EAL

MHFS: Food Safety (2012-2013)

Citation:

Study Design:

Class:

- Click here for explanation of classification scheme.

Quality Rating:

Research Purpose:

The purpose of this study was to assess food safety knowledge and practices among women working in Alexandria University.

Inclusion Criteria:

Female
Had the responsibility of food preparation at home.

Exclusion Criteria:

Not described.

Description of Study Protocol:

Recruitment

Females that had the responsibility of food preparation at home were recruited from six faculties and institutions affiliated to Alexandria University, High Institute of Public Health and Medical Research Institute, in addition to the faculties of Pharmacy, Sports, Education and Science.

Design

Cross-sectional study.

Statistical Analysis

Data was analyzed using SPSS program version 14.0
The cut-off point for significance was a P-value of <0.05 and all tests were two-sided
Data was tabulated and presented in the form of arithmetic mean and standard deviation for score percentage of the total food safety knowledge and practices and their parameters
Non-parametric tests such as Kruskal-Wallis and Mann-Whitney were used for not normally distributed data
Monte Carlo proportion was used to compare the percentages of food poisoning cases, as well as right answers among different jobs.

Data Collection Summary:

Timing of Measurements

Data was collected through distributing 45 questionnaires in each faculty or institution.

Dependent Variables

Food safety knowledge and practices: Questionnaires included four different sections such as personal characteristics, previous attack of a prominent food poisoning, food safety knowledge and food safety practices
Questions in each section of the food safety knowledge and practices were included under the four main parameters: Food purchasing and storage, preparation, cooking and personal hygiene
All questions were of the multiple choice type. Each knowledge question has only one right answer and scored by giving 1 for the right answer and 0 for the wrong, as well as to any "don't know" answer.
33 practice questions had three responses and scored from 0 to 2, while the remaining two questions had four responses and scored from 0 to 3 with higher scores for better practices. The score of each parameter was calculated by summing the scores of its questions and the total score of the whole food safety knowledge and practice was calculated by summing the scores of its four parameters.
All knowledge and practice scores were converted into percentages
Cronbach's alpha coefficient of internal consistency was used to estimate the reliability of the questionnaire. Alpha coefficient was 0.798.

Independent Variables

Personal characteristics.

Description of Actual Data Sample:

Initial N: 270 women
Attrition (final N): 270 women
Age: Average age was 42.5±10.6 years, with 1/3 of them in the age group of 40 to 50 years
Ethnicity: Not reported
Other relevant demographics: Not reported
Anthropometrics: Not reported
Location: Alexandria University, Egypt.

Summary of Results:

Key Findings

The highest percentage of food poisoning cases (46.8%) belonged to staff members and 39.7% were in the Under 10 Years age group
Half of the cases resulted from eating outside the home, compared to 16.7% from eating at home
The mean score percentage of the total safety knowledge of the sample was 67.4%, compared to 72% for their safety practices
The highest knowledge score was in personal hygiene (73.8%), while the highest practice score was in cooking (77.5%)
The lowest knowledge score was in food preparation (59.8%), whereas the lowest practice was in purchasing and storage 62.7%
The highest mean score percentages of the total food safety knowledge and its four associated parameters were among staff members, with significant differences among different jobs, except in food preparation
The highest scores of the total food safety practices and their parameters were among clerks in practicing safe purchasing and storage, where the highest mean score was among staff members (66.5±12.8%), with significant differences among jobs except in practicing personal hygiene.

Author Conclusion:

The study showed inadequate safety knowledge and practices among all job categories
Food safety education should be launched to women and repeated at specific intervals to ensure that learned information is put into daily life practices
The information gained by this study can be used to formulate essential messages for such educational programs.

Funding Source:

University/Hospital:

Alexandria University, Egypt

Reviewer Comments:

The limitations of this study included choosing the faculties and institutions, based on personal communications
Also, food safety practices were assessed through self reporting. Self-reporting usually overestimates the correct practices.

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)	Yes
	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?	Yes
	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?	Yes
	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?	No
	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)?	No
	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