Research in Food Science Education
Food Safety Knowledge and Beliefs of
Middle School Children: Implications for
Food Safety Educators
Carol Byrd-Bredbenner, Jaclyn Maurer Abbot, and Virginia Quick
ABSTRACT: To create effective educational
interventions that address the food safety
informational needs of youth, a greater
understanding of their knowledge and skills is
needed. The purposes of this study were to
explore, via focus groups, the food-handling
responsibilities of middle school youth and
obstacles they face in practicing safe food
handling and develop recommendations for the
design of food safety interventions for youth.
Most youth reported that they prepared food at
least once weekly and rated learning to prevent
foodborne illness as important. Youth knew that
food could make them sick, described foodborne
illness as resulting from “something” getting
into food, not cooking food “right,” or the food
going bad. Most responses lacked details,
suggesting knowledge was basic. Nearly all
were interested in learning about food safety.
Barriers that deterred them from learning about
food safety were time and feeling they were not
susceptible to foodborne illness. To overcome
barriers, youth suggested focusing on the
seriousness of and risks for foodborne illness,
using a serious but comical educational
approach, and using hands-on educational
media. Parents highly rated the importance of
and degree to which they wanted youth to learn
about food safety. Parents felt that their children
had moderate levels of food safety knowledge,
but many questioned whether they practiced
food safety procedures when unsupervised.
Parents felt that food safety education needed to
be taught and reinforced in school and at home.
After having reviewed youth and parent data,
food safety experts proposed recommendations
for youth-focused food safety education that
paralleled current consumer food safety
initiatives.
c
2010 Institute of Food Technologists®
Little attention has been given to children and teen’s understanding of safe
food-handling knowledge and skills, despite their interests in studying food
safety and preparing food, growing food shopping and preparation
responsibilities, and future roles as caregivers for infants, young children, and
elderly parents (Neumark-Sztainer and others 1999; Endres and others 2001;
Yankelovich Co. 2001; Coulson 2002; Haapala and Probart 2004; Larson and
others 2006). Moreover, the most common jobs held by youth are in the food
service industry, ranging from cashier to table buser to server to cook (Davich
2002).
Changes in the educational system, that once taught food safety in family and
consumer sciences (home economics) classes in virtually every secondary
school, have resulted in a reduction or even elimination of such courses over the
past 2 decades (Beard 1991; Koeppl and Robey 1998). Opportunities for
children to learn safe food handling via observation have diminished as more
mothers have taken employment outside the home and as the reliance on fully
or partially pre-prepared convenience foods has increased. As a result, a large
proportion of teens and adults have limited food preparation experience, have
never learned basic food safety principles, and, thus, lack critical knowledge
needed to proactively protect themselves and their future families (Beard 1991;
USDA/FDA 1991; Williamson and others 1992; Knabel 1995; Partnership for
Food Safety Education 1998; Unklesbay and others 1998; Altekruse and others
1999; Durant 2002; USDA/FSIS 2002; Haapala and Probart 2004;
Byrd-Bredbenner and others 2007). These societal changes indicate that the risk
of foodborne illness arising from unsafe food handling in the home is likely to
rise.
To create effective educational interventions that address the food safety
informational needs of youth, a greater understanding of their food safety
knowledge and skills is needed. Therefore, one purpose of this study was to
establish baseline data regarding the food-handling cognitions and
responsibilities of middle schoolers as well as the obstacles they face in adopting
safe food-handling practices. A 2nd purpose was to develop recommendations
for the design of food safety interventions for middle school youth.
Methods
A qualitative research design involving focus groups with middle school
youth, parents of middle school youth, and food safety experts was used. This
study had 3 phases: baseline focus groups with middle school youth and
baseline focus groups with parents of middle schoolers, interviews with food
safety experts, and follow-up focus groups with middle schoolers. The protocol
MS 20090403 Submitted 5/5/2009, Accepted 9/4/2009. Authors are with Rutgers Univ., 26 Nichol
Ave., New Brunswick, NJ 08901, U.S.A. Direct inquiries to author Byrd-Bredbenner (E-mail:
[email protected]).
Vol. 9, 2010—Journal of Food Science Education
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JFSE: Journal of Food Science Education
for all phases of this study was approved by the Institutional
Review Board at the authors’ university.
Sample
Baseline youth focus groups
For baseline youth interviews, middle school children in
varying geographic regions (that is, Maine, New Jersey,
Tennessee, Georgia, New Mexico) were recruited from schools
and extracurricular youth groups. Prior to recruiting youth,
permission was obtained from school administrators or youth
group leaders. The recruitment materials described the focus
group purpose (that is, explore middle schoolers’ food safety
knowledge, beliefs, interests, and practices) and length (that is,
30 to 45 min) as well as compensation (that is, each participant
received $15 or a T-shirt or movie gift certificate of similar
value). The form of compensation varied to comply with the
wishes of school administrators or youth group leaders and/or
policies of these organizations. Informed consent letters signed
by each youth’s parent or guardian were obtained. In addition,
each youth gave his or her oral assent prior to participating in a
focus group.
Baseline parent focus groups
Parents of middle schoolers from the same 5 states were
recruited to participate in baseline parent focus groups. Parents
were recruited through middle schools, youth organizations,
workplaces, and word of mouth. To be eligible, parents had to
have the primary food-handling responsibility in their
households and currently have at least 1 middle school child
living in their household; eligibility did not depend on a parent’s
child participating in a youth focus group. Recruitment
materials described the focus group purpose (that is, gain
information needed to design educational materials for middle
school children) and length (that is, 30 to 45 min) as well as
compensation (that is, $30). Informed consent letters were
signed by all participating parents.
Food safety expert interviews
Food safety education experts (for example, USDA
Cooperative Extension’s Food Safety and Nutrition Specialists)
were recruited via e-mail to participate individually a series of
2 telephone interviews. The purpose of the interviews was to
review baseline focus group findings and gather input for the
development of recommendations for the design of food safety
education interventions for middle school children that could be
delivered at school, after-school, home, online, or other venues.
Theory of Reasoned Action (that is, attitude and subjective
norm) guided the development of the focus group moderator
guides (Champion and Skinner 2008; Montano and Kasprzyk
2008). These theories were selected because they provide a
framework for understanding why individuals are (or are not)
motivated to follow health care advice and perform
health-protective behaviors. The “Results” section shows
questions included in the focus group interviews. The focus
group moderator encouraged participants to give clear and
complete answers by providing feedback such as “please tell me
more about that” and “why do you think. . . ” followed by a
restating of the participant’s comment (for example, “why do
you think your friends would be interested?”).
All focus groups were led by a researcher who was trained in
collecting qualitative data and had extensive experience in
conducting focus groups (that is, a trained and highly skilled
moderator). To ensure consistency, 1 moderator conducted all
focus groups within a type (that is, baseline youth, parent, and
follow-up youth). One to 2 other trained assistants attended
each focus group to take comprehensive notes. Following each
focus group, the assistant(s) transcribed the notes for review by
the focus group moderator for clarity and thoroughness. Any
discrepancies were discussed and resolutions made.
Baseline youth focus groups
These focus groups explored middle school children’s
knowledge and awareness of food safety and food poisoning
prevention behaviors, perceived susceptibility to food
poisoning, barriers to receiving food safety information and
implementing safe food-handling behaviors, how to capture
their interest in food safety, cues that would motivate them to
practice safe food handling, their intention to perform safe
food-handling recommended practices, and preferences for
learning about food safety. At the conclusion of each focus
group, participants completed a brief survey to gather
demographic data (that is, gender, age, grade level), food
preparation activities, handwashing practices, and importance
of and interest in learning about food poisoning prevention.
Parent focus groups
Parent focus groups described the current food preparation
activities performed by their children, explored perceptions of
their middle school children’s food safety knowledge and
practices, described the importance they placed on their
children learning about food safety, identified barriers to middle
school children receiving and implementing safe food-handling
behaviors, and determined strategies to overcome these barriers.
Following completion of each focus group, parents completed a
short survey collecting demographic data (that is, gender, age,
education, occupation, number/age of child/ren), frequency
Follow-up youth focus groups
with which their middle school children help prepare food and
For the follow-up focus groups, middle school youth from
2 geographic regions (that is, New Mexico, New Jersey) (n = 45) wash hands prior to preparing food, self-ratings of their middle
school children’s knowledge of preventing food poisoning, and
were recruited from schools to participate in a focus group
importance and desire placed on their children learning about
lasting 30 to 45 min. Children in the follow-up youth focus
preventing food poisoning.
groups did not participate in the baseline youth focus groups.
Recruitment materials, compensation, and consent procedures
Food safety expert interviews
paralleled those used in baseline youth focus groups.
Experts (n = 13) critically reviewed baseline research findings
and assisted in translating them into recommendations for those
Data Collection
developing food safety educational materials for middle school
youth. Approximately 1 wk before the first of 2 individual
Separate focus group moderator guides were developed for
telephone interviews, experts received the baseline focus group
youth baseline, parent, and youth follow-up focus groups
following guidelines for conducting focus groups (Rollnick and summary via e-mail. The 1st interview lasted approximately
30 min, during which a trained moderator briefly reviewed the
others 1999; McLafferty 2004). Constructs from the Health
study results and asked the expert to reflect on these results and
Belief Model (that is, perceived threat [susceptibility and
severity], benefits, barriers, self-efficacy, and cues to action) and recommend food safety topics to highlight in interventions for
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Journal of Food Science Education—Vol. 9, 2010
Available on-line through ift.org
Food safety and middle schoolers . . .
middle school children. Approximately 1 wk before the 2nd
telephone interview, each expert was sent a summary of the 1st
expert interviews. The 2nd individual interview lasted
approximately 15 min and served to refine the
recommendations.
Follow-up youth focus groups
The purpose of follow-up focus groups with middle school
children was to review experts’ food safety recommendations
and determine their interest in learning about each of these
topics. A 5-point Likert scale (that is, not interesting at all, not
interesting, not sure if it is interesting or not interesting,
interesting, very interesting) was used to assess the degree of
interest in each topic. The focus group moderator also asked
children to identify barriers to practicing food safety and
describe how parents and schools could help them prevent food
poisoning. At the conclusion of each focus group, participants
completed the same brief survey as in the baseline youth focus
groups.
Data Analysis
Themes and trends in qualitative data were identified using
standard methods by 2 researchers trained in qualitative content
analysis (Miles and Huberman 1994; Harris and others 2009).
Content analysis methodology was used to analyze focus group
and interview data because it yields objective, systematic, and
quantitative descriptions (Berelson 1971; Pratt and Pratt 1995).
This methodology also enables researchers to “provide
knowledge, new insights, a representation of facts” and draw
“replicable and valid inferences from the data to their context”
(Krippendorf 1980, p. 21) which can facilitate an understanding
of food safety knowledge and beliefs. Each researcher
independently organized, classified, and summarized focus
group and interview data based on its content. Using the
constant comparison method, they derived and refined data
classification codes throughout data analysis (Harris and others
2009). In cases where coding differed, the researchers discussed
the differences and reached a unanimous decision. Data were
analyzed simultaneously with data collection to determine
when data saturation was reached. (Data saturation, or
informational redundancy, is the point at which new
information, trends, or themes emerge from the data
[Sandelowski 1995; Harris and others 2009].) Once data
saturation was reached within a focus group type or expert
interviews, data collection ceased. Data descriptions were
written after coding was complete. Quantitative methods were
combined with qualitative methods to provide an objective
description of the study participant characteristics. Descriptive
statistics were generated to describe the quantitative study
sample data and summarize the brief surveys administered at
the end of the focus groups.
Results
Baseline youth focus groups
Middle school youth (n = 147) participated in 1 of 17
baseline focus groups (n = 3 to 10 youth per group) held in 2007
and 2008 (see Table 1). Slightly more than half were female
(55%). Participants had a mean age of 12.6 ± 0.9 standard
deviation (SD) years. Although youth were not asked to identify
their race or ethnicity, visual observation revealed that the
participants were of diverse backgrounds with approximately
even representation between white and non-white students. All
were in grades 6 to 8 with most (42%) being in 7th grade. The
Available on-line through ift.org
Table 1—Baseline (N = 147) and follow-up (N = 45) youth focus
group participant demographics and characteristics.
Characteristic
Gender
Female
Male
Year in school
6th Grade
7th Grade
8th Grade
How often do you help prepare food, make
a snack, or help make dinner?
Everyday
5 to 6 d/wk
3 to 4 d/wk
1 to 2 d/wk
Never
How often do you wash your hands before
cooking or preparing food?a
Always
Often
Sometimes
Never
I never make snacks or meals
How important do you think it is to learn
about preventing food poisoning?
Not at all important
Not important
Not sure
Important
Very important
How much do you want to learn about
preventing food poisoning?
Not at all
A little
Not sure
Some
A lot
aN
Baseline
N (%)
Follow-Up
N (%)
81 (55)
66 (45)
25 (56)
20 (44)
35 (24)
62 (42)
50 (34)
4 (9)
6 (13)
35 (78)
47 (32)
22 (15)
32 (22)
38 (26)
8 (5)
17 (38)
7 (16)
12 (27)
8 (18)
1 (2)
79 (54)
45 (31)
21 (14)
0 (0)
1 (1)
16 (36)
10 (22)
17 (38)
1 (2)
1 (2)
0 (0)
0 (0)
12 (8)
60 (41)
75 (51)
0 (0)
0 (0)
3 (7)
14 (31)
28 (62)
1 (1)
12 (8)
4 (3)
58 (39)
72 (49)
1 (2)
5 (11)
2 (4)
19 (42)
18 (40)
= 146.
vast majority (95%) helped prepare food, with a 3rd reporting
they engage in these activities everyday. Approximately half
(54%) reported that they always washed their hands before
preparing food. When asked to rate the importance of learning
about food poisoning prevention, 92% rated it as important to
very important; no youth considered this topic as not important.
Most participants were interested in learning about food safety
with nearly half rating their degree of interest as “a lot” and
another 39% wanted to learn about the topic “some.”
Focus group responses from youth in all 5 states were similar.
The findings are organized below by the main questions posed
by the moderator. Youth responses were grouped into categories
based on content and are presented, insofar as possible, using
the vernacular and syntax of focus group participants.
Do you think it is possible for food to make you sick?
Youth overwhelmingly answered “yes,” indicating they felt
susceptible to food poisoning. The reasons they answered
affirmatively grouped into these broad categories.
Pathogen-related: Food contamination (for example, food has
bacteria, germs, mold, fungus, Salmonella, E. coli, tape worms);
unwashed food; expired, spoiled, or rotten food; undercooked
food (for example, “raw batter could get you sick”; “meat not
completely cooked”; “if you don’t cook fish well enough you
may get a tapeworm”); unsafely stored food; kitchen cleanliness;
Vol. 9, 2010—Journal of Food Science Education
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personal hygiene (for example, preparing food or “eating with
dirty hands”; “cracking eggs and not washing hands”); and
contamination by an individual who is ill (for example, “if
someone is sick, they pass germs onto food”).
Toxin-related: Environmental toxins (for example, “fish. . . .
contains mercury”), food components (“some chemicals can
make you sick”), preparation methods (“do not put plastic in the
microwave”), natural toxins (for example, eating mushrooms),
and intentional introduction of toxins.
Allergy-related: Consumption of an allergenic food by
individuals with food allergies.
Cooking skill-related: For example, “didn’t prepare food the
right way”; “if you cook foods wrong it could make you sick,
like puffer fish”; and “if food is burnt it could make you sick or
give you cancer.”
Food quality-related: Food composition (for example, “greasy
food can upset your stomach”), food preferences (for example,
dislike texture, smell, appearance), unfamiliarity (for example,
“foreign” food), quantity eaten (“you can eat too much and get
sick”), and temperature (that is, food that is too hot).
Miscellaneous: “Bugs” in food, certain combinations of food,
and eating too quickly.
sushi, spicy food, foreign food, fast food); eating places (for
example, cruise ships, foreign countries, buffets); food qualities
(for example, origin, such as sick animals [bird flu, mad cow],
cloned animals, food reclaimed from trash bags; contaminants,
such as steroids or pesticides in meat; organoleptic properties);
spoiled food (for example, “molded and green” food);
intentional addition of “something” to food (for example,
poison, wrong ingredients, object that causes choking); and
miscellaneous (for example, poisonous plants).
Has anyone ever told you how to prevent food poisoning?
What did they tell you? Do you follow their advice?
Although not all youth said they had been taught how to
prevent food poisoning, those who had been taught most
commonly learned from family (for example, parents,
grandparents) and school (for example, health, home economics
class), with a few learning from television (for example, cooking
shows) and extracurricular activities (for example, Boy Scouts).
They indicated they had learned the following information.
Personal hygiene: Wash hands before eating, when dealing
with food, and after touching eggs.
Kitchen cleanliness: Keep surfaces clean, use clean utensils,
“must clean counters really well after making raw meat and
Is it possible for you to get sick from foods that you
eggs,” use hot soapy water to clean.
prepared?
Food preparation: Wash food before eating, use separate
Most replied “yes” to this question, with reasons clustering
cutting boards for meat and vegetables, wash cutting boards
into these categories:
with soap.
Food storage: Store food in sealed containers, keep dairy
r Lack of knowledge (for example, “may not know that you
food refrigerated and “smell to make sure it is not bad.”
should wash your hands after touching raw chicken and you
Storage temperatures: “Keep foods out of the danger zone.”
can get Salmonella,” “may not know how to cook”).
Cooking temperatures: Cook food completely, look at the
r Lack of cooking experience/food preparation errors (for
color of meat to see if it is cooked well enough, use a
example, “I can’t cook, I would get sick”).
thermometer to check if a hamburger is done.
r Lack of confidence (for example, “probably would get sick
Food contamination: “Share food only with family and not
because I would mess it up”).
r Poor personal hygiene (for example, “yes, because you have strangers,” “don’t let people talk or breathe over food,” “wash
food if it is dropped on the floor.”
germs on your hands and if you don’t wash them they can get
Foods: “Keep food covered when you are outside,” smell or
on the food”).
look at food to make sure it is not bad (no mold, weird colors, or
r Cross-contamination (for example, making food on dirty
dirt) before using it, check expiration dates, follow the 5-s rule
surfaces, “didn’t wash fruits”).
(that is, if a food falls to the floor and it is picked-up within 5 s,
r Food qualities (for example, “ingredients aren’t fresh,”
it is safe to eat it [note: time varied between 3, 5, 10, and 30 s]).
“lettuce could be contaminated with E. coli”).
Restaurant food: “Be careful about restaurants,” “check that
r Miscellaneous (for example, yes, but “not from food
they are clean.”
poisoning. . . from overconsumption or allergies,” “taste will
Overall, students reported sometimes following this advice,
make you sick if you don’t like it,” by “not rinsing dishes well
but not always, especially if they were very hungry or parents
enough”).
weren’t around.
The youth who did not believe they could become sick from
foods they prepared felt this way because they did little cooking When you are making food, what types of things do you
think you should do to be sure that you don’t get food
or prepared simple foods (I “only use the microwave for
poisoning?
prepared foods”), were knowledgeable and careful (“if you
Answers to this question mainly echoed those that they had
know what you are doing and you are careful”), or got help (“if
been taught about food poisoning prevention. Responses not
you have help from someone with experience, you won’t get
given previously included the following.
sick”).
Kitchen cleanliness: After touching meat or eggs, clean up
before moving on to the next step; don’t make food directly on
What do you think of when you hear the words food
counter—“has germs from hands and dog”; clean counter with
poisoning?
spray cleaner; rinse out pans before and after use.
Youth reported that many things came to mind when they
Food preparation: “Wash fruits and veggies—even
heard the words “food poisoning,” including: personal illness
pre-washed,” “don’t touch raw chicken,” use gloves with raw
(for example, intestinal distress, vomiting, upset stomach,
diarrhea); fear (for example, “scary,” “I’m gonna die”); poor food meats, “throw away egg shells,” boil water before using or
drinking.
handling (for example, sick food handler, unsafe food storage
Cooking temperatures: “Overcooking . . . will . . . kill all the
[“food left out”], insufficient cooking, cross-contamination
germs,” “use a thermometer to ensure proper temperature in
[“animals being around the food you might eat,” “not cleaning
utensils properly,” “juices from food getting into other foods that turkey to know it’s done,” “meat has Salmonella and should be
heated to kill bacteria,” “meat is done when it is rougher and
they should not be getting into”], unsanitary areas, insects);
specific foods or food types (for example, spinach, meat, pizza, not as pink.”
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Food safety and middle schoolers . . .
Food contamination: “Don’t lick utensils” when cooking, “no
double dipping” when tasting food, “make sure the person
cooking is not sick and getting it all over the food,” “bacteria on
orange peel gets on hands then can get on orange,” “keep food
away from pets.”
Foods: “Check the seal on foods to be sure it isn’t broken”;
look to see if cans are dented.
Miscellaneous: Quality brands give secure feeling of safety,
consult an adult if you feel sick, “don’t put bubble gum on
glasses.”
What do you think your friends need to know about
keeping food safe so they won’t get food poisoning?
Youth felt that their friends need to know or do the following:
Personal hygiene: Wash hands more (friends are lazy), use
hand sanitizer, clean themselves up after getting dirty, not share
sanitary wipes, “cough into your arms instead of your hands.”
Kitchen cleanliness: Sanitize cups and thermometer after
someone is sick, do “not drink directly out of a glass [in
restaurants]—use a straw,” do not set food down unless surface
is clean, clean counter before beginning to cook, use clean
utensils when cooking or grilling, “wipe up everything that
could cause poisoning,” learn how to wash dishes.
Food preparation: Pay attention when preparing food, defrost
food all the way, learn cooking skills, store leftovers safely.
Food storage: Know that “takeout food may not be able to be
stored and eaten later,” “keep meat products in plastic bags in
the refrigerator because maggots could come and get on them,”
“keep food in containers and away from things that could get on
it.”
Cooking temperatures: Know that food needs to be cooked
well, “not eat undercooked meat, it has bacteria and will give
you food poisoning,” not eat old food, know “how to order food
properly when out and get it cooked enough.”
Food contamination: Follow (or do not follow) the 5-s rule,
not eat things off the floor, wash or throw away food that
dropped on the floor, not put food directly on lunch trays or
tables, not take food from buffet table without a plate, not touch
all cookies before selecting one, not eat or drink after others
[“saliva goes on spoon; if you share food, you’ll share your
germs”], “not drink out of the carton if others also will drink out
of it,” split food up before sharing, not talk with food in your
mouth (“it spits out onto others’ eating areas”).
Foods: Do “not eat anything you cannot pronounce,” know
how to tell good food from bad, “take it back, if it doesn’t taste
right.”
Miscellaneous: “Know about [friends’] allergies,” “friends
already know” [about food safety].
Miscellaneous: School should be more concerned, need to
know about “stuff” you are eating.
Youth answering both yes and no gave these reasons:
“sometimes I don’t want to bother with being concerned about
food safety and just eat what I want, other times I am concerned
and want to stay healthy” and, “I know the basics already.”
About one-third were not interested in learning about food
poisoning prevention because they already knew what to do,
were not interested, had other more important or competing
interests (for example, “I’m interested in boys”; “other things are
more important right now”), didn’t perceive they were
susceptible (I have never been sick from it; and “we live in a
clean environment and are forced to wash our hands”), or did
not want to worry about their food.
Do you think your friends would be interested in
learning how to prevent food poisoning?
Most felt that their friends would not be interested because
they lacked experience with foodborne illness. For example,
youth indicated that their friends would not be interested
because: getting sick is not a big deal (get to miss school); they
might not realize they can get sick from food; and “they think
they are immune.” Other reasons were friends’ assumptions,
such as “they just assume food is safe.” Priority-related reasons
for their friends’ lack of interest were that other things are more
important (sports, friends, looks, gossip); they don’t want to
discuss serious topics; “they have a long time before they need
to worry about it; they just want to be a kid.” Personal qualities
given as reasons some youth felt their friends would not be
interested are: some just don’t care about themselves; “they are
lazy”; and they feel they have everything they need.
Youth who felt their friends would like to learn about this
topic gave these reasons for their answers: it’s an important
topic, they want to stay healthy, “everyone wants to know how
to be safe”; people want to know what to do if they get food
poisoning; “they want to know how to cook it right”; and they
are athletes and more concerned with what they eat. Youth
added, that their friends want to learn but don’t want to be
obsessive about it.
How could we make it interesting so that you and your
friends would like to learn about food poisoning?
Participant responses grouped into 2 main categories:
teaching techniques and style. The teaching techniques youth
desired focused on the following.
Games: Game types (for example, Jeopardy® -type, board,
trivia, computer, card, and outdoor games); game colors should
be bright to grab your attention; games should be challenging,
adventurous, and make you think; games should include
competition and have scores and winners; games should not
Would you be interested in learning about
seem educational; make food safety piñata; puzzles; quizzes.
how to prevent food poisoning?
Video games: Should have characters “we know or can relate
Youth mostly replied yes, giving these reasons.
to,” villains, and heroes; should be modeled on an action game,
Cooking interests and responsibilities: Likes cooking and “it’s music video, or Harry Potter® ; should have lots of
good to keep food safe,” enjoys cooking and wants to be
action/sports/violence; could include puzzle solving; could
healthy, “my mom is making me learn to cook, so I need to
have player choosing “a safe food or have them cooking safe
know,” “ I help my dad cook.”
foods”; make it like Nintendo Wii® so it is active.
Health interests and concerns: Health is important, “don’t
Experiments/science and food preparation labs:
want to miss out on fun things,” “you’ll save time by knowing
Demonstrations and examples, “take us through the steps of
food safety by not being sick and missing daily activities.”
preparing safe food,” prepare food and handle it on a class trip,
Food relationships: “Food is my friend, I don’t want to get sick show “food samples with an explanation of what could happen
and not like food.”
if it was contaminated.”
Desire for knowledge: “I only know the basics”; want to
Videos: Show videos that show consequences, watch a movie
know about wild mushrooms, how to store leftovers, grill steaks, that will make kids think about what they eat and why they
keep food from burning, select safe restaurants, what might
should be concerned if it is safe to eat, “show a corny movie
make me sick, and what can happen from food poisoning; “if it about food safety—people remember stupid extreme things”;
is preventable, why not learn.”
some students did not want videos.
Available on-line through ift.org
Vol. 9, 2010—Journal of Food Science Education
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JFSE: Journal of Food Science Education
Guest speaker: “Have an assembly” speaker who describes
food poisoning and explains what could happen or someone
who has had food poisoning; some did not want
assemblies.
Others: Announcements over school public address system,
plays or skits, field trips, songs/music, rhymes, Internet social
networks.
Style features the middle schoolers requested included the
following.
Content: Easy to understand; tell why it is important; start
with results—severity of topic with pictures; tell worst symptoms
and bad effects to make us cautious; give do’s and don’ts of
keeping food safe; relate it to what youth like to do, their
lifestyles, and habits.
Flexibility: Build in room for kids to have control over learning
experience, make it able to be individualized so kids can pick
activities they like, give lots of options that make it real.
Language: Use catchy slogans.
Visuals: Use lots of pictures, photos, and video; “show how
food gets when it’s rotten and what it can do to the body”; show
visual consequences.
Tone: Make it funny or scary to grab attention; “needs to be
fun and serious—like Bill Nye the Science Guy® ”; “get bored
with too much seriousness”; “teachers have to want to teach
and make it fun”; entertaining; “grossing people out helps them
learn”; “make it real life, not cartoony”; “scary things might just
scare kids.”
Interactive: Don’t like lectures and taking notes, include
discussion and group work, no reading.
Feedback and Rewards: Go over correct answers, “want to
get a score and have winners.”
Other: Make it something fun and enjoyable where you do
little work but learn, no homework, keep lessons short.
Baseline parent focus groups
Seventy-five parents participated in 1 of 14 focus group
interviews (n = 1 to 10 parents per group) held in 5 states in
2007 and 2008 (Table 2). Most participants were female (76%),
between the ages of 40 and 49 y old (67%), and had an average
of 2 children under the age of 18 still living at home (56%). The
mean age of their middle school children was 12.5 ± 1 SD.
Overall participants had education beyond high school (66%
had at least a baccalaureate degree), but the majority had never
completed a college-level nutrition (64%), food science (88%),
or microbiology (71%) course. While 80% reported always
washing their hands before cooking and preparing food, only
23% reported that their middle school child did, despite 97% of
parents reporting their child prepared or helped prepare food at
least once weekly. Using a scale of 1 to 5 (5 being the highest
score), parents moderately rated their child’s food safety
knowledge (2.8 ± 0.9 SD) (see Table 3). Parents highly rated
both the importance (4.9 ± 0.3 SD) they placed on their middle
school child learning how to prevent food poisoning and their
desire (4.9 ± 0.3 SD) for their child to learn these skills.
A qualitative review of baseline parent focus groups did not
reflect systematic differences among parents living in different
states. The findings are organized below by the main questions
posed by the moderator. Responses were grouped into
categories based on content.
What types of food preparation activities
does your middle school child do?
Parents indicated that their children’s interest ranged from
little interest to “loves to cook,” and “makes lots of things from
scratch.” Parents reported that their children engaged in varied
food preparation activities including use of small kitchen
24
Journal of Food Science Education—Vol. 9, 2010
Table 2—Parent focus group participant characteristics (N = 75).
N (%)
Characteristic
Gender
Female
Male
Age
20 to 29 y
30 to 39 y
40 to 49 y
50 to 59 y
Number of children ≤ 18 y
1
2
3
4
Child demographics (number of middle school children)
Female
Male
Years of school completed
High school graduate
Some college
Associate degree/tech school graduate
Baccalaureate degree
Advanced degree
Occupation category (Stevens and Cho 1985)
Executive, administrative, and managerial
Professional specialty (for example, nurse, professor)
Technicians and related support specialists
Sales
Administrative support (for example, clerical)
Protective service (for example, police officer)
Service occupations
Precision production, craft and repair
Transportation and material moving
Homemaker
Number of college-level nutrition courses completed
0
1
≥2
Number of college-level food science courses completed
0
1
≥2
College-level microbiology courses completed
0
1
>2
Had formal culinary training
No
Yes
Frequency participant washes hands before cooking or
preparing food
Always
Often
Sometimes
Never
Frequency participants’ middle school children prepare
snacks or meals or help parent prepare food
Everyday
5 to 6 d/wk
3 to 4 d/wk
1 to 2 d/wk
Never
Frequency participants’ middle school children wash their
hands before cooking or preparing food
Always
Often
Sometimes
Never
57 (76)
18 (24)
1 (1)
14 (19)
50 (67)
10 (13)
17 (23)
42 (56)
13 (17)
2 (3)
47 (51)
45 (49)
2 (3)
11 (15)
13 (17)
23 (31)
26 (35)
7 (9)
29 (39)
4 (5)
1 (1)
20 (27)
1 (1)
3 (4)
3 (4)
1 (1)
6 (8)
48 (64)
15 (20)
12 (16)
66 (88)
2 (3)
7 (9)
53 (71)
14 (19)
8 (11)
70 (93)
5 (7)
60 (80)
13 (17)
2 (3)
0
25 (33)
9 (12)
21 (28)
18 (24)
2 (3)
17 (23)
29 (39)
28 (37)
1 (1)
Available on-line through ift.org
Food safety and middle schoolers . . .
Table 3—Parent focus group participant knowledge of and
importance placed on food safetya (N = 75).
Knowledge and importance of food safety
Mean ± SD
Parents’ self-rated knowledge level of how to prevent
food poisoning when handling and preparing foods
Parents’ ratings of their middle school children’s
knowledge level of how to prevent food poisoning
when handling and preparing foods
Importance parents placed on their middle school
children learning about food safety
Degree to which parents wanted their middle school
children to learn about food safety
4.2 ± 0.7
2.8 ± 0.9
4.9 ± 0.3
4.9 ± 0.3
a All items were 5-point scales with 1 = most negative response and 5 = most positive
response.
appliances and stove top, and a variety of meal preparation
activities (for example, washing and chopping vegetables,
pouring milk, grating cheese, thawing meat, cracking eggs). A
few indicated some restrictions (for example, child cooks
mainly with parent supervision, “I am not comfortable with her
handling meat,” “I don’t let her use the oven much” without
assistance), and that their children “need to learn how to clean
up.” Foods prepared by middle schoolers included sandwiches,
salads, cereal and milk, frozen microwavable meals, cookies
baked from refrigerator cookie dough, macaroni and cheese,
pasta, eggs, quesadillas, popcorn, pies, and stir-fry. Most youth
did not prepare meat, other than that in pre-prepared meals or
hamburgers.
Do you think your middle school aged children are
at risk of getting sick from foods that they prepared
themselves?
Parents had mixed feeling about their own children’s risk of
getting food poisoning from foods they prepared themselves.
Those who thought their child was at risk felt this way because
of the child’s unsafe behaviors (for example, not washing hands
before eating or not washing food before eating; “my daughter
likes to taste [food mixtures] before [they are] cooked, then
continues to stir mix with tasting spoon,” sharing food/drinks.
Another reason for thinking their child was at risk is that they ate
food off unclean surfaces (for example, “son. . . picks up things
off floor, and drinks after others,” “my child ate a hamburger
after it had been run over in the parking lot”). Several felt their
child’s lack of concern (“there are more things going on in their
mind other than food safety”) put them at risk.
On the other hand, some parents reported that their child was
not at risk because they felt their child knew safe food-handling
behaviors (“I taught them all about food safety”), could identify
unsafe foods (“good at. . . smelling things to know if they are still
good to eat”), and/or didn’t eat high risk foods (“I don’t worry
because we are vegetarians—a little bacteria builds immunity [I]
try not to be over zealous”; “I don’t think so because my
daughter only reheats leftovers”). Other reasons parents
indicated their child was not at risk were that the child knew
how to cook (“she cooks a lot and I would not be afraid”) and/or
they didn’t prepare food.
Clean food: Washing produce (“she knows how to wash
vegetables thoroughly before preparing and eating them”),
washing food preparation surfaces, washing dishes.
Fresh food: Checking food expiration dates, visually
inspecting, and smelling food.
Storage: Uses sealed containers, cools foods before
refrigeration, refrigerates cold foods, discards old leftovers/food.
Cross-contamination prevention: Uses different cutting
boards for meat/produce, “my son . . . follows the 10-s rule,”
“my kids know the 3-s rule is not for real.”
Parents reported that their children did not always practice
the food safety behaviors they know (“their life is busy and don’t
have time to think and use their food safety skills,” “just the
other day I caught him drinking right out of a milk carton when I
know he knows better than that”). A few parents indicated that
their middle schoolers learned food safety from them as well as
from watching the Food Network and they would like children
to learn food safety in school.
How important do you think it is for your middle schooler
to learn about food safety (food poisoning prevention)?
All parents felt that learning about food safety was very
important because it is an important life skill that could help
safeguard the health of their child, stating: it’s “very
important. . . there seems to be more and more health risk out
there now”; “it is a life skill. . . they will use what they learn in
this type course more than many other mandated course”; they
need it “for lifelong skills and job skills, like working at
McDonalds or the mall.” Some parents further stated it was
important that kids learned food poisoning prevention skills
both at school as well as at home (“I already do education at
home on this, but it would be good if the school was supportive
in reinforcing the information . . . the science behind it is
important”; “it’s important to include this in the school
curriculum”).
What do you see as barriers to getting middle schoolers
like your son or daughter to take steps to prevent food
poisoning?
Barriers fell into these categories:
Time and inclination: Other things to worry/care about, no
time to wash hands before eating, too busy, laziness.
Invincibility/lack of perceived susceptibility: Never had food
poisoning, not concerned about getting it, “think parents and
most adults overreact to food dangers,” “are at an age [when]
they think they know it all,” “don’t understand the
consequences.”
Peer pressure: If peers aren’t practicing safe food-handling
behaviors, then other students won’t be inclined/encouraged to
do so.
Lack of education: At school as well as at home, lack of
enforcement and encouragement of good behaviors, they
believe “that when they buy the food, it is already safe.”
What could we do to overcome these barriers?
Parents suggested developing learning opportunities that are
fun, informational, and hands-on (for example, “the students
really have an interest in learning how to cook and this would
help get them involved and realize this topic is important”).
Learning activities included handwashing demonstrations
What do you think your middle school age child knows
(“show them the germs on their hands. . . how touching food
about safe food handling/preparation (food poisoning
with dirty hands can make them sick”) and video/computer
prevention)?
games. Parents suggested using peer-led activities (“as for peer
Parents reported that their children knew some skills that
pressure, I tell my kids to act like it is a normal behavior
would help them prevent food poisoning.
Personal hygiene: Handwashing (“I tell her to wash her hands washing your hands before you eat”; “info will sink in if a peer
is relaying it”) because kids think parents “don’t know.” In
a lot, but she may not use soap”).
Available on-line through ift.org
Vol. 9, 2010—Journal of Food Science Education
25
JFSE: Journal of Food Science Education
addition, parents felt schools need to provide time for students
to wash their hands or make hand sanitizing wipes accessible.
Food safety expert interviews
Thirteen food safety experts located in 12 different states,
with an average of 22 ± 10 SD years of professional experience
in the field (92% worked in higher education and/or
Cooperative Extension), individually participated in a series of
2 individual interviews. Most were female (92%) and had
experience in teaching food safety (77%) to youth. Using a
5-point rating scale (that is, 1 = not important at all to 5 = very
important), experts felt that it was important (mean = 4.5 ± 0.6
SD) for middle school youth to learn about food safety because
youth are engaging in more food preparation for themselves
and, possibly other family members who are at increased risk
for foodborne illness and/or will be assuming more food
preparation responsibilities as they mature. In addition, many
likely will be working in food service establishments as part of
their 1st paid employment.
When asked to rate how interested in learning about food
safety they thought middle school youth would be, their mean
scores (3.3 ± 0.8 SD) on a 5-point scale (1 = not very interested
and 5 = very interested) indicated they were neutral. Several
experts qualified their rating by indicating that the level of
interest in the topic of food safety by middle schoolers would
depend upon how the information was delivered. Interview
findings are organized below by the main questions posed by
the interviewer with responses grouped into categories based on
content.
How knowledgeable would you say middle schoolers are
about how to prevent foodborne illness when handling and
preparing foods for themselves? Why?
Most experts indicated that their responses were drawn from
the summary of the baseline focus groups findings as well as
their personal experiences with middle school youth. Most
thought that middle schoolers were “not very knowledgeable;
although after reading your report [of baseline focus group
data], it seems that they know more than I thought,” such as
information about handwashing and cross-contamination. Some
experts felt that while youth may “know” some information
about preventing foodborne illness, they did not understand
why this information and related behaviors are important and
frequently did not (or had to be reminded to) practice these
behaviors.
Based on your professional opinion/experience and the
summary of baseline focus group findings, what do you
think are the top issues related to food safety that middle
school children need to learn? Why?
The following were identified by the experts as the top issues:
Personal hygiene: Nearly all experts (n = 12) identified
personal hygiene/clean hands as a top issue because “this is the
most important thing they can do to safeguard their health” and
prevent transfer of pathogens. Experts felt middle schoolers
needed to know how and when to wash hands and why this
practice was important and to believe that handwashing is
important.
Safe food storage temperature: Storage temperature was
named by almost 3 quarters (n = 9) of the experts as an
important issue. The interviewed experts believed that middle
school youth need information about which foods need to be
kept cold and which need to be heated, and the length of time it
is safe to leave foods at room temperature (for example, in a
backpack). Experts also mentioned the need to promote the use
of refrigerator thermometers.
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Journal of Food Science Education—Vol. 9, 2010
Food preparation: Most (n = 8) stated that food preparation
was an important topic because middle schoolers “will be
cooking someday and these are life skills they need to learn.”
Others pointed out that many youth are already doing some
cooking and are handling raw ingredients, so they need food
safety information now. Because cooking in microwave ovens is
common, some experts felt addressing food safety issues related
to this cooking method was important. Two experts did not feel
that cooking should be a priority for safety reasons (“could be
dangerous to children”) and because middle schoolers “are
putting foods together, but use mostly pre-prepared foods.”
Another expert pointed out that food preparation could serve as
the “umbrella” for linking all safe food-handling behaviors.
Cross-contamination: Prevention of cross-contamination was
cited as an important issue by half (n = 7) of the interviewed
experts. Experts felt that it was important to “debunk the myth of
the 5-s rule” help middle schoolers “understand how
contamination spreads” to food contact surfaces as well as to
food by sharing food, beverages, and straws; licking fingers; and
touching food with hands. Nearly a third (n = 4) of the experts
cited kitchen cleanliness as an important cross-contamination
topic for middle school youth. Experts felt that it was important
for youth to know how to clean and sanitize food preparation
areas and that they needed to know to do this every time before
preparing food.
Cooking temperatures: Safe cooking temperatures
(thermometer use) was named by nearly half (n = 6) as a top
issue because middle schoolers need to “understand the
importance of appropriately cooking food.” In addition, youth
“need more confidence in how to do things in the kitchen,”
such as using food thermometers. Experts also suggested
addressing general safety in the kitchen to prevent burns, cuts,
and other injuries.
Food qualities: Approximately one-quarter of the experts (n =
3) indicated that food quality characteristics and awareness of
food pathogens were important topics for middle school youth.
In specific, experts felt youth needed to know how to identify
risky foods, know that mishandling (for example, licking serving
utensils) can make a low risk food a higher food safety risk food,
that visual appearance and expiration dates do not always
connote that a food is safe to eat, and recognize whether a
restaurant exhibits qualities signifying safe food handling. One
expert pointed out that identification of high-risk foods is
important because “kids erroneously transfer food safety
concerns to low risk foods. . . if they know the high risk ones,
they can make better (targeted rather than blanket) food safety
decisions.” Further, experts felt that youth should know about
common foodborne pathogens and which foods are usually
contaminated by these pathogens. This knowledge could
enhance awareness of foods most likely to pose a food safety
risk as well as, hopefully, encourage safer food handling to
prevent spread of these pathogens.
What do you see as barriers to getting middle schoolers to
take steps to prevent foodborne illness?
The major barrier cited by nearly all experts (n = 10) was that
middle schoolers do not perceive the topic of food safety as
relevant to them. Reasons for this lack of relevance included
that middle schoolers do not cook much, lack personal
experience with foodborne illness, and “don’t always make the
connection between food being able to make them ill and
having control over this.” Another major barrier named (n = 5)
was that middle school youth have other interests that take
priority for their time and attention.
One expert pointed out that a barrier to technology-based
food safety education is that some may lack access to
Available on-line through ift.org
Food safety and middle schoolers . . .
technology (for example, computers). In addition, various
aspects of school environments (for example, curriculum
requirements, policies) may be a barrier to food safety education
efforts. This expert indicated that after-school activities are a
possible alternative, but they also have barriers, such as
transportation, time conflicts, and different interests that don’t
include food safety. Another barrier identified by one expert was
the potential for gender bias. That is, “anything related to food
may be misperceived as a ‘woman’ thing, but both genders need
to know about this information.”
Table 4—Interest in learning about food safety topics among middle
school participants in the follow-up focus group (N = 45).
Meana (SD)
Topic
Foods most likely to cause food poisoning
How to keep bacteria and germs off food
Bacteria and germs that cause food poisoning
How bacteria and germs spread–like when kitchen
counters are not cleaned, fingers are licked, or drinks
are shared
The “5-s rule” isn’t true
How to prevent food poisoning when cooking foods in
microwave ovens
How could we as educators help overcome these barriers?
To overcome barriers to getting middle schoolers interested in How storing food carefully can prevent food
poisoning—like putting away cold foods into the
learning and practicing safe food handling, all experts (n = 13)
refrigerator once finished using them, how long it is
stressed making this education relevant (put it “in middle
safe to leave cold foods out of the refrigerator, how to
schoolers’ ‘frame of reference’,” help them see they are
use refrigerator thermometers
susceptible by “working to increase risk perception [and] sense How handwashing can help prevent food poisoning
of susceptibility”), and make it fun and interesting to the
How to clean and sanitize areas where food is prepared
audience (“make it something they want to know”). Messages
How to use a food thermometer to find out if foods are
should be easy, simple, short, clear, important, and appropriate
cooked enough to not cause food poisoning
for the audience. They felt that middle schoolers need to
understand why the topic is important, how they can benefit,
and “what can happen. . . if they get infected” (use the “fear
factor” or “gross factor,” but be sure it is relevant, has
educational value, and doesn’t overdo it because “kids can get
carried away” or it can “cause unintended consequences, like
causing the child to never want to eat a particular food again”).
One expert pointed out that, as food safety educators, we
need to remember that the baseline focus group data collected
in this study tells us that kids are interested in food safety and
that we should not let our [experts] (mis)perception that they are
not interested in the topic be a barrier to developing and
implementing food safety education opportunities for this age
group.
Experts (n = 11) recommended using active, engaging, and
hands-on educational methods (“don’t just tell them, show
them”) and “infusing” these learning experiences into other
educational activities at school, (for example, “need to get
teachers to incorporate food safety education into their
curriculum. . . show them how to do this without adding to their
workload,” identify nonobvious subject matter areas where food
safety can be taught, such as, in “math, have kids plot
exponential growth of bacteria”), during after-school activities
(for example, target water bottle sharing in after-school sports
activities; add safe food handling to babysitting training), and at
summer camps. Experts also recommended getting youth
involved in the “development and design of the education”
about food safety and involving parents in food safety education
activities (“show parents the relevance of the topic,” “show
parents how to teach their children” about food safety and
“reinforce messages at home. . . [so they] become a ‘norm’”),
but one expert cautioned that home-based activities are
“probably not realistic due to parents’ time pressures.” Another
recommendation was to “find ways to make food safety a
priority” for middle schoolers. For example, food safety
education could be marketed as skills to make them “more
desirable as an employee,” such as in food service or
babysitting. Incentives, such as accruing points for a T-shirt or
other gift by participating in food safety games, was cited as a
method that could help overcome barriers to motivation for
learning about food safety.
Experts provided a variety of suggestions regarding creative
means for delivering food safety education. Several
recommended tapping into peer relationships (for example, use
peer teaching) and tying food safety lessons to topics of interest
to middle schoolers (for example, health, appearance, earning
Available on-line through ift.org
a Scales
4.53 (0.73)
4.31 (0.85)
4.24 (1.13)
4.09 (0.95)
3.89 (1.27)
3.58 (1.16)
3.53 (1.08)
3.36 (1.03)
3.36 (1.05)
2.98 (1.16)
range from 1 to 5, with 5 indicating the greatest interest.
money). Experts often recommended using cooking as a
springboard for food safety lessons. Other methods named as
making food safety education “very catchy, cool and appealing”
included games, demonstrations (“show kids how ‘touch can
travel’ using the GloGerm® handshake. . . ‘reach out an infect
someone’”), web-based activities, text messaging, videos (“use
CSI® as a way to have them learn about food pathogens,”
storytelling, such as a “person describing what happened to
them when they got food poisoning,” reality type shows),
graphics, and a “fun” spokesperson who models safe
food-handling behaviors.
Follow-up youth focus groups
Forty-five middle school youth participated in 1 of 8
follow-up focus groups (n = 4 to 6 youth per group) held in Fall
2008. Follow-up focus group youth were similar to those in the
baseline focus groups (see Table 1), with the exception that
follow-up youth tended to be concentrated in 8th grade. Table 4
indicates that middle schoolers are especially interested in foods
most likely to cause food poisoning and bacteria (“germs”) and
least interested in sanitation (handwashing, kitchen cleanliness)
and using food thermometers. Responses from youth in the 2
states were similar and are organized by the main focus group
questions. Only data that differ from or extended baseline focus
group data appear below.
How could parents make it easier for you
to prevent food poisoning?
Middle schoolers suggested that to set good examples, parents
“can clean up after themselves in front of us,” “wash hands with
soap,” and “make the food right.” Youth suggested that parents
“teach us how to prevent it [food poisoning],” “make rules to
wash hands,” and post reminders. To prevent food poisoning,
youth suggested parents buy them easy to prepare foods and
foods with tamper-proof seals, and “send hand wipes to school”
with the child. Some children also suggested that parents
provide bribes or rewards for washing hands. Some pointed out
that parents did not know how to prevent food poisoning
because they had never taken a class on the topic.
What could schools do to make it easier
for you to prevent food poisoning?
Middle schoolers suggested that schools provide reminders
(“teachers don’t tell us to wash our hands,” “they could hang
Vol. 9, 2010—Journal of Food Science Education
27
JFSE: Journal of Food Science Education
signs in the bathroom,” “daily reminder before lunch”), supplies
(put “sink in the lunchroom,” and put hand “sanitizer in front of
the snack bar. . . kids will get bored in line and use it,” “provide
soap in different colors” to grab their attention), and educational
opportunities (“give info during health class”), instructional
materials (“funny videos of kids like us that we can relate
to. . . should have music, cool videos,” “black light to show
germs”). Middle schoolers also suggested that schools could
give “an award for not getting sick” and set a good example
(“cafeteria tables should be clean,” “sanitize the tables,” “clean
the microwaves”).
Discussion and Conclusion
The youth focus group findings indicate that middle
schoolers, as a group, are regularly preparing food and have a
clear interest in and need for food safety education. The data
also indicate that middle schoolers have a broad knowledge
base related to safe food handling. However, the data also
suggest this knowledge is primarily at the knowledge (recall)
level of the cognitive domain (Bloom 1956) with limited
comprehension as to why safe food handling is important and
how to practice safe food handling. In addition, youth have
some misconceptions with regard to safe food handling (for
example, “5-s” rule). They also could benefit from a sharply
focused definition of “food poisoning” to avoid confusing it with
food qualities, poorly (but not unsafely) prepared food, or
allergens. These findings are congruent with those reported by
others (Haapala and Probart 2004) regarding the level of food
safety knowledge and perceptions of 7th and 8th graders. Focus
group responses from parents also indicate that they, too, could
benefit from food safety education.
According to the Health Belief Model, knowledge affects
beliefs related to perceived susceptibility and severity of disease,
benefits of and barriers to practicing preventive health
behaviors, and self-efficacy (Champion and Skinner 2008).
Because these beliefs, in turn, affect behavior, food safety
education efforts for youth likely should be designed to enable
them to build a solid knowledge base, develop an appreciation
for why food safety is important, and become willing and able
to practice safe food handling. In addition, as the interviewed
food safety experts suggested, the efforts should include
components for parents that enable them to reinforce food
safety education messages at home. The importance of parent
education is underscored by the fact that youth who said they
had learned to prevent food poisoning frequently named parents
as the source of this information as well as the positive feelings
parents expressed about the importance of food safety
education. In addition, youth indicated that they expect parents
to be a role model, thus parents need to know how to model
safe food-handling practices.
An examination of the youth focus group data addressing the
Health Belief Model’s threat construct (that is, perceived
susceptibility to and severity of disease) revealed that most
youth believe that they are susceptible to food poisoning and
that it could have serious consequences. Their responses
indicate that most are aware that unsafe food-handling practices
increase susceptibility. Similar to previously reported data on
this age group (Haapala and Probart 2004), not all youth
recognized their susceptibility to foodborne illness, thus food
safety education materials should clearly establish that everyone
is at risk.
Most middle schoolers also felt that the foods they prepared
could cause food poisoning, with the main reasons being that
they lacked knowledge, food preparation experience, and/or
confidence, or engaged in unsafe food-handling practices.
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Journal of Food Science Education—Vol. 9, 2010
These reasons suggest that food safety education efforts should
focus on helping them gain knowledge, experience, and
confidence (self-efficacy construct of the Health Belief Model).
The importance of assisting youth in developing food safety
self-efficacy is further supported by the responses from youth
who did not believe that they were at risk for food poisoning
from foods they prepared. That is, their knowledge, food
preparation practices, and ability to access assistance from
those with experience helped them feel confident in their
abilities to prevent food poisoning. The finding that some youth
felt they were not at risk for food poisoning from foods they
prepared because they did little cooking or prepared simple
foods suggests that food safety education efforts may need to
take an orientation that helps middle schoolers project ahead
and realize that their food preparation responsibilities are likely
to increase greatly in the future.
Although many youth reported that they had been taught how
to prevent food poisoning, they reported that they did not
always practice safe food handling because of barriers, such as
hunger (for example, too hungry to spend time on precautionary
steps) and importance of other priorities. Other barriers cited by
parents included their middle schoolers’ lack of food safety
knowledge, perceptions of invincibility (lack of susceptibility),
and peer pressure. Additional barriers noted by food safety
experts included middle schoolers’ misperceptions regarding
the relevance and importance of the topic and the realities of
adding content to school curricula or after-school activities. In
addition, the presence of parents appears to be a cue to perform
safe food-handling procedures, whereas the absence of parents
presented a temptation to neglect these procedures. According
to the Theory of Reasoned Action, attitudes are affected by
beliefs about the outcomes of performing a behavior and
subjective norm is based on whether important others (for
example, parents, peers) approve of the behavior and the
individual’s motivation to comply with important others
(Montano and Kasprzyk 2008). Thus, to increase the rate at
which youth engage in safe food-handling practices, education
efforts likely should strengthen attitudes about the link between
safe food-handling practices and good health and the value of
engaging in these practices even when faced with barriers or
temptations. These findings also suggest that food safety
education for middle schoolers should help them develop a
repertoire of strategies that help them overcome barriers, such
as by developing self-efficacy and reinforcing their beliefs that
they have the power to overcome barriers. To overcome issues
with peer pressure, experts suggest addressing this directly by
using peer teaching and working to make safe food-handling
behaviors (for example, handwashing before lunch—a practice
seldom engaged in before eating at a school cafeteria [Haapala
and Probart 2004]) a normative behavior within schools.
The study findings reveal that most middle schoolers are
interested in food safety. Many of the reasons given for this
interest reflect their positive attitudes toward being healthy, the
value of learning, and their interest in cooking. Thus, it likely
would be worthwhile for food safety efforts to capitalize on
these attitudes.
Youth were clear that they and their friends want food safety
education to be fun, interesting, interactive, visually intense,
and hands-on learning that incorporates technology. They also
wanted the educational materials to be reflective of middle
schoolers’ lifestyles and habits, to give them control over
learning, and to give them feedback and rewards. Parents cited
many of these same teaching techniques and styles as methods
for overcoming barriers middle schoolers’ have to practicing
safe food handling. To these, food safety experts added that to
overcome barriers, food safety education should be succinct,
Available on-line through ift.org
Food safety and middle schoolers . . .
Table 5—Middle school children’s food safety focus group findings organized by constructs from the Health Belief Model and Theory of
Reasoned Action.
Construct
Description
Modifying variable: knowledge
a
Threata
Susceptibilitya
Severitya
Barriersa to learning about food safety
Barriersa to practicing safe food handling
Self-efficacya
Attitudesb related to safe food handling
Subjective normb
a Health Belief Model.
b Theory of Reasoned
Knowledge is broad, lacks depth, includes some misconceptions
Recognized that a lack of knowledge could increase susceptibility to food poisoning
Most rated learning about preventing food poisoning as important
Most were interested in learning about preventing food poisoning
Most felt susceptible to food poisoning in general
Most felt susceptible to food poisoning from foods they prepared
Most recognized the potential for food poisoning to be severe
Competing interests and priorities
Some did not feel susceptible to food poisoning
Lack of experience with food poisoning
Lacks an understanding of why food safety is important to them now as well as in the future
Some felt topic is not interesting or is irrelevant
Some felt they already know how to handle food safely
Some assume that food is safe
Lack of time to add content to school curricula or after-school activities
Parents not present during food preparation activities
Being very hungry or in a rush when preparing food
Habits (for example, eating uncooked high-risk foods)
Lack of concern
Lack of knowledge or education
Peer pressure
Limited food preparation experience
Peers who don’t practice safe food-handling behaviors and the desire to fit in and be like
friends
Some expressed a lack of confidence in knowledge and skill needed to prevent food poisoning
Some lacked confidence related to food preparation skills
Felt safe food handling would protect their health
Health is important
Felt parents thought practicing food safety was important, but not always motivated to comply
when parents are not present
Peers are important, want to be like peers
Action.
infused into existing educational activities, presented in a way
that makes “it something they want to know,” and marketed in a
way that makes safe food-handling skills an asset. To ensure
food safety education efforts have the characteristics desired by
youth and overcome barriers cited, experts recommended
involving youth in the development and design of the education
about food safety.
The food safety education content identified by experts as
appropriate for middle schoolers parallels current consumer
food safety initiatives, such as Fight Bac! (Partnership for Food
Safety Education 1998), namely, personal and kitchen
cleanliness, safe cooking and chilling temperatures and
practices, and cross-contamination prevention. Other topics
recommended included identification of types of foods that
pose greater/lesser food safety risks. Youth interest in these
topics, however, varied widely. Food safety educators could
build on their interest in types of foods that pose food safety
risks as well as “germs” and bacteria, using this interest as a
springboard for addressing topics deemed to be of lesser interest
by youth. For example, concepts related to sanitation and food
thermometer use are closely linked to the reduction of “germ”
spread and increase in safety of risky foods (for example,
undercooked animal protein).
The findings of this study are intended to inform the
development of food safety programs that help youth develop
and practice safe food-handling practices. However, research
findings alone are unlikely to lead to the most effective health
interventions—they need to be applied in tandem with health
behavior change theory (Grol and others 2007; Glanz and
Available on-line through ift.org
others 2008). The challenge, however, is linking theory and
research and then further linking them to program planning and
evaluation. Thus, Table 5 was developed to demonstrate the
relationships among the research findings from the baseline and
follow-up youth focus groups to key constructs from theories of
individual health behaviors, namely, the Health Belief Model
and Theory of Reasoned Action. The value of this table in
organizing food safety education program planning and
development that lead to both short- and long-term changes in
middle schoolers warrants further investigation.
In the words of one youth participant, “we are old enough to
make good decisions on our own”—it is our responsibility, as
food safety educators to give them the tools they need to make
these decisions. Research findings, like those present here,
coupled with health behavior change theory (Grol and others
2007) and ongoing formative evaluation with the target
audience (Posavac and Carey 2007), can provide direction for
designing effective educational interventions that improve food
safety behaviors of middle school children. The value of food
safety education for this audience is important not only because
they are preparing food now, but also will have increased food
preparation responsibilities in the future. In addition, because
many are just learning to prepare foods, teaching them safe
food-handling practices while in this formative stage will
minimize the need to “undo” established practices that increase
the risk for foodborne illness and will teach them valuable
lifelong skills. Investing in this skill development will not only
benefit the middle schooler and his or her family immediately,
but also could track into adulthood and benefit those for whom
Vol. 9, 2010—Journal of Food Science Education
29
JFSE: Journal of Food Science Education
the child will be responsible in the future (for example, child’s
own future children, aging parents—all of which are at
increased risk of foodborne disease).
Acknowledgments
This study was funded by USDA, Natl. Food Safety Initiative
2007-51110-03813.
References
Altekruse S, Yang S, Timbo B, Angulo F. 1999. A multi-state survey of consumer
food-handling and food-consumption practices. Am J Preven Med 16:
216–21.
Beard T. 1991. HACCP and the home: the need for consumer education. Food
Technol 45:123–4.
Berelson B. 1971. Content analysis in communications research. New York:
Hafner Publishing Co.
Bloom B. 1956. Taxonomy of educational objectives, handbook I: the cognitive
domain. New York: David McKay Co. Inc.
Byrd-Bredbenner C, Maurer J, Wheatley V, Schaffner D, Bruhn C, Blalock L.
2007. Food safety self-reported behaviors and cognitions of young adults:
results of a national study. J Food Prot 70:1917–26.
Champion V, Skinner C. 2008. The health belief model. In: Glanz K, Rimer B,
Viswanath K, editors. Health behavior and health education. Theory,
research, and practice. 4th ed. San Francisco, Calif.: Jossey-Bass. p 45–65.
Coulson NS. 2002. Source of food safety information: whom do adolescents
trust? Appetite 38:199–200.
Davich J. July 23, 2002. School’s out, work’s in. Northwest Indiana News.
Durant D. 2002. Checking on changes: consumer research. Food Saf Educ
7(1):1–2.
Endres J, Welch T, Perseli T. 2001. Use of a computerized kiosk in an
assessment of food safety knowledge of high school students and science
teachers. J Nutr Educ 33:37–42.
Glanz K, Rimer B, Viswanath K. 2008. Health behavior and health education.
Theory, research, and practice. San Francisco, Calif.: Jossey-Bass.
Grol R, Bosch M, Hulscher M, Eccles M, Wensing M. 2007. Planning and
studying improvement in patient care: the use of theoretical perspectives.
Milbank Q 85:93–138.
Haapala I, Probart C. 2004. Food safety knowledge, perceptions, and behaviors
among middle school students. J Nutr Educ Behav 36:71–6.
Harris J, Gleason P, Sheean P, Boushey C, Beto J, Bruemmer B. 2009. An
introduction to qualitative research for food and nutrition professionals. J Am
Diet Assoc 109:80–90.
Knabel S. 1995. Foodborne illness: role of home food handling practices.
Scientific status summary. Food Technol 49:119–31.
30
Journal of Food Science Education—Vol. 9, 2010
Koeppl P, Robey E. 1998. USDA/FDA education initiative: evaluating the
placement of food safety education in American schools. In: Food and drug
administration. Washington, D.C.: U.S. Dept. of Agriculture.
Krippendorf K. 1980. Content analysis: an introduction to its methodology.
Beverly Hills, Calif.: Sage Publications.
Larson NI, Story M, Eisenberg ME, Neumark-Sztainer D. 2006. Food
preparation and purchasing roles among adolescents: associations with
sociodemographic characteristics and diet quality. J Am Diet Assoc
106:211–8.
McLafferty I. 2004. Focus group interviews as a data collecting strategy. J Adv
Nurs 48:187–94.
Miles M, Huberman A. 1994. Qualitative data analysis. An expanded
sourcebook. Thousand Oaks, Calif.: Sage Publications.
Montano D, Kasprzyk D. 2008. Theory of reasoned action, theory of planned
behavior, and the integrated behavioral model. In: Glanz K, Rimer B,
Viswanath K, editors. Health behavior and health education. Theory,
research, and practice. 4th ed. San Francisco, Calif.: Jossey-Bass. p 67–96.
Neumark-Sztainer D, Story M, Perry C, Casey M. 1999. Factors influencing
food choices of adolescents: findings from focus-group discussions with
adolescents. J Am Diet Assoc 99:929–37.
Partnership for Food Safety Education. 1998. Fight Bac! Snapshot of consumer
behavior and attitudes.
Posavac E, Carey R. 2007. Program evaluation: methods and case studies.
Upper Saddle River, N.J.: Pearson Prentice Hall.
Pratt C, Pratt C. 1995. Comparative content analysis of food and nutrition
advertisements in ebony, essence, and ladies’ home journal. J Nutr Educ
27:11–7.
Rollnick S, Mason P, Butler C. 1999. Health behavior change: a guide for
practitioners. Edinburgh, U.K.: Churchill Livingstone.
Sandelowski M. 1995. Sample size in qualitative research. Res Nurs Health
18:179–83.
Stevens G, Cho J. 1985. Socioeconomic indexes and the new 1980 census
occupational classification scheme. Soc Sci Res 14:142–68.
[USDA/FDA] U.S. Dept. of Agriculture, Food and Drug Administration. 1991.
Results of the Food and Drug Administration’s 1988 health and diet
survey—food handling practices and food safety knowledge for consumers.
Washington, D.C.: U.S. Dept. of Agriculture and Food and Drug
Administration.
[USDA/FSIS] U.S. Dept. of Agriculture, Food Safety Inspection Service. 2002.
Changes in consumer knowledge, behavior, and confidence since the 1996
PR/HACCP Final Rule. Available from: http://www.fsis.usda.gov/OA/research/
haccpimpacts.pdf. Accessed Feb 22, 2003.
Unklesbay N, Sneed J, Toma R. 1998. College students’ attitudes, practices,
and knowledge of food safety. J Food Prot 61:1175–80.
Williamson D, Gravani R, Lawless H. 1992. Correlating food safety knowledge
with home food-preparation practices. Food Technol 46:94–100.
Yankelovich Co. 2001. Nickelodeon/Yankelovich youth MONITOR. Norwalk,
Conn.: Yankelovich Co.
Available on-line through ift.org