Purpose: This study was undertaken to develop and validate a comprehensive index (considering knowledge, practices, and enabling assets) to assess the food safety status at the household level in India.
Methods: A cross-sectional study was conducted among primary home food preparers (n=400) in rural and urban (200 each) areas of Telangana, India. A 87 item comprehensive index questionnaire which covered knowledge, practices, and enabling-environment was developed and administered. Demographic profiles, food safety risk perceptions, and incidence of food/waterborne diseases were, also, collected. Weightages were assigned for responses. The maximum possible score combining knowledge, practices, and enabling-environment scores was 205. In addition, stored cooked food samples (100 samples of 100g each) of rice, lentils, vegetarian and non-vegetarian foods, drinking water (250 ml), and hand rinses from subjects were collected for microbiological analysis (USDA-BAM).
Results: The mean score of the comprehensive index was 124.9. Index scores were significantly associated with the presence of fecal coliforms, Salmonella spp. and Bacillus cereusin food samples and hygiene indicator organisms in drinking water. Eleven out of 87 index parameters were significantly associated (P<0.05) with pathogen risk contamination levels in foods. The optimal cut-off value for the pooled, 11 item food safety index (FSI) score was ~ 9 and found to have a sensitivity (77%), specificity (74%) and AUC (-0.808), which are acceptable.
Significance: Validated index is a simple and useful way to evaluate the food safety status at the household level and can be used for designing targeted food safety promotion measures.