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A reliable and validated set of food safety behavior questions that could be used with confidence when evaluating food safety education programs was identified in this study. A list of 29 food-handling and consumption behaviors rank-ordered within five pathogen control factors by nationally recognized food safety experts was the basis for the development of the behavior questions. Questions were evaluated for reliability and several forms of validity. During a kitchen activity session, 70 graduates of a nutrition education program completed four food preparation tasks while being observed and videotaped. The individuals also participated in an in-depth interview to validate behaviors that could not be observed during the food preparation activity, e.g., refraining from preparing food for others when experiencing diarrhea. Criterion validity was established by comparing questionnaire responses to observed behavior and interview responses. Twenty-eight questions met the validity criterion (> or = 70% agreement between observed and interviewed responses and self-reported responses), with three or more questions from each of five pathogen control factor areas. Observation assessments revealed that hand washing was more likely to be performed prior to beginning food preparation than between working with raw meats and fresh produce. Errors in methods of washing hands, utensils, and preparation surfaces between food preparation tasks were common. Most participants did not use thermometers to evaluate doneness but still cooked to safe internal temperatures. The results provide a tool that educators can use to evaluate food safety programs and will help guide the development of more effective food safety education programs targeting needed improvements in behavioral skills.

To be effective in reducing the incidence of foodborne illness, consumers and food safety educators need information about behaviors that will decrease exposure to foodborne pathogens. A four-round Delphi technique was used to survey nationally recognized experts in food microbiology, epidemiology, food safety education, and food safety policy with the aim of identifying and ranking food-handling and consumption behaviors associated with 13 major foodborne pathogens. The food safety experts ranked behaviors related to keeping foods at safe temperatures as of primary importance in preventing illness caused by Bacillus cereus and Clostridium perfringens and of secondary importance in preventing illness caused by Staphylococcus aureus. The use of a thermometer to cook foods adequately was ranked as of primary importance for the prevention of illness caused by Campylobacter jejuni, Salmonella species, Escherichia coli O157:H7, Toxoplasma gondii, and Yersinia enterocolitica, with the avoidance of cross-contamination being ranked as of secondary importance for most of these pathogens. Hand washing was the top-ranked behavior for the prevention of shigellosis. The avoidance of certain foods that are likely to be contaminated was the top-ranked behavior for the prevention of illnesses caused by Listeria monocytogenes, Noroviruses, and Vibrio species. The expert panel's ranking of behaviors for the reduction of the risk of illness caused by major foodborne pathogens can enable consumers to make informed choices about food consumption and handling behaviors and can guide food safety educators in prioritizing their educational efforts.

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