DEVELOPMENT AND ASSESSMENT OF PILOT FOOD SAFETY EDUCATIONAL MATERIALS FOR HISPANIC WORKERS IN THE MUSHROOM INDUSTRY USING THE HEALTH ACTION MODEL

Open Access
Author:
Nieto-Montenegro, Sergio
Graduate Program:
Food Science
Degree:
Doctor of Philosophy
Document Type:
Dissertation
Date of Defense:
January 27, 2006
Committee Members:
  • Juanita Lynne Brown, Committee Chair
  • Luke F Laborde, Committee Member
  • Catherine Nettles Cutter, Committee Member
  • Rama B Radhakrishna, Committee Member
Keywords:
  • Mushroom
  • Hispanic
  • Handwashing
  • Observation
  • Theory
  • Produce Safety
  • Education
  • Food Safety
Abstract:
Pennsylvania accounts for 55 percent of the total volume of mushroom sales in the United States. Mushroom farming and packing involve intense manual labor in all phases of production. Approximately 98% of the mushroom workers in southeast PA are Mexicans. Education and training of food handlers is needed to prevent foodborne illnesses since food handlers’ mishandling has caused many outbreaks reported in the food industry. Sometimes educational materials do not work because they are designed without examining the worksite social and environmental factors affecting the target audience. Educational materials based on application of theory-based models may address more effectively the cause of food safety problems. The Health Action Model (HAM) identifies five constructs or systems that represent conditions surrounding mushroom workers: Baseline food safety knowledge, normative system, motivational system, food safety/belief system, and appropriate working environment and conditions. An opportunity to test the HAM plus Expectancy Theory (HAM-ET) arose when the Pennsylvania mushroom industry requested a food safety education program to be implemented industry wide. For this thesis research, a food safety education program for the mushroom industry was developed and factors, such as ethnic background, motivation, and peer role models were evaluated to determine how they would affect food safety educational programs. The first objective was to design and carry out a food safety needs assessment in the mushroom industry using the HAM as a framework. Some refinements of the motivational construct for its use in this research were made. All mushroom companies (packers, growers, or both) affiliated with the American Mushroom Institute were sent a fax explaining the project. Companies were contacted in the order derived from a randomized list to determine interest. Ultimately seven companies and its subsidiaries agreed to be part of the project. The information gathering process included an observation exercise and a focus group at each worksite (n=7) and 10-12 interviews/worksite (N=100 total). Each method explored one or more systems of the model. The information was triangulated across the HAM and the findings were helpful to identify factors that should be taken into account in designing an educational intervention for the target audience. The needs assessment is reported in Chapter 2. Additionally, no reports of an ‘observation method’ applicable to conducting a needs assessment for food safety training in a food production setting were found. To address this gap in methodology, we developed a ‘Worker-Experience Protocol’, in which a person, unconnected to either the regulatory system or the food company, served as a ‘worker’ as a way to make direct observations of company operations and worker behaviors. It was postulated that this protocol would provide valuable and unique information that would be useful in designing a food safety program. The effectiveness of this protocol is reported in Chapter 3. Evaluation of program impact is needed to show the worth of a program. The HAM model can also be helpful in the evaluation process considering that the literature indicates debate about the effectiveness of food safety training programs. The objectives in this part of the study were to develop, implement and evaluate a pilot food safety educational program for the mushroom industry target audience. Because of mushroom production unit time constraints, four lesson modules, each 25-40 minutes long, were developed based on specific learning objectives derived from the needs assessment. Each lesson in the program included visual aids and a script outlining presentation content that addressed the learning objectives. Risk perception and principles of adult education were introduced through discussion topics, demonstrations, and hands-on activities. The impact of three independent variables was tested in the pilot test: (1) the effect of the food safety lessons themselves as knowledge score; (2) item 1 plus altering employee motivation through increasing expectancy (supervisors were to encourage and enforce the desired behaviors and were to also act as role models by practicing the behavior themselves thus increasing the expectancy) and increasing instrumentality (supervisors were to praise workers when they perform the desired behavior); and (3) item 1 and 2 plus altering the employee motivational valence by examining the effect of a economic incentive on the dependent variables (Actions), three different handwashing opportunities plus jewelry and hairnet usage. One observer collected the pre-post and delayed post intervention data to assess the effect of the food safety program on food safety behaviors change over the time. For comparison, a control group received no treatment. A pre-post knowledge test was given to each participating worker. Three months after the end of the waiting period, retrospective scripted interviews were conducted. Based on the findings of the current study, there was a significant knowledge increase after the intervention on workers who completed the program. No effect of the monetary incentive was observed. Expectancy (as enforcement and role modeling) seems to be more effective in the mushroom industry. Instrumentality was not evident in supervisory actions as reported by both supervisors and workers. This observation may reflect the cultural expectations of the Hispanic workers when employed in a hierarchical unit. It was concluded that training must be followed by the involvement of the supervisory personnel to enforce behavioral rules. Ultimately, management support of the supervisory role will increase the success in any food safety program within the industry. Based on these findings the HAM model can be used as a guide to develop customized food safety educational materials at a variety of different settings and target audiences in food production facilities.