EAL

MHFS: Food Safety (2012-2013)

Citation:

Study Design:

Class:

- Click here for explanation of classification scheme.

Quality Rating:

Research Purpose:

The purpose of the study was to investigate the awareness of selected Jamaican consumers to food safety issues using a household survey and to examine whether socio-economic status and gender had any effect on the level of food safety awareness observed.

Inclusion Criteria:

Written informed consent provided
120 households (40 from each socio-economic group of low, medium or high) were surveyed
Respondents were adults over the age of 18.

Exclusion Criteria:

Not described.

Description of Study Protocol:

Recruitment

Men and women were recruited from households in North Central St. Andrew, Jamaica, in which they had primary responsibility for food preparation in the home.

Design

Cross-sectional study.

Statistical Analysis

Analysis of variance (ANOVA) was used to test the effect of gender and SES on food safety variables
A significance level of P<0.05 was used
Data were entered into the software programme EPI INFO 6.04 (Centers for Disease Control, 1997)
Mean responses as well as the percentages of responses in each category were calculated and presented in tabular form.

Data Collection Summary:

Timing of Measurements

Study conducted January to March 1999
The investigator visited each household selected and explained the purpose and nature of the study briefly to the adult with the responsibility for food preparation in the household and their permission to participate was sought. To guarantee anonymity of responses and easy identification of questionnaires by individuals, identity numbers were randomly assigned to each questionnaire.
The questionnaire was divided into four sections:
1. Socio-economic and demographic characteristics of the respondents
2. Consumers' food safety practices
3. Consumers' food safety knowledge
4. Consumers' attitude to food safety.

Dependent Variables

Consumers' food safety practices
Consumers' food safety knowledge
Consumers' attitude to food safety
Food safety concerns were measured by a 31-item questionnaire based on previous surveys on consumer food safety. The questionnaire was pilot tested on a comparable sample of consumers for clarity and validity. Adjustments were made where necessary.

Independent Variables

Socio-economic and demographic characteristics of the respondents.

Description of Actual Data Sample:

Initial N

110 adults (75 female and 35 male).

Attrition (Final N)

110 adults (75 female and 35 male).

Age

Under the age of 30: 20%
Between 30 to 39 years: 31.8%
Between the ages of 40 to 49: 27.3%
Between the ages of 50 to 59 years: 13.6%
Over the age of 60: 7.3%.

Ethnicity

Jamaican.

Other Relevant Demographics

Lower socio-economic status: 36.4%
Middle socio-economic status: 36.4%
Upper socio-economic status: 27.3%.

Anthropometrics

Not reported.

Location

North Central St. Andrew, Jamaica.

Summary of Results:

Key Findings

The majority of respondents reported a fairly high knowledge of safe food handling practices, however more than half were unfamiliar with the correct procedure for freezing and thawing foods
Householders were very concerned about the food they purchased for preparation at home and displayed strong concerns about sanitation of food handling establishments, food handlers practices and the appearance of foods purchased
The majority of respondents had never contacted their local Health Department or Ministry of Health regarding food safety concerns
Diarrhea, stomach pain, vomiting and nausea were reported as the major symptoms of food-borne illness, while animal foods including dairy, beef, chicken, pork and fish or shellfish were implicated as the main source of foodborne illnesses.
The majority (73%) indicated that they were very concerned about which foods they purchased for preparation at home; 23% were somewhat concerned; only 5% were either not concerned or unsure
The appearance of food was the only food safety concern of the respondents that showed a significant difference (P<0.05) with gender (X²=4.45) and socio-economic group (X²=7.15, df=2)
Males were significantly more concerned than females, while the middle and upper socio-economic groups tended to be more concerned than the lower socio-economic groups
68% of respondents also reported that they had discontinued buying certain food items because of household food safety concerns. Meat, poultry and dairy products were cited as the foods most often discontinued for consumption by about 63% of the respondents. The food items specifically implicated were chicken, beef, pork, milk, yogurt and ice cream.
There was a strong agreement among most respondents that both washing hands before preparing food (89%) and cooking meat thoroughly (84%) makes food-related illnesses less likely to occur
Almost everyone (99%) indicated familiarity with the term food-related illness. About 46% said they had a food-related illness at least once in their lives, while 41% said "no" and 13% did not know.

Author Conclusion:

This study has public health implications which appear to focus on food safety regulation and education at various levels
All public health regulating authorities must ensure all food-handling establishments attain and maintain at least minimum health standards, give attention to food-handlers' practices within the food trade and ensure that the inspection and quality-control programs remove substandard foods from trade
Also, there should be an increased emphasis on education programs.

Funding Source:

Government:

Ministry of Health, Health Protection and Promotion Unit, Jamaica

Reviewer Comments:

Quality Criteria Checklist: Primary Research
Relevance Questions
	1.	Would implementing the studied intervention or procedure (if found successful) result in improved outcomes for the patients/clients/population group? (Not Applicable for some epidemiological studies)	N/A
	2.	Did the authors study an outcome (dependent variable) or topic that the patients/clients/population group would care about?	Yes
	3.	Is the focus of the intervention or procedure (independent variable) or topic of study a common issue of concern to dieteticspractice?	Yes
	4.	Is the intervention or procedure feasible? (NA for some epidemiological studies)	N/A

Validity Questions
1.	Was the research question clearly stated?		Yes
	1.1.	Was (were) the specific intervention(s) or procedure(s) [independent variable(s)] identified?	Yes
	1.2.	Was (were) the outcome(s) [dependent variable(s)] clearly indicated?	Yes
	1.3.	Were the target population and setting specified?	Yes
2.	Was the selection of study subjects/patients free from bias?		Yes
	2.1.	Were inclusion/exclusion criteria specified (e.g., risk, point in disease progression, diagnostic or prognosis criteria), and with sufficient detail and without omitting criteria critical to the study?	Yes
	2.2.	Were criteria applied equally to all study groups?	Yes
	2.3.	Were health, demographics, and other characteristics of subjects described?	Yes
	2.4.	Were the subjects/patients a representative sample of the relevant population?	Yes
3.	Were study groups comparable?		Yes
	3.1.	Was the method of assigning subjects/patients to groups described and unbiased? (Method of randomization identified if RCT)	N/A
	3.2.	Were distribution of disease status, prognostic factors, and other factors (e.g., demographics) similar across study groups at baseline?	Yes
	3.3.	Were concurrent controls or comparisons used? (Concurrent preferred over historical control or comparison groups.)	Yes
	3.4.	If cohort study or cross-sectional study, were groups comparable on important confounding factors and/or were preexisting differences accounted for by using appropriate adjustments in statistical analysis?	Yes
	3.5.	If case control study, were potential confounding factors comparable for cases and controls? (If case series or trial with subjects serving as own control, this criterion is not applicable.)	Yes
	3.6.	If diagnostic test, was there an independent blind comparison with an appropriate reference standard (e.g., "gold standard")?	N/A
4.	Was method of handling withdrawals described?		Yes
	4.1.	Were follow-up methods described and the same for all groups?	Yes
	4.2.	Was the number, characteristics of withdrawals (i.e., dropouts, lost to follow up, attrition rate) and/or response rate (cross-sectional studies) described for each group? (Follow up goal for a strong study is 80%.)	Yes
	4.3.	Were all enrolled subjects/patients (in the original sample) accounted for?	Yes
	4.4.	Were reasons for withdrawals similar across groups?	Yes
	4.5.	If diagnostic test, was decision to perform reference test not dependent on results of test under study?	N/A
5.	Was blinding used to prevent introduction of bias?		N/A
	5.1.	In intervention study, were subjects, clinicians/practitioners, and investigators blinded to treatment group, as appropriate?	N/A
	5.2.	Were data collectors blinded for outcomes assessment? (If outcome is measured using an objective test, such as a lab value, this criterion is assumed to be met.)	N/A
	5.3.	In cohort study or cross-sectional study, were measurements of outcomes and risk factors blinded?	N/A
	5.4.	In case control study, was case definition explicit and case ascertainment not influenced by exposure status?	N/A
	5.5.	In diagnostic study, were test results blinded to patient history and other test results?	N/A
6.	Were intervention/therapeutic regimens/exposure factor or procedure and any comparison(s) described in detail? Were interveningfactors described?		Yes
	6.1.	In RCT or other intervention trial, were protocols described for all regimens studied?	N/A
	6.2.	In observational study, were interventions, study settings, and clinicians/provider described?	Yes
	6.3.	Was the intensity and duration of the intervention or exposure factor sufficient to produce a meaningful effect?	Yes
	6.4.	Was the amount of exposure and, if relevant, subject/patient compliance measured?	N/A
	6.5.	Were co-interventions (e.g., ancillary treatments, other therapies) described?	N/A
	6.6.	Were extra or unplanned treatments described?	N/A
	6.7.	Was the information for 6.4, 6.5, and 6.6 assessed the same way for all groups?	N/A
	6.8.	In diagnostic study, were details of test administration and replication sufficient?	N/A
7.	Were outcomes clearly defined and the measurements valid and reliable?		Yes
	7.1.	Were primary and secondary endpoints described and relevant to the question?	Yes
	7.2.	Were nutrition measures appropriate to question and outcomes of concern?	Yes
	7.3.	Was the period of follow-up long enough for important outcome(s) to occur?	Yes
	7.4.	Were the observations and measurements based on standard, valid, and reliable data collection instruments/tests/procedures?	Yes
	7.5.	Was the measurement of effect at an appropriate level of precision?	Yes
	7.6.	Were other factors accounted for (measured) that could affect outcomes?	Yes
	7.7.	Were the measurements conducted consistently across groups?	Yes
8.	Was the statistical analysis appropriate for the study design and type of outcome indicators?		Yes
	8.1.	Were statistical analyses adequately described and the results reported appropriately?	Yes
	8.2.	Were correct statistical tests used and assumptions of test not violated?	Yes
	8.3.	Were statistics reported with levels of significance and/or confidence intervals?	N/A
	8.4.	Was "intent to treat" analysis of outcomes done (and as appropriate, was there an analysis of outcomes for those maximally exposed or a dose-response analysis)?	N/A
	8.5.	Were adequate adjustments made for effects of confounding factors that might have affected the outcomes (e.g., multivariate analyses)?	Yes
	8.6.	Was clinical significance as well as statistical significance reported?	Yes
	8.7.	If negative findings, was a power calculation reported to address type 2 error?	N/A
9.	Are conclusions supported by results with biases and limitations taken into consideration?		Yes
	9.1.	Is there a discussion of findings?	Yes
	9.2.	Are biases and study limitations identified and discussed?	Yes
10.	Is bias due to study's funding or sponsorship unlikely?		Yes
	10.1.	Were sources of funding and investigators' affiliations described?	Yes
	10.2.	Was the study free from apparent conflict of interest?	Yes