An ambulance can only move so fast: problems with partnership’s food safety educator study

Chapman’s right when he says I probably didn’t notice him the first year he worked in my lab: it was big, and I had people supervising people.

ben.doug.2.12But he stuck with it, ended up coaching girls hockey with me, bailed me out of jail, published lots of cool research, and now he’s his own prof at North Carolina State.

And he gets to make his own mistakes.

The recent work he and graduate student Nicole Arnold did with the food safety partnership thingies might have been good experience, but he got pressured into violating some basic research tenets: surveys, on their own, suck (they had limited cash), and press release before peer review is always a bad idea.

At least Chapman insisted all the raw data be made available.

The draconian consistency of partnership messages – cook, clean, chill, separate – while all valid, lead to a snake-oil salesman effect and ignore one of the biggest causes of foodborne illness that has been highlighted by both the U.S. Centers for Disease Control and the World Health Organization: food from unsafe sources.

What did consumers have to do with outbreaks involving peanut butter, pizza, pot pies, pet food, pepper and produce (washing don’t do much). That’s just the Ps.

Reciting prescriptive instructions like some fascist country line-dancing instructor benefits no one. Food safety is complex, and it takes effort.

The survey found that in today’s digital environment, most food safety education is done in person. According to the survey, 90 percent of the people that consider themselves food safety educators connect with consumers via face-to-face meetings and presentations. The next most-used channel is online, with 36 percent of educators using this method to connect with consumers.

But such a conclusion ignores the multiplier effect of messages, or the social amplification of risk: where did those messages originate and are they valid?

If anything the results argue for marketing microbial food safety at retail, where people can vote at the checkout aisle.

And education is the wrong word: people make risk-benefit decisions all the time. For those who care, food safety information should be provided using multiple media and messages; then people can decide for themselves.

At least Chapman stressed the need for medium and message evaluation, which is sorely lacking.

US taxpayers continue to pay to be told they suck at food safety

In 2010, I and about everyone else in the small incestuous world of food safety, was contacted by the U.S. Department of Agriculture and asked if we would advise on a food safety communications campaign they were planning with the Ad Council.

It became clear from the beginning that USDA was committed to the cook, clean, chill separate dogma.

I asked questions like, do those messages work? Where is the evidence. Why so much Terry Frenchfocus on blaming consumers?

None was forthcoming.

It also soon became evident this was not an evidence based-exercise.

Today the Ad Council, the U.S. Department of Agriculture (USDA), the U.S. Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) are partnering with Food Network’s World Extreme Chef winner, Terry French, to help promote food safe practices in every kitchen.

According to the taxpayer funded promos, Chef French’s unique experiences, rock ‘n roll approach to food – sounds more Journey than Stones — and vibrant personality made him the perfect candidate to promote food safe practices for the USDA and the Ad Council. By the final episode of the Food Network’s World Extreme Chef, French wowed judges with the perfect bite to receive the title of World Extreme Chef. French graduated from the Scottsdale Culinary Institute and had apprenticeships in continental, European and Asian cuisine following his completion of two world tours with the U.S. Navy. His catering company, Culinary Dreams, creates unique dining experiences and he gives back with his nonprofit organization, Chefs for Life.

There’s lots of vanity presses out there, promoting all kinds of stuff that lack scientific evidence. They might as well be publishing food-safety horoscopes.

The last thing the food safety biz needs is more apologists promoting messages that don’t work.

Food safety is not simple

If food safety is simple, why do so many get sick?

Because it’s not simple: it’s complex, constant, requires commitment and information must be compelling.

But as Americans delve into turkey gluttony and Australians break out the barbie, the number of inane stories about how food safety is simple proliferate.

Government, industry and academics continue to flog the food safety is simple line, despite outbreaks becoming increasingly complex and in the complete absence of any data that the message works.

We’ve shown that food safety stories can work.

FDA figures out Americans speak many languages

The. U.S. Food and Drug Administration now offers publications in five foreign languages: Arabic, Chinese, French, Portuguese and Spanish.

The Packer reports the agency’s Office of International Programs began offering the foreign language versions in early April. The intent is to enable the FDA’s foreign counterparts and industry to better understand the agency’s laws and practices.

Among the translated publications is the FDA’s produce guidance document, “Guide to minimize microbial food safety hazards for fresh fruits and vegetables.” It and other documents are available in the foreign language versions on a special page on the agency’s

As a language professor I hang out with might say, translation often fails to capture cultural nuances and meaning. I say, if the message isn’t clear, don’t expect a translated version to be clear or clearest.

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.

Shock and Shame: graphic messages can increase handwashing compliance

Graphic messages and reminders that use a shock-and-shame approach may get more people to wash their hands, according to a Kansas State University professor and his colleagues.

"Those ‘Employees Must Wash Hands’ signs in bathrooms may not be the most effective reminder," said Doug Powell, professor of food safety at K-State. "We wanted a comprehensive review of what others had done, and combined this with our own work on food safety messages that lead to behavior change. We weren’t interested in self-reported surveys where everyone says they always wash their hands, but studies based on observed increases in handwashing compliance."

Powell worked with Casey Jacob, a former K-State research assistant in the department of diagnostic medicine and pathobiology, and Sarah Wilson, formerly of the University of Guelph. Their review of techniques to improve handwashing behavior was just published in the journal Critical Public Health.

The review was conducted as background for several ongoing experiments involving Powell and colleagues to increase handwashing rates in cafeterias, restaurants, hospitals, veterinary clinics and petting zoos. The team has previously designed handwashing campaigns at K-State involving both shock and shame.

"Social pressure, or shame, has been successfully used, especially within an entire organization," Powell said. "If you were in the bathroom at a restaurant and saw an employee not washing his or her hands, would you say, ‘Dude, wash your hands?’ The shock approach is designed to get people to ‘be the bug’ — just for a moment — and think about where their hands have been and where they are going to be, especially when around hospitals, food service or animals. Dangerous microorganisms move around a lot."

Behavior-change interventions to improve hand-hygiene practice: A review of alternatives to education
Critical Public Health
Sarah Wilson; Casey J. Jacob; Douglas Powell
Despite the role of hand hygiene in preventing infectious disease, compliance remains low. Education and training are often cited as essential to developing and maintaining hand-hygiene compliance, but generally have not produced sustained improvements. Consequently, this literature review was conducted to identify alternative interventions for compelling change in hand-hygiene behavior. Of those, interventions employing social pressures have demonstrated varying influence on an individual’s behavior, while interventions that focus on organizational culture have demonstrated positive results. However, recent research indicates that handwashing is a ritualized behavior mainly performed for self-protection. Therefore, interventions that provoke emotive sensations (e.g., discomfort, disgust) or use social marketing may be the most effective.

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

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.

Since September 2006 over 150 food safety infosheets have been produced and are available to anyone at The website has had a recent redesign, adding a search function, automatic email alerts and RSS feeds. The new database is also sortable by pathogen, location and risk factor.

Now I have something to tell Frank.

Food tube: Coverage of food safety issues through video

A couple of ag journalism types from Nebraska and Ohio State have the right idea — although I’m not sure it’s completely executed — in a new paper examining the role of YouTube videos in food safety.

Emily Rhoades and Jason D. Ellis write in the Journal of Food Safety that food safety in restaurants is an increasing concern among consumers. A primary population segment working in foodservice is receiving food safety information through new media channels such as video social network websites. This research used content analysis to examine the purpose and messages of food safety-related videos posted to YouTube. A usable sample of 76 videos was identified using “food safety” in the YouTube search function. Results indicate that videos must be artfully developed to attract YouTube users while conveying a credible and educational message. Communicators must also monitor new media for competing messages being viewed by target audiences and devise strategies to counter such messages. This one-time snapshot of how food safety was portrayed on YouTube suggests that the intended purpose of videos, whether educational or entertainment, is not as relevant as the perceived purpose and the message being received by viewers.

I have no idea what this means. There’s a lot of BS in the paper about where foodborne illness happens and how consumers are motivated and the authors seem hopelessly stuck in the educational framework. But at least they are looking at different media. Too bad the message sucks.

Marshall McLuhan had it right when he said that those who try to distinguish between entertainment and education don’t know the first thing about either.

Does hand sanitizer use decline when there seems to be fewer scary bugs around? NZ study says yes

New Zealand researchers report in Eurosurveillance today about hand sanitiser use in a hospital entrance foyer four months after a baseline study during New Zealand’s influenza pandemic.

Of the 743 people observed over one (summer) day in December 2009, 8.2% used the hand sanitiser, which was significantly lower (p<0.0001) than the 18.0% reported in the August (winter) study. Health authorities may need to intensify promotion of hand hygiene to reduce the impact of future influenza pandemic waves.

We’re exploring more on the shock and shame approach in a number of settings.