Educating home food preparers: Where has the message gotten through? An analysis of trends in at-home food handling and consumption practices in the United States

Foodborne disease is a significant public health problem in the US, annually causing an estimated 76 million illnesses and 5,000 deaths. Importantly, most foodborne illness is caused by inappropriate practices of home food preparers. Consumer food-handling and risky food consumption practices have been described before; however, previous studies were not designed to analyze trends in these practices. We combine and analyze data from the US Food Safety Surveys collected in 1988, 1993, 1998, 2001 and 2006 to identify trends in food handling and consumption practices and the factors explaining these trends. This data series is ideal for trend analysis because the food handling questions are identical in all years. Although other topics included in each questionnaire changed, the food handling questions were always asked near the beginning of the questionnaire, which should control for any contextual effects. To control for potential bias caused by differential non-response, all data are weighted to adjust for probability of selection and for race, education and gender. Various statistical methods are used(e.g., ANOVA, multivariate regression). We identify some positive changes in food practices (e.g., hand-washing, hamburger cooking); however, we also find no change (e.g., meat storage) or deteriorations (e.g., fish storage, raw food consumption) in other food behaviors. The relative safety of handling specific foods is consistent across years. Food handlers' knowledge of pathogens has improved, but perceptions of food risk have remained relatively constant. Factors identified as influencing these results can help food safety educators refine messages and target specific consumer populations.