| Foodborne illnesses are a significant health problem in the United States. Based on the most recent 2011 CDC estimates, each year roughly 1 in 6 Americans (or 48 million people) will get sick, 128,000 will be hospitalized, and 3,000 will die of foodborne diseases, with the top five pathogens contributing to domestically acquired foodborne illnesses listed as Norovirus, Salmonella, Clostridium perfringens, Campylobacter spp, and Staphylococcus aureus. To address these growing concerns, government agencies have implemented various social marketing, food safety educational campaigns and programs. Some of these programs specifically target limited-resource audiences such as participants of the Supplemental Nutrition Assistance Program (SNAP-Ed), the Expanded Food and Nutrition Education Program (EFNEP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Studies have suggested that limited resource populations exhibit deficiencies in food safety knowledge and safe food handling practices at higher rates compared to the general population. Further, limited resource, food insecure individuals, previously surveyed under the direction of Dr. Debra Palmer, admitted to engaging in a variety of non-traditional food acquisition and food management practices to survive hunger. To assess the relative risk level associated with engaging in these practices, a preliminary, 21 question survey, was administered to 85 food safety experts from American Land Grant institutions. Consequently, a survey was developed to include conditions mentioned in the first survey that would alter the risk level of engaging in the practices examined, and to remove behaviors that experts had related were not a concern or for which expertise and consistent literature was lacking. The revised survey was completed by 67 food safety experts. It contained sixteen questions, 14 of which included a list of sub-questions that, according to responses from the first survey, altered risk level ratings. Descriptive statistics were used to describe the behaviors' risk levels under various conditions. Out of 105 practices, 54 practices were determined to be minimally risky, 29 were moderately risky, and 22 were highly risky. Most of the risk levels assigned by experts to the food acquisition and management practices studied varied from low to high, depending on the conditions under which the practices were performed, except for four practices. Factors such as temperature, foods' degree of exposure to contaminants and/or pathogens, certain food characteristic differences, and the cleanliness of the environment in which the food was stored, prepared, or served led to variation in risk level ratings. USDA consumer guidance on these food acquisition practices used by limited-resource individuals was also evaluated, and the practice of removing insects from grains before consumption was the only practice displaying risk variation from minimal to high that was not alluded to in USDA campaigns or consumer guidance. For 15 (about 14%) of the food acquisition and management practices studied, significantly different risk level ratings were found between Food Science experts and Nutrition Educators. For all 15 practices, nutrition educators responded with a higher risk level rating. Results of this study have helped to recognize that the limited resource populations engaging in practices determined to be moderate or high risk have an increased likelihood of acquiring a foodborne illness caused by the five most potentially dangerous pathogens identified. Findings also suggest that supplementary food safety education messages that are culturally sensitive, contain content with a low grade level reading, and that are relevant to the high risk food practices identified in this study, may need to be developed. Lastly, students pursuing a career in Community Nutrition or Public Health Promotion, who will have an impact on food safety education disseminated to limited resource populations, should acquire more extensive training in the areas of food safety and food science. |
