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This is to certify that the

thesis entitled
Safe Food Handling:

Knowledge of Third-grade Teachers and

School Foodservice Personnel in Michigan Schools

presented by
Wen-yu Chin

has been accepted towards fulfillment
of the requirements for

Master of Science degree in Institution Admin.

 

 

OM &. Judi/rd

Major professor

Date Dec. 22, 1992

 

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-———-——- r - -—_

SAFE FOOD HANDLING: KNOWLEDGE OF
THIRD-GRADE TEACHERS AND SCHOOL FOODSERVICE PERSONNEL
IN MICHIGAN SCHOOLS

BY

Wen-yu Chin

A THESIS

Submitted to
Michigan State University
in Partial fulfillment of the requirements
for the degree of

MASTER OF SCIENCE

Department of Food Science and Human Nutrition

1992

ABSTRACT

SAFE FOOD HANDLING: KNOWLEDGE OF
THIRD-GRADE TEACHERS AND SCHOOL FOODSERVICE PERSONNEL
IN MICHIGAN SCHOOLS

3?
Wen-yu Chin

Michigan third-grade teachers (n= 439/997 or 43.9% response
rate) and school foodservice personnel (n= 597/1400 or 42.6%
response rate) were surveyed by mail to determine their
knowledge of safe food handling. Teachers correctly
answered 55% of eight knowledge questions. Teachers over 40
years of age had a higher mean knowledge score on safe food
handling than teachers under 40 years of age (p 5 0.05).
School foodservice personnel correctly answered 76% of the
knowledge questions. Managers/supervisors of school
foodservice operations had a higher mean knowledge score on
safe food handling than school foodservice personnel with
other job titles such as cooks and cook assistants (p g
0.05). Separate training programs about safe food handling
for both teachers and school foodservice personnel should
focus on safe temperatures for operating refrigerators and

methods of identifying unsafe food.

To my parents

for their love and support.

ii

ACKNO'LEDGENENTS

I would like to express my appreciation to the members of my
guidance committee, Dr. Carol Sawyer, Dr. Sandra Andrews, Dr. June
Youatt, and Dr. James Pastka, for the encouragement and education.
A special thank goes to Dr. Sawyer for her professional guidance
throughout the graduate program.

A special note of gratitude is given to Dr. Murphy for her
assistance in survey research. I would also like to thank Dr.
Gill for answering the questions about data analysis.

Angela Fraser, Kuo-Tung Li and Ya-Lan Tan also deserve a
special mention for the assistance and friendships. Thank you
for sharing your ideas and skills in all aspects of this project.
Thanks also to Ya-Li Huang and Ya-Hsien Chen for the special

friendships.

iii

TABLE OF CONTENTS

Page
LIST OF TABLES ......... . ....................... ......... Vi
LIST OF FIGURES ........................................viii
1.0 INTRODUCTION ........................................ l
2.0 REVIEW OF LITERATURE ...... . ............. . ...... ..... 4
2.1 Food Safety ......................................... 4

Foodborne Disease Problems in the U.S. .............
Foodborne Disease Related to Children ..............

\IUI

2.2 Nutrition and Safe Food Handling Education .......... 8

Food Safety Education Programs for School Children . 8
Teachers' Attitude Toward and Knowledge

About Nutrition ................................. 9
The Application of Computers for Instruction ...... 12

2.3 School Foodservice ......... ..... ... .......... . ..... . 13

The National School Lunch Program .................. 14
Control of Microbial Problems in the School

Foodservice Industry ............................ 15
The Roles of School Foodservice Personnel .......... 17
Evaluation of School Foodservice Personnel ......... 18
Training for School Foodservice Personnel .......... 19
Introduction of Training Programs .................. 19

3.0 NICHIGAN THIRD-GRADE TEACHERS: KNOWLEDGE OF SAFE FOOD
HANDLING .....OOOOOOOOO......OOOOOOOO0.00.00.00.00... 23
3.1 Abstract ....OOOOOOOOOOOOOOOOOOOOOOO......OOOOOOOOOOO 23
3.2 IntrOduCtion 0000............OOOOOOO......OOOOOOOOOOO 24
3.3 methads ......OOOOOO0.0.00.00.00.00......OOOOOOOOOOOO 27
Description of Sampling Frame....................... 27
Design of the Questionnaire......................... 28
Pilot Testing of the Questionnaire.................. 29
Administration of the Questionnaires................ 3O
StatiStical AnaIYSj-S ......OOOOOOOIOOOOOO0.0.0.0.... 31

iv

3.4 Results and DiscuSSion .......................O...... 32

Personal Demographics .............................. 32
Professional Demographics .......................... 34
School Demographics ................................ 39
Knowledge of Safe Food Handling .................... 42

3.5 ConCIuSions ......................................... 54

4.0 MICHIGAN SCHOOL FOODSERVICE PERSONNEL: KNOWLEDGE OF SAFE
rwnmnING........................................ 57

4.1Abstract...........................................O. 57

4.2 IntrOduction......................................... 58

4.3 Methads......................O..............0......0. 61

The Sampling Frame.................................. 61
Design of the Questionnaire ........................ 62
Pilot Testing of the Questionnaires................. 63
Administration of the Questionnaire ................ 65
Statistical Analysis ............................... 65

4.4 Results and Discussion............................... 66

Personal Demographics .............................. 66
Professional Demographics .......................... 69
School Demographics ................................ 73
Knowledge of Safe Food Handling .................... 78
Statistical Analysis................................ 84

4.5 conCIuSionSeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee 88

5.0 BUMYMCONCLUBIONB ......O...................... 90

LIST OF
1.
2.
3.
4.
5.
6.
7.
8.
9.

10.
11.

LIST OF

APPENDICES ...................................... 94
Request Letter .................................. 94
Reply Card ...................................... 96
Questionnaire for Third-grade Teachers .......... 97
Cover Letter to Third-grade Teachers ............106
Inventory Sheet Sent to Contact Person...........1o7
Direction Sheet .................................108
Gift-certificate for Third-grade Teachers .......109
Thank You Letter to Third-grade Teachers ........110
Locations and Brands of Computers Available

in Third-grade Classrooms ....................111
Questionnaire for School Foodservice Personnel...112
Cover Letter to School Foodservice Personnel ....119

REFERENCES ..............................O.......120

1.0 INTRODUCTION

Foodborne disease, caused mostly by foodborne
pathogens, is a critical health problem in the United States
(Bean and Griffin, 1990; Swintek, 1991; Titus and Talbot,
1991). Among the threats posed by potentially unsafe foods,
microbiological issues are the primary areas that have been
emphasized (Wolf, 1992). The Centers for Disease Control
(CDC) stated that foodborne disease remains one of the most
common and important causes of disease and death in the
United States (USDA, 1989a). The CDC estimated that between
6.5 and 81 millions cases and 9,000 deaths related to
foodborne disease occur annually in the U.S. (Amler and
Dull, 1987; Archer and Kvenberg; 1985, USDA, 1989a; Synder,
1992).

One cause of foodborne disease is unsafe food handling
practices (USDA, 1989b; Synder, 1992). According to CDC
data, the most frequently reported food-preparation]
practices that contributed to foodborne disease betwen 1983
to 1987 were improper storage or holding temperature of
food, followed by poor personal hygiene of food handlers
(Bean et al., 1990). Other studies have indicated that U.S.
consumers are not always knowledgeable about food handling
and preparation, especially concerning cold holding

1

2
temperature, storage of leftovers, and methods of thawing
frozen foods (Beard, 1991; Gravani, 1992).

Not everyone faces the same risk from eating food
contaminated with pathogenic microorganisms or their toxins.
Individuals who are particularly vulnerable to foodborne
disease include senior citizens, pregnant women, young
children, and people suffering from chronic diseases (Wolf,
1992; Snyder, 1992).

Children may be particularly at risk for foodborne
disease (Neill, 1989; Potter, 1989; Foster, 1987). Although
many studies have shown that schools can play an important
role in health promotion, little information is available on
the safe food handling knowledge of school employees such as
teachers and school foodservice personnel (Nader et a1.,
1986; Kirks and Hughes, 1986). Thus, the purpose of this
study was to determine the safe food handling knowledge of
third-grade teachers and school foodservice personnel in
Michigan schools.

This study is part of a larger safe food handling
project. To decrease the potential occurrence of foodborne
disease in Michigan children and their families, a needs
assessment in the area of safe food handling was designed by
researchers at Michigan State University. Third-grade
children were chosen because they, most likely, had not yet
received any formal instruction on safe food handling.

Questionnaires were mailed to third-grade children and adult

3

populations who may influence them in the area of safe food
handling. The adult populations included third-grade
teachers, school foodservice personnel, household members of
the children, and health information providers.

The outcome of this project has been the development of
a curriculum for children 9 to 11 years of age. The
curriculum included classroom lessons for use with
fourth-grade children, two take-home packets for use by
children with their other household members, and a

hypermedia software game on safe food handling.

2.0 REVIEW OF LITERATURE

In recent years food safety has emerged aS'a major
health concern of consumers and federal agencies (Beran,
1991; Foster et a1. 1985; Huang, 1992; Wolf, 1992). The
concept of food safety has been defined to include all
conditions and measures that are necessary during the
production, processing, storage, distribution, and
preparation of food to ensure that it is safe, wholesome,

and fit for human consumption (Poster at al., 1985).

2.1 Food Safety

In the area of food safety, many consumers are
concerned about chemical hazards (Wolf, 1989). Chemical
hazards include cleaning compounds, food additives,
pesticide residues, food processing aids, and preservatives
(Synder, 1992). However, most toxicologists and food safety
experts concur that microbiological contaminants have been a
more serious problem than chemical residues in the U.S. food
supply (Lee, 1989; Swintek, 1991; Titus and Talbot, 1991;
Wolf, 1992).

According to the Centers for Disease Control (CDC)

data, bacterial pathogens caused the largest number of

5
foodborne disease outbreaks and cases from 1983 to 1987
(Bean et a1., 1990). Because of this fact, the U.S. Food
and Drug Administration began to focus on the emphasis on

foodborne microorganisms (Albrecht, 1986).

2.1.1 Foodborne Disease Problems in the 0.8.

Foodborne disease is typically usually either
infectious or toxic in nature. It is caused by agents that
enter the body through the consumption of food (Foster,
1985).

Foodborne disease is a major cause of morbidity in the
United States (Bean and Griffin, 1990). Estimates of the
annual U.S. outbreaks of foodborne disease vary widely, from
6.5 million cases to 81 million cases (Amler and Dull, 1987;
Archer and Kvenberg, 1985; USDA, 1989a; Synder, 1992).

Outbreaks of foodborne disease are believed to be
under-reported (Eilers, 1990). Public health officials
estimated that only one person out of 25-100 cases of food
poisoning actually seeks medical attention (Archer and
Kvenberg, 1985). During the period 1983-1987, 2,397
outbreaks accounting for 91,678 cases of foodborne disease
were reported to the CDC . The number of outbreaks reported
to the CDC was probably only a small fraction of the true
number that occurred (Bean et al., 1990).

Among outbreaks in which the etiology was determined,

bacterial pathogens cause the largest number of outbreaks

6
(66%) and cases (92%) (Bean et al., 1990). From 1973 to
1987, bacterial pathogens accounted for 90% of deaths from
foodborne disease, with Listeria monocytogens (317/1,000
cases) and Clostridium botulinum (192/1,000) causing the
highest death-to-case rate (Bean and Griffin, 1990).

Many new foodborne pathogens have been identified
recently (Potter, 1989). Previous to 1975, only six
pathogens were widely recognized as foodborne pathogens.
Since 1975, this list has grown to over 25 organisms and
continues to increase. Some of the newest pathogens to
emerge are Listeria monocytogens, Campylobacter jejuni, and
Escherichia coli 0157:H7 (Potter, 1989; Cliver, 1990). Why
new pathogens are emerging was discussed by Cox (1989).
Changes in primary food production, changes in food
processing technology, changes in food handling practices,
and changes in the behavior of microorganisms have caused
the emergence of new pathogens.

Unlike other types of disease, a large number of
foodborne disease could be prevented by safe food handling
(USDA, 1989b). Consumers and foodservice employees have the
responsibility to use proper safe food handling practice.
According to CDC data, foodborne outbreaks reported to the
CDC between 1973-1987 were caused by commercial or
institutional foodservice establishments in 79% of the
cases, while mishandling of food in homes caused 21% (Bean

and Griffin, 1990). Food industry employees have the

7
responsibility to follow sanitary regulations which ensure
the safety and stability of food until it reaches the

consumers (Wolf, 1989).

2.1.2 Foodborne Disease Related to Children

Not everyone faces the same risk from eating food
contaminated with pathogenic microorganisms or their toxins.
In fact, populations who are particularly at risk of
foodborne disease include senior citizens, pregnant women,
very young children, and people suffering from chronic
diseases (Wolf, 1989; Synder, 1992). .

Some foodborne pathogens such as E. coli. 0157:H7 have
been especially dangerous for children. One of the
principle syndromes linked to E. coli. 0157:H7, hemolytic
uremic syndrome (HUS), is the leading cause of renal failure
in children (Cliver, 1990). In HUS, blood clots plug the
convoluted tubules in the kidney which results in an
accumulation of waste products in blood. The patient may
require dialysis and may become permanently debilitated. In
some cases the child will go into a coma or die. This
syndrome has killed elderly people as well as children

(Cliver, 1990).

8
2.2 Education of Nutrition and Safe Food Handling
Many studies have shown that school has an important
role in health promotion for students (Nader et a1., 1986;
Kirks and Hughes, 1986; Williams and wynder, 1976). Health
professionals also agreed about the importance cf
interventions that teach health-enhancing eating patterns in

childhood (Crockett, 1988).

2.2.1 Food safety Education Programs For School Children

In the past 20 years there have been many changes in
the educational system. Courses in home economics or
"Survival in the Kitchen," once taught in every grade school
and high school, have been reduced in number or even
eliminated (Beard, 1992). The result has been that children
have not had the chance to learn much about food handling in
the classroom (Beard, 1992).

In the state of Michigan, the Michigan Model for
Comprehensive Health Education (MDE, 1987) addresses safe
food handling in only two units in the fourth grade. The
topics of these two units were related to food storage and
to the reasons why food spoils. However, topics related to
nutrition are covered in more than 15 units, from
kindergarten through grade eight. With such emphasis on
nutrition issues, the importance of safe food handling was

easily forgotten (Weinstein, 1990).

9
Although most all children in Michigan receive

nutrition education through the Michigan Health Model (MDE,
1987), the major emphasis is on food choice and not on safe
food handling. Using current school curricula, children are
likely to have very limited exposure to safe food handling
information. A number of research studies have found that
young children are more knowledgeable about nutrition and
other health care practices as a result of classroom efforts

(Mather, 1984; Thompson, 1985, Essa, et al., 1988).

2.2.2 Teachers' Attitude Toward and Knowledge About
Nutrition A

Elementary school teachers hold a distinct position of
authority in the classroom. The student-teacher
relationship can be used to provide good nutrition education
and to help children develop good habits (Baird, 1981).
Teachers' attitudes toward nutrition play a major role in
the success of nutrition education for school children
(Baird, 1981). Also, their attitudes affect whether
nutrition education will be taught at all (Baird, 1981).
For teachers’ influence to be beneficial, they should have
basic nutrition knowledge and know how to incorporate that
knowledge into school lessons (Cortes, 1973).

A number of studies have evaluated school teachers'
attitude toward nutrition and knowledge of nutrition. In
the state of Oklahoma, 390 public school teachers were

surveyed to determine their attitudes and practices of

10
nutrition (Baird, 1981). Over half the respondents (67%)
thought that nutrition concepts should be taught at every
grade level; 18% thought in elementary grades; only 1.35%
thought that nutrition education is not the school's
responsibility. The most frequently used teaching methods
for nutrition included classification of food groups,
discussions, keeping and/or revising records of food eaten
in one day, using films or filmstrips, and having children
develop plans for improving their food practices. Over 90%
of the respondents thought that nutrition education is
important to help children form good habits.

The second study involved the Kansas Nutrition
Education and Training Program, which provided baseline data
about Kansas elementary teachers’ knowledge about, and
practice of nutrition (Soliah et al., 1983). Kansas
elementary school teachers tended to have favorable
attitudes toward nutrition. Almost all the teachers (90%)
indicated that nutrition should be taught in all grades or
in a combination of grades (Soliah et al., 1983). Only 40%
thought that they had sufficient materials to provide
nutrition instruction to their students (Soliah et al.,
1983). In those schools with on-premise food production
facilities, teachers tended to work with the school
foodservice personnel and use the cafeteria as a laboratory
for instruction more frequently than did teachers in schools

with only satellite service centers (Soliah et al., 1983).

11

Teachers in Kansas suggested that more nutrition
education materials should be developed on these topics: (1)
nutritious breakfasts, (2) healthful snacks, (3) dental
health, (4) the importance of drinking milk, (5) proper food
handling, and (6) food additives (Soliah et a1., 1983).
Elementary teachers who had a background in nutrition had
higher knowledge scores than teachers who did not had
nutrition background. Similarly, teachers who were already
teaching nutrition to their students had higher scores on
nutrition knowledge and practices than those who were not
teaching nutrition (Soliah et a1., 1983).

Petersen and Kies (1972) studied the nutrition
knowledge and attitudes of early elementary school teachers
in Nebraska. The survey results indicated that teachers did
not have enough educational background for nutrition
education. Overall nutrition knowledge scores of Nebraska
elementary teachers were low. These authors concluded that
this may be due to their lack of retention of nutrition
facts from formal courses in nutrition (Petersen and Kies,
1975).

The importance of the development of favorable food
attitudes was rated "highly positive" by the Kansas teachers
(Soliah et a1., 1983). Ninety-one percent of the
respondents agreed that developing a favorable attitude
toward good nutrition was more important than teaching facts

(Soliah et a1., 1983). However, 56% of the respondents

12
agreed that learning facts was the best way to achieve
change in food habits for school children. The relationship
between teachers' knowledge scores on nutrition and
attitudes toward nutrition was determined by the study
(Soliah et a1., 1983). The result indicated that attitudes
toward teaching nutrition are not affected by the extent of
the elementary school teachers’ nutrition knowledge (Soliah
et a1., 1983).

Another study was developed to assess the influence of
teachers' attitudes toward school lunch programs and
nutrition education by Perkins et a1. (1980) in Texas.
Teachers in the Texas study had a positive attitude toward
the importance of nutrition and school lunch programs
(Perkins et a1., 1980). The respondents believed that
school foodservice personnel and nutritionists would be
valuable resources of nutrition education. The Texas
teachers believed that cooperation with school foodservice
personnel was important for effective nutrition education
(Perkins et a1., 1980). And they believed that school
foodservice personnel can help children develop better
eating habits if they offer a wide variety of foods (Perkins

et a1., 1980).

2.2.3 The Application of Computers for Instruction
In a recent study of teachers (n=608) who have

integrated computers into classroom practice, Sheingold and

13
Hadley (1990) found that software was used most frequently
in word processing (95%). Instructional software followed
with 89%, and analytic and information tools followed with
87%. When asked to give examples of their most productive
and interesting uses of computers in their classrooms, 75%
of the sample gave more examples of writing and language
projects than of any other uses (Sheingold and Hadley,
1990).

Plomp and Pelgrum (1990) studied school computer use in
eight countries for the International Evaluation
Association. They found that the type of software programs
most commonly available in U.S. schools were: (1) word
processing (93%), (2) drill and practice (92%), (3)
educational games (91%), and (4) tutorial programs (81%).

Swick (1989) suggested that the computer is effective
with children when it provides a medium for extending
learning to new visual and manipulative models. The
environment should be flexible, unique, enjoyable, and

produce a sense of achievement in the child (Swick,1989).

2.3 School Foodservice
School foodservice establishments may be considered as
a primary health care provider (Sen, 1991). Foodservice
personnel accept certain responsibilities at the food
consumption point to supply adequate, nutritious and proper

food for the consumers (Bryan, 1986).

14

2.3.1 The national School Lunch Program

The U.S. National School Lunch Program (NSLP) is
permanently authorized under the National School Lunch Act
of 1946. The NSLP was established because: (1) during
physical examinations for military service many young men
were found to be malnourished; (2) there was a need for an
outlet for agriculture commodities produced by flourishing
farms after World War II; and (3) a nutritious lunch at
school facilitated learning (ASFSA, 1983; Hawkins et a1.,
1989).

The U.S. National School Lunch program has been
administered by the United States Department of Agriculture
(USDA) at the federal level and by state departments of
education (Pannell, 1990). Any public or nonprofit private
school (high school or under) was eligible to participate in
the NSLP, except for private schools with tuition of more
than $2,000. Cash reimbursement and commodity assistance
were provided to nonprofit foodservice operations that
agreed to follow federal regulations (Pannell, 1990).

In 1988-1989, 91,485 U.S. public and private schools
and residential institutions participated in the program,
serving lunches to approximately 24.2 million children
(USDA, 1989a). The federal government provided about $4.5
billion in cash assistance to lunch programs in schools,

according to preliminary estimates in 1989 (USDA, 1989a).

 

15

2.3.2 Control of Microbial Problems in the School
Foodservice Industry

Many research studies focused on methods to control
microbial problems in the school foodservice programs. The
phases of product flow in the preparation and service of
spaghetti and chili in a school foodservice system producing
18,000 meals/day were developed by Cremer and Chipley
(1977a; 1977b).

Thorough cooking of the products prior to assembly and
thorough reheating of the products for service were
considered important keys to the safety of the food (Cremer
and Chipley, 1977a; Cremer and Chipley, 1977b). Because of
pathogens, the potential for public-health hazards can be
great if food is mishandling in satellite systems of school
foodservice operations (Cremer and Chipley, 1980).

Raccach et a1. (1985) suggested the use of a critical
control point (CCP) system as shown in Table 1. Most of the
phases in food preparation (expect for procurement, heating,
and holding) were to be controlled by at least two CCPs--a
time-temperature combination and sanitation of personnel and
equipment. Procurement would be controlled through the raw
materials, while heating and holding would be controlled by
appropriate time-temperature combinations. Every CCP would
contribute to the reduction or elimination of health hazards
of microbial origin. Recommendations for time-temperature

combinations and sanitary practices could be based on the

 

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l7
Foodservice Sanitation Manual of the Food and Drug
Administration (FDA, 1978).
2.3.3. The Roles Foodservice Personnel

Foodservice personnel at any establishment, including
schools, may be considered as a primary health care provider
(Sen, 1991). Foodservice personnel accept certain
responsibilities at the food consumption point to supply
adequate, nutritious and proper food for consumers (Raccach,
et a1., 1985). In general, foodservice personnel play a
significant role in reducing the morbidity and mortality of
the consumer by interrupting the casual factors of diarrheal
diseases and the malnutrition cycle (Sen, 1991). Therefore,
they become a prominent member of the primary health care
team (Sen, 1991).

Foodservice personnel should be well informed on all
aspects of the relation between health and foodservice to
the customer (Bryan, 1986). Foodservice personnel should
provide appropriate information to the general consumer and
should also assist children in minimizing the occurrence of
foodborne disease (Bryan, 1986; Sen, 1991). Accordingly,
the foodservice operator is concerned with three variables:
(1) the quality of the food, (2) the consumer's health
status and (3) the environmental factors for preventing

contamination (Bryan, 1986; Sen, 1991).

18
2.3.4 Evaluation of School Foodservice Personnel

Evaluations of knowledge for school foodservice
personnel have been reported in various areas such as
nutrition. However, limited information about safe food
handling knowledge was found in the published literature.

The knowledge about, and use of the Dietary Guidelines
for Americans by school foodservice personnel were evaluated
(Glover et a1., 1991). The results indicated that school
foodservice managers had good knowledge of the Guidelines,
but did not often follow them when serving meals to
children. Managers expected the modified recipes from the
USDA to assist them in preparing healthier meals.

In the Kansas Nutrition Education and Training Program
Needs Assessment Project, a survey to determine the
nutrition-related training, knowledge, attitude and
practices of Kansas school foodservice personnel (n-464) was
conducted (Bowen, 1982). Almost two-thirds of the Kansas
school foodservice personnel indicated that they had not
completed any type of nutrition-related training.
Respondents with formal training in nutrition had a higher
score on most knowledge measurements. Generally, nutrition
knowledge was positively related to scores for nutrition-
related attitudes and practices. The results also indicated
that increased emphasis on training in nutrition for school

foodservice personnel is needed.

19
2.3.5 Training for Foodservice Personnel

Several research papers described the functions of
training school foodservice personnel. Ricci (1988)
stressed the importance of job-related training. Training
programs for school foodservice personnel are designed not
only to provide important knowledge and job-related skills
but also to improve job performance (Ricci, 1988).

Penninger (1984) reported that food safety training and
certification of foodservice managers had improved the
actual sanitary conditions of facilities in which they
worked. All foodservice personnel should be offered
frequent refresher courses.

Regulations should require that the majority of food
handlers have a basic understanding of food safety. The
specific areas of understanding included the ways and
conditions in which bacterial grow, the effect of food
poisoning, personal health and hygiene, how to keep
equipment clean, pest control, and the food handler's

responsibilities under law (Health and Hygiene, 1990).

2.3.6 Introduction of Training Programs
Four training programs related to safe food handling
are available for Michigan school foodservice personnel. A

brief description of these four programs follows.

20
. .6 ' v' a ° '0

The Applied Foodservice Sanitation course is a training
program developed by the National Institute for the
Foodservice Industry (NIFI) in liaison with the national
Sanitation Foundation (Hauer, 1985). The NIFI course is
designed for use as an introductory course in practical
sanitation for foodservice operations. The course is
suitable for use in professional level courses in schools
offering a full complement of hotel and foodservice
management instruction (Hauer, 1985).

The content of Applied Foodservice Sanitation includes
information on sanitation and health, serving sanitary food,
new equipment, and material on cleaning and sanitizing
operations (Hauer, 1985). The course also includes vital
information on how to work through people to maintain a
sanitary operation, training workers, working with a pest
control operator, and dealing with local health officers
(Hauer, 1985).
2.2.5.2 American S9399; Foodservice Association Erggzgm

The American School Food Service Association's
Certification program gives recognition to school
foodservice personnel who have achieved a specific level of
professional development (ASFSA, 1990). The Sanitation and
Safety course consists of ten hours of formal training for

school foodservice personnel (ASFSA, 1990). Upon completion

21
they earn a certificate from American School Food Service
Association (ASFSA).

This course provides school foodservice personnel with
the knowledge and skills needed to maintain a sanitary
foodservice Operation (ASFSA, 1990). The content of the
Sanitation and Safety course focuses on the principles and
practices of sanitation, preper food handling, causes of
foodborne illness, understanding how to control the growth
of microorganisms, foodservice regulatory standards, insect
and pest control, proper lifting techniques, and fire safety
(ASFSA, 1990).
2IlIéIl_MDE_lQQ_2nQ_HD§_129_QQQI§£§

The Michigan Department of Education (MDE) provides
several training courses for Michigan school foodservice
personnel in Michigan related to nutrition and safe food
handling (MDE, 1992). The statewide training program for
school foodservice personnel was designed to stimulate
personal and professional growth for school foodservice
personnel (MDE, 1992).

MDE 100: School Foodservice Basics was designed for
school foodservice personnel to provide simple explanations
about the nutrition needs of school children (MDE, 1992).
The purpose was recognize the Child Nutrition Programs,
their main features, and their goals (MDE, 1989a). The
course also helps school foodservice personnel identify

reimbursable meal patterns. Topics in the six sections

22
after course were: current child nutrition programs, meeting
meal patterns, the responsibilities for meal programs,
record keeping requirements, and federal assistance
(MDE,1989a).

MDE 120: Sanitation and Safety was designed to make
Michigan school foodservice personnel knowledgeable about
the Michigan Health Code and the causes of and protection
from foodborne disease (MDE, 1992). The goal of this course
is to teach principles and practices of foodservice
sanitation to help school foodservice feed children safely.
Topics of the MDE 120 course include: (1) the challenges to
food safety, (2) a definition of sanitation and how it
affects food quality, and (3) foodborne illness and its

consequences (MDE, 1989b).

3.0 MICHIGAN THIRD-GRADE TEACHERS: KNOWLEDGE OF
SAFE FOOD HANDLING

3.1 Abstract

Third-grade teachers in Michigan (n= 439/997 or 43.9%
response rate) were surveyed to determine their knowledge of
safe food handling. Most respondents were female (89%) and
were between 31 and 50 years of age (66%). Their highest
degree was Bachelor’s (43.6%) or Master's degree (53.2%).
Almost three-fourths of third-grade teachers in Michigan
(74%) had never received any formal training in safe food
handling. When asked about safe food handling practices of
children, teachers responded that opportunities were "almost
always" provided for third-grade children in school to wash
their hands before eating a snack (61%), before lunch (74%),
and after using a toilet (99.1%). Although teachers were
knowledgeable about storage and thawing of food, they did
not know the maximum safe operating temperature (4STW of a
refrigerator. Teachers over 40 years of age were more
knowledgeable about safe food handling than teachers under
40 years of age (p g 0.05). Information from this study
could be used to develop statewide in-service workshops and

graduate curricula for elementary teachers.

23

3.2 Introduction

Food safety has become one of the leading consumer
issues of the 19905. Each year approximately 24-81 million
people in the United States contract foodborne disease, of
which more than 9,000 die (Amler and Dull, 1987; Archer and
Kvenberg, 1985). Unlike many other types of disease,
foodborne disease is almost completely preventable by safe
food handling (USDA, 1989b; Cliver, 1990; Pannell, 1990).

Young children may have a higher risk of infection from
microbiological contamination of foods than do other
populations (Wolf, 1990; Potter, 1989; Synder, 1992). For
example, infections of Escherichia coli 0157:H7 have been
reported to occur most frequently in children ages 0-9 years
(Potter, 1989). This type of foodborne disease may lead to
death, especially in children (Cliver, 1990).

Many factors can be identified which increase the
chance of foodborne disease in children. Lifestyle changes
in the family, the food-quality preferences of children, the
types of food marketed to children, and the lack of
instruction for children in safe food handling have
contributed to this higher risk (MDE, 1987; Auld, 1990;

Hildebrand, 1990).

24

25

Many studies have shown that schools have been
essential in health promotion (Nader et a1., 1986; Kirks and
Hughes, 1986; Williams and Wynder, 1976). Schools have many
opportunities to influence children’s habits and food
handling practice in the elementary school years (Soliah, et
a1., 1983). Several research studies have found that young
children were more knowledgeable about making nutritious
food choices and following other health-care practices as a
result of classroom efforts (Mather, 1984; Thompson, 1985;
Essa, et a1., 1988). However, most school systems have
placed a greater emphasis on nutrition, especially the
selection of foods with a high nutrient density, rather than
on safe food handling (MDE, 1987).

During the elementary school years, teachers are
possibly the first adults outside of the home to play an
important role in children’s lives and have an influence on
children's knowledge about food (Head, 1974; Baker, 1972).

A review of the literature indicated that the nutrition
knowledge of elementary teachers has been evaluated in many
studies, but not their knowledge of safe food handling
(Petersen and Kies, 1972; Perkins et a1., 1980; Baird and
Sibley, 1981; Soliah et a1., 1983). Thus, the purpose of
this study was to determine the safe food handling knowledge
of Michigan third-grade classroom teachers.

This survey of teachers’ safe food handling knowledge

was a part of a larger safe food handling project which

26
surveyed Michigan third-grade children and four influential
adult groups (household members, classroom teachers, school
foodservice personnel, and health information providers) who
might influence their knowledge of safe food handling.
Third-grade children were chosen because they represented
children prior to any formal instruction on safe food
handling (MDE, 1987). The first concepts about safe food
handling under the Michigan Model are introduced to fourth-
grade children. Third-grade classroom teachers were
surveyed because their knowledge of safe food handling could
influence the knowledge about, and the practice of safe food

handling of children in their classroom.

3.3 Methods

This study was one component of a statewide (Michigan)
assessment project which evaluated safe food handling
knowledge of third-grade children and the influential adult
populations that could impact their knowledge. One such
population was third-grade teachers. The purpose of this
study was to determine the safe food handling knowledge of
Michigan third-grade teachers. A mailed questionnaire was
the method used to obtain the data on safe food handling
knowledge. Mailed questionnaires were used because this
method can (1) accommodate a large sample, (2) reach widely
dispersed respondents inexpensively, and (3) get a high ‘

response rate (Alreck and Settle, 1985).

3.3.1 Description of Sampling Frame

Access to teachers was obtained by requesting from
school principals’ or other administrators' permission for
teachers to participate in this study. A request letter and
a reply card (Appendices 1 and 2) were sent to principals of
all public elementary schools (N=1993) in the state of
Michigan. The letters requested that principals give

permission for third-grade teachers to participate in the

27

28
study. Third-grade teachers from all participating schools

(n=271) were used as the sample population.

3.3.2 Design of the Questionnaire

The questionnaire for third-grade teachers, developed
during March and April 1991 (Appendix 3), consisted of 35
questions. Included were questions about knowledge of safe
food handling and questions about demographics.

Teachers’ knowledge level of safe food handling was
assessed by eight knowledge questions. The knowledge
questions were based on the most frequently reported food-
preparation practices that contribute to foodborne disease--
improper storage, improper holding temperature, and poor
personal hygiene (Bean, et a1., 1990). Areas of evaluation
were food temperature and storage, potentially hazardous
foods , personal hygiene, and cross-contamination.

Personal, professional, and school-related demographic
data were collected. Personal demographic data requested
were gender, age, education, income level, and perception of
the importance of safe food handling. Professional
demographic information included years on the job, sources
of information on safe food handling, and safe food handling
teaching materials and methods. School demographic
information included class size, classroom resources,
opportunities for children to keep their lunches cold,

opportunities for children to wash their hands, and

29
teachers' perceptions of how often children eat spoiled
foods.

A letter describing the proposed study and directions
for answering the questionnaire was on the cover of each
questionnaire. The questionnaire was approved for use by
the University Committee on Research Involving Human
Subjects (UCRIHS) at Michigan State University (MSU) in

March 1991.

3.3.3 Pilot Testing of the Questionnaire

The questionnaire on safe food handling for teachers
was pilot tested. The content, construCt, and face validity
of the questionnaire was assessed by expert review. Content
validity was assessed by determining whether the questions
chosen were accurate (right answers were correct; wrong
answers were incorrect). Face validity was determined by
ascertaining whether the survey was appropriate for the
intended population. Construct validity was assessed by
determining whether the items represented the concept (safe
food handling) they were intended to measure.

The questionnaire was pilot tested (n=50) to determine
criterion validity. Criterion validity was defined in this
study by whether the instrument discriminated between
masters and non-masters of information represented by the
censtruct. The discrimination index was used to assessed

criterion validity and was calculated for individual items

30
and for the total survey. The index of discrimination used
in the item analysis was calculated as the difference
between the proportion of the high scorers (27%) who
selected the correct answer minus the proportion of the low
scorers (27%) who selected the right answer.

The index of difficulty (proportion of the total group
who got the item correct) was also calculated (Morris et a1.
1987). A high index indicated the item was easy and a low
index indicated the item was difficult. Both the difficulty
and discrimination indices were acceptable (survey mean
difficulty = 51; survey mean discrimination a 30) (Morris et

a1., 1987).

3.3.4 Administration of the Questionnaires

All questionnaires (n=997) for teachers were sent to
participating schools by bulk mail during April and May of
1991. To facilitate a high response rate, return postage
for the surveys was prepaid. Each school included in the
research sample was mailed a box/envelope including a cover
letter (Appendix 4), an inventory sheet (Appendix 5), a
direction sheet (Appendix 6), the appropriate number of an
eight-page teacher questionnaire.

In late May 1991 the designated contact person in each
school that did not respond (n=85, a nonresponse rate of

31.3%) was contacted by telephone. The contact person was

31
requested to obtain and return the completed questionnaires
as soon as possible.

Two incentives for teachers to participate were
offered. The first was a certificate of recognition from
the College of Human Ecology, Michigan State University,
signed by the College Dean. The certificate acknowledged
their contribution to improving the health of third-grade
children and their families. The second was a $5.00 gift-
certificate (Appendix 7) to purchase educational materials
from the Dairy Council of Michigan. The gift certificates
were donated to MSU by a grant from the Dairy Council of
Michigan.

A "thank you" letter (Appendix 8), the certificate, and
the gift certificate were sent to the participating schools
when the returned questionnaires were received between May

and June, 1991.

3.3.5 Statistical Analysis

Responses to the questionnaire were statistically
analyzed using The Statistical Package for the Social
Sciences (SPSS/PC+, version 4.0.1, 1990). Analyses of data
gathered from the surveys included frequency distribution
and ANOVA methods (Moore, 1989). A probability of p 5 0.05

was used as the significance level in all analyses.

3.4 Results And Discussion

The purpose of this study was to determine-safe food
handling knowledge of Michigan third-grade classroom
teachers. Questionnaires On safe food handling for Michigan
third-grade teachers (n=997) were mailed in May 1991.
Completed questionnaires (n=439) from 194 schools were
returned between May and June, 1991 (response rate = 43.9%).
Demographic characteristics of Michigan third-grade teachers
and their knowledge of safe food handling are discussed

below.

3.4.1 Personal Demographics

Respondents were predominantly female (89.7%), between
31 and 50 years of age (66.1%), and had a Bachelor's (43.6%)
or Master's degree (53.2%) (Table 1). Almost all
respondents were white (92.7%). The private residential
setting most frequently selected was "less than 10,000
people" (35.8%). More than half the third-grade teachers
(54.1%) reported an annual household income in the range of
$20,001 to $70,000. Over one-fourth of the respondents

(32.0%) did not answer the optional income question.

32

33

Table 1. Personal demographic characteristics of Michigan third-grade
teachers (n-439)'iwho responded to a mailed questionnaire on
safe food handling in 1991.

 

 

 

 

 

 

Characteristic No.” of responses Percent (t)
Gender
Male 41 . 9.4
Female 393 89.7
Total 434 99.1
Age‘ (years)
22-30 37 8.4
31-40 89 20.2
41-50 202 45.9
51-60 69 15.7
61-65 5 1.1
Total 402 91.3
Education (highest degree)
Associate Degree 5 1.2
Bachelor's Degree 191 43.6
Master's Degree 233 53.2
Ph.D. or Equivalent 3 0.7
Total 432 98.7
Residential Setting
Farm 36 8.2
Less than 10,000 people 157 35.
10,000-50,000 people 112 25.6
Suburb, more than 50,000 78 17.8
City, more than 50,000 44 10.0
Total - 427 97.4
Household Income (optional)
Less than $20,000 20 4.5
$20,001-30,000 50 11.4
$30,001-40,000 50 11.4
$40,001-50,000 47 10.7
$50,001-60,000 35 8.0
$60,001-70,000 55 12.6
$70,001-80,000 14 3.2
$80,000-90,000 12 2.7
590,000—100,000 8 1.8
more than 100,001 7 1.6
Did not answer 141 32.0
Total 439 100.0

 

a. (439/997)*100§-42.6% response rate.

b. Total number of responses varies among demographic characteristics
because some respondents did not answer all questions.

c. Mean age a 43.5 1 9.4 years (Mean 3 Standard Deviation)

34

The first question in the questionnaire (Appendix 3)
for Michigan third-grade teachers was to determine the
relative importance of safe food handling regarding
maintenance of health for the respondents. Only 13.0% of
the respondents thought safe food handling was the most
important thing they did to maintain their health. Seventy
nine percent (79.2%) of the respondents thought that it was
important to maintain their health. A small portion of the
respondents thought safe food handling was less important
than most things they did (6.2%), or they were not familiar
with safe food handling.

‘ 3.4.2 Professional Demographics

The "years of teaching experience" of Michigan third-
grade teachers surveyed ranged from 1 to 36 years with a
mean of 15.81 i 8.67 years. The sources of information on
safe food handling, training in safe food handling, and the
methods of teaching safe food handling are discussed below.

, .. ,.u -2 . ' . .1. 7'., ., '... ,. .g ,.

The respondents were asked to identify the sources from
which they obtained information on safe food handling.
Newspaper/consumer magazines were most often reported as the
source of information about safe food handling (66.0%)
(Table 2). The Cooperative Extension Service, family and
friends, and the National and Michigan Dairy Councils were

also popular sources of information. When asked to identify

35

Table 2. Professional demographics of Michigan third-grade teachers
(n=439)‘ who responded to a mailed questionnaire on safe food

handling in 1991.

 

Question Part

 

 

 

A B
Questions/Foils % of t of
on professional respondents respondents
demographics who rated
most accurate
or best

 

Question 1R
Part A. During the past year, from what gggzggg_g£_ have you received
information on food handling? (Check all that apply)

Part 8. Of your choices in the previous question, please circle the
source of information that you believe provides the most
accurate information on food handling. (Circle one)

Cooperative Extension Service 23.3 14.8
Family and friends 40.4 1.8
Government pamphlets 11.6 6.2
Local school district 11.6 2.1
Newspaper/consumer magazines 66.0 23.5
National/Michigan Dairy Council 39.5 11.4
Professional journals 8.2 2.3
Professional or job-related

meeting 7.3 2.3
Otherc‘ ~ - 5.9 2.5
None 16.9 32.0

Question 2‘.
Part A. Which of the following ggtggg; did you use to teach safe food
handling? (Check all that apply)

Part 8. Please circle the method in the previous that worked best for
your class. (Check one)

Computer 1.4 0.0
Discussion 43.8 21.4
Field trips/site visits 1.6 0.2
Games 2.7 0.5
Michigan Model materials 36.4 13.2
Presentation/lecture 20.9 3.1
Written exercise 8.9 0.2
Other‘ 5.0 2.7
None 46.6 59.8

 

a. (439/997)*100%=42.6% response rate.

b. Question 2 and 3 (Appendix 3).

c. OthersMichigan Model material, books, TV, videotape, classes taken in
college.

d. Question 11 and 12 (Appendix 3).

e. Other-TV, video-tape.

36
the source of information on safe food handling they
considered most accurate, 23.5% of the respondents indicated
newspapers, 14.8% indicated the Cooperative Extension
Service, and 11.4% indicated the National or Michigan Dairy
Councils (Table 2).

The sources of information on safe food handling
available to Michigan third-grade teachers are similar to
the sources available to consumers (Gravani, 1992). In a
nationwide consumer survey on home food preparation
practices conducted by Cornell University, researchers
learned that the most frequent sources of information on
food safety preferred by U.S. consumers were newspapers,
magazines, television, and health professionals (Gravani,
1992).

Newspapers, magazines, and health professionals were
ranked as "reliable" or "very reliable" sources of safe food
handling information by 75% of the respondents. Television
was considered "the most convenient" way to obtain food
safety information, followed by newspapers and magazines.
Health professionals were ranked fourth (4% of the
respondents), along with food manufacturers and pamphlets in
supermarkets (Gravani, 1992).

Michigan third-grade teachers used some information
sources on safe food handling similar to those of Kansas
elementary school teachers. Science, health, and nutrition

books were listed by many teachers in Kansas as major

37
sources of nutrition information (Soliah et a1., 1983).
Films and filmstrips were used by approximately three-
fourths of Kansas teachers; more than half used posters, and
about a third used pamphlets. Other information sources and
materials included National Dairy Council materials,
journals, and magazines such as School Foodservice Journal,
FOod Management, Learning, Instructor, Reader’s Digest, and
Newsweek (Soliah et a1., 1983).
3.3,z.2 Training in sate fgog hagdiigg

In this study, third-grade teachers in Michigan
reported that they had not received any training in safe
food handling (94.3%) during the previous 12 months.
Information on training in safe food handling for teachers
in states other than Michigan was not found in the
literature review.

In education literature, nutrition often includes safe
food handling concepts (Soliah et a1., 1993). Soliah et a1.
(1983) indicated that almost 60% of elementary teachers in
Kansas had had no training in nutrition. Only 20% of Kansas
elementary teachers reported that they had completed one or
more college or continuing education courses in nutrition
(most often one to three hours in length). Twenty percent
(20%) of Kansas elementary teachers had attended nutrition
workshops, most within the last five years (Soliah et a1.,
1993). Less than 1% had completed a correspondence course.

Kansas elementary teachers listed two preferred ways of

38
obtaining additional nutrition training: nutrition
education materials (65%) and attending nutrition workshops
during the school year (50%). More than 80% indicated that
they did not want summer school courses in nutrition
(Soliah, et a1. 1983).
. e d te c ' e o d d

When the respondents of this study were asked whether
they teach safe food handling concepts to third-grade
children, only 53.4% answered affirmatively. "Discussion"
and "Michigan Model materials" were the methods teachers
used most frequently to teach safe food handling (Table 2).
Only 1.4% of the respondents used a computer to teach the
concept of safe food handling. Teachers rated "discussion"
as the best method to teach safe food handling.

No other studies have reported methods of teaching safe
food handling. However, several studies reported the
methods that elementary school teachers use to teach
nutrition. "Classification of foods according to four food
groups," "discussion," "using films or filmstrips," and
"having children develop plans for improving food practices"
were listed as successful methods in nutrition education by
Oklahoma elementary teachers of grades 1-7 (Baird, 1981).
Over 90% of the Oklahoma respondents thought that nutrition
education is important to help students form good habits

(Baird, 1981).

39

A report from the Kansas Nutrition Education and
Training Program provided baseline data about Kansas
elementary teachers’ practice of teaching nutrition (Soliah
et a1., 1983). Over half the Kansas elementary teachers
(70%) "rarely" or "never taught" safe food storage practices
or involved their students in planning school lunch menus.
Teachers in Kansas suggested that the topic of safe food
handling should be included in the nutrition education
materials. In those Kansas schools with on-premise food
production facilities, teachers tended to work with the
school foodservice personnel and use the cafeteria as a
laboratory for instruction more frequently than did teachers
in schools with only satellite service centers (Soliah et
a1., 1983).

Safe food handling was considered by teachers to be a
part of a nutrition knowledge base (Soliah et a1. 1983).
When teachers have learned to integrate safe food handling
and nutrition, safe food handling could more easily be
incorporated into classroom curricula. Other sources within
the schools such as school foodservice personnel and kitchen
facilities could be used by teachers in teaching safe food

handling (Soliah et a1. 1983).

3.4.3 School Demographics
Classroom demographics and classroom practice were

reported by Michigan third-grade teachers.

40
3.4 85 o o a hics

About three-fourths of the respondents (76.6%) had a
classroom size of 20-30 children. The number of teachers
who used computers when teaching third-grade children was
79.2%. Apple was the brand of computer most often used in
third-grade classrooms. Available computers were most often
located in the teachers’ classroom (68.6%). Other locations
reported were laboratories (22.1%) and libraries (13.4%)
(Appendix 9).

Since computers were available in most third-grade
classrooms (68.6%) and 80% of teachers did use computers to
teach students, computers could also assist teachers in
teaching safe food handling if appropriate software such as
Risk Raiders (Department of Food Science and Human

Nutrition, Michigan State University) was available.

WW

Safe food handling as practiced in school was also
reported by Michigan third-grade teachers. Over 80% of the
respondents thought that children "almost never" brought a
cold pack from home to keep their lunch cold (Table 3).
About 40% of teachers (42.2)% reported that children almost
never had the opportunity to wash fruits and vegetables
before eating them, but only 8.3% believed that children
"almost always" or "sometimes" brought to school and ate

food that was spoiled or bad (Table 3).

41

Table 3. Practices regarding safe food handling of third-
grade children as perceived by Michigan third-grade
teachers (n=439)‘ who responded to a mailed
questionnaire on safe food handling in 1991.

 

Practice Area Perceived Practice Level
and Question

 

 

 

almost always sometimes almost never
<-——————— No. of responses”-———————>
< (% of responses) ————-——->
1. Cold Pack:
How often do the n=4 n=77 n=354
children bring a (0.9%) (17.6%) (80.8%)

cold pack from home
to keep their lunch
cold?

2. Eat spoiled food:'
How often do children n=2 n=34 n=356
bring to school and (0.5%) (7.8%) (81.3%)
eat food that is
spoiled or bad?

3. Fruit washing: '
Is an opportunity n=185 n-54 n-172
provided in the (42.2%) (12.3%) (39.3%)
classroom for the
children to wash fruits
and/or vegetables before
eating them?

4. Hand washing:
Is an opportunity
provided for the
children to wash
their hands....

before eating a snack? n=271 n=115 n=4?
(61.9%) (26.3%) (10.7%)
before eating lunch? n=324 n=72 n=38
(74.0%) (16.4%) (8.7%)
after using the n=434- n=3 n=1
toilet? (99.7%) ( 0.7%) - ( 0.2%)

 

a. (439/997) * 100% = 43.9% response rate

42

Additionally, over half of the respondents believed
that children "almost always" have an opportunity to wash
their hands before eating snacks (61.9%) and lunch (41.0%).
Almost all of the respondents (99.7%) reported that children
had the opportunity to wash their hands after using the
toilet. The opportunities for children to wash their hands
does not always mean that hand washing actually occurred.

Based on observations of teachers, most children almost
never brought a cold pack from home to keep their lunch safe
to eat. Also, the opportunities to wash the
vegetables/fruits and to wash hands before eating a snack
were not always provided by about 40% of teachers. Teachers
should realize that safe food handling practices such as
bringing cold pack and washing hands before eating a snack
could protect children from foodborne disease. Children
need to be encouraged by teachers to bring cold pack from
home to keep their lunch cold. Additionally, more
opportunities of washing vegetables/fruits and washing hands
before eating a snack should be provided to children.
Equally important, safe food handling concept need to be

taught in the classroom.

3.4.4 Knowledge of Safe Food Handling
The questionnaire for Michigan third-grade teachers
contained eight questions about their knowledge of safe food

handling (Appendix 3, Q14 to Q21). The four safe food

43
handling constructs presented were: (1) food temperature
and storage, (2) identification of potentially hazardous
foods (3) cross-contamination, and (4) personal hygiene.
Table 4 summarizes the eight knowledge questions and the
percentage of the respondents who answered correctly.
Although teachers were knowledgeable about storage and
thawing food, they did not know the maximum safe operating
temperature (4ST? of a refrigerator.

Figure 1 shows the distribution scores of safe food
handling knowledge. The total number of correct answers to
safe food handling questions by teachers was distributed in
a normal curve. The mean score of all respondent was 55.5%
i 13.6% S.D. More than half the respondents (52.3%)
correctly answered four or five questions. No respondent

correctly answered all of the knowledge questions (n=8).

LMIW

Most respondents (z 95%) correctly answered two
questions about methods of storing and thawing ground beef
(Appendix 3, Q14 and Q15) (Table 4). Almost all the
respondents knew that a refrigerator is the safest place to
store raw ground beef (99.3%) and to thaw frozen ground
beef(95.9%). Only 39.3% knew the maximum safe operating
temperature for a refrigerator (4ST? (FDA, 1976)(Appendix

3, Q18) (Table 4). The question related to the maximum safe

44

Table 4. Knowledge on safe food handling (n=8) items and
percent of correct responses from Michigan third—
grade teachers (n=439) who responded to a mailed
questionnaire on safe food handling in 1991.

 

Knowledge Item (Content) % of respondents who
correctly answered
the question

 

A. Food temperature and storage

1. Best location to store fresh, raw 99.3
ground beef overnight

2. Best location to safely thaw frozen, 95.4
ground beef

3. Recommended maximum temperature 39.3
of an operating refrigerator

4. Chilled storage of leftover stew in 14.4
a shallow container

B. Identification of potentially hazardous foods

1. Potentially hazardous foods 44.3
a. Chicken breasts (96.6% correct)
b. Skim milk (91.6% correct)
c. Baked potato (86.6% correct)
d. Refried beans (91.8% correct)
e. Corn oil (59.8% correct)
f. White vinegar (80.4% correct)

2. Identification of unsafe food by 46.6
sight, smell, and/or taste

C. Personal hygiene
(Method of handwashing) 90.0

D. Cross-contamination
(transfer of Staphylococcus aureus
from foodhandlers to potato salad) 39.5

 

* (439/997) * 100% = 43.9% response rate

45

KNOWLEDGE SCORE OF SAFE FOOD HANDLING

Michigan third-grade teachers

% of Respondents

 

30
25 "

20 ,

 

 

 

 

 

 

 

 

 

Knowledge Score

Figure 1. Knowledge scores of Michigan third-grade teachers
(n=365) who responded to all knowledge questions
(N=8) in a mailed questionnaire on safe food
handling in 1991.

46
operating temperature for a refrigerator was more difficult
than the other seven questions because it was open-ended
instead of multiple-choice.

When asked about the proper type of container for
storing leftovers (Appendix 3, Q21), 74.2% of the
respondents answered that the depth of the container is not
important (Table 4). Only 14.4% knew that a shallow
container can limit the growth of harmful bacteria
(Table 4).

In a nationwide survey of consumers related to safe
food handling, 23% of the respondents said they would thaw
hamburger meat on the counter top at room temperature
(Gravani, 1992). In the present study, 99% of teachers knew
that refrigerator is the best way to thaw frozen ground
beef. Similarly, only 32% of consumers knew to store
leftovers in a shallow container while only 14% of teachers
had the same knowledge in this study.

Michigan third-grade teachers' knowledge about storage
of food was similar to that of Kansas elementary school
teachers. Soliah et a1. (1983) reported that 80.5% of
Kansas teachers knew that turkey should be refrigerated
immediately after use. About half of Kansas teachers
(49.2%) were able to identify a food not requiring
refrigeration, but only 19.9% knew that meat can be refrozen

if ice crystals are still present.

47
;.§.§,z Identifiicgtign o; pgtentially hazardous fogg

On the questionnaire for third-grade teachers,
respondents were asked to identify which of six foods were
potentially hazardous (Appendix 3, Q16). "Potentially
hazardous" foods were defined as "any perishable food which
consists in whole or in part of milk or milk products, egg,
meat, poultry, fish and shellfish, or other ingredients
capable of supporting rapid and progressive growth of
infectious or toxigenic microorganisms (FDA, 1976)."

Among the answers, 96.6% of the respondents considered
meat products (chicken breasts) and 91.6% considered milk as
potentially hazardous foods (Table 4). For vegetable
products, baked potatoes were correctly identified by 86.6%
of the respondents, and refried beans were correctly
identified by 91.8% of the respondents (Table 4). Although
corn oil and white vinegar were not potentially hazardous
foods, many respondents still selected them (corn oil: 40.2%
: white vinegar: 19.6%). Only 44.3% of the respondents were
able to correctly identify all potentially hazardous foods
(Table 4). Over half (51.6%) of third-grade teachers
incorrectly responded that spoiled food could only be
identified by looking at, smelling, or tasting it (Appendix
10, Q12) (Table 4). Third-grade teachers did not understand
that unsafe food sometimes can not be identified by looking

at, smelling or tasting it.

48

By contrast, a study by Gravani (1992) showed that 28%
of consumers in the United States agreed with the statement
that, "You can always tell when a food will cause foodborne
disease because it will smell or taste bad."

.4 ' e

Most Michigan third-grade teachers (90.0%) in this
study knew that washing hands with soap and clean water
before handling foods is the best way among the four foils
given to prevent foodborne disease (Appendix 3, Q17)(Table
4). Other foils used with this knowledge item included:
rinsing hands under hot water, wiping hands on a clean towel
and none of these are important. Hand washing, identified
as a way of controlling the spread of infection, has been
viewed as a possible method of reducing foodborne disease
(CDC, 1985; Larson, 1984). Proper hand washing can
effectively remove transient food-borne pathogens (Guthrie,

1972).

- a ' ' n
Results of this study indicated that only 39.5% of the
respondents correctly answered that Staphylococcus aureus is
most often introduced into foods by food handlers (Appendix
3, Q19)(Table 4). Cross-contamination is a major food
safety concern which can be controlled by food handlers at

the preparation stage (Gravani, 1992).

49

Results of analyses of variance (ANOVA) of safe food
handling knowledge score versus selected demographic
characteristics of Michigan third-grade teachers is shown in
Table 5. Age was categorized into two groups: under 40
years and over 40 years. The teaching experience of third-
grade teachers was categorized into three groups: under 10
years, 11-20 years, and over 21 years. These values were
selected as the dividing point because they would allow the
two sets of data to be separated into approximately equal
cell sizes.

A statistically significant difference in knowledge
about safe food handling was found between third-grade
teachers less than 40 years of age and third-grade teachers
over 40 years of age (p 5 0.05) (Table 5). Older
respondents had a higher mean knowledge score (56.4% i
13.4%) about safe food handling than did younger respondents
(53.5% .t 14.3%). I

This result was expected since convenience foods have
become a way of life, all but eliminating regular food
preparation in the kitchen of most U.S. consumers (Beard,
1991). Younger generations may not have had the chance to
learn how to handle food safely. In addition, during the
past 20 years, instruction in safe food handling in home

economics courses has been replaced by the study of food

50

Table 5. Analysis of variance (ANOVA) of mean knowledge
scores of safe food handling vs. selected
demographic characteristics of Michigan third-grade
teachers (n=439)‘ who responded to a mailed
questionnaire on safe food handling in 1991.

 

Demographic No. of Knowledge score p.
Characteristics respondents (Mean 1 S.D.) value

 

I have taught safe food

handling to children 0.932
Yes 184 55.9% 1 13.9%
NO 162 55.3% i 13.4%
Age 0.046*
Under 40 yrs 103 53.6% 1 14.3%
Over 40 yrs 243 56.4% i 13.4%
Experience 0.457
1-10 yrs 98 56.1% i 14.4%
11-20 yrs 135 54.5% i 13.0%
21-36 yrs 113 56.0% i 13.9%
Highest academic degree 0.277
Bachelor’s degree 160 56.4% i 13.3%
Master's degree 186 54.5% i 15.2%

 

a. (439/997) * 100% = 43.9% response rate.

b. No higher interactions among more than two factors were
important.

* (p g 0.05) statistically significant.

51
choice in nutrition courses. One result is that children
who did not learn much about safe food handling over the
past twenty years are now adults who are "lost" in the
kitchen (Beard, 1991).

In a survey related to the food safety knowledge of
consumers (Gravani, 1992), the knowledge scores of consumers
were also different among age groups and educational level.
Respondents under 35 years of age scored the lowest. Mean
food safety knowledge scores increased up to the 65-years-
of-age group, and then decreased slightly for the over-65-
years-of—age group. Educational level also had an effect in
the study by Gravani (1992). Mean scores increased with
educational level up to the associate degree, but decreased
for college graduates and those with advanced degrees
(Gravani, 1992). However, in the present study, there was
no significant difference in knowledge scores among
educational levels.

Several studies have explored the effect that teaching
nutrition would have on those teachers' nutrition knowledge
scores. Soliah (1983) found teachers who taught nutrition
to their students achieved higher scores on food selection,
nutrition practices, and food preparation than did those who
did not teach nutrition. However, Spollen (1974) found no
significant difference in nutrition knowledge scores between
teachers who taught nutrition and those who did not. In the

present study, no significant difference in knowledge scores

52
of safe food handling was found between teachers who taught
safe food handling and those who did not.

The positive and negative impacts of nutrition training
for teachers has been explored in some research papers.
Spollen (1974), Wasley (1975), and Soliah et a1. (1983)
reported that teachers trained in nutrition scored higher on
nutrition tests than did those without training. However,
Byrd (1977) and Petersen and Kies (1972) found that
including nutrition courses in the undergraduate curriculum
of elementary teachers did not result in higher nutrition
knowledge scores. In the present study, there was no
significant difference in knowledge scores between teachers

who received training and those who did not.

WWW
Although almost three-fourths of third-grade teachers
(74%) had never received any formal training in safe food
handling, teachers had knowledge scores of 2 50% correct on
the knowledge questions about location of storing ground
beef overnight, locations to safely thaw ground beef, and
the best method of hand washing. Teachers had score of
S 50% correct on the knowledge questions about maximum safe
temperature for an operating refrigerator, chilled storage
of leftover stew in a shallow container, methods to identify
unsafe foods, and identification of potentially hazardous

foods.

53
If teachers became more familiar with the proper methods to
identify unsafe food, they could help to protect children
from eating unsafe food. Teachers need more training in
safe food handling if they are to provide children with
correct information in this area. Constructs related to
safe food handling in which teachers should receive further

training are in Table 6.

3.5 Conclusions

Although teachers correctly answered questions about
chilled storage of food and hand washing, they had low score
in identification of potentially hazardous foods, proper
methods for Storing leftovers and correct methods to
identify unsafe foods. Post-graduate nutrition courses for
teachers should include safe food handling constructs (Table
6).

Teachers should be encouraged to enhance the safe food
handling/nutrition curricula of their students by using
available school sources such as foodservice personnel,
tours of school food production sites, and the use of
computers. Attendance at such courses can be facilitated by
the use of new technologies such as satellite conference

where downlink sites are within easy driving distance.

54

55

 

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4.0 MICHIGAN SCHOOL FOODSBRVICB PERSONNEL:
KNOWLEDGE OP SAFE FOOD HANDLING

4.1 Abstract

School foodservice personnel in Michigan (n= 597/1400 or
42.6% response rate) were surveyed to determine their
knowledge of safe food handling. While almost all
respondents (98%) had received some formal training in safe
food handling during the previous year, they still were
unable to correctly respond to questions about the
recommended operating temperature of a refrigerator (68%
correct answer), identification of potentially hazardous
foods (40% correct answer), and methods to identify spoiled
foods (53.9% correct answer). Significant differences in
the safe food handling knowledge scores were found among
school foodservice personnel with different job titles (p g
.05). "Managers" and "supervisors" had higher mean
knowledge scores than did others with job titles such as
"cooks" and "kitchen assistants." Further training provided
by units such as the Michigan Department of Education,
especially for cooks and cook assistants, should provide
information about safe food temperatures, proper storage
methods, and the identification of potentially hazardous

foods.

57

4.2 Introduction

School foodservice was the third largest market segment
in the foodservice industry during the 19903 with an annual
expenditure in excess of 14 billion dollars (Pannell, 1990).
Major goals of school foodservice have been not only to
provide safe and nutritious meals, but also to provide
information about food safety and nutrition to school
children (Sen, 1991).

Foodborne disease in the United States has been a
significant.problem, especially in foodservice
establishments such as school cafeterias (Bean and Griffin,
1990). Between 1973 and 1987, 79% of foodborne outbreaks
reported to the CDC occurred in foodservice establishments
(Bean and Griffin, 1990). Limited information on the actual
number of school children involved in foodborne disease
outbreaks was available. The largest reported outbreak in
school foodservice was caused by Campylobacter (Stern and
Kazini, 1989). This outbreak was associated with the
consumption of raw milk. The outbreak resulted in illness
among 2,500 school children in Nebraska (Stern and Kazini,
1989).

Most outbreaks of foodborne disease have involved

contamination of food by microbial pathogens or some

58

59
chemical agent (Synder, 1986). The most commonly reported
food preparation practices that contributed to foodborne
disease in the United States from 1982 to 1987 were improper
storage, improper holding temperatures, and improper
personal hygiene of food handlers (Bean et a1., 1990).
Unlike other diseases, foodborne disease can be prevented by
proper food handling (USDA, 1989b). Correction of faulty
food preparation practices in foodservice establishments
such as school cafeterias is especially important (Bean et
a1., 1990).

School foodservice personnel have an important role in
preventing the occurrence of foodborne disease both during
production of school meals and during interaction with
children either in the cafeteria or classroom. However,
some foodservice personnel lack accurate knowledge of
foodservice sanitation and often do not understand the
causes of foodborne disease (Avens, 1980). According to
Neill (1979), many problems in foodservice operations were
due to inadequate training of staff.

Unlike commercial foodservice, the goal of the school
lunch program is not only to provide adequate meals to
students but also to provide nutrition education (Hinton,
1964; Neill, 1981; Sen, 1991). School lunch programs are
also recognized as a part of the educational program in many
schools (Hinton, 1964). Nutrition education which includes

constructs related to food safety will assist students in

60
developing proper attitudes about food choice and food
preparation (Neill, 1981).

Various areas of school foodservice have been evaluated
(Bowen et a1., 1982; Parcel et a1., 1989; Frank et a1. 1989;
Glover et a1., 1990; Ho et a1., 1991; Synder, 1992). A
review of the literature indicated that limited information
about safe food handling training and knowledge of school
foodservice personnel was available. The purpose of this
study was to determine the safe food handling knowledge of
school foodservice personnel.

This study was part of a larger safe food handling
project in Michigan. The overall project objective was to
determine the safe food handling knowledge of children and
adult population groups such as school foodservice personnel

who could influence their safe food handling knowledge.

4.3 Methods

This study was one component of a statewide (Michigan)
assessment project that evaluated the safe food handling
knowledge of thirdégrade children and the influential adult
populations that could impact their knowledge. The purpose
of this study was to determine safe food handling knowledge
of Michigan school foodservice personnel.

A mailed questionnaire was used to obtain the
information. Mailed questionnaires were used because this
method can: (1) accommodate a large sample (2) reach widely
dispersed respondents inexpensively, and (3) get a high
response rate (Alreck and Settle, 1985). The sampling frame
and the design, administration, and pilot testing of the
questionnaire for school foodservice personnel are discussed

below.

4.3.1 The Sampling Frame

The population for this study was defined as "employees
who worked in Michigan school foodservice operations during
the 1991-1992 academic year." The sampling frame was a
mailing list of Michigan school foodservice personnel

provided by the Michigan Department of Education (MDE).

61

62
This list included names and addresses of Michigan school
foodservice personnel who had taken or were registered to
take the two courses: MDE 100 School Foodservice Basics and
MDE 120 Sanitation and Safety between 1985 and the Present
(N=2839). This list was used because other mailing lists
for this population were not available. Fourteen hundred
(1,400) names of school foodservice personnel from the MDE

list were randomly selected to participate in the study.

4.3.2 Design of the Questionnaire

The questionnaire for school foodservice personnel,
developed in October 1991 (Appendix 10), consisted of 25
questions. Questions on knowledge of safe food handling and
questions designed to collect information about demographic
characteristics were included.

The knowledge level of safe food handling of school
foodservice personnel was assessed using eight questions.
Content areas of knowledge items were food
temperature and storage, potentially hazardous foods,
personal hygiene, and cross-contamination.

The questionnaire requested information on three types
of demographic factors: personal, professional, and school.
In this study, personal demographics included gender, age,
generations of family living in the United States,
ethnicity, residential setting, education, income level, and

attitude toward safe food handling. Professional

63
demographics included type of facility in which the
respondent was employed, job title, job functions, and
number of years on the job. School demographics included
frequency and types of interactions between school
foodservice personnel and school children, opportunities for
children to keep their lunch cold, opportunities for
children to wash their hands, and the estimated frequency
that children in school ate unsafe foods.

A letter describing the study and directions on how to
answer the questionnaire were on the cover of each
questionnaire. The questionnaire was approved for use with
the specified population by the University Committee on
Research Involving Human Subjects (UCRIHS) at Michigan State

University in March 1991.

4.3.3 Pilot Testing of the Questionnaires

The questionnaire was pilot-tested with 50 Michigan
elementary school foodservice personnel. The content,
construct, and face validity of the questionnaire was
assessed by expert review. Content validity in this
research was assessed by determining whether the questions
chosen were accurate (right answers were correct; wrong
answers were incorrect) (Morris, 1987). Face validity was
determined by assessing whether the survey was apprOpriate
for the intended population (Morris, 1987). Construct

validity assessed whether the items represented the concept

64
(safe food handling) it was intended to measure (Morris,
1987).

The questionnaire was pilot tested (n=50) to determine
criterion validity and difficulty level. Criterion validity
was defined in this research as whether the instrument
discriminates between masters and non-masters of the
information represented by the construct. The
discrimination index was used to assess criterion validity
and was calculated for individual items and for the total
survey. The index of discrimination used in this item
analysis was calculated as the difference between the
proportion of the high scorers (27%) who selected the
correct answer minus the proportion of the low scorers (27%)
who selected the right answer. An item discrimination index
of greater than 0.33 was the standard for acceptability in
this research.

The index of difficulty (proportion of the total group
who got the item correct) was also calculated for each item
on the questionnaire. A high index indicated the item was
easy and a low index indicated that the item was difficult
(Morris, 1987). Both the discrimination and difficulty
indices for the survey were acceptable (mean difficulty =

0.73; mean discrimination = 0.40) (Morris, 1987).

65
4.3.4 Administration of the Questionnaires
All questionnaires (N=1400) were sent to school
foodservice personnel during October and November of 1991.
Each school foodservice employee included in the research
sample was mailed an envelope (4.25" x 9.50") which included
a cover letter (Appendix 11), an addressed, stamped, return

envelope and the 6-page questionnaire in booklet form.

4.3.5 Statistical Analysis

Responses to the questionnaire were statistically
analyzed using The Statistical Package for the Social
Sciences (SPSS/PC+, version 4.0.1, 1990). Analysis of the
data gathered from the surveys included frequency
distribution and ANOVA (Moore, 1989). A probability of
p 5 0.05 was used as the test of significance level in all

analyses.

4.4 Results and Discussion

The purpose of this study was to determine the safe
food handling knowledge of Michigan school foodservice
personnel. Questionnaires on safe food handling for
Michigan school foodservice personnel (N=1400) were mailed
in October and November 1991. Completed questionnaires
(n=597) were returned between November 23 and December 11,
1991 (response rate = 42.6%). Demographic characteristics
of Michigan school foodservice personnel and their knowledge

of safe food handling are discussed below.

4.4.1 Personal Demographics

Data in Table 1 summarizes personal demographic
characteristics of Michigan school foodservice personnel who
responded to a questionnaire on safe food handling.
Respondents were predominantly female (97.2%) with a mean
age of 48 i 9.29 years; most had either graduated from high
school or had received a General Education Diploma
(GED)(79.4%). The residential setting most frequently
selected was "less than 10,000 people" (39.5%). More than

half the school foodservice personnel (52.8%) respondents

66

67

Table 1. Personal demographic characteristics of Michigan school
foodservice personnel (n=597r‘who responded to a mailed
questionnaire on safe food handling in 1991.

 

 

 

 

 

 

Characteristic No. of responses5 Percent (t)
Gender
Male 9 1.5
Female 580 97.2
Total ’ 589 98.7
Age‘ (years)
19-30 9 1.5
31-40 126 21.1
41-50 202 33.8
51-60 179 30.0
Over 60 57 9.8
Total 573 96.2
Education (highest degree)
Grade school 5 0.8
Some high school 30 5.0
High school or GED 474 79.4
Associate degree 39 6.5
Bachelor's degree 18 3.0
Others‘ 25 4.2
Total 591 97.9
Residential Setting
Farm 77 12.9
Less than 10,000 people 236 39.5
10,000-50,000 people 126 21.1
Suburb, more than 50,000 78 13.1
City, more than 50,000 52 8.7
Total 569 95.3
Household Income (optional)
Less than $10,000 34 5.7
$10,001-20,000 67 11.2
$20,001-30,000 78 13.1
$30,001-40,000 93 15.6
$40,001-50,000 77 12.9
$50,001-60,000 39 6.5
$60,001 or more 33 5.2
Did not answer 176 29.4
Total 597 99.6

 

a. (597/1400)*100%=42.6% response rate

b. Total number of responses varies among demographic characteristics
because some respondents did not answer all questions.

c. Mean age = 48 1 9.29 years (Mean 1 Standard Deviation)

d. Other: Some years in college, vocational training in foods, Master's
degree

68
reported an annual household income between $10,001 to
$50,000.

The first question on the questionnaire was to asked
the respondent about the relative importance of safe food
handling to their other health maintenance practices. IOver
half of the Michigan school foodservice personnel (64.2%)
responded that safe food handling was the "most important"
thing they did to maintain their health; 35.0% thought it
was as important as most things they did to maintain their
health.

Personal demographic characteristics of school
foodservice personnel in the present study were similar to
those of other studies. The demographic profile of Kansas
school foodservice personnel in the study by Bowen et a1.
(1982) indicated that most respondents were female (99.3%),
31 to 60 years old (80.4%), and most were high school
graduates (71.5%).

The demographic characteristics of Michigan school
foodservice personnel who responded to the questionnaire
were also similar to a national population of school
foodservice personnel (USDA, 1978). In the national sample,
the typical school foodservice employee was 45 to 50 years

old and had a high school diploma.

69
4.4.2 Professional Demographics

The professional demographic characteristics reported
by Michigan school foodservice personnel are shown in Table
2. Almost one-third of the respondents (32.0%) had the job
title of "cook," and 25.6% were employed in positions
entitled "kitchen assistant." On the average, these
respondents had 8.67 i 6.54 years of foodservice work
experience_in schools. When asked, "In what type/types of
facility do you primarily work?" they most often answered
elementary school (46.0%) or high school (46.9%).

The professional demographic characteristics of school
foodservice personnel in the present study were similar to
those in other studies. In the study by Bowen et a1. (1982)
almost 70% of the school foodservice personnel were "cooks,"
"kitchen assistants," "bakers," or "foodservice workers."
Of that total, 43.8% had been employed eight or more years.
In the national sample by USDA (1978), the typical school
foodservice employee had about eight years of experience in
school foodservice.

4. . . o e o ' ormat' n o saf ood handlin

Personnel working in Michigan school foodservice
operations were asked to identify the sources from which
they received information about safe food handling (Table
3). Professional or job-related meetings were most often
reported as the source of information on safe food handling.

When asked to identify the most accurate source of

70

Table 2. Professional demographic characteristics reported
by Michigan school foodservice personnel (n=597)‘
who responded to a mailed questionnaire on safe
food handling in 1991.

 

Characteristic Number of Responses Percent(%)
of Respondents

 

Job title
Cook 191 32.0
‘ Kitchen assistant 153 25.6
Supervisor/director 78 13.1
Manager 74 12.4
Foodservice worker 40 6.7
Cashier 11 1.8
Baker 10 1.7
Maintenance/delivery 10 1.6
Salad maker 7 1.2
Secretary/office assistant 6 1.0
Other” -4 0.7
Total 584° 97.8
Years of experience in foodservice
1-10 394 66.0
11-20 168 28.1
21-30 30 5.1
31-36 2 0.4
Total 594° 99.6
Type of facility
Elementary school 275 46.0
Middle school 226 34.9
High school 280 46.9
Commissary kitchen 85 14.2
Other 50 8.4
Total 916d 150.4c

 

a. (597/1400)*100=42.6% response rate.

b. Other= dishwasher, meal packer and foodservice consultant

c. n < 597 because some respondents did not answer all
questions.

d. n > 597 because some school foodservice personnel checked
more than one type of facility.

e. Multiple responses were made.

71

Table 3. Sources from which Mic

higan school foodservice

personnel (n=-597)a received information on safe
food handling as reported in a mailed questionnaire

 

 

 

on safe food handling in 1991.
Sources of information Respondents Respondents
on safe food handling who received who rated the
information source as most
from this accurate
sourceb
<-— % of respondents -——>
Cooperative Extension Service 24.1 7.0
Family and friends 16.8 0.2
Government pamphlets 38.7 9.5
Local school district 47.9 4.5
Newspaper/consumer magazines 45.4 1.8
National/Michigan Dairy Council 21.9 2.0
Professional journals 42.0 9.2
Professional or job-related
meeting 71.0 32.0
Otherc 22.4 13.1
None 2.8 20.7
a. (597/1400)*100=42.6% response rate.

b. Multiple choices were made.
c. Other-Class taken at college
television, videotape and bo

, work experience,
ok.

72
information on safe food handling, 32% of the respondents
indicated job-related meetings, 9.5% indicated government
pamphlets, and 9.2% indicated professional journals (Table
3).

The sources of information on safe food handling for
Michigan school foodservice personnel are different from the
sources of information identified by some consumers. In a
nationwide consumer survey on home food preparation
practices conducted at Cornell University, the researchers
learned that the most frequent sources of information on
food safety for consumers in the United State were
newspapers, magazines, television, and health professionals
(Gravani, 1992).

The results of this study indicated school foodservice
personnel differed from the typical U.S. consumer, because
they considered professional or job-related meetings more.
accurate than other sources when providing information on
safe food handling.

Newspapers, magazines, and health professionals were
ranked as "reliable" or "very reliable" sources of safe food
handling information by 75% of the respondents (Gravani,
1992). Television was considered as "the most convenient"
way to obtain food safety information, followed by
newspapers and magazines. Health professionals were ranked
fourth (4%), along with food manufacturers and pamphlets in

supermarkets.

73
4. . . . ' ' 'n sa od n i

Courses in safe food handling available to Michigan
school foodservice personnel are shown in Table 4. Almost
all respondents (98.8%) had taken at least one training
course on safe food handling during the previous five years.
Training courses offered by the Michigan Department of
Education (MDE 100 and MDE 120) were the courses most
frequently reported taken by the respondents (72.9% and
62.6% respectively). This result could be expected since the
MDE mailing list used to identify potential respondents was
a list of Michigan school foodservice personnel who had
signed up, or signed up and taken one or more of the MDE
courses.

Respondents in the present study suggested that all
school foodservice personnel in Michigan should be required
to take the MDE 100 Basics of Foodservice and the MDE 120
Sanitation and Safety. One respondent strongly wrote on the
questionnaire that she believed that certification should be
a requirement for at least one person in each foodservice

operation.

4.4.3 School Demographics
More than half of Michigan school foodservice personnel
reported interacting with children on the topic of safe food

handling (Table 5). The most frequent type of interaction

74

Table 4. Courses in safe food handling taken by Michigan

school foodservice personnel (n=597r'between 1985
and 1991 as reported in a mailed questionnaire on
safe food handling in 1991.

 

Name of Course Agency or Association % of respondents

Sponsor who had taken
the courseb

 

 

l. MDE‘ 100: School Michigan Dept.
Foodservice Basics of Education 72.9

2. MDE 120: Sanitation Michigan Dept. 62.6
and Safety of Education

3. Sanitation and American School 47.7
Safety Foodservice Association

4. Sanitation and Local County Health 17.9
Safety Department

5. Applied Foodservice National Restaurant 14.4
Sanitation (NIFI)‘ Association

6. Other3 18.4

a. (597/1400)*100=42.6% response rate.

b.
c.
d.
e.

Some respondents could have taken more than one course.
MDE=Michigan Department of Education.

NIFI=National Institution of Foodservice Industry.

other responses included Michigan School Foodservice Association,
MDE 160: Principles of Food Preparation; MDE: Introduction to Nutrition.

75

Table 5. Type of interaction on safe food handling with

school children reported by Michigan school
foodservice personnel (n=597)‘ who responded to a
mailed questionnaire on safe food handling in 1991.

 

Types of Interaction Percent of responses (%)

 

1.

Conversation with children 37.3
in the lunch room

Tours of the school foodservice 11.3
facility to children

Talk to children in a 5.7
classroom setting about
safe food handling

 

4. Other” 5.3
ram. 53.7““
a. (597/1400)*100-42.6% response rate.
b. Examples of other types of interaction were : cook for

c.
d.

children, plan menu with children.

Multiple choices were made.

43.2 % respondents answered ” None"; 8.6% did not answer
the question.

76

was conversation with children in the lunch room (37.5% of
responses) followed by giving children tours of the school
foodservice facility. This result indicated that school
foodservice personnel in Michigan have an opportunity to
decrease the occurrence of foodborne disease. Not only must
they use their knowledge of safe food handling during
production of school meals and but also during interaction
with children either in lunchrooms and in classrooms.

Perceived practices of children related to safe food
handling in school were also reported by school foodservice
personnel on the questionnaire (Table 6). The majority of
respondents (69.4%) believed that children almost never used
a cold pack to keep cold lunches brought from home.
Similarly, over one-fourth of the respondents believed that
children "sometimes" or "almost always" brought to school
and ate food that was spoiled or bad. Lastly, almost 40% of
school foodservice personnel believed that children
sometimes or almost never had an opportunity to wash their
hands before eating lunch. One respondent added this
comment: "Children's hands are not washed most of the time
after they come in from the playground just before lunch.
Most high school students do not wash their hands before
coming to lunch also." These results should only be
considered in light of the facts: (1) that children may have
an opportunity to wash their hands does not mean that hand

washing has actually occurred; and (2) most school

77

Table 6. Practices regarding safe food handling of Michigan
school children as perceived by Michigan school
foodservice personner'(n=597) who responded to a
1991 mailed questionnaire.

 

Practice Area Perceived Practice Level
and Question

 

 

almost always sometimes almost
never
1. Use of cold packP: <-———————-No. of responses ——————>
<-——————— % of respondents -—————>
How often do the
children bring a =8 n=137 n=415
cold pack from home (1.3%) (22.8%) (69.4%)
to keep their lunch
cold?
2. Eat spoiled food:
How often do children n=1 n=158 n=314
bring to school and (0.2%) ' (26.4%) (52.4%)
eat food that is
spoiled or bad?
3. Hand washing:
Is an opportunity
provided for the n=309 n=131 n=107
children to wash (51.5%) (21.9%) (18.0%)

their hands before
eating lunch?

 

a. (597/1400) * 100%=42.6% response rate
b. Or freezer pack. Cold pack was the term used in the
questionnaire.

78
foodservice personnel do not have direct interaction with
children before they come into the lunchroom.

Hand washing has been identified as a way of reducing
the absenteeism and foodborne disease rate of school
children (Larson, 1984). Results of the present study
(Table 6) indicated that students may need more
opportunities to wash their hands before going to lunch.
Also, children need more encouragement about the importance
of good hand washing practices from teachers and school
foodservice personnel as well as classroom lessons on safe

food handling.

4.4.4 Knowledge of Safe Food Handling

The questionnaire for Michigan school foodservice
personnel contained eight knowledge questions about safe
food handling. The four safe-food-handling constructs used
were presented: (1) food temperature and storage, (2)
identification of potentially hazardous foods, (3) cross-
contamination, and (4) personal hygiene. Table 7 contains
the knowledge items and percent of respondents who answered
correctly.

Figure 1 shows the distribution of knowledge scores for
eight questions on safe food handling. The mean score of
all respondent was 75.6% i 15.6%. About 56.0 % of the

respondents answered six or more knowledge questions

79

Table 7. Knowledge about safe food handling (n=8) items and
percent of correct responses from Michigan school
foodservice personnel (n=597y'who responded to a
mailed questionnaire on safe food handling in 1991.

 

Knowledge Item (Content)

% of respondents

who correctly

answered

the question

 

Food temperature and storage

Best location to store fresh, raw
ground beef overnight

Best location to safely thaw frozen,
ground beef

Recommended maximum operating temperature
of a refrigerator

Chilling of leftover foods in a shallow
container

Identification of potentially hazardous foods

Potentially hazardous foods

a. meat product (chicken breasts)(98.8% correct)

b. milk (skim milk)(85.4% correct)

c. vegetables (baked potato)(76.9% correct)
(refried beans)(81.8% correct)

d. oil (corn oil)(69.8% correct)

e. vinegar (white vinegar)(83.7% correct)

Identification of unsafe food by
sight, smell, and/or taste

Personal hygiene
(Method of hand washing)

Cross contamination
(transfer of Staphylococcus aureus
from foodhandlers to potato salad)

98.9

98.0

68.8

70.7

40.9

53.9

91.0

58.8

 

(597/1400) * 100% = 42.6% response rate

80

KNOWLEDGE SCORE OF SAFE FOOD HANDLING

Michigan school foodservice personnel

% of Respondents

 

 

 

 

 

 

Knowledge Score

Figure 1. Knowledge scores of Michigan school foodservice
personnel (n=489) who responded to all knowledge
questions (N=8) in a mailed questionnaire on safe
food handling in 1991.

81
correctly while only 10.4% of the respondents correctly
answered all the knowledge questions.
4 4 . Fo e e n t

Most school foodservice personnel (3 98%) correctly
answered the first two questions about the method of storing
and thawing ground beef (Appendix 10, Q6 and Q7). Although
almost all school foodservice personnel knew that a
refrigerator was the safest place to store (98.9%) and to
thaw (98.0%) raw ground beef, only 69% knew the maximum safe
operating temperature of a refrigerator (4??) (Appendix 10,
010) (Table 7). The question related to the maximum safe
operating temperature of a refrigerator was more difficult
because it was open-ended instead of multiple-choice.

When asked about the type of container best suited to
chill precooked food (Appendix 11, Q), 70.7% of the
respondents knew that a shallow (Figure 1) container would
minimize the growth of harmful bacteria during the chilling
process. Conversely, only 22.6% of the respondents thought
that the depth of the container was not important in chilled
storage.

In a nationwide survey of consumers about safe food
handling, 23% of consumers said they would thaw hamburger
meat on the counter top at room temperature (Gravani, 1992).
In the present study, 98% of school foodservice personnel
knew that refrigerator was the best place to thaw frozen

ground beef. Similarly, 32% of consumers knew that

82
precooked food should be chilled in a shallow container
while 70.7% of school foodservice personnel had the same

knowledge in this study (Gravani, 1992).

4.- '. .- ' ' - 'o; o co -, '= a =_dou ‘ oo-

On the questionnaire for school foOdservice personnel,
respondents were asked to identify which of six foods were
potentially hazardous (Appendix 10, Q8). "Potentially
hazardous foods" have been defined as "any perishable food
which consists in whole or in part of, milk or milk
products, egg, meat, poultry, fish and shellfish, or other
ingredients capable of supporting rapid and progressive
growth of infectious or toxigenic microorganisms (FDA,
1976)."

Among the answers, 98.8% cf the respondents considered
meat products (chicken breasts) and 85.4% considered milk as
potentially hazardous foods (Table 7). For vegetable
products, baked potatoes were correctly identified by 76.9%
of the respondents and refried beans were correctly
_identified by 81.8% of the respondents (Table 7). Although
corn oil and white vinegar are not considered as potentially
hazardous foods, many respondents selected them (corn oil:
30.2%; white vinegar: 16.3%). Only 40.9% of the respondents
could correctly identify all the potentially hazardous foods
(Table 7). Over half (53.9%) of the school foodservice

personnel incorrectly responded that spoiled food could only

83

be identified by looking at, smelling, or tasting it
(Appendix 10, Q12) (Table 7). School foodservice personnel
did not understand that unsafe food sometimes cannot be
identified by looking at, smelling or tasting it.

By contrast, a study by Gravani (1992) showed that 28%
of consumers in the United States agreed with the statement:
"You can always tell when a food will cause foodborne

disease because it will smell or taste bad."

iiiiiil_£§£§Qnsl_h¥Qifin§

Most of the respondents (91.0%) in the present study
knew that "washing hands with soap and clean water before
handling foods" is the best way to prevent foodborne disease
(Table 7). Other foils used in this knowledge item
included: rinsing hands under very hot water, wiping hands
on a clean towel and none of these are important. About 5%
of the respondents answered that washing hands with soap and
clean water "after" handling food is as important as
"before" handling foods (Appendix 10, Q9).

Hand washing, identified as a way of controlling the
spread of infection, has been viewed as a possible method of
reducing foodborne disease (CDC, 1985; Larson, 1984).

Proper hand washing can effectively remove transient

foodborne pathogens (Guthrie, 1972).

84

4.4.5.4 ngss-ggntamination

Results of the present study indicated that only half
of Michigan school foodservice personnel (58.8%) knew that
Staphylococcus aureus was most often introduced into potato
salad from food handlers (Appendix 10, Q12) (Table 7).
Cross-contamination is a major food safety concern that can,
for the most part, be controlled by school foodservice

personnel.

4.4.5 Statistical Analysis

Results of an analysis of variance (ANOVA) of safe food
handling knowledge scores versus selected demographics of
Michigan school foodservice personnel is shown in Table 8.
Significant differences of scores were determined by an
ANOVA (pg.05). Age was categorized into three groups:
under 40 years of age, 41-50 years of age, and over 40
years. These values were selected as the dividing points
because they allowed the population to be into three groups
of the approximately same size. Work experience in the
foodservice area was categorized into two groups: under 10
years and over 10 years. This value was selected as the
dividing point because it was the median value, resulting in
the development of two groups of equal size. Also, job
title was categorized by the functions of the job into four
groups: managers/supervisors, cooks, kitchen assistants,

and others. A statistically significant difference in

Table 8. Analysis of variance (ANOVA) of mean knowledge

scores of safe food handling vs. selected

demographic characteristics of Michigan school
foodservice personnel (n=597)‘ who responded to a
mailed questionnaire on safe food handling in 1991.

 

 

Demographic No. of Knowledge score p
Characteristics respondents (Mean 1 S.D.) value
Age 0.214
under 40 yrs 116 73.6% 1 14.8%
41-50 yrs 170 75.3% 1 15.5%
Sl-over 60 yrs 203 77.1% 1 16.4%
Experience 0.376
over 10 yrs 163 75.9% 1 16.4%
under 10 yrs 326 75.5% 1 15.4%
Job title 0.025*
managers/
supervisors 135 79.1% 1 15.4%
cook 151 74.6% 1 15.1%
kitchen assist. 121 73.1% 1 16.3%

 

* (p 5 0.05) statistically significant.

a. (597/1400) * 100% =

42.6% response rate.

b. No higher interactions between/among two or more factors

were important.

86

knowledge of safe food handling was found among school
foodservice personnel with different job titles (p g 0.05).
Respondents with the job titles of "manager" and
"supervisor" had a significantly higher knowledge score
(mean score = 79.1%) than did respondents with the job
titles of "cook" (mean score = 74.6%), "kitchen assistant"
(mean score = 73.1%), and "others" (mean score = 75.5%).

Results from this study indicated that cooks and cook
assistants had significantly lower mean knowledge scores on
safe food hadnling than did managers/supervisors. Cook and
cook assistants prepare food for service to school children.
Outbreaks of foodborne disease could occur in school
foodservice operations because of unsafe handling of food by
cooks or their assistants. Because of the lower mean
knowledge scores on safe food handling, administrators of
school foodservice personnel as well as school foodservice
managers have the responsibility to provide training in safe
food handling to cook and cook assistants.

Managers/supervisors probably had a higher knowledge
score because they had higher education levels and more
experience in the foodservice industry. In this study, more
than 80% of cooks, kitchen assistants, and personnel with
other job titles were high school graduates; only 68% of
managers/supervisors were high school graduates. Burch and
Sawyer (1991) reported that the manager’s knowledge of safe

food handling was significantly correlated with the actual

87
sanitation score of the food preparation area in a
convenience store. If school foodservice operations are in
any way similar to those of convenience stores, then
managers’ knowledge of safe food handling is important.
Mandatory certification in foodservice sanitation should be
recommended for managers of school foodservice facilities; a
certified manager should be on duty during all school hours

when food being prepared and served.

4.5 Conclusions

Based on findings from this research, specific
constructs suggested for use in training are the maximum
safe operating temperature for a refrigerator and
identification of potentially hazardous foods (Table 9).
Classroom teachers and other adults interacting with school
children should consider use of school foodservice personnel
especially managers/supervisors who had a higher mean
knowledge score of safe food handling as an important
resource for information about safe food handling.
Professional societies such as the American School
Foodservice Association should emphasize knowledge about
safe food handling as a significant component in a

professional education program.

88

89

Table 9. Recommendations related to education about safe
food handling for Michigan school foodservice

 

 

personnel.
L
Educational Recommendations Rationale
factors
Construct/ A. Food temperature and 1. Because only

objectives

 

 

storage:

After a course on safe
food handling taught by
a food safety
professional, school
foodservice personnel
would be able to
identify the
recommended operating
temperature of
refrigerator.

B. Potentially
hazardous foods:
After receiving
accurate information
about safe food
handling, school
foodservice personnel
would be able to
accurately identify
potentially hazardous
foods.

 

68.8% respondents
knew the
recommended maximum
temperature of an
operating
refrigerator (Table
7).

2. Because only
40.9% respondents
can correctly
identify four of
six potentially
hazardous foods
(Table 7).

 

 

5.0 CONCLUSIONS AND RECOMMENDATIONS

As part of a larger food safety education assessment
project in the state of Michigan, third-grade teachers (n=439)
and school foodservice personnel (n=597) were surveyed to

determine their safe food handling knowledge.

5.1 Conclusions
As a result of the present study, the following

conclusions were drawn:

(1) Michigan third-grade teacher respondents could only
correctly answer half the knowledge questions on safe
food handling. Most of them (74%) had not previously
received any formal training in safe food handling.

(2) Over three-fourths (80.8%) of the teachers reported
that children almost never bring a cold pack from home
to keep their lunch cold. About 40% (39.3%) of
teachers believed that children almost never had an
opportunity to wash vegetables/fruits before eating
them.

(3) Constructs and specific learning objectives for safe
food handling training programs for third-grade

teachers were developed (Table 3.6).

90

 

(4)

(5)

(6)

(7)

91
Teachers over 40 years of age were more knowledgeable
about safe food handling than were teachers under 40
years of age. This difference in age/knowledge may be
attributed to single generation of change. Younger
teachers were more likely to have grown up during the
(recent) era of convenience foods in their homes; they
were less likely to have learned about meal preparation
from their parents or significant adults in their
household. Further, the study of food in schools since
the 1960s has more often emphasized food choice
(nutrition) than food preparation (safe food handling
or home economics).
Results indicated that Michigan school foodservice
personnel could only correctly answer two-thirds of the
eight knowledge questions (76%). This result was
unexpected since 98% reported that they had received
training in safe food handling.
Constructs in which more knowledge on safe food
handling is needed by Michigan school foodservice
personnel and specific learning objectives are in Table
4.9.
Michigan school foodservice personnel, especially cooks
and kitchen assistants, should have more training in
safe food handling because they had significantly lower

scores than did their managers/supervisors.

92
(8) Teachers should consider involving school foodservice
personnel when teaching safe food handling to children
9 to 11 years of age. Other school resources such as
school foodservice production and service facilities

could also be used by teachers for this purpose.

5.4 Recommendations for Future Research

The use of new food technologies such as cook/chill
foodservice operations, aseptic canning, and controlled
atmosphere packaging have resulted in the identification of
new bacterial pathogens. Some of the newly emerging
pathogens such as Listeria and Yersinia grow at temperatures
used for refrigeration (35°-45°F) . Teachers and school
foodservice personnel should be retested and retrained on
the implications of these emerging pathogens.

In this study, Michigan third-grade teachers were
tested on their knowledge of safe food handling. Most
teachers were knowledgeable about the methods of thawing
frozen foods and personal hygiene, but they did not know the
maximum temperature of an operating refrigerator. Further
training related to safe food handling for third-grade
teachers should focus on the topics in Table 3.6.

The knowledge on safe food handling of teachers in other
grades also should be assessed. The resulting information
could be used to determine constructs and learning

objectives for the training of all school teachers.

93

Teachers need more opportunities to learn about safe
food handling. Satellite conferences, in-service workshops,
and graduate courses were by teacher as the methods they
preferred to use for such learning. More training was also
necessary for Michigan school foodservice personnel in the
area of safe food handling. Development of training
materials related to safe food handling for use in in-
service workshops, and courses taught by the Michigan
Department of Education and professional societies is
necessary. Professional organizations to which Michigan
school foodservice personnel belong should consider the
topic of safe food handling (Table 4.9) when establishing
criteria for certification programs.

In this study, safe food handling knowledge of school
foodservice personnel were assessed about their safe food
handling knowledge. Further research should focus on the
evaluation of the sanitary quality of school foodservice
operations as well as the safe food handling practices of

school foodservice personnel.

 

APPENDICES

 

APPENDIX 1. REQUEST LETTER

 

941

APPENDIX 1. REQUEST LETTER

MICHIGAN S'I'A'I'li UNIVERSITY

 

 

. ... —_-_,

 

lXPMTNLVT 0. N10" St‘thCl. AND IH'HAS NI'I’NI‘I'IUN lASl' IANVNK. ° MI(.III(..\N 0 43110 l.‘.'|

February 21. 1991

Dear Principal:

Your assistance is requested in a study that will help clarify the
relationships between children and foodborne illness.

We are three researchers at Michigan State University who are interested in
the food practices of young children and their families, and how these may
create susceptibility to foodborne illness. The occurance of foodborne
illness is a growing problem in the U.S. As one outcome of this study,
instructional materials will be developed for use with young children.
Specifically, a computer hypermedia program on food safety will be developed
which can be used by elementary school children.

Would you allow teachers in third grade classrooms to administer to children a
short survey about their food preparation, food handling, and eating habits?
A draft survey is enclosed for your review. The survey is intended to require
only a few minutes of classroom time, and very little teacher assistance.
Please be assured that surveys will only be identified by school; individual
names of children or their families will not be requested. For their
assistance, each teacher participant will receive a nutrition-related teaching
resource. He also hope to learn about the food safety knowledge of adult
populations in your school district, including third grade teachers, parents
of third grade students and food service personnel.

Findings from the study will be available to you upon request. As a school
administrator, you might be interested to know how many meals children are
preparing for themselves, their ”typical" meals, and what they know about
proper food handling. Such nutrition-related information is of growing
concern to school personnel. Current research is showing a clear link between
proper nutrition, intellectual growth, and achievement of young children.

While we appreciate the constraints of accessing school children as part of
research projects, we hope your school district is open to assisting us in
this way. Please return the enclosed card before March 1, 1991, and we will
forward to you the requested number of copies of the survey. An informational

"N u an Vin—I‘M"? .41 'N'II'qudl “protein-uh IQI'Il-IO‘O.

—_- -— ---.-~_ _--

Principal
February 21, 1991
Page 2

95

letter describing this study has been forwarded to your school district ‘
superintendent and the local area coordinator for the Michigan Model for
Comprehensive School Health Education.

Thank you again for your interest and assistance.

Sincerely,

  

  

issociat P ofessor
Family a d’Child Ecology
1-800-327-4691

_;><fovvutbv" Cineobteuuot/

Sandra Andrews, Ph.D., R.D.
Assistant Professor
Food Science and Human Nutrition

*Contact person’

Enclosures: Postcard for Reply

Child Survey

C M >Ja~d7VJ

Carol Sawyer, Ph.D., R.0.
Associate Professor
Food Science and Human Nutrition

APPENDIX 2. REPLY CARD

 

96

APPENDIX 2. REPLY CARD

 

Michigan State University

Carol Sawyer, Ph.D.

Department of Food Science
and Human Nutrition

East Lansing, Michigan 48824

swam

Contact Person
School Name
Address

Check AH That Apply:

CI Our third grade teachers are willing to assist. Send _.___
copies of the survey.

CI Our school is also willing to collect similar data from parents,
teachers and food service personnel.

 

 

 

C] Our school is unable to assist you.
Thank you.

Please return this card no later than March 1, 1991.

APPENDIX 3. QUESTIONNAIRE FOR THIRD-GRADE TEA“.

 

97

APPENDIX 3. QUESTIONNAIRE FOR THIRD-GRADE TEACHERS

MICHIGAN STATE UNIVERSITY

FOOD HANDLING STUDY

to improve the health of our Michigan children

QUESTIONS FOR TEACHERS

 

Dear Third Grade Teacher:

This study is designed to learn about your beliefs, knowledge and
practices related to food handling. Food handling refers to the
things typically done when storing, preparing, cooking, and/er
serving food. Information learned from this study will be used to
educate Michigan children about safe food handling.

Please note:

1. The questionnaire will take about ten minutes to complete.
2. Answers are confidential.
3. Your name is no; required.

You indicate your voluntary agreement to participate by completing
and returning this questionnaire. You may decline to answer any of
the questions.

Thank you in advance for your participation.

Department of Food Science and Human Nutrition
Michigan State University
anst Lansing, MI 48824
517/353-9663

98

QUESTIONS FOR THIRD GRADE TEACHERS

1. You do many important things to keep yourself healthy. Compared to
most of the things you do to maintain your health, how important is

We? (Check one)

1119; Safe food handling is the most important thing I do.
1212; Safe food handling is as important as most things I do.
6,2} Safe food handling is less important than most things I do.
Q! Safe food handling is not important. E
9,1} I am not familiar with methods of safe food handling. —

 

2. During the past year, from what 19339;; have you received information
on food handling? (Check all that apply)

92. QB.

21111___1§1§1 Co-operative Extension Service (CES)
59.53 1.8: Family and friends

11,51 5,21 Government pamphlets

11,65 2.13 Local school district

§§.Q; 2;,51 Newspapers, consumer magazines
32,5} 11,5! National/Michigan Dairy Council

8,23 2,}; Professional journals
. 7,3; 2,}; Professional or job related meeting

5.9% 2.53 Other. Please specify: M1gh1g§g_flggg14mg§g;1§151_

booksI TV, vgdgotgpe, clgsgeg taken in collgge.

16.91 I have not received information on food handling.
(Go to question 5)

3. Of your choices in question number 2 above, please circle the source of
information that you believe provides the most accurate information on
food handling. (Circle one choice in question 2 above).

 

4.

99

Describe the most beneficial 19;;11_§;§131gg in food handling that you
received during the past 12 months (April 1, 1990 to March 31, 1991).
(Check A or 3 below and fill in the blank if applicable)

5.7% A. Topic/Name of Training Session

 

 

Length of training hrs or days
Location
Presenter (Sponsoring agency)

 

 

Date
74.93 B. I have not received any formal training in food
handling.

 

How many children are in your third grade classroom?

Do you teach with 99323111111 in your third grade classroom? (Check
one)

12121 Yes 12.2: No (Please go to question 10)

Children in my classroom have a computer(s) available to them during
school hours: (Check all that apply)

in my classroom. 7.71 in another classroom.

in a laboratory. 13.43 in a library.

in another building.
other. Please specify:

The piggglgl of computer available to children in your third grade
classroom during school hours is(are): (Check all that apply)

EEEE’

 

\l
O .
fl

Apple.
IBM.
IBM compatible (Tandy, CompuAdd, Zenith).

EEE

Other. Please specify:

 

 

 

10.

11.

12.

13.

100

When using computers for instruction with your third grade students,
what is the usual £3119 of computers to children? (Fill in two blanks)

There is (are) computer(s) for children
(n or 0 computers) 1 (number of children)
in my third grade classroom. '

Have you taught any safe food handling concepts to the third grade
children in your classroom during the past school year? (Check one)

53151_Yes 5§1§1 No (Please go directly to the question 14)

If you answered yes to question 10, which of the following methods did
you use to teach safe food handling? (Check all that apply)

Computer 20,21 Presentation/lecture
Discussion §§.4§ Michigan Model materials
Games 1.§% Field trips/site visits

Written exercise

Other.Please specify: 1!, vggigggpg

Please circle the method in question 11 that has worked best for your
class. (Circle one choice in question 11)

EEEEE

Please describe below any 1311135119g31_311151511 on safe food
handling that you have found useful with the third grade children in
your classroom. (Please fill the blanks below 9; go directly to
question 14)

 

 

 

 

Year Price 5

 

 

14.

15.

16.

17.

18.

19.

101

To keep fresh, raw ground beef safe to eat, the best place to store it
overnight is (Check one)

0% in a cupboard. 0% in a kitchen sink.
22.3% in a refrigerator. 0% on the top of a kitchen counter.

 

95 all of these choices are OK.

The best place to safely 32;! frozen, raw ground beef is (Check one)
__91 in a cupboard.
1.45 in a kitchen sink (without water).
25.4% in a refrigerator.
2.75 on the top of a kitchen counter.
_Q121 all of these choices are OK.

On which of the following foods are bacteria (germs) able to grow?
(Check all that apply)

§§1§1 baked potato 25155 chicken breast

49.25 corn oil 91.6% glass of skim milk

21121 refried bean 12.5% white vinegar

Which of the following activities is the best way to 9111131 getting

sick from bacteria and viruses (germs) in food? (Check one)
1,51 rinsing hands under very hot water before handling raw chicken

22121 washing hands with soap and clean water before handling
raw chicken
2,75 Wiping hands on a clean towel before handling raw chicken
_5121 none of these are important

A unopened carton of milk is stored in a refrigerator overnight. The

ggghest egge gggpgrgtggg of the refrigerator would be (Check one and
fill in the temperature if required)

29.2% The temperature would be 40-4§T'(or °C).
I do not know the temperature.
Staphylococcus aureus, a potentially harmful bacteria, is most often
introduced into potato salad from (Check one)
people who handle the potatoes.
diseased potatoes.
soil and dust on the potatoes.
all of these choices are OK.

EEEEE

none of these choices.

 

 

102

20. You usually can tell when a food such as ham has bacteria (germs) that

could make you sick by how it looks, smells or tastes.

512g; true 4§.6§ false

(Check one)

21. When refrigerating leftover stew, which container will best limit the

22.

growth of harmful bacteria (germs)? (Check one)

1525; a shallow container such as an uncovered cake pan (2 inches
deep)
1.21 a deep container such as an uncovered, eight-quart pot (12
inches deep)
15,22 the depth of container is not important

Below are some things that kids do. Do you gelieve that the children
in your third grade classroom do these things almost always?
sometimes? almost never? (For each question, please circle the one

answer you bgligzg is right)

a.How often do the
children bring a
cold pack from home
to keep their lunch
cold?

b.1s an opportunity
provided for the
children to wash
their hands before
eating a snack?

c.Is an opportunity
provided for the
children to wash
their hands before
eating lunch?

d.Is an opportunity
provided for the
children to wash
their hands after
using the toilet?

e.How often do children

bring to school and
eat food that is
spoiled or bad?

f.Is an opportunity
provided in the
classroom for the
children to wash
fruits and /or
vegetables before
eating them?

almost always
0.9%

almost always
61.9%

almost always
74.0%

almost always
99.7%

almost always
005‘

almost always
42.2%

sometimes
17.6%

sometimes
26.3%

sometimes
1604*

sometimes
0.7%

sometimes
708‘

sometimes
12.3%

almost never
80.8%

almost never
10.7%

almost never
8.7%

almost never
0.2%

almost never
81.3%

almost never
39.3%

23.

24.

25.

26.

27.
28.

29.

30.

103

Guidelines on safe food handling are provided for parents (other
householders) who bring food to school for parties or snacks. (Check
one)

2.2} Yes 22.2} No (Please go directly to question 24)
If you answered yes to the question above, please enclose, if

conveniently available, a copy of the guidelines on safe food handling
for parents.

Please tell us your job title. (Fill in the blank below)

 

How many years has you been in this job? (Fill in the blank)
years

What is your gender (sex)? 29,73 female 221; male

What is your age? (Fill in the blank) yrs.

During a typical week, how many meals are made in your household?
(Write in number of meals)

meals per week are made in my household.
(number)

Of the meals made in your household during a typical week, how many do
you personally prepare? (Write in number of meals)

I typically make meals per week.
(number)

For how many ggggEQSigg; have your mother's ancestors been in the US?
(Check one)
0.2% newly immigrated (you were born outside of the US)

3.7; one generation (your mother was born outside of the US)
21.75 two generations (your mother's mother was born outside of the
US)
70.1% more than two generations
2.2% I am not sure.
__91 a visitor to the Us (for example, an ex-change student)

31.

32.

33.

104

The following question is 92522921. What is your main family
background? The reason for this question is that we would like to
learn about the special food handling practices of the various ethnic
groups in Michigan. (Check all that apply)

2,}: African-American (Black)
_Q223 Arab/Chaldean

9; Asian/Pacific Islander

 

 

 

Asian Indian Chinese

Filipi Japanese
Hmong Laotian
Vietnamese

 

91 Hispanic (Latino)
Central America Cuban
Mexican PuertoRican
South American

 

93 Native American (American Indian) or Alaskan Native
22.71 White, non-hispanic

If none of the above adequately describes your ethnic heritage, please
write it in here.

 

Please describe your {ggiggn§i;1_gg§§1gg. (Check one)

2,21 farm
222§;_town under 10,000 people or rural non-farm

252;; town or city of over 10,000 to 50,000 people
1122; suburb of city over 50,000 people
12291 city of over 50,000 people or more

Please describe the setting of your g§§921_gi;§;;g_. (Check one)

7.2% farm
22,6% town under 10,000 people or rural non-farm

22211 town or city of over 10,000 to 50,000 people
12.15 suburb of city over 50,000 people
10,Q% city of over 50,000 people or more

-L4'L O

 

105

34. What is the highggg academic degree you have achieved?
(Check one)

52.6% Bachelor's degree
52.2% Master's degree

9.7% Ph.D. or equivalent
9.2% Professional degree. Please specify:

 

9.73 Other. Please specify

 

35. The following question is 22;;gggl. In what range is your annual
W? (Check one)
95 less than $10,000 2,25 $80,001 to $90,000
Q,2% $10,001 to $20,000 2,75 $90,001 to $100,000
5.2% $20,001 to $30,000 2.2% $100,001 to $110,000
11.4} $30,001 to $40,000 2.2% $110,001 to $120,000
.4% $40,001 to $50,000 . % $120,001 to $130,000
12,7% $50,001 to $60,000 0. % $130,001 to 140,000
8.95 $60,001 to $70,000 0.25 $140,001 to 150,000
lzégg $70,001 to $80,000 2.55 $150,001 or greater

I do not wish to say or I do not know.

 

We would like to hear your comments. Please write any additional
comments in the space provided below.

THANK YOU FOR PARIICIPAIION IN THE “80 FOOD HANDLING STUDY.

Please return questionnaires to:

Carol A. Sawyer, Ph.D., R.D.

Dept. of Food Science and Human Nutrition

Michigan State University

East Lansing, MI 48824

If you have any questions about this study, please call Dr. Sawyer at
517/353-9663.

APPENDIX 4. COVER LETTER 1'0 THIRD-GRADE TBA“.

 

106

APPENDIX 4. COVER LETTER TO THIRD-GRADE TEACHERS

FOOD HANDLING STUDY
to improve the health of our Michigan children

SQZIB_L§IIIB
April 16, 1991

Your box contains the questionnaires from the MSU Food Handling
Study. These were requested by your school. The purpose of this
study is to help to determine beliefs and knowledge of food
handling of third grade students. ‘

The inventory sheet attached to this cover letter indicates the
number of questionnaires enclosed. Please check the contents of
your box against the inventory sheet to make sure you have received
all of the materials your school requested.

A sheet of directions entitled

gitn_thg_£ggd_and_!gg_§nzygy has also been enclosed. The sheet of
directions explains how to administer the survey to third grade
students.

Please feel free to duplicate the questionnaires.

If possible, please return the questionnaires to MSU by May 20,
1991. The enclosed self-addressed.mailing label and stamps are for
your use when returning the questionnaires to MSU.

If you have any questions about the contents of your box, or about
the procedure for distributing and collecting questionnaires, we do
want to know. Please call us at 517/336-2295.

The return address is:

Carol Sawyer

Department of Food Science and Human Nutrition
139 Food Science Building

Michigan State University

East Lansing, MI 48824

Thank you for your assistance.

APPENDIX 5. INVENTORY SHEET SENT TO CONTACT PERSON
AT EACH BCEOOI.

 

107

APPENDIX 5. INVENTORY SHEET SENT TO CONTACT PERSON
1UP EAIfii SCUKMDL

MSU FOOD HANDLING STUDY
to improve the health of our Michigan children
RETURNSEEET
QIBEQIIQN§=
Complete and return this sheet with your questionnaires.

1. Fill in information for the contact person who distributed
and collected the questionnaires.

2. Write in the table-below the quantity of questionnaires
returned.

CONTACT PERSON

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SCNOOL NAME
ADDRESS
ZIP CODE
SCHOOL DISTRICT
COUNTY DATE RETURNED
PHONE NUMBER (DAY) L )
QUANTITY OF NUMBERS ON THE.
QUESTIONNAIRES QUESTIONNAIRES
TYPE SEEI_IQ_§§HQQL
SENT ' RETURNED BEGIN END
1. Student Questionnaire __ __ §___ §____
2. Foodservice Personnel _______ _______ £______ £______
Questionnaire
3. Household _______ _______ H, H
Questionnaire
4. Third Grade Teacher _______, _______ T T
Questionnaire

 

*P-Foodservice Personnel Questionnaire H-Household Questionnaire
T-Third Grade Teacher Questionnaire s-Student Questionnaire
Please return all available questionnaires by May 20, 1991.

TRAN! YOU

 

APPENDIX 6. DIRECTION SHEET

108

APPENDIX 6. DIRECTION SHEET

PORTHIRDGRADETEACHER

MSU FOOD HANDLING STUDY

to improve the health of our Michigan children

 

2.

3.

4.

6.

The student questionnaire, entitled Peed and You should be completed in
class. The University Comittee on Research with Human Subjects requires,
however, that we provide to you some language to read to students who may
choose not to complete this questionnaire. 'You may choose to answer some
or all of the questions on this questionnaire. If you choose not to do the
questionnaire, please draw your favorite food and write two sentences that
explain why it is your favorite food.‘

Since the questionnaire asks students to recall typical 'school week"
behaviors, please administer the questionnaire on

. Please DO NOT have students complete the questionnaire
on madly.

Since the questionnaire asks students to recall what they ate for lunch, if
possible, please minister the questionnaire W.

Please encourage students to read all the responses before choosing one. for
each multiple choice question, have students mark the box in whatever way
they are used to doing so in your classroom - with an 'x", darkening the
entire box, etc. You will want to note that for all questions except #3
students should select only one answer.

Question 4 on the questionnaire asks students to identify their family
background. This refers to their race or ethnic heritage. This is always
an optional question, but we hope to learn the food ways of various cultures.
If students do not identify with any of the provided choices, they may write
in their own identification (Puerto Rican, Lebanese, etc.)

Students are encouraged to use their own spelling. Don’t worry if their
spelling is unconventional.

If you are sending home household questionnaires, please make sure the
household number corresponds to the student number. For example, if Nancy
Smith has questionnaire S-l (Student-l), please make sure you send home to
the Smith household questionnaire H-l (Household-1) . No attempt will be made
to identify the respondents, but we do need to correlate the student
questionnaire to the household questionnaire. A " TEACHER WORKSHBBT" is
included to assist you in keeping track. DO NOT return the worksheet to us.

Carol A. Sawyer, Ph.D., R.D.

Department of Food Science and Human Nutrition
Michigan State University

East Lansing, MI 48824

517/ 336-2295

 

APPENDIX 7 .

GIFT-CERTIFICATE POR THIRD-GRADE TEA“.

 

I. .‘fi‘.u.‘l

109

APPENDIX 7.

GIFT-CERTIFICATE FOR THIRD-GRADE TEACHERS

 

Hoonom ousuocmwm

Emom mmomo Z<UHIUHZ ho AHUZDOU >mH<D
mZO um omHZ<m20004 mm BmDZ ZOQDOU IU¢N
dawn .w mHQZNBmwm umB<O ZOHB<mmem
DNB‘UHQADQ mm 802 2<U ZOQDOU mHIB
szon mm Ema: ZOQDOU meB

mmomo mum ZOmDOU NZO

ZOmKNQ “mm ZOmDOU mZO
mZOHHHQZOU
mdflHmmfiflz ZdOHSUHS m0 QHOZDOO fimHfin 0&4309 oo.mw

g ”038% OZHAOS 000% sz

 

APPENDIX 8. THANX YOU LETTER TO THIRD-GRADE TEACHERS

1110

APPENDIX 8. THANK YOU LETTER TO THIRD-GRADE TEACHERS

0/

DAIRY (‘ulIXClL HF MI! 'I In :.-\.\'
(517):HSMHHII thtl.hllylh:ul “kc-mm. Mic-higan Mum-l I-HmI-.'.-m-mm7

July 25, 1991

Dear Ms. Purvis:

Thank you for your participation in the MSU Pood Handling Study.
As researchers we are anxious to learn about the food handling
practices of Michigan children and their families and to explore
ways to keep.our children healthy!

In appreciation for your assistance, the Michigan Dairy Council and
the MSU Peed Handling Project would like to provide a nutrition
education-related teaching resource to each classroom teacher whose
students participated in this study. Enclosed is a $5.00 coupon
for each teacher toward any Dairy Council material. Bach coupon

must be returned to the Dairy Council with an order blank before
September 6, 1991.

You.may want to consider the finng:__zgg series of materials in the
Dairy Council Catalog (enclosed). These materials emphasize
nutrition and fitness, and were developed for children 9-11 years
old. ggpgg__xgg includes a Parent/Leader guide ($2.00), a
children's workbook ($.60), a poster ($.40), and stickers ($.60).

The enclosed certificate is also to thank the participants of your
school for their help. Your assistance has made a significant
contribution to our understanding of children and food safety.

Sincerely,

Sandra Andrews, R.D., Ph.D. June Pierce Youatt, Ph.D.
Food Science and Human Nutrition Pamily and Child Ecology
Michigan State University Michigan State University
Carol Sawyer, R.D., Ph.D. Grace Tasker, Ph.D.

Food Science and Human Nutrition Executive Director
Michigan State University Dairy Council of Michigan

Enclosures: 3

. u- m»

 

‘r

APPENDIX 9. LOCATIONS AND BRANDS OP CONPUTERS AVAILABLE
IN THIRD-GRADE CLASSROON

 

111

APPENDIX 9. LOCATIONS AND BRANDS 0F COMPUTERS AVAILABLE
IN THIRD-GRADE CLASSROOM

The brands and locations of computers
available in third-grade classroom

 

Items % of respondents

 

Brand of computer

Apple 74.8
IBM 7.5
IBM compatible 2.2
Other 12.8

Location of computer

Third-grade classroom 68.8
Another classroom 7.7
Laboratory 22.1
Library 13.4
Another building 0.6

Other 4.7

 

APPENDIX 10. QUESTIONNAIRE FOR SCHOOL POODSERVICE PERSONNEL

112

APPENDIX 10. QUESTIONNAIRE FOR SCHOOL FOODSERVICE PERSONNEL

MICHIGAN STATE UNIVERSITY

FOOD HANDLING STUDY

to improve the health of our Michigan children

QUESTIONS FOR FOODSERVICE PERSONNEL

 

Dear Foodservice Employee:

This study is designed to learn about your beliefs, knowledge and
practices related to food handling. Food handling refers to the
things typically done when storing, preparing, cooking, and/or
serving food. Information learned from this study will be used to
educate Michigan children about safe food handling.

Please note:

1.
2.
3.

You
and
the

The questionnaire will take about ten minutes to complete.
Answers are confidential.

Your name is n95 required.

indicate your voluntary agreement to participate by completing

returning this questionnaire. You may decline to answer any of
questions.

Thank you in advance for your participation.

Department of Food Science and Human Nutrition
Michigan State University
East Lansing, MI 48824
517/353-9663

1.

113

QUESTIONS FOR FOODSERVICE PERSONNEL

You do many important things to keep yourself healthy. Compared to
most of the things you do to maintain your health, how important is

W? (check one)

25225 Safe food handling is the most important thing I do.

22525 Safe food handling is as important as most things I do.
0% Safe food handling is less important than most things I do.
25 Safe food handling is not important.
2% I am not familiar with methods of safe food handling.

During the past year, from what 19255;; have you received
information on food handling? (Check all that apply)

92 QB

25,15 1,25 Co-operative Extension Service (CES)

16.2% 2.25 Family and friends

22.15 2,55 Government pamphlets

51,25 5,25 Local school district

52.55 1,25 Newspapers, consumer magazines
21,25 2.05 National/Michigan Dairy Council

52,25 2.25 Professional journals
11.25 22.25 Professional or job related meeting

M4 - Other- Please specify: Wiesel.
Wishes-.—

2.8% I have not received information on food handling. (Go
to question 6)

Of your choices in question number 2, please circle the source of
information that you believe provides the most agcugagg information
on food handling. (Circle one choice in question 2 above).

114

4. What kind of training have you received during the past 6 school
years (1985-1991)? Did you pass the test at the end of the training?
(Check all that apply)

 

 

 

 

Name of Course Agency or Association Year Pass The Test
§pgn§or TAKES

Applied Foodservice National Restaurant 19 15,55 Yes No
Sanitation (NIFI) Association

Basics of School Michigan Department 19 12,25 Yes No

Foodservice 100 of Education

Sanitation and American School 19 51,75 Yes No

Safety Foodservice Association

Sanitation and Michigan Department 19 225§5_Yes No
Safety 120 of Education

Other. Please
specify
19 12555 Yes No

 

5. Describe any 13513595193 on food handling you may have had with
third grade children in your school(s). (Check all that apply)
2,15 Talk to students in a classroom setting
21525 Conversation with children in the lunch room
11525 Give children tours of the school foodservice facility

9.3.12; Non-
i}: other. Please specify: WW

I would like an opportunity to work in this area.

6. To keep fresh, raw ground beef safe to eat, the best place to
159;; it overnight is (Check one)
__25 in a cupboard.
__25 in a kitchen sink.
22525 in a refrigerator.
2,25 on the top of a kitchen counter.
__25 all of these choices are OK.

7.

115

The best place to safely 525! frozen, raw ground beef is:
(Check one)
_2525 in a cupboard.
22.0% in a kitchen sink (without water).
2.25 in a refrigerator.
2% on the top of a kitchen counter.
0% all of these choices are OK.

On which of the following foods are bacteria (germs) able to grow?
(Check all that apply)

16.25 baked potato 22.2% chicken breast
22525 corn oil 22,5% glass of skim milk

.21525 refried beans 12,2% white vinegar

9. Which of the following activities is the best way to pggvent

10.

’11.

12.

getting sick from bacteria and viruses (germs) in food?
(Check one)

25 rinsing hands under very hot water before handling raw
chicken

91.2% washing hands with soap and clean water before handling
raw chicken

_2525 wiping hands on a clean towel before handling raw chicken
__25 none of these are important
A unopened carton of milk is stored in a refrigerator overnight.
The 2132255 sag; gempggature of the refrigerator would be: (Check
one and fill the temperature if required)
22525 The temperature would be 52;5ST'(or °C).
2,25 I do not know the temperature.
Staphylococcus aureus, a potentially harmful bacteria, is most
often introduced into potato salad from (Check one)
28.25 people who handle the potatoes.
1.3% diseased potatoes.
1.25 soil and dust on the potatoes.
7,25 all of these choices are OK.
22.2% none of these choices.

You usually can tell when a food such as ham has bacteria (germs)
that could make you sick by how it looks, smells or tastes.
(Check one)

44.9% true 53.9% false

13.

14.

15.

16.

17.

116

When refrigerating leftover stew, which container will best
limit the growth of harmful bacteria (germs)? (Check one)
12515 a shallow container such as an uncovered cake pan (2 inches
deep)
2.75 a deep container such as an uncovered eight-quart soup pct (12
inches deep)
22525 the depth of container is not important

Below are some things that kids do. Do you yel1eve that the
children in your school do these things almost always? sometimes?
almost never? (For each question, please circle the one answer

you belies: is right)

a. How often do the
children bring a

cold pack from home almost always sometimes almost never
to keep their lunch 1.3% 22.8% 69.4%
cold?

b. Is an opportunity
provided for the
children to wash almost always sometimes almost never
their hands before 51.5% 21.9% 18.0%

eating lunch?
c. How often do children
bring to school and
eat food that is almost always sometimes almost never
spoiled or bad? 0.2% 26.4% 52.4%

In what types of facility do you primarily work? (Check all that

46. % Elementary school.

25525 Middle school.

52525 High schol.

15525 Commissary kitchen for school district.

8.45 Other. Please specify

 

Please tell us your job title. (Fill in the blank below)

 

How many years have you been in this job? (Fill in the
blank years

18.

19.
20.

21.

22.

117

What are your main job functions? (Check all that apply)
Management Dishwashing
Supervision Bake/cook foods
Prepare salad/sandwich fixings Reheat prepared foods
Other. Please specify. -

What is your gender (sex)? _21525 female _1525 male

What is your age? (Fill in the blank) yrs.

 

For how many 95352551991 have your mother's ancestors been in
the US? (Check one)

2,25 newly immigrated (you were born outside of the US)

2.75 one generation (your mother was born outside of the US)
12555 two generations (your mother's mother was born outside

of the US)

29,25 more than two generations

2,25 I am not sure.
__25 a visitor to the US (for example, an ex-change student)
The following question is 99512951. What is your main family
5595352332: The reason for this question is that we would like to
learn about the special food handling practices of the various
ethnic groups in Michigan. (Check all that apply)

1.25 African-American (Black)
__25 Arab/Chaldean

25 Asian/Pacific Islander

 

 

 

Asian Indian Chinese
Filipino Japanese
Hmong Laotian
Vietnamese

 

0.7% Hispanic (Latino)
Central American Cuban
Mexican Puerto Rican
South American

2,25 Native American (American Indian) or Alaskan Native
22.6% White, non-hispanic

If none of the above adequately describes your ethnic heritage,
please write it in here.

 

 

23.

24.

25.

118

Please describe your 12512235151_5255129. (Check one)

12,2% farm
22,2% town under 10,000 people or rural non-farm

21.1% town or city of over 10,000 to 50,000 people
13.1% suburb of city over 50,000 people
2,75 city of over 50,000 people or more

What is the 21g§gg5 academic degree you have achieved?
(Check one)

2.2% Some grade school 2.25 8th grade
2,2% Some high school 79.25 High school or CE
2.25 Associate degree (community college or university)
2.2% Bachelor's degree or higher
.5121.0th0r- Please Specify:_s2as_xsars_ia_sellsgsi_zesatienel_
traiaias_ia_feessl_hestsr;s_sssrssi_

The following question is 92512351. In what range is your annual
household 122222: (Check one)

 

2.75 less that $10,000 2,25 $80,001 to $90,000
11.9% $10,001 to $20,000 0.95 $90,001 to $100,000
11111 $20,001 to $30,000 _9525 $100,001 to $110,000

.6% $30,001 to $40,000 9,95 $110,001 to $120,000
.9: $40,001 to $50,000 95 $120,001 to $130,000

6. 5 $50,001 to $60,000 95 $130,001 to $140,000

9,25 $60,001 to $70,000 05 $140,001 to $150,000

1.05 $70,001 to $80,000 95 $150,001 or more

6. % I do not wish to say or I do not know.

We would like to hear your comments. Please write any additional
comments in the space provided below.

THANK YOU FOR PARTICIPATION IN THE MSU FOOD HANDLING STUDY.

Please return questionnaires to:

Carol A. Sawyer, Ph.D., R.D.

Dept. of Food Science and Human Nutrition
Michigan State University

East Lansing, MI 48824

If you have any questions about this study, please call Dr. Sawyer at
517/353-9663.

 

APPENDIX 1].. COVER LETTER TO SCHOOL FOODSERVICE PERSONNEL

119

APPENDIX 11. COVER LETTER TO SCHOOL FOODSERVICE PERSONNEL

MICHIGAN STATE UNIVERSITY

 

noun-en Of F000 SCIENCE AND HUMAN mnmox (m) m-em
Mussel!) . mcmGAN . «nu-nu ran; um um:

November 18, 1991

DOA! .3

Your assistance is requested to participate in a Michigan State
University study. The study is intended to determine the
attitudes, beliefs and knowledge about safe food handling of school
foodservice personnel in the state of Michigan.

The occurrence of foodborne illness is a continuing problem in the
United States. As the number of cases increase annually,
identifying problems leading to foodborne illness becomes critical.
To aid in the identification of these problems, food handling
practices of food handlers need to be identified.

This MSU Safe Food Handling Project has received the assistance of
the Michigan Department of Education (MDE). Your name has been
provided to us by MDE, as an employee of a school foodservice
organization. To acquire a true picture of food handling practices
in school foodservice operations throughout Michigan, you are asked
to individually complete a questionnaire. A copy of the
questionnaire is enclosed. Please fill out the questionnaire
completely and return it in the enclosed, addressed, stamped,
envelope by November 27.

The questionnaire will take approximately 15 minutes to complete.
Participation is completely voluntary. All of the answers to
questions on the survey are confidential. Names are not required
on the survey. However, completing and returning the questionnaire
would provide information which will be used to help improve the
understanding of food handling practices in Michigan schools.

If you have any questions regarding this study at any time, please
call Carol Sawyer at MSU (517/353-9663). The return address for
the questionnaire is below. Thank you in advance for your
assistance.

sincerely,

W (55%“ny

Carol Sawyer, Ph.D., R.D.
Associate Professor

139 Food Science Building
Michigan State University
East Lansing, MI 48824-1224

Enclosures: One questionnaire
Addressed, stamped envelope

"\l n as 40.0w 4":- Iqesl lm'eMs Jam's"...

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