validity and work. We are striving to develop Barfblog TV using comedy and behavioral science to convey messaging which could also potentially be used for corrective action plans or monthly food safety messaging at the retail level. The possibilities are endless, let’s be creative.

 

Cross-contamination at Jade Dragon Wok-Out leads to poor inspection

A couple of years I saw cross-contamination in the wild while sitting at a bar that faced an open kitchen. The was grilling and used the same tongs for raw and cooked (but not temped) burgers.

And placed the cooked burgers back on the same tray he used for raw patties.Screen Shot 2015-01-14 at 12.27.20 PM

I chatted with the manager and was assured that the burgers wouldn’t make it service.

Our food safety infosheet evaluation work showed that cross contamination was pretty prevalent (on average, one cross-contamination event per food handler, per hour).

And the Jade Dragon Wok-Out in Lawrenceville, GA, according to the Atlanta Journal-Constitution has an issue with cross-contamination.

During a recent inspection at Jade Dragon Wok-Out in Lawrenceville, an employee dipped a ladle that was contaminated by raw meat into a container of spices.

The spices were discarded, and points were deducted from the health score. Points were also taken off because raw shrimp were prepped next to broccoli without any separation.

Employees were performing multiple tasks using single-use gloves instead of changing the gloves and washing their hands, the inspector said. One employee touched raw meat then touched a ladle. Another touched raw egg then touched a utensil and a to-go container.

Good food safety interventions are evidence-based and evaluated

Food safety and public health folks are pretty good at writing proposals, getting funds to do research, and, because of a funder’s requirement, sometimes add on an outreach throwaway activity to make something in the name of education.

Usually it is a brochure, or posters, or a website where the outputs are shared.

And they often suck.

I’m becoming more cynical as I get older and increasingly frustrated with how slow things progress. At one of my first IAFP meetings a decade ago I sat through a 3-hour session on cleaning and sanitation in processing environments and each speaker ended their talk with the same type of message – things would be better if we could just educate the staff, ritely stating it like it would be simple to in a 1-hr training session.

And no one mentioned evaluation.

There’s about 10,000 papers in the adult education, behavioral science and preventive health world that set the stage on how to actually make communication and education interventions that might work. The literature has some common tenants: know thy audience; have an objective; base your message on some sort of evidence; ground the approach in accepted theory and evaluate.

Unfortunately food safety professionals who are good at microbiology don’t usually consult it.

Young and colleagues from Canada recently published a paper in Foodborne Pathogens and Disease which provides an output of summarized packages of systematic reviews into one-and three page formats (abstract below).

The application of systematic reviews is increasing in the agri-food public health sector to investigate the efficacy of policy-relevant interventions. In order to enhance the uptake and utility of these reviews for decision-making, there is a need to develop summary formats that are written in plain language and incorporate supporting contextual information. The objectives of this study were (1) to develop a guideline for summarizing systematic reviews in one- and three-page formats, and (2) to apply the guideline on two published systematic reviews that investigated the efficacy of vaccination and targeted feed and water additives to reduce Salmonella colonization in broiler chickens. Both summary formats highlight the key systematic review results and im- plications in plain language. Three-page summaries also incorporated four categories of contextual information (cost, availability, practicality, and other stakeholder considerations) to complement the systematic review findings. We collected contextual information through structured rapid reviews of the peer-reviewed and gray literature and by conducting interviews with 12 topic specialists. The overall utility of the literature searches and interviews depended on the specific intervention topic and contextual category. In general, interviews with topic specialists were the most useful and efficient method of gathering contextual information. Preliminary evaluation with five end-users indicated positive feedback on the summary formats. We estimate that one-page summaries could be developed by trained science-to-policy professionals in 3–5 days, while three-page summaries would require additional resources and time (e.g., 2–4 weeks). Therefore, one-page summaries are more suited for routine development, while three-page summaries could be developed for a more limited number of high-priority reviews. The summary guideline offers a structured and transparent approach to support the utilization of systematic reviews in decision-making in this sector. Future research is necessary to evaluate the utility of these summary formats for a variety of end-users in different contexts.

While there’s a whole lot of information on how these summaries were designed – and that eight end-users were asked to participate in the development, there’s no mention of behavioral or education theory, why message and design choices were made or what they hoped the end users would do with them. And no evaluation at all.

Here’s how we’ve evaluated our food safety infosheets for a different user group, food handlers:

Assessment of Food Safety Practices of Food Service Food Handlers: Testing a Communication Intervention
June 2010, Journal of Food Protection

Abstract: Globally, foodborne illness affects an estimated 30% of individuals annually. Meals prepared outside of the home are a risk factor for acquiring foodborne illness and have been implicated in up to 70% of traced outbreaks. The Centers for Disease Control and Prevention has called on food safety communicators to design new methods and messages aimed at increasing food safety risk-reduction practices from farm to fork. Food safety infosheets, a novel communication tool designed to appeal to food handlers and compel behavior change, were evaluated. Food safety infosheets were provided weekly to food handlers in working foodservice operations for 7 weeks. It was hypothesized that through the posting of food safety infosheets in highly visible locations, such as kitchen work areas and hand washing stations, that safe food handling behaviors of foodservice staff could be positively influenced. Using video observation, food handlers (n ~ 47) in eight foodservice operations were observed for a total of 348 h (pre- and postintervention combined). After the food safety infosheets were introduced, food handlers demonstrated a significant increase (6.7%, P , 0.05, 95% confidence interval) in mean hand washing attempts, and a significant reduction in indirect cross-contamination events (19.6%, P , 0.05, 95% confidence interval). Results of the research demonstrate that posting food safety infosheets is an effective intervention tool that positively influences the food safety behaviors of food handlers. 

Food safety is not simple

If food safety is simple, why do so many get sick?

Because it’s not simple: it’s complex, constant, requires commitment and information must be compelling.

But as Americans delve into turkey gluttony and Australians break out the barbie, the number of inane stories about how food safety is simple proliferate.

Government, industry and academics continue to flog the food safety is simple line, despite outbreaks becoming increasingly complex and in the complete absence of any data that the message works.

We’ve shown that food safety stories can work.

Food safety story time: researchers find stories can help improve food safety behavior

I never thought Chapman would finish — his degree, his fantasy football, and especially this paper.

We’ve been talking about food safety stories since at least 2002. I knew from research done in the 1990s about food and dieting and the power of exemplars – personal examples to get people’s attention. Chapman dug into the literature and found references going back decades.

The storytelling approach has underpinned much of what we’ve done over the past seven years, including food safety infosheets and the posts in barfblog.com. Now we, along with our colleague Tanya MacLaurin of Guelph (who used to be at Kansas State, go figure) can say, see, these things work. And here’s how it’s done.

From the K-State press release this morning:

Food safety advice may fail because it’s too prescriptive — wash your hands, use a thermometer — and it often doesn’t include stories to make such information relevant. Researchers at North Carolina State University, Kansas State University and the University of Guelph have found that using short food safety stories with vibrant graphics can be a better training tool for food service workers.

A new paper by the researchers in the British Food Journal details the concept, creation and distribution of food safety infosheets, like those found at http://foodsafetyinfosheets.wordpress.com/. These single-page posters are created around a current food safety issue or outbreak, and are supplemented with graphics and information targeted at the food service industry. The infosheets are used to provide food safety risk-reduction information to generate behavior change and support a food safety culture.

"Food safety infosheets were designed with the goal of communicating risk reduction messages with the objective of changing behavior," said Ben Chapman, assistant professor in the department of 4-H youth development and family and consumer sciences at North Carolina State. "These infosheets differ from much of what is currently used in training, because we focus on the consequences of mishandling food by providing real examples taken from recent events."

A recent food safety infosheet detailed an outbreak of E. coli O157 linked to a festival in Winnipeg, Canada, that sickened 40. Another focused on food preparation and cooling for large crowds, sparked by an outbreak at a church turkey dinner in Kansas that sickened 159.

"Whether it’s a waitress, a line cook or the stock boy, people learn through stories," said Doug Powell, an associate professor of food safety at K-State. "We want to reach out to the last person who touched your food and make it safer."

Over the course of two years and using multiple methods, food safety infosheets transformed from a text-heavy memo to compelling, story-laden posters supported with contextual messages on what a food handler could do to reduce food safety risks, according to the researchers.

As part of the design phase of the infosheets, Chapman spent 185 hours working as a dishwasher in a local restaurant.

"We felt it was important to really immerse into the culture of a food handler, and get a better understanding of what types of conversations occurred and what the hierarchy was like," Chapman said. "The experience directed us to refocus our messages to be a bit edgier and include references to celebrity and music where possible."

Food safety infosheets at http://foodsafetyinfosheets.wordpress.com/ are created semi-weekly and are posted in restaurants, retail stores and on farms. They also are used in training throughout the world. Since September 2006 more than 150 food safety infosheets have been produced. They are available for download at no cost. The website has been recently redesigned, adding a search function, automatic e-mail alerts and RSS feeds. The new database is also sortable by pathogen, location and risk factor.

Citation and abstract:
Food safety infosheets: Design and refinement of a narrative-based training intervention
British Food Journal, Vol. 113 Iss: 2 (pre- print edition)
Benjamin Chapman, Tanya MacLaurin and Doug Powell
http://www.emeraldinsight.com/journals.htm?issn=0007-070x&volume=113&issue=2&articleid=1895862&show=abstract

Purpose – Despite extensive investments in food handler training, research suggests that training programs are inconsistent, and rarely evaluated for efficacy. The generic prescriptive content and school-like delivery methods used in current food safety training may be a barrier to application. The purpose of this research was to develop a food safety communication tool, food safety infosheets, targeted specifically to foodservice food handlers utilizing popular media stories to illustrate the consequences of poor food handling.

Design/methodology/approach – Food safety infosheets were designed to be surprising, connect food handlers’ actions and consequences, and generate discussion through a verbal narrative framework. A Delphi-like exercise (n = 19), a posting pilot (n = 8) were carried out to assess the appropriateness of the concept of food safety infosheets. An intense participatory ethnographic study with an Ontario, Canada restaurant, and in-depth interviews with food service operators in Manhattan, Kansas, and Lansing, Michigan (n = 17) were conducted to gather qualitative data on the food service kitchen environment, including barriers to food safety practices, and the communication preferences of those who work in such kitchens.

Findings – The expert group, foodservice operators, and food handlers accepted food safety infosheets as an appropriate concept and valued storytelling as an effective communication strategy. Learning in the kitchen environment is largely hands-on and visual, and time pressure dictates practices. It is often difficult to attract and keep the attention of food handlers. Storytelling, celebrity and local outbreaks are of interest to the target audience.

Originality/value – This research provides a blueprint for the design and refinement of food safety communication tools targeted towards a specific audience. By utilizing multiple methodologies, this article provides a framework for other researchers to follow.
 

Food safety stories can improve safety of restaurant meals

Contact: Dr. Doug Powell, dpowell@ksu.edu
785-317-0560
barfblog.com
bites.ksu.edu

Posting graphical, concise food safety stories in the back kitchens of restaurants can help reduce dangerous food safety practices and create a workplace culture that values safe food.

It’s the first time that a communication intervention such as food safety information sheets have been validated to work using direct video observation in eight commercial restaurant kitchens.

“The food safety messages we’ve looked at are as effective as those ‘Employees must wash hands’ signs in bathrooms.,” said Dr. Douglas Powell, an associate professor of food safety at Kansas State University and one of the co-authors on a new paper in the Journal of Food Protection. “They just don’t work.”

Powell and then graduate student, Ben Chapman, now an assistant professor of food safety at North Carolina State University, came up with the idea for food safety infosheets to promote discussion and improve food safety behaviors while playing hockey at the University of Guelph in 2003.

“Chapman and I were playing hockey a lot,” says Powell, “and there was a bar and restaurant that overlooked the one ice surface where we often engaged in after-hockey food safety meetings with our industry, provincial and federal government colleagues. We had all this food safety information, and the manager of the bar around 2003 was into food safety, so we thought, if daily sports pages are posted above urinals and on the doors of washroom stalls, why not engaging food safety information?”

As part of his PhD research, Chapman partnered with a food service company in Canada and placed small video cameras in unobtrusive spots around eight food-service kitchens that volunteered to participate in the study. There were as many as eight cameras in each kitchen, which recorded directly to computer files and later reviewed by Chapman and others.

The work built on other direct food safety observational studies conducted at Kansas State University and published in the British Food Journal in 2009.

Food safety inforsheets, highlighting the importance of handwashing or preventing cross-contamination, for example, were then introduced into the kitchens, and video was again collected. The researchers found that cross-contamination events decreased by 20 per cent, and handwashing attempts increased by 7 per cent.

Since September 2006 over 150 food safety infosheets have been produced and are available to anyone at www.foodsafetyinfosheets.com. The website has had a recent redesign, adding a search function, automatic email alerts and RSS feeds.

Katie Filion, who coded much of the video as an undergraduate student researcher, has moved from Canada and is now completing a Master’s degree with Powell at Kansas State University. She has just returned from a year of research with the New Zealand Food Safety Authority helping to design a national restaurant inspection disclosure system.

Dr. Tanya MacLurin, who collaborated on the research, was born on a farm/ranch in Kansas and received all her degrees from Kansas State University before joining the School of Hospitality and Tourism Management at the University of Guelph in 1991, where she subsequently collaborated with Powell.

The study, “Assessment of food safety practices of food service food handlers : testing a communication intervention” was authored by Dr. Ben Chapman of North Carolina State University, Dr. Douglas Powell and Katie Filion of Kansas State University, and Tiffany Eversley and Tanya MacLaurin of the University of Guelph in Canada. The study is published in the June issue of the Journal of Food Protection.

“Assessment of Food Safety Practices of Food Service Food Handlers: Testing a Communication Intervention”
Authors: Benjamin J. Chapman, North Carolina State University; Douglas A. Powell, Katie Fillion, Kansas State University; Tiffany Eversley, Tanya MacLaurin, University of Guelph
Published: June 2010, Journal of Food Protection

Abstract: Globally, foodborne illness affects an estimated 30% of individuals annually. Meals prepared outside of the home are a risk factor for acquiring foodborne illness and have been implicated in up to 70% of traced outbreaks. The Centers for Disease Control and Prevention has called on food safety communicators to design new methods and messages aimed at increasing food safety risk-reduction practices from farm to fork. Food safety infosheets, a novel communication tool designed to appeal to food handlers and compel behavior change, were evaluated. Food safety infosheets were provided weekly to food handlers in working foodservice operations for 7 weeks. It was hypothesized that through the posting of food safety infosheets in highly visible locations, such as kitchen work areas and hand washing stations, that safe food handling behaviors of foodservice staff could be positively influenced. Using video observation, food handlers (n ~ 47) in eight foodservice operations were observed for a total of 348 h (pre- and postintervention combined). After the food safety infosheets were introduced, food handlers demonstrated a significant increase (6.7%, P , 0.05, 95% confidence interval) in mean hand washing attempts, and a significant reduction in indirect cross-contamination events (19.6%, P , 0.05, 95% confidence interval). Results of the research demonstrate that posting food safety infosheets is an effective intervention tool that positively influences the food safety behaviors of food handlers.
 

Real Canadian hockey women drink beer to celebrate Olympics

The Canadian women’s hockey team celebrated their gold medal last night by returning to the ice after the television cameras went elsewhere to guzzle Molson Canadian beer, smoke cigars and compete in would-be drunk Zamboni driving contests.

I miss hockey.

The International Olympic Committee will be investigating, but the bonding displayed by the Canadian women is exactly what I imagine was going on last Friday as the aging Guelph professors’ hockey team finally broke the 5-year Powell curse and again won the annual faculty tournament, this time without me in net.

It’s been a week of nostalgia and new opportunities. Sold my house in Guelph (closes Tuesday) along with all the leftover crap and bad memories (after my friend Steve retrieves the good stuff this afternoon). Meanwhile, Chapman gave a talk in Dubai (see below) while I was giving a talk in New Zealand (by video) with students scattered around the globe and Amy about to embark on a year-long sabbatical. I like the global village stuff, with a solid base in Manhattan (Kansas).

Still miss hockey, especially the coaching.

Steve Keough, a spokesman for the Canadian Olympic Committee, said the COC had not provided the alcohol nor initiated the party, adding,

"In terms of the actual celebration, it’s not exactly something uncommon in Canada.”

After Jon Montgomery won a gold medal for Canada in skeleton, he walked through the streets of Whistler guzzling from a pitcher of beer that he gripped with two hands.

Beyond Food Inspections- What Motivates Food Businesses to Ensure Food Safety
22.feb.10
Dubai International Food Safety Conference
Ben Chapman
Inspection has historically been the most prevalent performance measurement used by the food service industry. It is assumed by many that achieving positive inspection results provide motivation to business operators to implement foodborne illness risk-reduction practices. In reality, there are other factors driving risk reduction including risk of being linked to an outbreak; poor reputation; and, the threat of litigation. Weekly food safety infosheets (www.foodsafetyinfosheets.com), focusing on motivating factors are used as a practice-changing tool by many firms in the retail and foodservice industry. Food safety infosheets have been designed to impact the actions of food handlers by utilizing four attributes culled from education, behavioural science and communication literature: surprising messages in communication; putting actions and their consequence in context; generating discussion within the target audiences’ environments and using verbal narrative, or storytelling, as a message delivery device. While many training packages exist, seldom are evaluated for behavior change impacts. Of those that are evaluated, the majority of evaluations are based on self-reported data which are wrought with problems of reliability and literature shows that while food handlers may report the intent to perform safe food handling practices, actions are not always realized. Given the discrepancies between inspection results, individuals’ recall and actual behaviours, a focus on the results of observational studies will be provided. This workshop will provide you with tools to help identify and manage food safety risks in food service and support a culture of food safety in your business.

bites barfblog and food safety: information procedures

People often ask me, “Doug, how do you choose the information that goes in bites.ksu.edu? Do you have a basis for any of your food safety rants on barfblog? Why are you such a jerk?

People often ask Ben, “Why do you write so much about vomit?”

People often ask Amy, “Why are you with Doug?”

When we ran the food safety information centre back in Canada, we had detailed procedures for how to answer questions, what information was provided and why. We don’t answer questions so much anymore, but we do provide a lot of information so I figured we better clearly understand what we do and why. This is more for us and all the students that come through my lab than it is for you. Really, it’s me, not you.

bites.ksu.edu is a unique comprehensive resource for all those with a personal or professional interest in food safety. Dr. Powell of Kansas State University, and associates, search out credible, current, evidence-based information on food safety and make it accessible to domestic and international audiences through multiple media. Sources of food safety information include government regulatory agencies, international organizations such as the World Health Organization (WHO) and the Food and Agriculture Organization of the United Nations (FAO), peer-reviewed scientific publications, academia, recognized experts in the field and other sources as appropriate.

Throughout all bites activities, the emphasis is on engaging people in dialogue about food-related risks, controls and benefits, from farm-to-fork. bites strives to provide reliable, relevant information in culturally and linguistically appropriate formats to assist people in identifying, understanding and mitigating the causes of foodborne illness.

bites LISTSERV
The bites.ksu.edu listserv is a free web-based mailing list where information about current and emerging food safety issues is provided, gathered from journalistic and scientific sources around the world and condensed into short items or stories that make up the daily postings. The listserv has been issued continuously since 1995 and is distributed daily via e-mail to thousands of individuals worldwide from academia, industry, government, the farm community, journalists and the public at large.

The listserv is designed to:

•    convey timely and current information for direction of research, diagnostic or investigative activities;
•    identify food risk trends and issues for risk management and communication activities; and
•    promote awareness of public concerns in scientific and regulatory circles.

The bites listserv functions as a food safety news aggregator, summarizing available information that can be can be useful for risk managers in proactively anticipating trends and reactively address issues. The bites editor, Dr. Powell, does not say whether a story is right or wrong or somewhere in between, but rather that a specific story is available today for public discussion.

barblog.com

barfblog.com is where Drs. Powell, Chapman, Hubbell and assorted food safety friends offer evidence-based opinions on current food safety issues. Opinions must be evidence-based – with references – reliable, rapid and relevant. The barfblog authors edit each other – viciously.

TWITTER
Breaking food safety news items that eventually appear in bites or barfblog are often posted on Twitter for faster public notification.

INFOSHEETS
Food safety infosheets are designed to influence food handler practices by utilizing four attributes culled from education, behavioral science and communication literature:

•    surprising and compelling messages;
•    putting actions and their consequence in context;
•    generating discussion within the target audiences’ environments; and
•    using verbal narrative, or storytelling, as a message delivery device.

Food safety infosheets are based on stories about outbreaks of foodborne illness sourced from the bites listserv. Four criteria are used to select the story: discussion of a foodborne illness outbreak; discussion of background knowledge of a pathogen (including symptoms, etiology and transmission); food handler control practices; and emerging food safety issues. Food safety infosheets also contain evidence-based prescriptive information to prevent or mitigate foodborne illness related to food handling. And now, available in French, Spanish and Portuguese.

bites bistro videos
A nod to the youtube generation, but we don’t really know what we’re doing.

NEHA 2009 Annual Educational Conference training showcase materials

I’m in Atlanta for the National Environmental Health Association’s Educational Conference.

At 1pm today I’ll be presenting during the Food Safety Training Showcase (Courtland Rm at the Hyatt Regency Atlanta for those of you who are in town).

You can find the materials I’ll be presenting at bites.ksu.edu/NEHA2009.

Managing food safety at convenience stores

I didn’t know C-store was short for convenience store – the kind at street corners and attached to gas stations. But that’s what you learn when you read Dean Dirks.

Dean says:

• In your weekly newsletters or communications with employees, post articles about other retailer’s misfortunes or law suits. The point isn’t to smear other retailers but to keep the fear in the minds of your team. Don’t let associates go a day without thinking about it. (check out our weekly food safety infosheets and subscribe for the free electronic distribution)

• Require your district managers, store managers and foodservice managers to become ServeSafe certified.

• Develop food safety audits to be completed daily at the store level and have regular audits completed at the district level. Record temperatures of refrigeration and product every four hours, date and rotate products, constant hand washing to name a few. All foodservice professionals know what needs to be done and inspected. The question being, are you doing it?

• Develop a food borne illness reporting procedure. Have a form on site that collects only contact information and train your associates to never comment other than to take the information. In addition, make sure the customer is given the corporate office’s contact information.

• Make it a policy that only the food service director or vice president (senior management) follows up on the call to the customer.

• If more than three customers call with the same symptoms then you legally have a food borne outbreak. The next step is to get the County Health Department involved. The worst thing you can try to do is hide it.

And as Sheetz discovered in a 2004 outbreak of Salmonella that sickened over 400 and was linked to tomatoes in ready-to-eat sandwiches, know your suppliers.