Partnership for Food Safety Education

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Archives for April 8, 2015

Dr. Christine M. Bruhn, University of California at Davis

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Dr. Christine M. Bruhn is a Specialist in Cooperative Extension at University of California at Davis. Dr. Bruhn investigates consumer food handling practices, quantifies food safety concerns, explores consumer information needs, and identifies preferred sources of information. Her work investigates consumer responses to information about issues in the news that impact health and safety. Most recently, Dr. Bruhn conducted observational research focusing on consumer preparation of chicken and a salad at home. Her work will be published in the September/October issue of Food Protection Trends.

Listen to the full recording of the BAC Fighter Knowledge Exchange conference call with Dr.Quinlan and Dr. Bruhn.

Q: You’ve just published the results of your observational study of people preparing chicken and salad at home.  How can the listeners access your research findings?

A: The manuscript will be in the September/October issue of Food Protection Trends published by the International Association for Food Protection. The web page is foodprotection.org.  Additionally Jennifer and I will present as part of a symposium at the association’s annual meeting in early August.

Q: As people who work to educate consumers about safe food handling, it is always great to have observational data.  Can you summarize what you believe are the top 3 points of interest for health educators coming out of this research?

A:

    1. People have heard of Salmonella and are aware that chicken is a source, but they believe themselves to be very or completely knowledgeable about how to prepare chicken, and only 20% believed their family could become ill from chicken prepared in the home.  So they don’t realize they could improve their handling practices.
    2. People didn’t follow recommended hygienic practices: 64% didn’t wash hands before starting meal preparation, 38% didn’t wash hands after handling raw chicken and before touching other services and 1/3 of hand washing used water only. While they didn’t follow hand washing practices, 47% washed their chicken, a practice that is not recommended.
    3. People undercooked their chicken. Although the chicken looked adequately cooked, 40% of the chicken registered below the recommended 165°F. Of those who grilled, 52% undercooked with an average of 18° below 165°F. 

Q: Can you briefly describe for us how you conducted the study.  Summarize your methods? How was the study funded?

A: Volunteers were recruited through an interview in the mall. The food preparer must serve chicken to their family and not be currently employed in the food or medical industry. Thirty volunteers each from Los Angeles, San Francisco, Portland and Seattle were selected to reflect the ethnic diversity of these areas. People were videotaped in their home preparing a chicken dish they normally serve and either a fresh green or fruit salad. Two video cameras were set up in the home, one capturing a view of the kitchen and the other hand held by the researcher who followed the food preparer outside if the chicken was barbecued. When the preparer declared the chicken cooked the researcher took the chicken temperature with a Fisher Scientific Thermometer. In some cases a household thermometer was also used to take the chicken temperature. Finally the researcher asked the food preparer questions about food safety and chicken handling.

Q: One of the key findings of the study was that consumers are very aware of food safety issues, yet do not follow recommended food safety practices when preparing their own meals at home. What do you believe are the origins of this disconnect?  What can we all do to address it? 

A: I believe the disconnect occurs because people don’t immediately become ill when they do something wrong. Most people believe their illness is caused by something they ate at their last meal. They don’t realize that symptoms from pathogens like Salmonella, E Coli, Listeria take time to develop. We need to remind people that should they become ill, they need to look beyond their last meal.

Q: Can you tell us what has surprised you most about consumer behavior coming out of the observational work you’ve done?  

A: That people don’t adequately wash their hands is not new. We found similar results when we observed people preparing burgers and a salad in their home. I was shocked that chicken can look fully cooked and not register 165°F .  I have started using a thermometer in my own home, even when I stir fry thin chicken pieces. 

I was also surprised that the reading on home thermometers sometimes differed significantly from that on the Instant Read Fisher Scientific thermometer. Consumers were not aware that dial thermometers could be calibrated and some were 30 or more degrees different from the Fisher Scientific thermometer.

Our food safety messages need to stress that even with chicken, you can NOT rely on appearance. Use a thermometer and calibrate it frequently.

Q: Your study found that under-cooking chicken is common and even more so when barbecuing  (grilling) and stir frying. Why do you think that is the case?

A: Cooking temperature is harder to control when grilling. I think the outside gets so brown that people think the inside must also be cooked. Cooking was most uniform in oven baking. Those who are able might be advised to use lower heat in their grill and put down the lid.

The information on the thermometer can also cause confusion. Some used meat guidelines for chicken. I don’t expect people to remember all these numbers. It is helpful if thermometers clearly indicated the recommended temperatures for beef, pork, chicken, fish, and egg containing dishes.

Q: We were alarmed to find out that about 65% of the participants did not wash their hands before meal preparation. Clearly hand washing must be a major focus of education efforts.  To what do you attribute the situation of consumers and hand washing during meal preparation? 

A: I think there is an assumption in some educational materials that hands look dirty prior to washing. We need to remind people that bacteria is everywhere. You can’t see it on your hands, but your hands still need washing. Hands also need to be dried! Bacteria is transferred easiest in a moist environment. People should dry their hands with a single service paper towel. Cloth towels become contaminated after a single use. 

Q: So we’ve talked about cooking and cleaning – what about chilling? What did you find out about consumers and their refrigerators?

A: Over half (56%) did not know the recommended refrigerator temperature. Only 26% responded correctly with 32-40° F. We placed a refrigerator thermometer where the volunteers had stored their chicken. 12% of the refrigs. were over 45°F and one was 60°F and 65% stored chicken in the middle or top shelf. People didn’t know that raw foods should be placed below cooked to avoid contamination by drips.

Q:  With so many educators on the phone – many of whom work with hundreds of consumers each year, I hope you will give your ideas for 3 actions they can take that help us turn around some of the behaviors that come out in your research?  

A: Key most important messages are:

    1. Wash your hands, especially after handing raw meat or chicken. Everything you touch can spread bacteria. Imagine chicken is covered with honey, touch it, then your refrigerator, your spices, or your cell phone, you spread the honey. You’ve got to wash to stop the stickies!
    2. Don’t wash you chicken. Bacterial splatters with the water and can spread as an aerosol. Cooking kills the bacterial. Go straight from package to cooking.
    3. Use a thermometer to be sure your chicken is cooked. Appearance is not reliable. Chicken cooked to 165°F is still moist, and it is also safe.

Dr. Jennifer Quinlan, Drexel University

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Dr. Jennifer Quinlan is Associate Professor, Nutrition Sciences Department at Drexel University. Dr. Quinlan’s research focuses on identifying food safety risks for minority and low income populations. Her work uses focus groups and surveys to explore differences in handling of food by consumers from different demographic groups. Through her research, she identified the common practice of incorrectly washing raw poultry by consumers of all demographics which lead to the “Don’t Wash Your Chicken” campaign. The focus group research behind “Don’t Wash Your Chicken” was published in the Journal of Food Protection and the research regarding the larger survey is under peer review currently.

Listen to the full recording of the BAC Fighter Knowledge Exchange conference call with Dr.Quinlan and Dr. Bruhn.

Q:  Tell me about the methods you used in your research that led to the discovery that consumers of ALL demographics are still rinsing their chicken? How was the study funded?

A: Our formative research regarding egg and poultry handling by consumers utilized a combination of focus groups and surveys.  We conducted a total of 9 focus groups with consumers of different demographics to discuss practices with these consumers in a more “casual” and “exploratory” setting.  Focus groups are a great tool because they allow researchers to get feedback from participants that they don’t ask about directly.  This allows themes and practices to emerge that researchers may not be aware of to even ask about.  This is essentially what happened with our focus groups.  Participants expressed to us unique pork and poultry purchasing and handling practices that we hadn’t anticipated, one of these was the apparently widespread nature of washing raw poultry among participants.  A limitation of focus groups is that because findings are based on such a small number of people it can’t be assumed that they can be extrapolated to a larger population.  For this reason we conducted a larger telephone survey among approximately 400 consumers in the Philadelphia area.  This survey included questions related to the unique practices we had identified in the focus groups including practices like washing raw poultry, cooking a turkey overnight and purchasing live birds.

Q: So why is it a bad practice to rinse poultry before cooking it? What does the science tell us?

A:  The science tells us that when you’re dealing with raw poultry there’s a chance that it will have either Salmonella or Campylobacter on it, or both.  The science also tells us that cooking poultry to 165 ° F will kill those pathogens.  Simply rinsing with water is not an effective way to eliminate pathogens. The risk associated with rinsing raw poultry is that you increase the chances for cross contamination to occur in the kitchen.  The water used to rinse the poultry can serve as a vehicle to allow the bacteria from the poultry to spread both in the sink and in areas around the sink.

Q: Did people in the focus groups explain why they believed it was a good idea to wash chicken?

A: We heard a number of reasons why people believed they should rinse raw poultry both from focus groups as well as through feedback on social media.  Some people said “I just thought I was supposed to” – either because that’s what they had learned in their home or they had seen it on TV or read it in a recipe or even just because they thought they should because it was raw. Another group of people felt strongly that they needed to rinse raw poultry to remove either blood or just stickiness associated with raw poultry.  Others felt that because the poultry had been processed there was some type of residue from processing that they needed to remove.

Q: I’m sure a great deal of research went into developing the materials for the “Don’t Wash Your Chicken” campaign. As you started the process, did you have a clear idea of how you would motivate people to change behavior? How many different ideas did you have?

A:  The Transtheoretical Model (TTM) played a role in how we approached the development of the materials. The TTM identifies stages where people are in their willingness and ability to carry out a desired behavior ranging from pre-contemplative – that is not even knowing what the proper desired behavior is – all the way to maintenance, which would include regularly performing the desired behavior.  From our results, as well as some results that were coming out of Australia and the UK around that time, we predicted that most consumers were at the pre-contemplative stage – that is, they weren’t even aware that washing raw poultry was an incorrect behavior.  Based on this we felt that the first need was simply to get the message out in a captivating and appealing way to tell consumers not to wash their raw poultry, and therefore at least start to “move” consumers to the next stages of the TTM to either contemplate or prepare to perform the desired behavior of not washing raw poultry.  We recognized that it was unlikely that one initial campaign would address all of the barriers to getting some consumers to adopt this food handling practice. 

We also knew that we wanted to develop a multi-media campaign that would include not only print materials but also internet videos, cartoons, etc. and thanks to USDA funding, we had the resources to do so.  Photo novellas are essentially “picture stories” that aim to teach a lesson through a storyline.  We decided early on that we wanted to use this format in the research.  We really worked as a team with our colleagues at New Mexico State University to develop storylines that would be culturally diverse as well as include a range of chicken recipes and cuts of chicken.

Q: Most of your photo novellas and videos focus on a specific chicken preparation technique, stir fry, oven fried, etc. Do you find that people are equally inclined to rinse their chicken when they’re cooking whole vs chicken parts and chicken breasts?

A:  From our data, it was difficult to tell if people are equally inclined to rinse their chicken when cooking whole vs. parts. It was a small sample and the numbers were very close.  I think that is a question that still needs to be answered with a larger sample of the consumers.  We developed the materials to include in the message that NO type or cut of poultry should be washed, which is why we included a number of different cuts in the different photo novellas.  At the same time, in order to make the materials as culturally diverse as possible we wanted to include a range of recipes and actors/actresses so that educators might be able to use a particular video or photo novella that would be more appealing or easily accepted by their particular audience.

The development of the “germ-vision” really came about through discussions as a group and wondering if there was a way to visualize for consumers the data from a report out of the UK in 2003 that had shown with dye that aerosolization of spray off poultry could travel up to 2.3 feet. This is what the germ-vision was based on.

Interestingly, when the message and campaign of “Don’t Wash Your Chicken” gained such national media and social media attention last year, it wasn’t our culturally appropriate photo novellas and videos that gained the most attention, but the 14 second “germ-vision”.  I think this was a lesson for us and should be a lesson for other public health and food safety educators about the limitations of getting a public health message across in the age of social media and short attention spans.  While to date our videos have been viewed between 1500-5,000 times, depending on the video, the 14 second germ vision has been viewed almost 470,000 times!

Q: Let’s talk about results of your outreach effort.  What can you share in the way of evaluation data?

A: Prior to the press release about the availability of the materials last August, we did a controlled piloting of the materials in Philadelphia, PA. The materials were made available over a 4 week period in a number of libraries and one grocery store. We used a post-test only design to avoid raising the question of washing raw poultry before exposing consumers to the materials. Consumers were surveyed over a 3 week period following exposure to the materials and those who were exposed to the materials were statistically significantly more likely to report not washing poultry. However the number of consumers in both groups that reported not washing raw poultry were still very low – in the 10-25% range, so it also reconfirmed our belief that many consumers are still at the pre-contemplative stage and don’t even know the correct behavior.  We felt the large amount of “discussion” that arose in the media and social media last fall after the materials were released also reconfirmed this idea with many consumers “surprised” to find out this was the proper and recommended handling practice for raw poultry.  While feedback has been that some consumers have been happy to stop the practice of washing raw poultry once they heard the message, it’s clear that there are barriers for other consumers to not wash raw poultry.  Now that the message of not washing raw poultry has become part of the discussion and more widely disseminated, we believe there is a need for more research to better understand the barriers for those consumers who are not accepting of the message and determine how to tailor additional consumer education messages to address those barriers.