Food Safety = Behavior, 30 Proven Techniques to Enhance Employee Compliance

My friend, Wal-Mart Frank, has written a follow-up to his 2008 book, Food Safety Culture. This is from the introduction:

food_safety_culture_0_story(1)As a food safety professional, getting others to comply with what you are asking them to do is critical, but it is not easy. In fact, it can be very hard to change other’s behaviors. And if you are like most food safety professionals, you have probably received little or no formal training on how to influence or change people’s behaviors.

But what if I told you that simple and proven behavioral science techniques exist, and, if applied strategically, can significantly enhance your ability to influence others and improve food safety. Would you be interested?

The need to better integrate the important relationship between behavioral science and food safety is what motivated me to write this book, Food Safety = Behavior, 30 Proven Techniques to Enhance Employee Compliance.

When it comes to food safety, people’s attitudes, choices, and behaviors are some of the most important factors that influence the overall safety of our food supply. Real-world examples of how these human factors influence the safety of our food range from whether or not a food worker will decide to wash his or her hands before working with food to the methods a health department utilizes while attempting to improve food safety compliance within a community to the decisions a food manufacturer’s management team will make on how to control a food safety hazard. They all involve human elements.

OLYMPUS DIGITAL CAMERAIf concepts related to human and social behavior are so important to advancing food safety, why are they noticeably absent or lacking in the food safety profession today? Although there are probably several good reasons, I believe it is largely due to the fact that, historically, food safety professionals have not received adequate training or education in the behavioral sciences. Therefore, there are numerous food safety professionals who approach their jobs with an over-reliance on the food sciences alone. They rely too heavily, in my opinion, on traditional food safety approaches based on training, inspections, and testing.

Despite the fact that thousands of employees have been trained in food safety around the world, millions of dollars have been spent globally on food safety research, and countless inspections and tests have been performed at home and abroad, food safety remains a significant public health challenge. Why is that? The answer to this question reminds me of a quote by the late psychologist Abraham Maslow, who said, “If the only tool you have is a hammer, you tend to see every problem as a nail.” To improve food safety, we have to realize that it’s more than just food science; it’s the behavioral sciences too.

Think about it. If you are trying to improve the food safety performance of an organization, industry, or region of the world, what you are really trying to do is change peoples’ behaviors. Simply put, food safety equals behavior. This truth is the fundamental premise upon which this entire book is based.

How does one effectively influence the behaviors of a worker, a social group, a community, or an organization?

frank.amy_.doug_.jun_.11While it is not easy, fortunately, there is good news for today’s more progressive, behavior-based food safety professional. Over the past 50 years, an incredible amount of research has been done in the behavioral and social sciences that have provided valuable insights into the thoughts, attitudes, and behaviors of humans. Applying these studies’ conclusions to our field has the potential to dramatically change our preventative food safety approaches, enhance employee compliance, and, most importantly, save lives.

One of the most exciting aspects of behavioral science research is that its results are often of simple and practical use to numerous professions, including ours – food safety. Generally, the principles learned through behavioral science research require little technical or scientific equipment to implement. They usually do not require large expenses. What is required, however, is an understanding of the research data and the ability to infer how the research might be used to solve a problem in your area of concern.

In this book, Food Safety = Behavior, I’ve decided to collect some of the most interesting behavioral science studies I’ve reviewed over the past few years, which I believe might have relevance to food safety. I’ve assembled them into one easy-to- use book with suggested applications in how they might be used to advance food safety.

To get the most out of this book, at the end of each chapter, I strongly encourage you to spend a few minutes thinking about the behavioral science principle you have just read, what it means to food safety, and how you might apply that principle in your own organization (or in your role) to improve food safety. For those in academic set- tings, you might also want to make a list of potential questions for further research.

frank.doug_.manhattan-300x225In summary, this book is devoted to introducing you to new ideas and concepts that have not been thoroughly reviewed, researched, and, more importantly, applied in the field of food safety. It is my attempt to arm you with new behavioral science tools to further reduce food safety risks in certain parts of the food system and world. I am convinced that we need to adopt new, out-of-the-box thinking that is more heavily focused on influencing and changing human behavior in order to accomplish this goal.

It is my hope that by simply reading this book, you pick up a few good ideas, tips, or approaches that can help you improve the food safety performance of your organization or area of responsibility. If you do, I will consider this book a success.

In closing, thanks for taking the time to read Food Safety = Behavior and, more importantly, for all that you are doing to advance food safety, so that people worldwide can live better.


Text me, don’t e-mail me, to influence food safety behavior

I hate texting.

I learned how to do it so I could chat with my kids, but I much prefer e-mail.

imagesChapman says I’m old, and the whole e-mail thing just passed by these kids.

The hardest lesson to teach any student working in my lab over the past 15 years was, check your e-mail.

When I went to Disney with food safety Frank in 2008, I was most impressed that he had all his chefs in the 20-something resorts checking their Blackberries every couple of minutes.

That’s the way I ran my lab.

But, I have kids, and they slowly drag the old man along to the new technology, and texting.

A Curtin University-led study (that’s in Australia) shows young adults are more apt to develop automatic, regular and long-lasting food-safety behaviors if a habit is formed.

However, this formation doesn’t have to be linked to education or motivation, but simply created with regular cues that prompt action.

Curtin University Associate Professor Barbara Mullan says the work flips the usual habit paradigm.

“There is a lot of research into how we break bad habits, particularly in clinical psychology, in areas such as obsessive-compulsion disorder,” Mullan says.

“But there’s very little about how humans establish good habits.

“Previous studies that do have largely involved people with a motivation to change, such as losing weight or exercising more, but we felt there was a lot of noise in that data.

“We wanted to strip the question of back to the purest level of ‘how long do people have to repeat an action for it to become automatic?'”

To answer that question, they drew on recent research which found microwaving a dishcloth—a major source of kitchen cross-contamination—for one minute was an effective method of sterilisation.

They enlisted 45 undergraduate students and divided them into three groups, two which received a reminder poster and text-message prompts every three and five days respectively to microwave their dishcloth, and a control group who received no reminders.

The test period lasted for three weeks, with a follow-up done three weeks after completion.

This follow-up revealed that a significant number of those given cues to act were still performing the habit, while those in the control group were not.

“The results are particularly important as they demonstrate that a relatively simple intervention was sufficient to change and maintain behavior,” A/Prof Mullan says.

“This suggests focusing on habit formation is a better strategy than attempting to change or improve behaviors through education or instruction, which have been shown to be largely ineffective.

“And they remove the need for motivation. While a person’s intentions may be good, intention does not always lead to behavior change.”

Mullan says they chose students as participants due to young adults being a population at a higher risk of experiencing foodborne illness, which affects a quarter of Australians each year.

The researchers are now looking at cue sensitivity and if sequences of habits can be built, including checking expiry dates and fridge temperatures.

Bakery owner: It’s easy to follow the rules; good food safety is about staff who care

Employing good food safety at retail is a combination of folks identifying risks and putting in mitigation steps to address them. The rub is that you need to cultivate a good staff who values the stuff that keeps patrons from getting sick. The science and guidance is relatively easy compared to the people stuff.

Mad Eliza’s Cakes and Confections, a pastry and bakery shop in Topeka, KS sorta has the people stuff figured out, according to

“It doesn’t matter what it is,” said co-owner Mark Murnahan, “I’m going to see it if it’s dirty.”

Murnahan said he has pretty high standards for his kitchen staff of four and constantly monitors everything to make sure they are in compliance. The KDA food guidelines, he said, are never farther than his laptop.

“I don’t want to serve anything I wouldn’t serve to my 98-year-old grandma or my 1-year-old son or anyone in between,” he said.

To accomplish that, Murnahan said, “training is critical” — and so is having a staff that cares about what it is serving.

“You have to know someone will take direction and have pride in what they serve,” he said. “Anyone who really wants to learn, the first thing they need to learn is food safety.”

“Anybody can have a good inspection,” Murnahan said. “It’s not hard to follow the rules. There are a lot, but once you know them, they’re really not hard to follow.”

Market food safety at retail so consumers can choose: Not training or technology

Maple Leaf Foods hosted its Sixth Annual Food Safety Symposium last week in Mississauga (that’s in Canada).

hucksterAccording to The Poultry Site, this year’s event was themed ‘People or Technology’, asking participants to debate which was the best investment to make a step change in food safety globally.

Dr. Randy Huffman, SVP Operations and Chief Food Safety Officer at Maple Leaf said, as many do, that food safety as a non-competitive issue and the company actively shares food safety learnings and promotes sharing of information among industry and government groups.

These are the wrong questions and wrong assumptions.

Yes, people need training – ever seen a peer-reviewed paper evaluating the effectiveness of such training?

Yes, new technology does wonderful things and also creates wonderful new opportunites for new bugs because food is a biological system that will always change.

Yes, food safety should not be a competitive issue and information should be shared.

But that’s not marketing at retail.

Any time I say, food safety should be marketed at retail – E. coli counts in spinach, Salmonella in eggs, Listeria in (Maple Leaf) cold cuts, I get told food safety is a non-competitive issue.

But I’m talking about marketing. People say the reason they buy local, organic, natural, sustainable, dolphin-free and hundreds of other categories is primarily because of safety.

market.naturalAs a consumer, I want to know which eggs have a history of low Salmonella counts. The technology exists and is being used to access complete restaurant  inspection reports with smart phones on those A-B-C rating in New York City.

Food safety may be non-competitive, but implementation is altogether different: some companies are better than others. As a parent doing all the grocery shopping, I want to know what companies are better at microbial food safety. As a PhD in food safety, I want to figure out how best to convey meaningful information.

But have your conferences, feel important, and read daily and bear witness to the outrageous levels of microbial food safety failures.

The kind that make people sick.

Toilet psychology: why do men wash their hands less than women?

By hiding in toilet cubicles for a new study, psychologists observed how long people spend using the loo, and how long they wash their hands for afterwards. That men usually wash their hands less conscientiously than women is a well-established finding. Thomas Berry and his colleagues wanted to find out more about the reasons for this gender difference.

toilet.hideFor one day, between 10am and 4pm, a male researcher secreted himself inside one of three cubicles in a gents toilet facility at a U.S. University. For optimal observational purposes he chose the cubicle adjacent to a row of three urinals. Nearby, in a similarly designed female toilet facility, a single female researcher positioned herself in one of the three cubicles available. Don’t worry, both researchers were provided with a “customised wooden bench” for comfort.

They were also equipped with stopwatches. The researchers used an “unobtrusive sight procedure” – that is, they spied on other visitors to the lavatories using the gaps beneath and by the side of the cubicle doors (for some reason, US toilet cubicles always have a gap of about a centimetre either side of the door). The researchers also used an “acoustic procedure”. That is, they listened to the visitors’ actions. The study authors explained:

“… research assistants recorded the facility [urinal or cubicle], and then started a stopwatch when the patron’s feet stood relatively still. For the men, the research assistants also recorded the orientation of the feet to gauge the patron’s use of the commode (i.e. as a commode or a urinal). When research assistants heard the flushing of the patron’s commode or urinal the stopwatch was turned off … and the duration of the restroom event was recorded.”

Similar procedures were followed for recording each visitor’s “hand washing event” if there was one. A clever twist was that for part of the study, the researchers put “out-of-order” signs over the men’s urinals. This was to see how much they’d hand wash if they were forced to urinate in a cubicle, rather than at a urinal.

The psychologists managed to observe the toilet behaviour of 34 women using cubicles; 32 men who used a cubicle to defecate; 40 men who had no choice but to use the cubicles for urinating (because of the out-of-order signs); and 64 men who used a urinal. The bare statistics show that the hand-washing rates for these four groups were 91 per cent, 87.5 per cent, 75 per cent and 59.4 per cent, respectively.

The difference in hand washing rates between women using a cubicle and men using a cubicle (for defecating) was not statistically significant. In contrast, both women using a cubicle, and men using a cubicle (for defecating), showed significantly higher hand-washing rates than men who used a urinal.

The data are somewhat compromised because, as the researchers delicately put it – the women’s “facility use is a constant (i.e., commode) and their behaviour (urination, defecation, or menstrual care) is confounded within the one environment.” However, taken together, the results suggest that the reason men wash their hands less than women overall, is not because of gender norms (i.e. men are less bothered about being clean), but because of the differences in the toilet environment and toilet behaviour for men and women. In fact, after using a toilet cubicle to defecate, men tended to wash their hands for longer than women (but remember we don’t know what the women had been doing).

The curious experiments of Dr Disgust

In the words of WKRP sales legend Herb Tarlek, tacky sells.

So does disgust.

ghostbusters.psych(A reason it’s called barblog?)

In North Carolina, there’s a company that manufactures bottles of an artificial fart spray called Liquid Ass™. The makers (who call themselves Assman #1 and Assman #2) are clearly proud of their product, writing lyrically on their website of its “genuine, foul butt-crack smell with hints of dead animal and fresh poo”.

The site also features user testimonials, mostly along the lines of “I sprayed this stuff all over a friend’s car, then laughed myself silly as he tried to work out where the stench came from”.

What the website fails to mention, however, is the vital role these little bottles of nastiness are playing in the cutting-edge experiments conducted, in perfect seriousness, by Auckland University psychology researchers.

Over the past few years, a team has been luring experimental subjects into a small room on the 12th floor of a building in Auckland City Hospital, putting them into a state of mild disgust with a covertly deployed dose of Liquid Ass (which, despite the stench, is non-toxic), then running a battery of psychological tests.

Other adventures facing the subjects included being handed a bag that looked like it may once have contained excrement.

It’s tempting to think that this proves little more than the popular hypothesis that psychologists are sadistic weirdos, but in fact these experiments are yielding powerful liquidAssinsights into the nature of human emotions.

More practically, they are providing clues for how to deal with some of the most intractable problems facing modern healthcare.

The man behind these experiments is Associate Professor Dr Nathan Consedine, director of the health psychology programme in the Department of Psychological Medicine.

He’s 42, has a skinny moustache vaguely reminiscent of Salvador Dali’s, and has been studying emotions and their role in healthcare throughout a career that began in Christchurch and has included long stints at Columbia University and Long Island University in New York.

It was only in 2009, though, after returning to New Zealand, that Consedine started paying close attention to the significance of one emotion in particular: disgust. It is, says Consedine, the “elephant in the room” when it comes to healthcare.

More on pink and thermometers

Surveys still suck.

Using I-own-a-thermometer as an indicator of thermometer use is as useful as I-own-a-sink therefore I wash my hands. Or, I own a toilet, so I always hit the bowl. Or … use your imagination.

Researchers at the U.S. Food and Drug Administration report in the Journal of Food Protection that the use of a food thermometer is the best way to ensure that meat, poultry, and other foods reach an internal temperature sufficient to destroy foodborne pathogens.

The 1998, 2001, 2006, and 2010 Food Safety Surveys were used to analyze changes in food thermometer ownership and usage for roasts, chicken parts, and hamburgers in the United States.

But surveys still suck.

The paper notes that when E. coli O157:H7 was first associated with ground beef in the 1980s, the U.S. Department of Agriculture (USDA) recommended that consumers cook hamburgers until the meat was ‘‘brown or pinkish brown in the center. However, as a result of research that showed that one out of four hamburgers may be brown in the center before reaching a safe internal temperature, the USDA changed its advice to consumers— instead of using color as an indicator of doneness in hamburgers, consumers should use a food thermometer to ensure that a safe temperature has been reached. In May 2000, the USDA launched the Thermy educational campaign to encourage consumers to use a food thermometer when cooking small cuts of meat, such as hamburgers and chicken parts. The USDA also provided guidance to consumers about the safe temperature for various cuts of meat and poultry.

Ho Phang and Christine Bruhn reported earlier in JFP that in video observation of 199 California consumers making hamburgers and salad in their own kitchens, handwashing was poor, only 4% used a thermometer to check if the burger was safely cooked, and there were an average of 43 cross-contamination events per household. They concluded Thermy had not been successful.

We did our own survey with 40 people brought in to cook a chicken meal in a Kansas State kitchen and videotaped their behaviors. Many participants reported owning a food thermometer (73%) and nearly half (42.5%) of participants reported knowing the suggested end temperature for cooking poultry to ensure doneness. When asked the final recommended internal temperature for chicken, the mean response was 214°F with a range of responses from 140°F to 450°F. (The correct answer is 165F)

Of those participants observed measuring the internal temperature of the product, only three used the thermometer correctly. During observation, two individuals who used the thermometers failed to remove protective casings prior to taking internal temperature readings, and therefore used the instruments incorrectly.

Surveys do not measure behaviors: they give an indication of what people think their behavior is, or what the survey person wants to hear, but that isn’t going to get people to use a thermometer (tip-sensitive, digital).

Sick sells; gross ads disgust consumers into action

Science is only now catching up with the late 1970s wisdom of Herbert “Herb” Ruggles Tarlek, Jr.

During one episode, Herb, the outrageously dressed salesthingy on the awesome television series, WKRP in Cincinnati, proclaims that tasteless sells. That’s why he’s so good at advertising.

USA Today reports a five-year study to be released Tuesday by Arizona State University’s W.P. Carey School of Business found that, again and again, advertisements that try to simply "scare" consumers into actions — such as buying protective sunscreens or avoiding dangerous drugs — are far less effective than ads that also "disgust" consumers into taking the action. The best way to elicit disgust: Display totally gross images (see our infosheets).

"If you really want to get people to act, disgust is much more powerful than fear," says Andrea Morales, an associate marketing professor at Arizona State University who oversaw the study to be published in the June issue of the Journal of Marketing Research. "It may seem counterintuitive, but it works."

Perhaps that’s why consumers have seen a recent slew of commercials with high gross-out factors.

A TV spot from the New York City Department of Health featured images of a soft drink turning into gobs of fat as a guy gulps it down. (Department officials say sugar-rich beverage consumption dropped 12% after the campaign.) A recent Febreze TV spot shows blindfolded volunteers sitting in an ultra-filthy room — but fooled into thinking that they smell something pleasant, thanks to the household odor killer. And a commercial for Colgate Total toothpaste shows a mouthful of icky-looking germs.

From 2006 to 2011, Morales and her colleagues oversaw five different studies. In each case, ads with the highest gross-out factor elicited far more cases of viewer willingness to take action than those without.

In one study, 155 undergraduate students viewed an anti-methamphetamine print ad showing a young man whose face is covered with open sores. It scored far more consumer interest than an ad with the same written copy, but which replaced the photo of the pock-marked young man with one of a coffin.

While consumer psychologist Kit Yarrow agrees with the premise — disgust attracts attention — she’s not sure it always works. "Disgust is a hard-wired self-preservation emotion designed to keep us from doing things like eating spoiled food," she says. But, she asks, "Will our protective reaction against assaults of any kind cause us to avoid paying any attention to the ad?"

Disgust: always the other emotion now hot; would you rather talk about poop or make kids die

James Gorman of the New York Times writes that disgust is having its moment in the light as researchers find that it does more than cause that sick feeling in the stomach. It protects human beings from disease and parasites, and affects almost every aspect of human relations, from romance to politics.

In several new books and a steady stream of research papers, scientists are exploring the evolution of disgust and its role in attitudes toward food, sexuality and other people.

Paul Rozin, a psychologist who is an emeritus professor at the University of Pennsylvania and a pioneer of modern disgust research, began researching it with a few collaborators in the 1980s, when disgust was far from the mainstream.

“It was always the other emotion,” he said. “Now it’s hot.”

Speaking last week from a conference on disgust in Germany, Valerie Curtis, a self-described “disgustologist” from the London School of Public Hygiene and Tropical Medicine, described her favorite emotion as “incredibly important.”

She continued: “It’s in our everyday life. It determines our hygiene behaviors. It determines how close we get to people. It determines who we’re going to kiss, who we’re going to mate with, who we’re going to sit next to. It determines the people that we shun, and that is something that we do a lot of.”

It begins early, she said: “Kids in the playground accuse other kids of having cooties. And it works, and people feel shame when disgust is turned on them.”

Dr. Curtis is involved in efforts in Africa, India and England to explore what she calls “the power of trying to gross people out.” One slogan that appeared to be effective in England in getting people to wash their hands before leaving a bathroom was “Don’t bring the toilet with you.”

Whatever the fine points of disgust, its power to affect behavior is unquestioned, and that power ought to be put to good use, Dr. Curtis said. So, in one of her projects, she has worked with an Indian public relations agency to come up with a disgust-based campaign to encourage hand washing among mothers in small villages, which could save countless children’s lives lost to diarrhea and other diseases.

The result, now being tested, is a skit involving two characters, one a supermom and the other a disgusting, dirty man. The man makes sweets using mud and worms, stops in the middle of the performance to rush off because he has diarrhea, never washes his hands and does everything possible to be revolting.

Supermom is scrupulously clean. Her children don’t get sick, the skit makes clear. In fact, her baby grows up to be a doctor. She washes her hands all the time.

The prominence of diarrhea in the skit is no accident. One thing about studying disgust, Dr. Curtis said, is that it makes you realize how important it is to talk about the very things that disgust us, because they often present dangers to public health.

“We need to talk about” excrement, she said, using a punchier single-syllable word for maximum effect — a word she is unapologetic about using, as befits a disgustologist.

“Which is worse?” Dr. Curtis asked. To talk about it, “or to make kids die.

Shock and shame.

We’ve been using disgust for a long time. It is called barfblog.

Like watching South Park: why feeling disgust can be good (or fart jokes)

Feelings of disgust help humans avoid, or at the very least recognize, the things that cause disgust like sick people, dirty water, vomit, body fluids and all the other stuff that makes us react "Yuck."

BBC News reports that in a paper published in Philosophical Transactions for the Royal Society B, Dr Val Curtis, from the London School of Hygiene and Tropical Medicine, argues that avoidance behavior is essential to prevent the spread of all the major current and recent infectious diseases which present a threat to humans.

Washing hands and food can prevent diseases like cholera and hepatitis A, avoiding sex with others who are infected helps prevent the spread of HIV, while keeping a distance from people with influenza or measles is a sensible move to reduce the risk of infection.

"The idea of contacting or consuming infectious substances such as saliva, feces or vomit, or of intimate contact with those known to be carrying infection is deeply uncomfortable to even contemplate," writes Dr Curtis.

"Self-limitation of such behaviour is so automatic and intuitive that it is often ignored as the front-line in our defense against disease.

Something as simple as handwashing with soap could save over a million lives a year globally, the paper says, just by stopping the transmission of disease.

Disgust is often used to get this message across in public health campaigns.

Stephen Fry, who has declared himself celibate in the past, is quoted in Dr Curtis’s paper describing how disgust played a part in his decision to abstain from sex.

"I would be greatly in the debt of the man who could tell me what would ever be appealing about those damp, dark, foul-smelling and revoltingly tufted areas of the body that constitute the main dishes in the banquet of love.

"Once under the influence of drugs supplied by one’s own body, there is no limit to the indignities, indecencies and bestialities to which the most usually rational and graceful of us will sink."

Why disgust matters
Philosophical Transactions of the Royal Society B, vol. 366, no. 1583, 3478-3490
Valerie Curtis
The new synthesis about disgust is that it is a system that evolved to motivate infectious disease avoidance. There are vital practical and intellectual reasons why we need to understand disgust better. Practically, disgust can be harnessed to combat the behavioural causes of infectious and chronic disease such as diarrhoeal disease, pandemic flu and smoking. Disgust is also a source of much human suffering; it plays an underappreciated role in anxieties and phobias such as obsessive compulsive disorder, social phobia and post-traumatic stress syndromes; it is a hidden cost of many occupations such as caring for the sick and dealing with wastes, and self-directed disgust afflicts the lives of many, such as the obese and fistula patients. Disgust is used and abused in society, being both a force for social cohesion and a cause of prejudice and stigmatization of out-groups. This paper argues that a better understanding of disgust, using the new synthesis, offers practical lessons that can enhance human flourishing. Disgust also provides a model system for the study of emotion, one of the most important issues facing the brain and behavioural sciences today.