The interplay between food handlers and food safety culture: assessment strategies and educational actions to the proactive evolvement
Arquivos
Data
2021-02-26
Autores
Zanin, Laís Mariano 
Orientadores
Stedefeldt, Elke
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: Esta tese investigou se as ações educacionais para manipuladores de alimentos poderiam evoluir a cultura de segurança dos alimentos (CSA) de forma proativa no contexto dos serviços de alimentação. Métodos: Foram realizados cinco estudos para atingir este objetivo, duas revisões de literatura (integrativa e sistemática) e três estudos empíricos. Na revisão integrativa (Capítulo 2) a pesquisa foi conduzida nas seguintes bases de dados ScienceDirect, Medline, Lilacs e Web of Knowledge. Na revisão sistemática (Capítulo 6), a pesquisa foi conduzida no ScienceDirect, Thomson Reuters Web of Science, Wiley Online Library, Scopus, Taylor & Francis Group, e Google Scholar, na qual foi realizada uma abordagem de método misto. No primeiro estudo empírico (Capítulo 3) foi desenvolvida e utilizada uma abordagem de métodos mistos (quantitativos e qualitativos) e utilizada para avaliar a CSA com base em oito elementos: liderança, comunicação, conhecimento, compromisso, percepção de risco, pressão de trabalho e crenças normativas, ambiente de trabalho e sistemas, estilos e processos de gestão. Os métodos quantitativos abrangeram questionários e listas de verificação e foram avaliados com estatísticas descritivas. Os métodos qualitativos incluíram observações e entrevistas dos participantes e foram avaliados com base na análise de conteúdo do tipo temática. Uma tabela de interpretação foi desenvolvida para triangular os dados usando um sistema de pontuação que classificou a CSA em reativa, reativa a ativa, ativa, ativa a proativa e proativa. Este primeiro estudo de caso realizado em um serviço de alimentação do exército brasileiro (39 manipuladores de alimentos e 3 gerentes). No segundo estudo empírico (Capítulo 4), conduzido em um serviço de alimentação da força aérea brasileira (30 manipuladores de alimentos e 2 gerentes), o método misto desenvolvido para avaliar a CSA foi testado, e um modelo para delinear ações de formação foi proposto para a evolução da CSA predominante. O último estudo empírico (Capítulo 5) utilizou um método longitudinal (22 meses) para testar a abordagem de métodos mistos e o modelo previamente descrito no mesmo serviço de alimentação do exército brasileiro do primeiro estudo empírico (59 manipuladores de alimentos e 5 gerentes). Esta pesquisa foi aprovada pelo Comitê de Ética em Pesquisa. Resultados: A revisão integrativa mostrou que no treinamento tradicional de segurança dos alimentos, não houve tradução adequada de conhecimento/atitudes em atitudes/práticas dos manipuladores de alimentos. No capítulo 3 (o primeiro estudo empírico), os métodos mistos desenvolvidos e os dados triangulados permitiram uma avaliação realista da CSA predominante no serviço de alimentação do exército (reativa a ativa), indicando que essa avaliação poderia ser a base para ações de formação. O capítulo 4 (segundo estudo empírico) ilustra a CSA prevalecente no serviço de alimentação da força aérea (ativa a proativa) como base para desenvolver um modelo que indicasse as recomendações para a evolução proativamente da CSA a curto, médio e longo prazo. O roteiro destacou as fragilidades da CSA (percepção de risco e sistemas de gestão, estilos e processos) e os pontos fortes (pressão de trabalho e crenças normativas) para evoluir a CSA com base no sistema de pontuação. O terceiro estudo empírico (Capítulo 5) demonstrou que a avaliação da CSA pode ser usada como um ponto de partida para ações de formação, pois tais ações evoluíram a CSA predominante de forma proativa (de uma avaliação reativa-ativa na primeira avaliação para uma ativa-proativa após as ações de formação iniciais e as ações do gerente local). As ações de formação foram eficazes porque se basearam nas necessidades educacionais, na criação de confiança e em métodos adequados de manipulação de alimentos (Capítulo 5). A revisão sistemática mostrou uma falta de consenso ou padrão para avaliar a CSA, destacando uma diversidade de elementos e dimensões utilizados na avaliação da CSA e que a principal recomendação para melhorar a CSA é o investimento nas pessoas. Conclusão: As ações educacionais concebidas com base no sistema de pontuação evoluíram a CSA de forma proativa assumindo um ciclo contínuo entre melhorias na CSA e as ações de formação no contexto dos serviços de alimentação. Esta pesquisa fortalece a relevância dos esforços na área de segurança dos alimentos para melhorar a saúde pública, minimizando os surtos de doenças transmitidas por alimentos.
Objective: This thesis investigated if the food handlers’ educational actions could evolve the food safety (FS) culture proactively in the food service context. Methods: Five studies were conducted to accomplish this aim, two literature reviews (integrative and systematic) and three empirical studies. In the integrative review (Chapter 2) the search was conducted in the followed bases ScienceDirect, Medline, Lilacs databases, and Web of Knowledge. In the systematic review (Chapter 6), the search was conducted in ScienceDirect, Thomson Reuters Web of Science, Wiley Online Library, Scopus, Taylor & Francis Group, and Google Scholar. A mixed-method approach was performed in the systematic review. In the first empirical study (Chapter 3) a mixed-methods approach (quantitative and qualitative) was developed and used to assess FS-culture based on eight elements, as followed: leadership, communication, knowledge, commitment, risk perception, work pressure and normative beliefs, work environment, and management systems, styles, and process. The quantitative methods encompassed questionnaires and check-lists and were assessed with descriptive statistics. The qualitative methods included participant observations and interviews and were assessed based on thematic content analysis. An interpretation grid was developed to triangulate the data using a scoring system that classified the FS-culture in reactive, reactive to active, active, active to proactive, and proactive. This first study was a case study conducted in a Brazilian army foodservice (39 food handlers and 3 managers). In the second empirical study (Chapter 4), conducted in a Brazilian air force food service (30 food handlers and 2 managers), the mixed-methods to assess FS-culture was tested, and a roadmap to design educational actions were proposed to evolve the prevailing FS-culture. The last empirical (Chapter 5) study used a longitudinal method (22 months) to test the mixed-methods approach and the roadmap previously described in the same Brazilian army food service than the first empirical study (59 food handlers and 5 managers). This research was approved in the Ethics Committee on Research. Results: The integrative review showed that in traditional food safety training, there was no proper translation of knowledge/attitudes into attitudes/practice of food handlers. In chapter 3 (the first empirical study), the mixed-methods developed and triangulated data enabled a realistic assessment of the prevailing FS-culture in the army’s food service (reactive to active), indicating that FS-culture assessment could be the basis for educational actions. Chapter 4 (second empirical study) illustrates the air force food service’s prevailing FS-culture (active to proactive) as a basis to develop a roadmap that indicated the recommendations to proactively evolve FS-culture in a short-, medium-, and long-term. The roadmap highlighted the FS-culture weaknesses (risk perception and management systems, styles, and process) and strengths (work pressure and normative beliefs) to evolve FS-culture based on the scoring system. The third empirical study (Chapter 5) demonstrated that the FS-culture assessment might be used as a starting point for educational actions because the educational actions evolved the prevailing FS-culture proactively (from reactive-active in the baseline assessment to an active-proactive after the initial educational actions and the local manager’s actions). Educational actions were effective because they were based on educational needs, confidence building, and adequate food handlers’ methods (Chapter 5). The systematic review showed a lack of consensus or standard to assess FS-culture, highlighting a diversity of elements and dimensions used in the FS-culture assessment and people’s investment as the main recommendation to improve FS-culture. Conclusion: The educational actions designed based on the scoring system evolved the FS-culture proactively assuming a continuous cycle between improvements in FS-culture and educational actions in the food service context. This research strengthens the relevance of food safety efforts to improve public health minimising the foodborne outbreaks.
Objective: This thesis investigated if the food handlers’ educational actions could evolve the food safety (FS) culture proactively in the food service context. Methods: Five studies were conducted to accomplish this aim, two literature reviews (integrative and systematic) and three empirical studies. In the integrative review (Chapter 2) the search was conducted in the followed bases ScienceDirect, Medline, Lilacs databases, and Web of Knowledge. In the systematic review (Chapter 6), the search was conducted in ScienceDirect, Thomson Reuters Web of Science, Wiley Online Library, Scopus, Taylor & Francis Group, and Google Scholar. A mixed-method approach was performed in the systematic review. In the first empirical study (Chapter 3) a mixed-methods approach (quantitative and qualitative) was developed and used to assess FS-culture based on eight elements, as followed: leadership, communication, knowledge, commitment, risk perception, work pressure and normative beliefs, work environment, and management systems, styles, and process. The quantitative methods encompassed questionnaires and check-lists and were assessed with descriptive statistics. The qualitative methods included participant observations and interviews and were assessed based on thematic content analysis. An interpretation grid was developed to triangulate the data using a scoring system that classified the FS-culture in reactive, reactive to active, active, active to proactive, and proactive. This first study was a case study conducted in a Brazilian army foodservice (39 food handlers and 3 managers). In the second empirical study (Chapter 4), conducted in a Brazilian air force food service (30 food handlers and 2 managers), the mixed-methods to assess FS-culture was tested, and a roadmap to design educational actions were proposed to evolve the prevailing FS-culture. The last empirical (Chapter 5) study used a longitudinal method (22 months) to test the mixed-methods approach and the roadmap previously described in the same Brazilian army food service than the first empirical study (59 food handlers and 5 managers). This research was approved in the Ethics Committee on Research. Results: The integrative review showed that in traditional food safety training, there was no proper translation of knowledge/attitudes into attitudes/practice of food handlers. In chapter 3 (the first empirical study), the mixed-methods developed and triangulated data enabled a realistic assessment of the prevailing FS-culture in the army’s food service (reactive to active), indicating that FS-culture assessment could be the basis for educational actions. Chapter 4 (second empirical study) illustrates the air force food service’s prevailing FS-culture (active to proactive) as a basis to develop a roadmap that indicated the recommendations to proactively evolve FS-culture in a short-, medium-, and long-term. The roadmap highlighted the FS-culture weaknesses (risk perception and management systems, styles, and process) and strengths (work pressure and normative beliefs) to evolve FS-culture based on the scoring system. The third empirical study (Chapter 5) demonstrated that the FS-culture assessment might be used as a starting point for educational actions because the educational actions evolved the prevailing FS-culture proactively (from reactive-active in the baseline assessment to an active-proactive after the initial educational actions and the local manager’s actions). Educational actions were effective because they were based on educational needs, confidence building, and adequate food handlers’ methods (Chapter 5). The systematic review showed a lack of consensus or standard to assess FS-culture, highlighting a diversity of elements and dimensions used in the FS-culture assessment and people’s investment as the main recommendation to improve FS-culture. Conclusion: The educational actions designed based on the scoring system evolved the FS-culture proactively assuming a continuous cycle between improvements in FS-culture and educational actions in the food service context. This research strengthens the relevance of food safety efforts to improve public health minimising the foodborne outbreaks.
Descrição
Citação
ZANIN, L. M. The interplay between food handlers and food safety culture: assessment strategies and educational actions to the proactive evolvement. São Paulo, 2021. 270 f. Tese (Doutorado em Nutrição) - Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP). Sã Paulo, 2021.