Food Safety Assessment and Programming

There continues to be increasing attention given to food related issues in our society as the public becomes more aware of the benefits and risks associated with food production, distribution and preservation, preparation, and consumption patterns. Recent announcements in the professional literature and public media regarding foodborne outbreaks demonstrate that food quality protection is but one measure of prevention that must be employed for the health of the public; appropriate food preparation represents yet another key factor in prevention (Centers for Disease Control and Prevention, 1993). National guidelines for prevention and health promotion in our society (e.g., Healthy People: 2000) provide directions and recommendations regarding food related issues, such as the need for "marked improvement in accessibility of nutrition information and education for the general public" (Office of Disease Prevention and Health Promotion, 1991).

Within this context, a Food Safety Advisory Committee, which was established five years ago in greater LaCrosse County, Wisconsin, continues to direct its efforts at accurately assessing the food related interests and needs of the general public, and then responding in a timely manner through educational and service channels. This report details the Committee's 1990 and 1993 efforts in conducting county-wide needs assessments to determine the food safety issues deemed important by the public, as well as the best means to convey key information to them.

The county-wide assessment was conducted under the auspices of the LaCrosse County Food Safety Advisory Committee, which is comprised of representatives from the University of Wisconsin - LaCrosse, the University of Wisconsin - Extension, the LaCrosse County Health Department, and a national food distributor with headquarters in LaCrosse. The purpose of the assessment was to serve as a follow-up to a 1990 county-wide assessment of priority food safety issues among the general public (Gilmore, Meehan- Strub & Mormann, 1992). In addition, efforts were made to determine the most appropriate educational and informational channels to use for follow-up activity.

Useful information was derived from the 1990 survey, particularly regarding the findings of the top three food safety concerns: pesticides used in food; drugs and other chemicals in food; and, manufacturing standards, with radio, television and newspapers as the informational channels of choice (Gilmore et al., 1992). The 1993 survey process served as a follow-up assessment using a completely revised inventory which assessed the public's overall level of food safety concern, concern about specific food safety issues, most likely source of information about food safety issues, and demographics. The survey approach was selected because of its relatively low cost, ability to reach diverse groups of people, and the tendency to elicit more accurate subject responses, in contrast to telephone and face-to-face interview approaches (Gilmore, Campbell & Becker, 1989).

Following the development and pilot implementation of a preliminary draft of the survey form, revisions were made for clarity and brevity. Since this inventory was to be distributed at high-traffic locations, the survey was constructed so that it could be completed in an average of five minutes. The final draft of the inventory (see Attachment) was distributed during the early part of 1993 by volunteers from the University of Wisconsin - LaCrosse, the University of Wisconsin - Extension, and the LaCrosse County Health Department to consumers frequenting the major LaCrosse area food chains; participants in the county elderly screening and nutrition sites; attendees at the county Women, Infants, and Children's program; participants at the County childhood immunization sites; area clinic patients; Extension Homemakers; 4-H Leaders; members of the County Board of Supervisors; and, members of community centers and fitness facilities. A total of 1,135 usable surveys were obtained.

Based on the 1,135 usable 1993 surveys, out of 1,275 distributed, the following top three food safety concerns emerged: foodborne illness, government role in food safety, and pesticides and chemicals in food production. This is somewhat in contrast with the 1990 (N = 1,549) survey responses that showed top concerns to be pesticides, drugs in food, and manufacturing standards (Table 1).

In addition, the 1993 survey assessed the level of concern about the safety of food one consumed, resulting in over 65% indicating a "very" or "extreme" level of concern, and 11% who were "not at all" or "somewhat" concerned.

During the period 1988-90, the only food related illnesses reported to the LaCrosse County Health Department were the result of bacterial or viral contamination, not pesticides, drugs, or poor manufacturing standards (LaCrosse County Health Department, 1988, 1989, & 1990). Due to the difference between the perceived concerns from the 1990 survey and the actual sources of food related illness, efforts described below were initiated in 1990 to help the public better understand the major food safety risks.

In the 1990 survey, there was not a great deal of variation in the ranked food safety concerns by occupation (Table 2).

In the 1993 survey, the occupational listings were expanded to include individuals who work in factories, construction, agriculture, health services, and government so that group related distinctions in food safety concerns might be more readily detected. Even with these additional listings, the leading concerns by occupation did not vary appreciably from the overall prioritized responses. The only exception was that biotechnology was the number one concern among those involved in agriculture. The authors speculate this is the result of people in agriculture being more aware of the use of growth hormones, organic food production, and other biotechnology issues related to food production than might be the case for the general public and the other cited occupations.

When the data were reviewed by age category (Table 3), foodborne illness was ranked high in all age groups except for respondents 19 years of age and under.

Priority concerns of this age group related to drug and chemical use. Because of their usual limited contact with community education resources, this age group would have had the least amount of exposure to the community education efforts about food safety risks provided by the LaCrosse County Food Safety Advisory Committee.

Regarding preferred formats for receiving information about food safety, radio, television, and newspapers were ranked highest by the respondents in both 1990 and 1993 (Table 4).

Additionally, the 1993 respondents emphasized to a greater degree, than the 1990 respondents, the importance of electronic media as the preferred informational channel. Educational workshops were identified by 16% of the 1993 respondents as an important way they would like to learn about food safety, while only 5% chose computer access to information; 8%, telephone; and, 13%, self-study. Newsletters and print materials were selected by 35% of the 1993 respondents, and 60% of the 1990 respondents. These data continue to substantiate the Food Safety Advisory Committee emphasis on print and electronic media for community food safety information dissemination.

In response to the 1990 food safety survey, the LaCrosse Food Safety Advisory Committee coordinated and presented numerous educational activities in an effort to extend food safety information to the general public. Initially, a "media breakfast" was featured as a kickoff event to release the results of the food safety survey. The breakfast was followed by a half-hour "newsmaker" presentation on public radio which included a question and answer session with representatives from local television and radio stations and one weekly newspaper. Additional "newsmaker" programs provided information on pesticides used on foods, food safety issues, and drugs and chemicals in food production. "Newsmaker" programs are aired on two local television stations and three-to-five local radio stations, with the potential to reach over 100,000 people in LaCrosse County and the surrounding area.

Public service announcements (PSAs) relating to holiday food safety were prepared and distributed to five local radio stations. A follow-up telephone survey conducted by the LaCrosse County University of Wisconsin - Extension office revealed that the PSAs were aired 175 times between December 17-31, 1990.

Two major foodborne illness incidents associated with restaurants in LaCrosse County in early 1991 prompted the Committee to coordinate "Wanted: Safe Food Handlers," a workshop for food handlers from restaurants, hospitals, school food services, delicatessens, and grocery stores. The Extension home economist began a weekly newspaper column entitled "Coulee Consumer" with food safety news and information included on a regular basis.

Based on the results of the 1990 and 1993 food safety surveys, the committee determined that preliminary community-based food safety educational efforts need to be offered through various media channels that clientele are most likely to use. For this reason, Extension and other community- service professionals are encouraged to identify local media outlets and explore the opportunities available to extend educational information. Programming opportunities might include:

1. a regular weekly television feature (e.g., segment on evening news programs);

2. a regular weekly television or radio show which could include a call-in question/answer format;

3. expanded satellite teleconferences or television programs for home viewing (e.g., community accessed cable TV);

4. a feature story in the daily newspaper in conjunction with a weekly food safety column;

5. free educational literature for distribution at key locations (e.g., libraries, municipal buildings); and

6. a bi-monthly or quarterly newsletter for individual/family subscription.

The financial requirements for this type of programming, particularly long-distance learning opportunities, may call for a reassignment of financial resources or alternative funding sources in order for county-based and statewide faculty to respond to clientele needs and interests in their most useful and preferred modes of learning. Collaborative efforts with other community-based agencies/organizations, both public and private, will need to expand to provide for the personnel and financial resources required to develop successful educational programs.

The results to date of a four-year collaborative community-based food safety assessment and educational effort involving the University of Wisconsin - Extension, the University of Wisconsin - LaCrosse, the LaCrosse County Health Department, and a national food distributor have been analyzed and incorporated into programmatic activity. It is quite clear that distinct target populations in the greater LaCrosse County region have unique food safety needs and interests, as well as preferred modes of learning more about them. Actual and proposed responses to these data by the community service agencies include public service announcements, press conferences, on-going informational updates through print and electronic media, and printed material dissemination through public sites. This type of collaborative effort can result in enhanced educational opportunities impacting positively on the health of the public.

Centers for Disease Control and Prevention (CDC). (1993). Preliminary report: Foodborne outbreak of escherichia coli 0157:H7 infections from hamburgers-Western United States, 1993. Morbidity and Mortality Weekly Report, 42(4), 85-86.

Office of Disease Prevention and Health Promotion (ODPHP). (1991). Healthy people: 2000. Washington, DC: U.S. Department of Health and Human Services.

Gilmore, G. D., Meehan-Strub, M., & Mormann, D. (1992). Community-based food safety survey. Journal of Extension, 30, 37-38.

Gilmore, G. D., Campbell, M. D., & Becker, B. L. (1989). Needs assessment strategies for health education and health promotion. Dubuque, IA: Brown & Benchmark.

LaCrosse County Health Department. (1988). LaCrosse county health department annual reports. LaCrosse, WI: Author.

LaCrosse County Health Department. (1989). LaCrosse county health department annual reports. LaCrosse, WI: Author.

LaCrosse County Health Department. (1990). LaCrosse county health department annual reports. LaCrosse, WI: Author.

            Are You Concerned About the Safety of Food?

The LaCrosse County Food Safety Advisory Committee, comprised of
representatives from the University of Wisconsin-Extension, the
University of Wisconsin - LaCrosse, LaCrosse County Health
Department, and Reinhart Foods, would appreciate your responses
to the following requests for information.  Your responses will
assist in guiding the development of appropriate educational and
informational efforts.  This should take only five minutes to
complete.

1) How concerned are you about the safety of the food you eat? 
   (please circle the response that most agrees with your choice)

   0=Not at all  1=Somewhat  2=Moderately  3=Very  4=Extremely

2) Please circle your level of concern about each one of the
   following items.

   0=Not at all  1=Somewhat  2=Moderately  3=Very  4=Extremely

*Organically-grown Foods      0     1     2     3     4

*Foodborne Illness (e.g., 
food poisoning)               0     1     2     3     4

*Food Safety at Home          0     1     2     3     4

*Biotechnology (e.g., BST/
BGH, cloning)                 0     1     2     3     4

*Pesticides & Chemicals in 
Food Production               0     1     2     3     4

*Food Additives (e.g., 
preservatives, food 
colorings)                    0     1     2     3     4

*Genetically Modified Foods
(e.g., gene-transfer to 
improve shelf life and/or
composition of foods)         0     1     2     3     4

*Environmental Impact/
Ecologic Issues (e.g., pack-
aging waste)                  0     1     2     3     4

*Irradiation of Food          0     1     2     3     4

*Government Role in Food 
Safety (e.g., inspection,
testing, regulations)         0     1     2     3     4

*Interpreting Food Labels
for Safety                    0     1     2     3     4

*Home Food Preservation
(e.g., canning)               0     1     2     3     4

*Drug Residues                0     1     2     3     4

*Other (please specify)       0     1     2     3     4

3) Please indicate which of the following resources you would be
   most likely to use to learn more about the issues in number 2.
   (check all that apply)

   _____Radio/TV
   _____Newspaper
   _____Educational Workshops/Conference
   _____Newsletter
   _____Self-Study (e.g., videotape, audio)
   _____Telephone Dial Access
   _____Print Material (e.g., book, pamphlet)
   _____Computer-accessed information
   _____Other (please specify)__________________________________ 

4) Please tell us something about yourself:

   County of Residence: _____________   Age: _____   Gender: M  F

   Occupation (check only one):

   _____Factory       _____Agriculture      _____Government
   _____Business      _____Health Services  _____Student
   _____Construction  _____Education        _____Homemaker
   _____Retired       _____Other (please specify) _______________

5) OPTIONAL -- If you are interested and willing to assist us in
   a follow-up to this survey and educational program efforts,
   please provide your name and telephone number.

Name: (please print)_________________________ Telephone #: ______

Thank you for assisting us.