I never thought Chapman would finish -- his degree, his fantasy football, and especially this paper.

We’ve been talking about food safety stories since at least 2002. I knew from research done in the 1990s about food and dieting and the power of exemplars – personal examples to get people’s attention. Chapman dug into the literature and found references going back decades.

The storytelling approach has underpinned much of what we’ve done over the past seven years, including food safety infosheets and the posts in barfblog.com. Now we, along with our colleague Tanya MacLaurin of Guelph (who used to be at Kansas State, go figure) can say, see, these things work. And here’s how it’s done.

From the K-State press release this morning:

Food safety advice may fail because it's too prescriptive -- wash your hands, use a thermometer -- and it often doesn't include stories to make such information relevant. Researchers at North Carolina State University, Kansas State University and the University of Guelph have found that using short food safety stories with vibrant graphics can be a better training tool for food service workers.

A new paper by the researchers in the British Food Journal details the concept, creation and distribution of food safety infosheets, like those found at http://foodsafetyinfosheets.wordpress.com/. These single-page posters are created around a current food safety issue or outbreak, and are supplemented with graphics and information targeted at the food service industry. The infosheets are used to provide food safety risk-reduction information to generate behavior change and support a food safety culture.

"Food safety infosheets were designed with the goal of communicating risk reduction messages with the objective of changing behavior," said Ben Chapman, assistant professor in the department of 4-H youth development and family and consumer sciences at North Carolina State. "These infosheets differ from much of what is currently used in training, because we focus on the consequences of mishandling food by providing real examples taken from recent events."

A recent food safety infosheet detailed an outbreak of E. coli O157 linked to a festival in Winnipeg, Canada, that sickened 40. Another focused on food preparation and cooling for large crowds, sparked by an outbreak at a church turkey dinner in Kansas that sickened 159.

"Whether it's a waitress, a line cook or the stock boy, people learn through stories," said Doug Powell, an associate professor of food safety at K-State. "We want to reach out to the last person who touched your food and make it safer."

Over the course of two years and using multiple methods, food safety infosheets transformed from a text-heavy memo to compelling, story-laden posters supported with contextual messages on what a food handler could do to reduce food safety risks, according to the researchers.

As part of the design phase of the infosheets, Chapman spent 185 hours working as a dishwasher in a local restaurant.

"We felt it was important to really immerse into the culture of a food handler, and get a better understanding of what types of conversations occurred and what the hierarchy was like," Chapman said. "The experience directed us to refocus our messages to be a bit edgier and include references to celebrity and music where possible."

Food safety infosheets at http://foodsafetyinfosheets.wordpress.com/ are created semi-weekly and are posted in restaurants, retail stores and on farms. They also are used in training throughout the world. Since September 2006 more than 150 food safety infosheets have been produced. They are available for download at no cost. The website has been recently redesigned, adding a search function, automatic e-mail alerts and RSS feeds. The new database is also sortable by pathogen, location and risk factor.

Citation and abstract:
Food safety infosheets: Design and refinement of a narrative-based training intervention
British Food Journal, Vol. 113 Iss: 2 (pre- print edition)
Benjamin Chapman, Tanya MacLaurin and Doug Powell
http://www.emeraldinsight.com/journals.htm?issn=0007-070x&volume=113&issue=2&articleid=1895862&show=abstract

Purpose - Despite extensive investments in food handler training, research suggests that training programs are inconsistent, and rarely evaluated for efficacy. The generic prescriptive content and school-like delivery methods used in current food safety training may be a barrier to application. The purpose of this research was to develop a food safety communication tool, food safety infosheets, targeted specifically to foodservice food handlers utilizing popular media stories to illustrate the consequences of poor food handling.

Design/methodology/approach - Food safety infosheets were designed to be surprising, connect food handlers’ actions and consequences, and generate discussion through a verbal narrative framework. A Delphi-like exercise (n = 19), a posting pilot (n = 8) were carried out to assess the appropriateness of the concept of food safety infosheets. An intense participatory ethnographic study with an Ontario, Canada restaurant, and in-depth interviews with food service operators in Manhattan, Kansas, and Lansing, Michigan (n = 17) were conducted to gather qualitative data on the food service kitchen environment, including barriers to food safety practices, and the communication preferences of those who work in such kitchens.

Findings - The expert group, foodservice operators, and food handlers accepted food safety infosheets as an appropriate concept and valued storytelling as an effective communication strategy. Learning in the kitchen environment is largely hands-on and visual, and time pressure dictates practices. It is often difficult to attract and keep the attention of food handlers. Storytelling, celebrity and local outbreaks are of interest to the target audience.

Originality/value - This research provides a blueprint for the design and refinement of food safety communication tools targeted towards a specific audience. By utilizing multiple methodologies, this article provides a framework for other researchers to follow.
 

When to go public about health warnings – like potential outbreaks of foodborne disease – remains contentious. And no one is willing to come clean about it and say – this is when we go public and why. Or at least write it down. Bureaucrat 101 – write it down, have to do it; so don’t write it down.

I understand the flexibility public health types require to do their jobs effectively, but much of the public outrage surrounding various outbreaks – salmonella in tomatoes/jalapenos, 2008, listeria in Maple Leaf deli meats, 2008, the various leafy green recalls and outbreaks of 2010, and the delay in clamping down on Iowa eggs – can be traced to screw ups in going public.

It’s long been a tenet of risk communication that it is better to default to early public information rather than later. People can handle all kinds of information, especially when they are informed in an honest and forthright manner. In new research that seems directly applicable to going public about foodborne illness outbreaks, two mathematical biologists at the Georgia Institute of Technology and Marshall University in Huntington, West Virginia reported today that at the first sign of a disease pandemic, public health officials should begin strongly communicating about the extent of the outbreak and the steps that can be taken by the public to avoid infection

During outbreaks of serious infectious diseases, many individuals closely follow media reports and as a result, take precautions to protect themselves against the disease. These precautions may include staying home, getting vaccinated, avoiding crowds, using disinfectants, canceling travel plans and wearing face masks.

Known as "self-isolation," these precautions can significantly reduce the severity of an outbreak, according to mathematical modeling done by "The more forcefully the media provides information about pandemic infections and deaths, the more the total number of infections is reduced," said Howard Weiss, a professor in the Georgia Tech School of Mathematics. "Media coverage also reduces the maximum number of infections at any particular time, which is important for allocating the resources needed for treating infectious diseases."

The benefit of publicly reporting disease outbreaks seems obvious, and public health officials in the United States have a policy of regularly communicating with the news media about such incidents. But according to Weiss, not all world governments choose to communicate so well – and nobody had used rigorous mathematical techniques to study the impact of that communication before.

In a paper about the model submitted to a biostatistics journal and posted on the Physics arXiv blog, Mummert and Weiss describe testing their model with a hypothetical outbreak of Ebola Hemorrhagic Fever in Huntington – a college community of about 50,000 residents.

In their model, Mummert and Weiss did not look at such issues as the quality of news coverage, or what may happen if news reports turn out to be false or overstated. They also didn't study the effect of individuals occasionally leaving their isolation to purchase food or medicine, for instance.

The paper cites the case of a false rumor spread across the Internet in 2003 about a restaurant worker in New York's Chinatown who had supposedly died of the SARS infection. That rumor led to a decrease in travel to that area.

"In general, our advice to public health officials anywhere in the world is not to hold back," he added. "They should get out the news about infectious disease outbreaks loudly and quickly. It's clear that vigorous media reporting can have a substantial effect on reducing the impact of an outbreak."

People often ask me, “Doug, how do you choose the information that goes in bites.ksu.edu? Do you have a basis for any of your food safety rants on barfblog? Why are you such a jerk?

People often ask Ben, “Why do you write so much about vomit?”

People often ask Amy, “Why are you with Doug?”

When we ran the food safety information centre back in Canada, we had detailed procedures for how to answer questions, what information was provided and why. We don’t answer questions so much anymore, but we do provide a lot of information so I figured we better clearly understand what we do and why. This is more for us and all the students that come through my lab than it is for you. Really, it’s me, not you.

bites.ksu.edu is a unique comprehensive resource for all those with a personal or professional interest in food safety. Dr. Powell of Kansas State University, and associates, search out credible, current, evidence-based information on food safety and make it accessible to domestic and international audiences through multiple media. Sources of food safety information include government regulatory agencies, international organizations such as the World Health Organization (WHO) and the Food and Agriculture Organization of the United Nations (FAO), peer-reviewed scientific publications, academia, recognized experts in the field and other sources as appropriate.

Throughout all bites activities, the emphasis is on engaging people in dialogue about food-related risks, controls and benefits, from farm-to-fork. bites strives to provide reliable, relevant information in culturally and linguistically appropriate formats to assist people in identifying, understanding and mitigating the causes of foodborne illness.

bites LISTSERV
The bites.ksu.edu listserv is a free web-based mailing list where information about current and emerging food safety issues is provided, gathered from journalistic and scientific sources around the world and condensed into short items or stories that make up the daily postings. The listserv has been issued continuously since 1995 and is distributed daily via e-mail to thousands of individuals worldwide from academia, industry, government, the farm community, journalists and the public at large.

The listserv is designed to:

•    convey timely and current information for direction of research, diagnostic or investigative activities;
•    identify food risk trends and issues for risk management and communication activities; and
•    promote awareness of public concerns in scientific and regulatory circles.

The bites listserv functions as a food safety news aggregator, summarizing available information that can be can be useful for risk managers in proactively anticipating trends and reactively address issues. The bites editor, Dr. Powell, does not say whether a story is right or wrong or somewhere in between, but rather that a specific story is available today for public discussion.

barblog.com

barfblog.com is where Drs. Powell, Chapman, Hubbell and assorted food safety friends offer evidence-based opinions on current food safety issues. Opinions must be evidence-based – with references – reliable, rapid and relevant. The barfblog authors edit each other – viciously.

TWITTER
Breaking food safety news items that eventually appear in bites or barfblog are often posted on Twitter for faster public notification.

INFOSHEETS
Food safety infosheets are designed to influence food handler practices by utilizing four attributes culled from education, behavioral science and communication literature:

•    surprising and compelling messages;
•    putting actions and their consequence in context;
•    generating discussion within the target audiences’ environments; and
•    using verbal narrative, or storytelling, as a message delivery device.

Food safety infosheets are based on stories about outbreaks of foodborne illness sourced from the bites listserv. Four criteria are used to select the story: discussion of a foodborne illness outbreak; discussion of background knowledge of a pathogen (including symptoms, etiology and transmission); food handler control practices; and emerging food safety issues. Food safety infosheets also contain evidence-based prescriptive information to prevent or mitigate foodborne illness related to food handling. And now, available in French, Spanish and Portuguese.

bites bistro videos
A nod to the youtube generation, but we don’t really know what we’re doing.

Watching the pronouncements and proclamations for Food Safety Education month makes me think about kids in the 1950s getting educated about nuclear bombs: Duck, Cover and Roll.

In the film, below, substitute foodborne illness for atomic bomb, and substitute consumers have a role, for duck, cover and roll.

In a month of foodborne illness, the signal of impending doom is not an air raid siren, but more likely explosive diarrhea; you might even be out playing when it comes.

The advice in Duck and Cover is as useful in protecting against radiation as the advice from various government, industry and advocacy types is in preventing foodborne illness.