Evaluation of a Food Safety Education on Knowledge, Attitude and Practice among 1300 College Students of Henan Province, China
1Department of Social Medicine and Health Service Management, College of Public Health ZhengZhou University, Zhengzhou, PR China
2Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, PR China
3College of Public Health, Zhengzhou University, Zhengzhou, PR China
Food safety is not only the elementary guarantee of people's health but also the foundation of social stability and development of various undertakings. To investigate the knowledge, attitudes and practice of food safety among college students of Henan Province, China and to evaluate the effect of food safety education. We randomly selected 1,300 students by stratified and cluster random sampling methods, then conducted questionnaire survey on their knowledge, attitudes and practice on food safety. Among them, 258 students who had received four weeks' food safety knowledge education as a required course in the school considered as the intervention group were given the questionnaire after a one-month food safety education. Those 1271 valid questionnaires indicated that the mean and standard deviation of food safety knowledge scores is 62.6 ± 14.6. The average score of girls (63.8 ± 15.0) and medical students are higher than that of boys (60.3 ± 13.7) (P < 0.01) and non- medical students (56.0 ± 11.4) (P < 0.01). 95.2% of the students very concerned or concerned about food safety issues; 50.4% of the students thought to guarantee food safety through enforcing the law strictly. And 32.9% of the students do not use food additives; however, as encountering with unsafe food, only 0.39% of them chose to complain to the Consumers' Association. In short, college students paid close attention to food safety issues, but they are lacking of adequate consciousnesses of food safety and exercising of rights for self-preservations. It is very necessary and effective to carry out food hygiene education among college students to improve their knowledge level of food safety.
Keywords: food safety, knowledge, attitudes, practice, Evaluation
Journal of Food and Nutrition Research, 2014 2 (4),
Received March 28, 2014; Revised April 15, 2014; Accepted April 23, 2014Copyright © 2014 Science and Education Publishing. All Rights Reserved.
Cite this article:
- Sun, Jinfeng, et al. "Evaluation of a Food Safety Education on Knowledge, Attitude and Practice among 1300 College Students of Henan Province, China." Journal of Food and Nutrition Research 2.4 (2014): 136-140.
- Sun, J. , Bo, Y. , Shi, J. , Wang, P. , Zhang, J. , Shi, B. , SAPA, W. , & Lu, Q. (2014). Evaluation of a Food Safety Education on Knowledge, Attitude and Practice among 1300 College Students of Henan Province, China. Journal of Food and Nutrition Research, 2(4), 136-140.
- Sun, Jinfeng, Yacong Bo, Jianxiang Shi, Pengfei Wang, Jun Zhang, Baoqing Shi, WB SAPA, and Quanjun Lu. "Evaluation of a Food Safety Education on Knowledge, Attitude and Practice among 1300 College Students of Henan Province, China." Journal of Food and Nutrition Research 2, no. 4 (2014): 136-140.
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Food-borne illnesses affect millions of people each year , so food safety is not only the elementary guarantee of people's health but also the foundation of social stability and development of various undertakings. Along with the improved living standard, rational and healthy diet has gradually been appreciated. Besides, they are eager to have more dietary guidelines and food safety knowledge. College students are in the golden age of learning, good nutrition and health can enhance students’ educational performance and learning . So understanding college students’ food safety knowledge and analyzing the influence factors are helpful in reducing food-borne illness. What’s more, it is not only helpful to launching the corresponding health education, but also to spread knowledge of food safety, thereby to influence a broader population. Knowledge gain must precede behavior change, attitude, also a precondition for behavior change . An attitude, whether positive or negative, is learned through the environment and can be used to describe mental readiness to act and predict the likelihood that a person will be motivated to move to action . Therefore, in order to provide the basis for the research on food safety knowledge, attitude and practice of college students, we conducted a food safety knowledge, attitudes and practice (KAP) questionnaire among the college students in Henan Province and evaluated the effect of the intervention.
2. Objects and Methods2.1. Objects
From October 2011 to November 2011, by using Multi-stage stratified cluster sampling, the 44 faculties of Zhengzhou University were divided into four majors: science, engineering, arts and medicine; Four faculties were randomly selected from each major, a total of 16 faculties were selected; According to the proportion of the students from different levels, faculties and grades,1300 students were selected to participate in the food safety KAP investigation. In order to evaluate the effect of food safety education intervention, 258 students in Grade 2009 whose majors are oral medicine, iconography and laboratory medicine were viewed as the intervention group. They had received four weeks' food safety knowledge education as a required course in the school. Questionnaires were carried out after the education. Meanwhile, we considered the students in Grade 2009 from preventive medicine who did not received the related education as the control group, and gave them the same questionnaire.2.2. Questionnaire Design and Grading Standards
The questionnaire was self-administered based on the food safety KAP model, from the college text book of "Nutrition and Food Hygiene" textbook (People's Medical Publishing House, the Sixth Edition, China) and the related literatures [5, 6, 7, 8], combined with the characteristics of college students in our school. Before the main survey, a small pre-survey was carried out. Based on the pre-survey, the questionnaire was discussed and revised. The final version of the questionnaire included basic information of respondents (college, major, grade, date of birth, place of birth, gender, ethnicity and monthly living expenses, etc.), 20 food safety knowledge questions (5 points for each), 6 questions about attitudes, 10 practice questions. We have released 1300 questionnaires in the scene and 1271 valid anonymous ones were fed back.2.3. Statistical Treatment
All the data were input using Epidata3.1 and the quality of the data were controlled by the double entry verification method. After that the data were analyzed by using SPSS13.0 version statistical software. Statistical analysis was done using the mean and standard deviation (SD) to summarize each student's age and score on nutrition knowledge. Frequency and proportion were calculated to describe gender, grades, majors, degree levels and attitudes towards food safety. Measurements of association were carried by Chi-square test and t test as appropriate. The Chi-square test for relativity was also used to examine the correlation between respondents’ nutrition knowledge awareness and relevant behaviors. The right response for each question received a score of 1, with 0 for the wrong response. Logistic regression analysis was used to examine the correlations between gender, grade, education level, and major compared with food safety knowledge scores. In the Logistic regression analysis we concerned sex (male = 1, female = 2), Grade (Grade 2007 = 1, Grade 2008 = 2, Grade 2009=4, Grade 2011 = 5), academic level (postgraduate = 1, undergraduate = 2, junior college students= 3), major (non-medical students=1, medical students=2) as independent variables, and considering food safety knowledge score as the dependent variable (below the average score =0, above the average score =1).
3. Results3.1. General Condition
The average age of 1271 randomly investigation respondents was 21.1 ± 2.1 age, the youngest was 17 years old and the oldest was 39 years old; the monthly average cost of living was 562 ± 202 RMB, in which the minimum monthly living expenses was 100 RMB, and the highest monthly living expenses was 1800 RMB. The respondents covered different majors of liberal arts, science, medicine and engineering from different grades and different academic levels (postgraduate, undergraduate and junior college students) in Zhengzhou University; among them 443 were boys and 828 were girls.3.2. Knowledge
The mean and standard deviation of food safety knowledge scores is 62.6 ± 14.6. The mean food safety knowledge score of the females (63.8 ± 15.0) is significantly higher than that of males (60.3 ± 13.7), There is a statistical significance difference (P < 0.01, ANOVA). Besides the food safety knowledge scores differed among their major, their academic levels and batches (Table 1).
Multiple comparison of the scores of students from different batches showed that there was no significant difference between the scores of students from Grade 2007 and Grade 2009 and the scores of students from Grade 2008 and Grade 2011(P>0.01), and there were significant differences among all other grade students' scores (P<0.01, Table 2). And Person correlational analysis showed that there is no correlation between the university students' monthly living expenses and their food safety knowledge scores (P > 0.01).
Logistic regression analysis showed that there were correlations between gender, grade, education level, and major compared with food safety knowledge scores (Table 3).
The majority of respondents concerned or very concerned the issue of food safety (95.1%) and that it was very important or important to develop healthy dietary habits (94.2 %). When asked “What they think of the food safety situation in China”, most students thought that it was very poor (73.3 %), followed by good (25.1%) and very good (1.6%). There was statistically significant difference in respondents’ attitudes towards all the six questions (Table 4).
Regarding food consumption, 30.6% of the students chose to buy food from large supermarkets; 77.1% of the students have the experiences of buying unsafe food which has been proved to be potentially harmful to human health. From those having bought unsafe food, 54.5% of the students chose "to discard"; 4.17% of the students choose "to continue to eat"; and 18.2% of the students chose "to accept the bad luck"; the proportions of "to require the return of goods" and "to complain to the Consumers' Association" were respectively 22.6% and 0.39%. Concerning choosing food, the most attention seeking issues are the production date and shelf-life respectively (78.9%), the other sequent aspects including: price (9.6%), the brand and appearance (6.2%), the food color (2.9%) and the certification mark (2.2%). In order to avoid the intake of unsafe food, if possible, 78.1% of the students chose "to eat at home"; 19.0% of the students liked "to eat at school cooked" and 2.91% preferred "to eat outside the school and home". Concerning about the expired food, 94.3% of the students selected "to discard"; 3.07% of the students selected "to warm to eat" and 2.6% selected "to continue to eat". Concerning frequency used to eat outside home in the week mentioned, 14.3% of the students said "never";25.3% said "once a week";15.8% said "twice or 3 times a week";36.5% said "4 times a week", and 7.95% said "almost every day". When talking about "Whether do you often order takeout?", most of the students, about 84.7% selected "4 times a week",4.17% of the students selected "never";4.01% selected "once a week", 4.41% selected "twice or 3 times a week"; and 2.68% selected "almost every day". The other question of "Where do you often eat?",73.3% of the students liked to eat "the market near the school";5.9% preferred to eat at "the restaurants in the city", and 21.4% chose "the dinning room in the school". The reasons for using out of the home are: "to invite the guests" (49.1%),"to get better food" (30.9%),"when the canteen meals is off ' " (17.8% ) and “feasting families" (2.12%).3.6. Evaluation of the Effect of Food Safety Education Intervention
The results of the survey showed that food safety knowledge score of the intervention group was significantly higher than that of the control group (P < 0.01). Data were shown in Table 5.
With the average score of 2.60 ± 14.6, the food safety knowledge score of the students is not satisfying. In the question of "What’s your attitude towards the issue of food safety?" 39.6% of the students selected "very concerned"; 55.6% selected "concerned"; which indicates that although students have the desire to pay much attention to the food safety, the absence of systematic food safety education leading to cognitive deficits. Simultaneously, the survey showed that the girls' awareness of the issue was significantly higher than that of boys, which was not consistent with the report of Han  and Chen , but was consistent with the report of Ye  and Ma . The reason for that is probably because the respondents were medical students in which girls have higher proportion (34.1%).Medical students' food safety knowledge score was significantly higher than the students in other majors, which is consistent with other domestic reports [6, 7, 8, 9, 10, 12, 13]. Medical students gave more attention to the learning of nutrition and health knowledge because of their major. Besides, they have more opportunities to access to the knowledge of nutrition and food hygiene than other non-medical students, so they could obtain relatively higher scores.
There was no association between the students' monthly living expenses and food hygiene knowledge scores, which is not consistent with the report of Chen . The report showed that food safety knowledge is increasing with the level of consumption. There were significant differences between the food safety knowledge scores of students from different academic levels, and the questionnaire showed that postgraduates scored higher than undergraduates; undergraduates scored higher than junior college students. This is the comparison of the scores of the undergraduates from different grades: students in Grade 2009 scored (69.7 ± 14.7)>Grade 2010 (62.8 ± 13.1) >Grade 2011 (56.2 ± 10.9) (P < 0.01). The higher the academic levels and the grades are, the more opportunities they have to get food safety education knowledge directly or indirectly, and the more rational and right understanding of food safety issues they have. The students who received medical training related to nutrition and food hygiene scored higher than those who did not. The intervention study we designed also showing that intervention group had higher scores than the control group, and therefore, carrying out some long-term and orderly food safety educational activities in colleges is necessary and feasible.
Because of the frequent occurrence of food safety incidents, university students in China are apparently lack of confidence in food safety. In the survey, 73.3% of the students thought that it is very worrying about Chinese food safety situation, 50.4% thought that we can ensure food safety through the "strict enforcement of the law". But when it comes to unsafe food, only 0.39% of the students chose to complaint to the Consumers' Association. On possible reason might because that they did not want to make trouble for themselves, on the other hand it might because of their weak awareness of the law of food safety. 31.8% of the students think that we should ensure food safety through "improving the national food safety awareness". There were only 2.2% of the students paying attention to certification mark when purchasing food. It also further proved that it is necessary to carry out food safety education for university students.
Food additives are compounds or natural substances put into food in order to improve food color, smell, taste and other quality of food. They are also used for embaling and food processing. Rational use of food additives is good for enriching food production and improving human health. Though food additive itself is safe, if you use properly, or they are other toxic and harmful substances illegally using in food, it could lead to food safety problems. In the varieties of food safety issues, illegal use of food additives is the most worried 43.6% of the college students were about. When referring to the question of "Do you accept food additives?", 17.6% of the students selected "acceptable"; 49.4% selected "barely acceptable" and 32.9% selected "unacceptable", which showed that there were some confusions about food additives among college students. On one hand it was related to media and food production enterprises using "without food additives" as a selling point, on the other hand it also suggested that we should strengthen college students' food safety knowledge education.
When mentioned to students' purchasing and consumption behavior, 84.7% of the students often ordered takeout (4 times a week averagely).The proportion of students who often go out to eat is also very high. Although college students are very concerning about food safety issues, 73.3% of the students chose bazaars near the college to dinner for the reason of entertaining guests, and improving their diet level and other reasons. It also indicated that their self-protection awareness is insufficient. In order to avoid the intake of unsafe food, 78.1% of the students chose to eat at home, if it is possible. It suggested that the food service and the quality of food are expected to be intrinsically improved by the dietary guarantee department of the college to attract more students to eat at school and eliminating food safety hazards, especially in the medical college.
The findings of this study demonstrated that the food safety knowledge score of the students is low, medical students’ score was higher than that of non-medical students. It is important to strengthen the non-medical students’ food safety and health education to improve students' overall level of food safety knowledge for the universities. College students paid close attention to food safety issues, and more than half of the students thought that the food safety situation in China is serious, the government should strengthen the construction of the food safety, recovering the confidence in food safety. College students paid close attention to food safety issues, but they are lacking of adequate consciousnesses of food safety and exercising of rights for self-preservations. We recommend that universities carry out some long-term and orderly food safety education activities and some relevant campus cultural activities to improve students' food safety knowledge and develop good food habits of hygiene in their daily acknowledgment.
The authors wish to express their sincere thanks to: all volunteers and staff of the Department of Social Medicine and Health Service Management, College of Public Health ZhengZhou University, Zhengzhou, PR China; as well as staff of the Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, PR China, for their cooperation in carrying out this research, and to Mr. Kiyoshi Tanaka & Mr. Hee Young Paik for proofreading the manuscript.
Statement of Competing Interests
All authors have no conflicts of interest to declare.
|||Mead PS, Slutsker L, Dietz V, et al. Food-related illness and death in the United States. Emerg Infect Dis 1999; 5: 607-625.|
|||McKenna ML. Issues in implementing school nutrition policies. Can J Diet Pract Res 2003; 64: 208-213.|
|||Medeiros LC, Hillers VN, Chen G, et al. Design and development of food safety knowledge and attitude scales for consumer food safety education. J Am Diet Assoc 2004; 104: 1671-1677.|
|||Fishbein M. Readings in Attitude Theory and Measurement. New York [etc.] : Wiley 1967: 1-13.|
|||Zhang X, Wang Q, Luo T, Zhang Q. Analysis of universities' food safety situation in Guangdong Province. CHINESE JOURNAL OF SCHOOL HEALTH 2005; 26: 1061.|
|||Ye W, Gao Y, Yin Z, Lin J. Investigation on Knowledge, Attitude and Practice About Nutrition and Food Safety Among University Students in Guangzhou. CHINESE JOURNAL OF SCHOOL HEALTH 2006; 27: 847-848.|
|||Sun C, Xie R, Li Y. The investigation of college students' food safety KAP. JOURNAL OF JINING MEDICAL COLLEGE 2007; 30: 73-74.|
|||Liu X, Ma S, Lin H, Huang C, Hu M. Investigation and analysis on food safety situation among university students in Changsha. SCIENCE AND TECHNOLOGY INNOVATION HERALD 2010: 245-246, 248.|
|||Han D. Investigation on knowledge, attitude, practice about food safety among university students. CHINA FOREIGN MEDICAL TREATMENT 2012; 31: 129, 177.|
|||Chen Y, Yao Y, Huang Y, Chen B. RISK FACTORS OF AWARENESS, PRACTICE AND ATTITUDE OF FOOD SAFETY IN COLLEGE STUDENTS. MODERN PREVENTIVE MEDICINE 2011; 38: 238-239.|
|||Ma S, Liu X, Huang C, Hu M. Investigation and analysis on the effectors of food safety among university students. Journal of Hygiene Research 2012; 41: 297-299.|
|||Yang S, Ran Z, Li-sh Z. SURVEY ON THE KNOWLEDGE, ALTITUDE AND PRACTICE ABOUT NUTRITION ANDFOOD SAFETY AMONG COLLEGE STUDENTS IN CHENGDU. Modern Preventive Medicine 2012;39:302-303, 306|
|||Yin J, Ran X, Wang Q, Wu S, Jiang S. Survey on Food Safety Knowledge, Attitude and Practice of 852 College Students in Kunming. PRACTICAL PREVENTIVE MEDICINE 2010; 17: 699-701.|