Purpose: Using educational materials produced in English and Spanish in formats that included a straightforward brochure and an illustrated story-based style (comic book), this study determined the efficacy of this educational intervention when distributed in a passive manner.
Methods: From a total of 125 participating restaurants, 508 food handlers who spoke either English or Spanish were interviewed during January through July 2009 to determine baseline knowledge and identify which knowledge questions were most frequently answered incorrectly. An educational brochure and a comic book were created based on the most frequently identified knowledge gaps from the baseline knowledge study. Sixty-two restaurants (276 food handlers) were randomly assigned to the intervention group and 63 restaurants (232 food handlers) to the control group. A follow-up knowledge survey was then performed.
Results: There was an increase of 1.7 points (knowledge score rose from 67% to 73%) among the 35 food handlers that read either or both of the intervention materials compared to their baseline score (P < 0.05). For comparison, 101 control food handlers did not have a significant rise in their knowledge score. Knowledge in the intervention group about bloody diarrhea being a possible manifestation of eating ground meat that is not completely cooked increased by 32% (P = 0.005).
Significance: These data demonstrate that even with a passively delivered educational intervention, measurable, significant knowledge increases may be observed among restaurant food handlers. This study quantifies the need for more active approaches. Editing these materials and performing a more active approach that includes requiring food handlers to read the materials may lead to more substantial improvement in knowledge in a much larger number of food handlers and is an area for future research.