Impact of Training on Employees' Handwashing Behaviors in School Nutrition Programs.

Background: School nutrition employee behavior plays an important role in preventing foodborne outbreaks and protecting the almost 30 million children who partake in daily school lunch.

Objective: The study aim was to compare the impact of using a food safety training program with or without using a realistic-event video on handwashing behavior modification for school nutrition employees.

Design: A 2-group (control and experimental) pretest with 2 post-tests design was used. The control group received training without the video and the experimental group received the food safety training with a realistic-event video. Measurements used to address the purpose and objectives of this study included questionnaires and direct observations.

Participants/setting: The sample consisted of 443 school nutrition employees responsible for food preparation and service affiliated with 21 school districts in 18 states. Approximately half of the sample attended the original unmodified training and the other half attended the modified training. Data were collected in the United States during 2017. A total of 338 employees participated in the observations and 443 participants completed the questionnaires during the 3 phases; 935 questionnaires were used for the analysis.

Intervention: The intervention involved a food safety training program embedded with a realistic-event video related to handwashing. The video used previous research to target antecedents to handwashing behavior among participants.

Main Outcome Measures: Actual behavior was observed across 3 phases-pretraining, post training, and final-for both the control and experimental groups. In addition, indirect and direct measures of behavioral intentions for handwashing were measured.

Statistical Analysis Performed: For the observation data, a 2-way, fixed-effects, mixed-model procedure was used to analyze the data. Simple and multiple linear regression and contingency table analyses looking for differences among phases and treatments were used for questionnaire data analysis.

Results: Most practices were reported as in compliance (51.3% to 80.6%) for both the control and experimental groups during all phases. The experimental group had a higher behavioral intention of properly washing their hands than participants in the control group.

Conclusions: The results showed that handwashing practices were in compliance most of the time for both the control and experimental groups during all 3 observation periods. Differences among the data collection periods on the theory of planned behavior constructs indicated no statistical effect of the treatment (exposure to the video) between the control and intervention groups.