The Use of a Consumer-Orientated Approach to Design and Develop Food Safety Interventions for Chemotherapy Patients and Family Caregivers

Introduction: Chemotherapy patients have an increased risk of foodborne illness due to immunosuppression, indeed the risk of listeriosis is reportedly five times greater to chemotherapy patients. Consequently, ensuring food safety at home is essential for patients/family caregivers. However, it is suggested that limited food safety information is available to chemotherapy patients/family caregivers in the UK and data on food safety practices during chemotherapy are particularly lacking.

Purpose: To establish current food safety practices and preferences to inform the development of targeted food safety interventions to aid patients/family caregivers to implement risk-reducing food safety practices.

Methods: A review of UK food-safety information, along with a consumer-orientated approach involving in-depth interviews, self-complete questionnaires and focus groups, allowed for the design, development and evaluation of a targeted food safety education strategy.

Results: A review of food-related information available to chemotherapy patients obtained from 42 of 141 NHS chemotherapy providers established many failed to highlight importance of food safety to prevent infection, considerable gaps exist and information varied between sources. In-depth interviews (n=15 patients/family-caregivers) determined food safety information during chemotherapy was considered to be inconsistent, insufficient and particularly sought after. Self-complete questionnaires (n=172 patients/family-caregivers) determined that despite increased awareness of the importance of food safety, malpractices were reported and perceived risks were underestimated, particularly among patients. During chemotherapy, information on ‘keeping active’/‘healthy eating’ were significantly (P<0.05) more likely to be received than on ‘food safety.’ Focus groups (n=23 patients/family caregivers) enabled design, development and evaluation of food safety education interventions. It was recognized that to enable a sense of ‘control’ for food safety, risk-reducing behaviors not only needed to be recommended, but why they are important needed to be addressed.

Significance: This research project has informed the design, development and evaluation of targeted food safety interventions using a data driven consumer-orientated approach. This, alongside input from food safety experts has resulted in tailored food safety resources that may help to increase implementation of risk-reducing food safety behaviors for patients undergoing chemotherapy treatment, and thus reduce risk of foodborne illness.