The impact of interventions on food hygiene knowledge and behaviour of social care staff and managers
This was a multi-disciplinary thesis to examine the impact of current interventions (health education material, training, HACCP and inspection) on food hygiene knowledge and behaviour in social care organisations (SCOs), reviewing current practice and recommending the most effective food hygiene intervention. A systematic review identified and critically appraised the evidence for the effectiveness of current food hygiene interventions. Quantitative and qualitative methods of data collection were employed, such as structured and semi-structured postal questionnaires, focus groups of stakeholders and follow-up telephone interviews, to investigate the food hygiene knowledge and behaviour of SCO staff and managers. The systematic review found that many interventions are not based on epidemiological evidence of the main causative factors associated with food-borne disease, or designed to change behaviour and as a result their effect is limited. Although food hygiene training of managers in SCOs is of a lower level than staff, critical control points are recorded in over 80% of workplaces. Following a review of health promotion theories, no single intervention resulted in effective behavioural change to safer food safety practices. All interventions should be evidence and competence based. Improved teaching of theoretical models and closer collaboration between practitioners and academics is recommended to achieve more effective interventions, and research using robust study designs.