Risk Perceptions, Efficacy Beliefs, and Serving Practices of South Carolina School Foodservice Managers

Introduction: Foodborne disease is rare in U.S. schools.  However, the number of cases could increase as many schools now offer self-service, including salad bars and bowls of fresh fruit. Hand hygiene is one way to reduce illness in schools but compliance is low so understanding underlying factors for lack of compliance is critical.

Purpose: The aim of this study was to determine the relationship between hygiene risk perceptions, efficacy beliefs, and serving practices of school foodservice managers in South Carolina.

Methods: An invitation letter and link to a 35-item web-based survey was emailed to all South Carolina Child Nutrition Directors (N = 82) asking them to forward the email to all managers in their district (N = 1231). The survey, based on Extended Parallel Process Model (EPPM) and Risk Perception Attitude (RPA), measured hygiene risk perceptions, efficacy beliefs, and serving practices using a 5-point Likert-type scale.  Descriptive statistics and hierarchical regression were performed using SAS version 9.

Results: Data from 403 surveys were analyzed. Most respondents were female (82.4%), aged 51 (26-73 years), and worked 15 years (1 - 42 years).  Many (75.9%) were certified managers and most (85.6%) reported hand hygiene training. Respondents reported high level agreement with safe serving practices. Most were categorized into the responsive group of EPPM, indicating high risk perception and high efficacy beliefs associated with preventing illness. The relationship between risk perceptions and serving practices (R² = 0.8, ΔR² = 0.001, P > 0.05) and the interactive effect of risk perception and efficacy beliefs on serving practices (R² = 0.8, ΔR² = 0.004, P > 0.05) were not significant. 

Significance: Because South Carolina schools receive federal funds, they must have a process HACCP Plan, which defines hand hygiene and serving practices.  The HACCP Plan in combination with manager certification and hand hygiene training were believed to influence perceptions, beliefs, and practices suggesting their importance.