背景:安全和营养的食物是维持生命和促进健康的关键。不安全的食品造成疾病和营养不良的恶性循环,特别是影响婴儿,年幼的孩子,老年人,和病人。
方法:本研究分为两个阶段,描述性横断面研究,和一项干预研究。两项研究均在区域卫生服务主任区进行,卡鲁塔拉,斯里兰卡。描述性横断面研究[食品处理人员(n=904),食品企业(n=421)]的目的是确定与食品经营者和食品企业的食品处理实践相关的因素。干预性研究是一项三臂非随机对照社区试验(每组n=50),由参与型消费者团体进行干预,教育套餐集团,和对照组。
结果:食品企业评估工具(FEAT)包含11个领域,其中包括75个项目,有一百多个评估点,并附有对食品处理进行评估的指南。描述性横断面研究发现,食品处理人员对储存牛奶的食品处理实践的了解,鱼,含有鱼和肉类的肉类和快餐食品非常差(96.6%)。食品机构内最后加工地点对消费者的可见性不足(19.2%),并且上述因素的缺失与食品机构中不令人满意的食品处理评分水平显著相关(p=0.03)。在非个人所有的食品场所中,不满意的食品处理水平明显较高(p=0.005),法律当局发出的通知数量很少(p=0.02),失职的业主/经理监督(p<0.001)和缺乏医疗证明的食品处理(p<0.0001)。参与式消费者群体干预和教育一揽子干预措施有效地改善了食品场所和食品处理人员的食品处理实践(p<0.0001)。使用Mann-WhitneyU检验的两个独立样本分析显示,食品处理实践的最佳改进是参与式消费者团体干预(p<0.0001),其次是教育一揽子干预(p<0.0001).
结论:参与者对食物处理的知识和实践很差。在改善食品处理者和食品企业之间的食品处理实践方面,参与性消费者群体比教育一揽子计划更有效。
BACKGROUND: Safe and nutritious food is the key to sustaining life and promoting good health. Unsafe food creates a vicious cycle of disease and malnutrition, particularly affecting infants, young children, the elderly, and the sick.
METHODS: The study consisted of two phases, a descriptive cross-sectional study, and an intervention study. Both studies were conducted in the Regional Director of Health Services area, Kalutara, Sri Lanka. The descriptive cross-sectional study [food handlers (n = 904), food establishments (n = 421)] was conducted with the objective of determining factors associated with food handling practices among food handlers and in food establishments. The interventional study was a three-arm non-randomized controlled community trial (n = 50 per arm) with interventions of a participatory consumer group, educational package group, and control group.
RESULTS: The food establishments assessment tool (FEAT) contained 11 domains including 75 items with more than a hundred assessment points with a guide to conduct an assessment of food handling. The descriptive cross-sectional study found that food handlers\' knowledge of food handling practices of storing milk, fish, and meat and fast-food items containing fish and meat was very poor (96.6%). Visibility of the last place of processing inside the food establishments to consumers was inadequate (19.2%) and the absence of the above-mentioned factor was significantly associated with an unsatisfactory level of food handling score in food establishments (p = 0.03). The unsatisfactory level of food handling was significantly higher among food establishments with non-personal ownership (p = 0.005), a low number of notices issued by legal authorities (p = 0.02), dereliction of duty by owners/managers on supervising (p < 0.001) and lack of medical certification to food handlers (p < 0.0001). Participatory consumer group intervention and educational package interventions were effective in improving food handling practices in food establishments and among food handlers (p < 0.0001). Two independent sample analysis using the Mann-Whitney U test showed, the best improvement in food handling practices was by participatory consumer group intervention (p < 0.0001) and the second was educational package intervention (p < 0.0001).
CONCLUSIONS: Knowledge and practices of food handling among participants were poor. A participatory consumer group is more effective than an educational package on improving food handling practices both among food handlers and in food establishments.