barfblog, bites and food safety

Posted on November 3, 2010 by Douglas Powell

There’s no shortage of food safety press releases, repeated and regurgitated using funky new media tools; there is a shortage of evidence-based, incisive approaches that challenge food safety norms and may eventually lead to fewer sick people.

barfblog.com is the fastest way to stay current on food safety issues. Powell, Chapman and assorted food safety friends offer evidence-based opinions on current food safety issues. Opinions must be reliable – with references — rapid and relevant.

Anyone can subscribe directly to barfblog.com and receive an e-mail immediately when something new is posted. Go to barfblog.com and click on the ‘subscribe’ button on the right side of the page.

Food safety infosheets are designed to influence food handler practices by utilizing four attributes culled from education, behavioral science and communication literature:
• surprising and compelling messages;
• putting actions and their consequence in context;
• generating discussion within the target audiences’ environments; and
• using verbal narrative, or storytelling, as a message delivery device.

Food safety infosheets are based on stories about outbreaks of foodborne illness. Four criteria are used to select the story: discussion of a foodborne illness outbreak; discussion of background knowledge of a pathogen (including symptoms, etiology and transmission); food handler control practices; and emerging food safety issues. Food safety infosheets also contain evidence-based prescriptive information to prevent or mitigate foodborne illness related to food handling. They are available in several languages.

The bites.ksu.edu listserv is a free web-based mailing list where information about current and emerging food safety issues is provided, gathered from journalistic and scientific sources around the world and condensed into short items or stories that make up the daily postings. The listserv has been issued continuously since 1994 and is distributed daily via e-mail to thousands of individuals worldwide from academia, industry, government, the farm community, journalists and the public at large.

The listserv is designed to:
• convey timely and current information for direction of research, diagnostic or investigative activities;
• identify food risk trends and issues for risk management and communication activities; and
• promote awareness of public concerns in scientific and regulatory circles.

The bites listserv functions as a food safety news aggregator, summarizing available information that can be can be useful for risk managers in proactively anticipating trends and reactively address issues. The bites editor (me – dp) does not say whether a story is right or wrong or somewhere in between, but rather that a specific story is available today for public discussion.

If you only want to receive specific news, use RSS feeds.

RSS (Rich Site Summary, or Really Simple Syndication) is a format for delivering regularly changing web content. Many news-related sites, weblogs and other online publishers syndicate their content as an RSS Feed to whoever wants it.

If you only want stories about food safety policy, or norovirus, go to bites.ksu.edu and click on that section. Then click on the RSS symbol, and add to your reader. barfblog.com is also available as a RSS feed.

Breaking food safety news items that eventually appear in bites-l or barfblog.com are often posted on Twitter (under barfblog or benjaminchapman) for faster public notification.

These are the various information products we deliver daily, in addition to research, training and outreach. Sponsorship opportunities are available for bites.ksu.edu, barfblog.com, and the bites-l listserv.

Any money is used to support the on-going expenses of the news-gathering and distribution activities, and to develop the next generation of high school, undergraduate and graduate students who will integrate science and communication skills to deliver compelling food safety messages using a variety of media. Research, training and outreach are all connected in our food safety world.

Restaurant inspection disclosure sucks in Maryland

Posted on June 28, 2010 by Douglas Powell

Foodies wanting to know how clean their favorite restaurant is must file public records requests in Wicomico County.

For several years, the health department has sought to change that by posting details of restaurant inspections online. But budget cuts, combined with opposition from restaurant owners, have made that an elusive goal, said Stuart White, supervisor of community health in the environmental health division.

"I think it would promote better practices. You’d want a better grade if it would be posted," White said.

A growing number of health departments across the U.S. are initiating programs aimed at improving the transparency of restaurant inspections, said Robert Pestronk, executive director of the National Association of County and City Health Officials. He said many health departments are putting information online, and others are placing scores — in the form of letter grades, numerical scores or color-coded decals — in plain sight at restaurants.

"It really makes the public part of the inspection work force," he said.

A study in June’s Journal of Food Protection suggests cross-contamination violations — which can lead to illnesses — may be more widespread than previously thought, and they may occur more frequently during peak hours.

Researchers from North Carolina State University used video cameras to monitor 47 food handlers at eight volunteering kitchens and found that the workers committed an average of one cross-contamination violation an hour.

"It really changes how we think about training," said Ben Chapman, the lead author of the study and assistant professor and food safety specialist in the Department of 4-H Youth Development and Family & Consumer Sciences at NCSU. Researchers from Kansas State University and the University of Guelph in Ontario co-wrote the study.

Food safety information posted in restaurant kitchens can improve meal safety

Posted on June 9, 2010 by Douglas Powell

Kansas State University came out with their version of the Chapman and me and other Blue Rodeo groupies study this morning.

Posting graphical, concise food safety information sheets in the kitchens of restaurants can help reduce dangerous food safety practices and create a workplace culture that values safe food, according to a new paper co-authored by Kansas State University’s Doug Powell.

The study, "Assessment of food safety practices of food service food handlers: testing a communication intervention," was published in the June issue of the Journal of Food Protection. It was authored by Ben Chapman, assistant professor of food safety at the North Carolina State University; Powell, associate professor of food safety at K-State; Katie Filion, master’s student in biomedical science at K-State; and Tiffany Eversley and Tanya MacLaurin of the University of Guelph in Canada.

It’s the first time that a communication intervention using food safety info sheets has been validated to work, Powell said.

Powell and Chapman came up with the idea for food safety info sheets to promote discussion and improve food safety behaviors while playing hockey at the University of Guelph in 2003. Chapman was a graduate student at the time.

"Chapman and I played hockey a lot, and there was a bar and restaurant that overlooked the one ice surface where we often had after-hockey food safety meetings with our industry, provincial and federal government colleagues," Powell said. "We had all this food safety information, and the manager of the restaurant was into food safety, so we thought that if daily sports pages are posted on the walls and doors of washroom stalls, why not post engaging food safety information in kitchens for restaurant employees to read."

As part of his doctoral research, Chapman partnered with a food service company in Canada and placed small video cameras in unobtrusive spots around eight food-service kitchens that volunteered to participate in the study. There were as many as eight cameras in each kitchen, which recorded directly to computer files that were reviewed by Chapman and others.

The work built on other direct food safety observational studies conducted at K-State and published in the British Food Journal in 2009.

Food safety info sheets, highlighting the importance of hand washing or preventing cross-contamination, for example, were then introduced into the kitchens, and video was again collected. The researchers found that cross-contamination events decreased by 20 percent, and hand-washing attempts increased by 7 percent.

The increases show the information sheets work, Powell said. "Food safety messages like ‘Employees must wash hands’ signs in bathrooms just don’t work," he said.

Since September 2006 more than 150 food safety info sheets have been produced and are available for anyone to use, http://www.foodsafetyinfosheets.com. The website has a search function and offers automatic email alerts and RSS feeds.

K-State’s Filion coded much of the video as an undergraduate student researcher in Canada. MacLaurin, who collaborated on the research, was born on a farm/ranch in Kansas and received all her degrees from K-State before joining the School of Hospitality and Tourism Management at the University of Guelph in 1991, where she subsequently collaborated with Powell.

The paper and study abstract are available at:

?http://www.ingentaconnect.com/content/iafp/jfp/2010/00000073/00000006/art00013

Food safety stories can improve safety of restaurant meals

Posted on June 8, 2010 by Douglas Powell

Contact: Dr. Doug Powell, dpowell@ksu.edu
785-317-0560
barfblog.com
bites.ksu.edu

Posting graphical, concise food safety stories in the back kitchens of restaurants can help reduce dangerous food safety practices and create a workplace culture that values safe food.

It’s the first time that a communication intervention such as food safety information sheets have been validated to work using direct video observation in eight commercial restaurant kitchens.

“The food safety messages we’ve looked at are as effective as those ‘Employees must wash hands’ signs in bathrooms.,” said Dr. Douglas Powell, an associate professor of food safety at Kansas State University and one of the co-authors on a new paper in the Journal of Food Protection. “They just don’t work.”

Powell and then graduate student, Ben Chapman, now an assistant professor of food safety at North Carolina State University, came up with the idea for food safety infosheets to promote discussion and improve food safety behaviors while playing hockey at the University of Guelph in 2003.

“Chapman and I were playing hockey a lot,” says Powell, “and there was a bar and restaurant that overlooked the one ice surface where we often engaged in after-hockey food safety meetings with our industry, provincial and federal government colleagues. We had all this food safety information, and the manager of the bar around 2003 was into food safety, so we thought, if daily sports pages are posted above urinals and on the doors of washroom stalls, why not engaging food safety information?”

As part of his PhD research, Chapman partnered with a food service company in Canada and placed small video cameras in unobtrusive spots around eight food-service kitchens that volunteered to participate in the study. There were as many as eight cameras in each kitchen, which recorded directly to computer files and later reviewed by Chapman and others.

The work built on other direct food safety observational studies conducted at Kansas State University and published in the British Food Journal in 2009.

Food safety inforsheets, highlighting the importance of handwashing or preventing cross-contamination, for example, were then introduced into the kitchens, and video was again collected. The researchers found that cross-contamination events decreased by 20 per cent, and handwashing attempts increased by 7 per cent.

Since September 2006 over 150 food safety infosheets have been produced and are available to anyone at www.foodsafetyinfosheets.com. The website has had a recent redesign, adding a search function, automatic email alerts and RSS feeds.

Katie Filion, who coded much of the video as an undergraduate student researcher, has moved from Canada and is now completing a Master’s degree with Powell at Kansas State University. She has just returned from a year of research with the New Zealand Food Safety Authority helping to design a national restaurant inspection disclosure system.

Dr. Tanya MacLurin, who collaborated on the research, was born on a farm/ranch in Kansas and received all her degrees from Kansas State University before joining the School of Hospitality and Tourism Management at the University of Guelph in 1991, where she subsequently collaborated with Powell.

The study, “Assessment of food safety practices of food service food handlers : testing a communication intervention” was authored by Dr. Ben Chapman of North Carolina State University, Dr. Douglas Powell and Katie Filion of Kansas State University, and Tiffany Eversley and Tanya MacLaurin of the University of Guelph in Canada. The study is published in the June issue of the Journal of Food Protection.

“Assessment of Food Safety Practices of Food Service Food Handlers: Testing a Communication Intervention”
Authors: Benjamin J. Chapman, North Carolina State University; Douglas A. Powell, Katie Fillion, Kansas State University; Tiffany Eversley, Tanya MacLaurin, University of Guelph
Published: June 2010, Journal of Food Protection

Abstract: Globally, foodborne illness affects an estimated 30% of individuals annually. Meals prepared outside of the home are a risk factor for acquiring foodborne illness and have been implicated in up to 70% of traced outbreaks. The Centers for Disease Control and Prevention has called on food safety communicators to design new methods and messages aimed at increasing food safety risk-reduction practices from farm to fork. Food safety infosheets, a novel communication tool designed to appeal to food handlers and compel behavior change, were evaluated. Food safety infosheets were provided weekly to food handlers in working foodservice operations for 7 weeks. It was hypothesized that through the posting of food safety infosheets in highly visible locations, such as kitchen work areas and hand washing stations, that safe food handling behaviors of foodservice staff could be positively influenced. Using video observation, food handlers (n ~ 47) in eight foodservice operations were observed for a total of 348 h (pre- and postintervention combined). After the food safety infosheets were introduced, food handlers demonstrated a significant increase (6.7%, P , 0.05, 95% confidence interval) in mean hand washing attempts, and a significant reduction in indirect cross-contamination events (19.6%, P , 0.05, 95% confidence interval). Results of the research demonstrate that posting food safety infosheets is an effective intervention tool that positively influences the food safety behaviors of food handlers.

Rapid, reliable, repeated and relevant information can improve food safety at food service

Posted on June 6, 2010 by Douglas Powell

In Sept.. 2007, my friend Frank was running food safety things at Disney in Orlando, and asked me to visit and speak with his staff.

“Doug, I want you to talk about food safety messages that have been proven to work, that are supported by peer-reviewed evidence and lead to demonstrated behavior change,” or something like that.

I said it would be a brief talk.

There was nothing – nothing – that could be rigorously demonstrated to have changed food safety behavior in any group, positive or negative. Everything was about as effective as those, ‘Employees must wash hands’ signs.

Sometime around 2001 things started to change in my lab at the University of Guelph. I’d gotten tired of genetically engineered food, had gone about as far as we could with the fresh produce on-farm food safety thing, and I wanted to focus more on the things that made people barf.

Chapman and I were playing hockey a lot – one of the advantages of having an on-campus office right beside two full-sized ice hockey surfaces (not the miniature size available in Manhattan, Kansas) – and there was a bar and restaurant that overlooked the one ice surface where we often engaged in after-hockey food safety meetings with our industry, provincial and federal government colleagues.

We had all this food safety information, and the manager of the bar around 2003 was into food safety, so we thought, if daily sports pages are posted above urinals and on the doors of washroom stall, why not engaging food safety information?

It took us awhile to become engaging, but we listened to criticism and made things better. We experimented with different formats in restaurants and on-line. There’s an entire paper describing all this but it hasn’t been published yet (accepted, but not published).

Meanwhile, Chapman took ownership of these food safety infosheets, they got translated into different languages depending on the capabilities of whatever students were around, and we had lots of e-mails from all over the world from people who like them and use them in the workplace.

But a bunch of e-mails doesn’t count as much in the way of evidence.

So Chapman (left, with Dani, 10 years ago at my place) partnered with a food safety dude at a company in Canada and they made things happen (we are forever grateful, dude, above right, exactly as shown, and you know who you are).

Katie and Tiffany had to watch hours of video, Tanya and me helped with the design, but otherwise it was Chapman, going to these sites at 5 a.m. to make sure the cameras were set up. I went once when visiting from Kansas, but otherwise, stayed out of the way, other than years of nagging to write it up, finish his thesis, and the weekly attempts to correct his horrendous spelling and grammar on the infosheets.

But after all those years and effort, Chapman has finally shown a food safety message that can translated into better food safety practices at food service. After exposure to the food safety infosheets, cross-contamination events went down 20 per cent, and handwashing attempts went up 7 per cent. We controlled for various factors as best we could.

Now I have something to tell Frank.

Chapman: How the Web makes cleaner kitchens

Posted on April 12, 2010 by Douglas Powell

With the end of the National Hockey League regular season last night – people in Kansas will have no idea what I am talking abooooout – it’s fitting Canadian Ben Chapman gets top billing in the small market of Raleigh, North Carolina – they used to be the Hartford Whalers – where the Carolina Hurricanes have proven they can suck as bad as the Toronto Maple Leafs.

General Manager Jim Rutherford, from Beeton, Ontario, what went wrong? Is it because Chapman moved to Raleigh?

The Charlotte Observer features Chapman this morning and has a few nosestretchers, beginning by billing Chapman as a molecular biologist: yah, me too, except neither of us has run a gel in the past decade.

Ben Chapman, a molecular biologist (right, sorta as shown, with a lot of photoshop), considers it a distinct honor to publish some of his academic findings on barfblog.com and post scholarly writings in restaurant kitchens.

The N.C. State University assistant professor, who also publishes academic findings in peer-reviewed journals, is a food safety expert. …

Chapman was inspired by flyers posted above urinals in an Ontario sports bar near where he did his graduate work. Then he washed dishes in a university restaurant for three months (nosestretcher alert – it was one month) and learned that food handlers care about celebrities, music and pop culture.

He replaced statistics with narratives and wrapped the information sheet in plastic, because in a kitchen that indicates something is important.

When he posted the information sheets in kitchens where video cameras monitored how often 47 food handlers washed their hands and switched knives after cutting raw chicken, it turned out that "telling stories about foodborne illnesses and the consequences to food handlers makes a difference," he said.

Since he conducted the study and moved to North Carolina, he’s learned about other tools he plans to tap to get his message across – YouTube, mommyblogs and Twitter.

Chapman says amateurs shouldn’t cook on Thanksgiving

Posted on November 20, 2009 by Douglas Powell

The idea of Chapman calling others amateurs is amusing.

P.J. O’Rourke wrote a National Lampoon column about how amateur drunks throw up on other people’s shoes. In Champan’s case, it would be other people’s rose bushes. That’s us, in 2000, at my house in Guelph. He barfed in the bushes.

But Chapman, food safety specialist and assistant professor of food science at North Carolina State University, did get quoted by a paper in Nebraska today saying,

"The biggest risk comes from undercooking. Color is not an indicator of safety or doneness. We see suggestions in recipes about making sure ‘the juices run clear’ but that’s a myth. You also have to worry about cross-contamination — which can happen when countertops, sinks or utensils aren’t being cleaned properly between use with raw meats and other foods."

And this was Chapman last weekend tailgating at the Kansas State football game. We left early because he had digestive upsets. Amateur.

bites barfblog and food safety: information procedures

Posted on September 25, 2009 by Douglas Powell

People often ask me, “Doug, how do you choose the information that goes in bites.ksu.edu? Do you have a basis for any of your food safety rants on barfblog? Why are you such a jerk?

People often ask Ben, “Why do you write so much about vomit?”

People often ask Amy, “Why are you with Doug?”

When we ran the food safety information centre back in Canada, we had detailed procedures for how to answer questions, what information was provided and why. We don’t answer questions so much anymore, but we do provide a lot of information so I figured we better clearly understand what we do and why. This is more for us and all the students that come through my lab than it is for you. Really, it’s me, not you.

bites.ksu.edu is a unique comprehensive resource for all those with a personal or professional interest in food safety. Dr. Powell of Kansas State University, and associates, search out credible, current, evidence-based information on food safety and make it accessible to domestic and international audiences through multiple media. Sources of food safety information include government regulatory agencies, international organizations such as the World Health Organization (WHO) and the Food and Agriculture Organization of the United Nations (FAO), peer-reviewed scientific publications, academia, recognized experts in the field and other sources as appropriate.

Throughout all bites activities, the emphasis is on engaging people in dialogue about food-related risks, controls and benefits, from farm-to-fork. bites strives to provide reliable, relevant information in culturally and linguistically appropriate formats to assist people in identifying, understanding and mitigating the causes of foodborne illness.

bites LISTSERV
The bites.ksu.edu listserv is a free web-based mailing list where information about current and emerging food safety issues is provided, gathered from journalistic and scientific sources around the world and condensed into short items or stories that make up the daily postings. The listserv has been issued continuously since 1995 and is distributed daily via e-mail to thousands of individuals worldwide from academia, industry, government, the farm community, journalists and the public at large.

The listserv is designed to:

•    convey timely and current information for direction of research, diagnostic or investigative activities;
•    identify food risk trends and issues for risk management and communication activities; and
•    promote awareness of public concerns in scientific and regulatory circles.

The bites listserv functions as a food safety news aggregator, summarizing available information that can be can be useful for risk managers in proactively anticipating trends and reactively address issues. The bites editor, Dr. Powell, does not say whether a story is right or wrong or somewhere in between, but rather that a specific story is available today for public discussion.

barblog.com

barfblog.com is where Drs. Powell, Chapman, Hubbell and assorted food safety friends offer evidence-based opinions on current food safety issues. Opinions must be evidence-based – with references – reliable, rapid and relevant. The barfblog authors edit each other – viciously.

TWITTER
Breaking food safety news items that eventually appear in bites or barfblog are often posted on Twitter for faster public notification.

INFOSHEETS
Food safety infosheets are designed to influence food handler practices by utilizing four attributes culled from education, behavioral science and communication literature:

•    surprising and compelling messages;
•    putting actions and their consequence in context;
•    generating discussion within the target audiences’ environments; and
•    using verbal narrative, or storytelling, as a message delivery device.

Food safety infosheets are based on stories about outbreaks of foodborne illness sourced from the bites listserv. Four criteria are used to select the story: discussion of a foodborne illness outbreak; discussion of background knowledge of a pathogen (including symptoms, etiology and transmission); food handler control practices; and emerging food safety issues. Food safety infosheets also contain evidence-based prescriptive information to prevent or mitigate foodborne illness related to food handling. And now, available in French, Spanish and Portuguese.

bites bistro videos
A nod to the youtube generation, but we don’t really know what we’re doing.

How on-farm food safety programs get developed – it’s the people, and data

Posted on September 11, 2009 by Douglas Powell

There was this time, we thought we’d killed Chapman.

Ben and I went along with Uncle Denton to the Canadian Horticulture Council meeting in Montreal in Feb. 2003. I had chaired a national committee on on-farm food safety program implementation – and the advice was completely ignored – Chapman and I had done years of groundwork with Denton and the Ontario Greenhouse Vegetable Growers, and we agreed to share a room at the annual meeting to cut down on expenses.

There was a couple of receptions and I still remember Ben and I asking Uncle Denton for drink tickets. We then retired to a hotel lounge and I knew trouble was ahead when Chapman asked for a cigarette.

He then went to the bathroom.

He didn’t return.

He showed up a few hours later, seemingly intact.

Denton had forgotten that story (Denton’s on the right in that pic with my grandfather, Homer) when I called him a couple of weeks ago, to thank him for the opportunity to develop on-farm food safety stuff back in 1998 with the Ontario Greenhouse Vegetable Growers. I’ve been using those anecdotes (not the ones about Chapman) and lessons learned a lot lately – seems like too many people are in a food safety time warp.

Guess it brought up a few memories for Denton, who wrote this in Sept.’s issue of The Grower:

As you journey through life you meet the occasional person who makes a real difference. Dr. Douglas Powell is one of those – to say the least.

Doug called me recently to talk about the early years. He was new in the On Farm Food Safety business when I was working with the Ontario Greenhouse vegetable group. Doug was at the University of Guelph and I would talk to him about the phone call I didn’t want to get. This would be the imaginary call from a senior’s residence wondering why all the occupants were very sick after consuming a fresh salad, and if the cause may have been the greenhouse tomatoes. I never got that call—thank God–but I wanted to be ready. And that readiness included a strong response indicating we had an On Farm Food Safety program and proof we were capable of tracing our greenhouse product. We’ve seen several incidences in the past few years with certain fresh veggies and berries that almost ruined the industry and certainly crippled those markets for a year or so.

From the University of Guelph and the beginning of the On Farm Food Safety program, Doug has moved to Kansas State University where he is associate professor of food safety. He is still very much in the industry – just relocated to a different university — and still writing newsletters, hence the reputation of “the guru” of On Farm Food Safety.

Doug has remained a good friend over all these years. We developed a bond as we developed an On Farm Food Safety program for greenhouse vegetables and more. Doug’s philosophy was to keep it simple. He could relate to growers, and had an uncanny ability to make the complicated science of bacterial contamination simple and understandable. Early on, he received a little help from Dr. Gord Surgeoner. These were the seeds of the On Farm Food Safety program in Canada, spreading from Ontario Greenhouse to CHC and to most vegetable growers across Canada.

I can still see Doug in an old T-shirt and jeans, holes in both, and running shoes–that was his fashion statement. Of course, his description of toilet paper “slippage” resulting in fecal contamination on your finger was priceless, but his crude description helped to break down the mystery of bacterial contamination by food handlers with dirty hands. Seems to me I got a T-shirt from Doug with “Don’t Eat Poop” written on the front. Doug continues to be a great communicator, a fair goalie, poor at politics but great at On Farm Food Safety and raising little girls.

Thanks, Doug. I am proud to say I knew you back when.

And I knew Chapman, way back when.

Telling students to wash their hands isn’t enough: new research identifies barriers to handwashing compliance in a university residence

Posted on September 4, 2009 by Douglas Powell

Food safety researcher and talk-show host Jon Stewart got it right back in 2002 when he said,

“If you think the 10 commandments being posted in a school is going to change behavior of children, then you think “Employees Must Wash Hands” is keeping the piss out of your happy meals. It’s not.”

Instead, getting college students to wash hands, halt disease, requires giving them proper tools and spreading the word in ways that get attention: the path to poor hand sanitation is paved with good intentions, according to researchers from Kansas State and North Carolina State Universities.

As college campuses prepare for an expected increase in H1N1 flu this fall, the researchers said students’ actions will speak louder than words.

"Many students say they routinely wash their hands," said Douglas Powell, an associate professor of food safety at Kansas State University. "But even in an outbreak situation, many students simply don’t."

In February 2006, Powell and two colleagues — Ben Chapman, an assistant professor at North Carolina State University, and research assistant Brae Surgeoner — observed hand sanitation behavior during an outbreak. What was thought to have been norovirus sickened nearly 340 students at the University of Guelph in Canada.

Hand sanitation stations and informational posters were stationed at the entrance to a residence hall cafeteria, where the potential for cross-contamination was high. The researchers observed that even during a high-profile outbreak, students followed recommended hand hygiene procedures just 17 percent of the time. In a self-reported survey after the outbreak had subsided, 83 of 100 students surveyed said they always followed proper hand hygiene but estimated that less than half of their peers did the same.

The results appear in the September issue of the Journal of Environmental Health.

Powell said that in addition to providing the basic tools for hand washing – vigorous running water, soap and paper towels — college students, especially those living in residence halls, need a variety of messages and media continually encouraging them to practice good hand hygiene.

"Telling people to wash their hands or posting signs that say, ‘Wash your hands’ isn’t enough," said Ben Chapman, an assistant professor at North Carolina State University. "Public health officials need to be creative with their communication methods and messages."

Most students surveyed perceived at least one barrier to following recommended hand hygiene procedures. More than 90 percent cited the lack of soap, paper towels or hand sanitizer. Additional perceived barriers were the notion that hand washing causes irritation and dryness, along with just being lazy and forgetful about hand washing. Fewer than 7 percent said a lack of knowledge of the recommended hand hygiene procedures was a barrier.

"Providing more facts is not going to get students to wash their hands," Powell said. "Compelling messages using a variety of media – text messages, Facebook and traditional posters with surprising images — may increase hand washing rates and ultimately lead to fewer sick people."

University students’ hand hygiene practice during a gastrointestinal outbreak in residence: What they say they do and what they actually do
01.sep.09
Journal of Environmental Health Sept. issue 72(2): 24-28
Brae V. Surgeoner, MS, Benjamin J. Chapman, PhD, and Douglas A. Powell, PhD
http://www.neha.org/JEH/2009_abstracts.htm#University_Students%92_Hand_Hygiene_Practice_During_a_Gastrointestinal_Outbreak_in_Residence:_What_They_Say_They_DO_and_What_They_Actually_Do
Abstract
Published research on outbreaks of gastrointestinal illness has focused primarily on the results of epidemiological and clinical data collected postoutbreak; little research has been done on actual preventative practices during an outbreak. In this study, the authors observed student compliance with hand hygiene recommendations at the height of a suspected norovirus outbreak in a university residence in Ontario, Canada. Data on observed practices was compared to post-outbreak self-report surveys administered to students to examine their beliefs and perceptions about hand hygiene. Observed compliance with prescribed hand hygiene recommendations occurred 17.4% of the time. Despite knowledge of hand hygiene protocols and low compliance, 83.0% of students indicated that they practiced correct hand hygiene during the outbreak. To proactively prepare for future outbreaks, a current and thorough crisis communications and management strategy, targeted at a university student audience and supplemented with proper hand washing tools, should be enacted by residence administration.

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