Development and Evaluation of a Food Safety Survey for the Deaf and Hard of Hearing

Introduction: Food safety practices in private homes in the United States do not align with food safety recommendations, even with adequate food safety knowledge, thereby putting individuals at risk for foodborne illness. Deaf individuals are at an increased risk for lack of food safety knowledge due to communication barriers and lack of educational approaches culturally appropriate for Deaf culture. 

Purpose: Develop and assess the usability of standard survey design techniques including: paper and online formats and two forms of Likert scale 5-point and 3-point response options with American Sign Language among Deaf adolescents.

Methods: Cluster sampling technique recruited 28 participants, ages 18-21 years old, from six schools for Deaf and hard of hearing in Idaho, Oregon, Washington, Arizona, Texas, and California.  The forty-five Food Safety Survey pilot survey questions assessed the following constructs: general food safety knowledge, food preparation frequency specifically fresh produce, food handling practices, hand washing knowledge and practices corresponding to key food safety recommendations, factors influencing hand washing frequency, and familiarity with common food safety related words and phrases. Validity, reliability, and item difficulty assessments, in addition to participant feedback were used to assess pilot study’s ability to measure food safety constructs for this population.

Results: Survey participants’ understood the importance agreeing the standard food handling practices including washing fresh fruits and vegetables before eating or serving them (100% agreed a lot); believed it is important that food is prepared in a safe way (96% agreed a lot); and washing hands before eating (86% agreed a lot). However participants were less likely to recognize the safest method for: thawing meat (14% disagree a lot that “Thawing meat on a countertop is the best way to thaw frozen meat”); washing hands for 20 seconds or more (43% every time); and wash hands after blowing their nose (61% every time). The food safety words and phrases respondents most frequently “know what word means” were bacteria (55.6%), virus (48.1%) and food preparation (40.7%) while the least familiar were handling produce (37.0%), foodborne illness (22.2%), and cross contamination (22.2%).

Significance: Reaching target audiences with unique communication challenges, such as with deaf and hard of hearing teenagers, requires development of tailored surveillance tools. Lessons from this study can be applied to the development of a food safety survey for Deaf and hard of hearing teenagers and research in other populations with low health literacy.