Cultivating Healthier Habits: The Impact of Workplace Teaching Kitchens on Employee Food Literacy.

This research explores the impact of workplace teaching kitchen cooking classes on participants' food literacy and identifies key predictors of employee engagement. Aligning with the existing literature, we demonstrate that a workplace teaching kitchen program, with hands-on cooking classes, effectively enhances food skills and intrinsic motivation-core aspects of food literacy. Importantly, our results reveal that even a single class can have a measurable impact. Teaching kitchens can successfully engage employees, particularly those with low food skills, showcasing their broad appeal beyond individuals already engaged in wellness or seeking social connection. Awareness emerges as the most influential predictor of participation, emphasizing the crucial role of marketing. Virtual classes prove as effective as onsite ones, offering the potential to increase access for employees. Recognizing employee wellness as a strategic opportunity for employers and a sought-after benefit for top talent, we underscore the importance of practical nutrition education to support individuals in shifting food choices within lifestyle constraints. Workplace teaching kitchens emerge as an effective and scalable solution to address this need. Future research should prioritize exploring the lasting impacts of teaching kitchen education on employee eating habits and health, contributing to ongoing strategy refinement.

University Students as Change Agents for Health and Sustainability: A Pilot Study on the Effects of a Teaching Kitchen-Based Planetary Health Diet Curriculum.

Global dietary habits are one of the main drivers of climate change. At the same time, they contribute to 11 million premature deaths every year. This raises the question of how the urgently needed transformation of food systems can be realized. Regardless of their degree paths, all university students, in their role as potential future experts and leaders in their fields, can serve as important change agents in society. In this paper, we (a) introduce a university curriculum in a teaching kitchen setting that is based on the planetary health diet (PHD) of the EAT-Lancet Commission, (b) investigate its feasibility, and (c) analyze its effects on the planetary health diet literacy of a pilot cohort of university students enrolled in various degree programs. We developed seven flipped classroom teaching kitchen sessions based on social cognitive theory (SCT), each consisting of a one-hour seminar with student presentations on various nutrition- and sustainability-related key topics, followed by corresponding two-hour hands-on cooking classes. To assess feasibility, specific questions from the official teaching evaluation of the University of Göttingen were analyzed. Changes in self-assessed planetary health diet literacy were measured using a pre- and post-survey. During the pilot phase, 26 students successfully completed the course. A total of 25 participants responded to the teaching evaluation and expressed high satisfaction with the course, the learning outcomes, and the level of demand. A total of 26 participants completed the pre- and post-survey. At the post-intervention, the students rated their planetary health diet literacy as 21 to 98% higher than before their course participation. The findings of this pilot study indicate that the curriculum was well-received and feasible with the target group, and they demonstrate that the course participation increased the university students' self-assessed ability to disseminate strategies for more sustainable and healthy diets. Through replication at other universities worldwide, the teaching kitchen-based planetary health diet curriculum might foster a social shift towards healthier and more climate-friendly food systems.

Changes in Anxiety following Taste Education Intervention: Fussy Eating Children with and without Neurodevelopmental Disorders.

Despite the surge in studies on fussy eating in recent years, anxiety as an associated factor is generally not considered, even though children with fussy eating and those with neurodevelopmental disorders, including Autism Spectrum Disorder or Attention Deficit/Hyperactivity Disorder (ADHD) often have higher levels of anxiety than typically developing children. The current study investigated changes in anxiety scores during a Taste Education intervention, a seven-week school-based intervention for 71 children with fussy eating. Comparisons were made based on neurodevelopmental status (between children with (n = 30) and without (n = 41) neurodevelopmental disorders). Participants were paired based on age, sex, and neurodevelopmental disorder. The Multidimensional Anxiety Scale for Children (MASC) was administered at delayed intervention (for those waiting 7 weeks before starting the intervention), pre-intervention, post-intervention, and at six-month follow-up. Results did not indicate elevated anxiety based on mean MASC T-scores. MASC Total T-scores ranged from slightly elevated to average, decreasing significantly between pre-intervention and post-intervention, plateauing at six-month follow-up. Significant reductions between measurement points were seen for the physical symptoms, social anxiety, and separation anxiety subscales, but not for harm avoidance. Repeated measures analysis of variance with neurodevelopmental disorders as between-subjects factors did not reveal a significant interaction effect between neurodevelopmental disorders and changes in MASC Total score or subscales. The results indicated that our food-based intervention did not elevate MASC scores in fussy eating children, with or without neurodevelopmental disorders.

Cross-Sector Partnerships for Improved Cooking Skills, Dietary Behaviors, and Belonging: Findings from a Produce Prescription and Cooking Education Pilot Program at a Federally Qualified Health Center.

Participant engagement, psychosocial factors, and dietary behaviors are important components of "Food as Medicine" and cooking education programs. The purpose of this study is to describe a multidisciplinary cooking program at a Federally Qualified Health Center in central Texas. During biannual harvest seasons (2022-2023), patients participated in four or six weekly 1.5 h hands-on cooking classes with shared meals, education, and produce delivery. Pretest-posttest surveys assessed sociodemographic information, health, psychosocial factors, and dietary behaviors; follow-up assessed group cohesion/sense of community in classes. Survey data were described using means and proportions. Across four cohorts, participants (n = 33; mean age: 45 ± 16 years) were 30% Hispanic/Latino, 18% non-Hispanic Black, and 52% non-Hispanic White; on average, participants attended 66% of sessions. Increases in cooking self-efficacy (p < 0.001) and diet-related self-management strategies (p < 0.001) were observed for those with follow-up data (n = 16); further, 44% reported increased vegetable consumption. All participants (100%) reported feeling like a valued member of their cooking group and 94% reported high levels of belonging. In a diverse community health center serving low-income patients, provision of produce and cooking education classes supported strategies to improve diet-related confidence, skills, and behavior. Cross-sector partnership within a health care setting may help patients and physicians prioritize nutrition and food access.

Survivors Overcoming and Achieving Resiliency (SOAR): Mindful Eating Practice for Breast Cancer Survivors in a Virtual Teaching Kitchen.

The practice of mindful eating brings awareness to food choices, brings attention to the eating experience, and encourages selecting and preparing food that is both satisfying and nourishing. We examined mindful eating in breast cancer survivors following a 9-week, multidisciplinary virtual teaching kitchen intervention called Survivors Overcoming and Achieving Resiliency (SOAR). SOAR engaged participants through weekly cooking classes that also taught multiple domains of mindfulness. Participants (n = 102) were breast cancer survivors and completed the Mindful Eating Questionnaire (MEQ) prior to and after completion of the intervention. Linear regression analyses examined relationships between the aspects of mindful eating and body mass index (BMI). Wilcoxon (paired) rank sum tests evaluated the significance of the change in the MEQ total sum and subscales scores. A total of 102 participants completed both the pre- and post-intervention surveys. The mean change between the pre- and post-SOAR MEQ summary scores was 0.12 (sd = 0.30; Wilcoxon p-value = 0.0003). All MEQ subscale scores significantly increased with the exception of the distraction subscale. The MEQ summary scores increased for participants across both BMI stratifications. The SOAR teaching kitchen represents one of the first interventions that is tailored for breast cancer survivors and combines behavioral strategies from mindful eating training to nutritional knowledge and culinary medicine pedagogy in a virtual teaching kitchen. Further research is needed to examine whether mindful eating practices among cancer survivors result in sustainable healthy eating behaviors and food choices consistent with the cancer risk reduction guidelines.

Standard Patient History Can Be Augmented Using Ethnographic Foodlife Questions.

The relationship between what and how individuals eat and their overall and long-term health is non-controversial. However, for decades, food and nutrition discussions have often been highly medicalized. Given the significant impact of poor nutrition on health, broader discussions about food should be integrated into routine patient history taking. We advocate for an expansion of the current, standard approach to patient history taking in order to include questions regarding patients' 'foodlife' (total relationship to food) as a screening and baseline assessment tool for referrals. We propose that healthcare providers: (1) routinely engage with patients about their relationship to food, and (2) recognize that such dialogues extend beyond nutrition and lifestyle questions. Mirroring other recent revisions to medical history taking-such as exploring biopsychosocial risks-questions about food relationships and motivators of eating may be essential for optimal patient assessment and referrals. We draw on the novel tools of 'foodlife' ethnography (developed by co-author ethnographer J.J.L., and further refined in collaboration with the co-authors who contributed their clinical experiences as a former primary care physician (D.M.E.), registered dietitian (J.W.M.), and diabetologist (H.Z.)) to model a set of baseline questions for inclusion in routine clinical settings. Importantly, this broader cultural approach seeks to augment and enhance current food intake discussions used by registered dietitian nutritionists, endocrinologists, internists, and medical primary care providers for better baseline assessments and referrals. By bringing the significance of food into the domain of routine medical interviewing practices by a range of health professionals, we theorize that this approach can set a strong foundation of trust between patients and healthcare professionals, underscoring food's vital role in patient-centered care.

Characteristics of Current Teaching Kitchens: Findings from Recent Surveys of the Teaching Kitchen Collaborative.

Teaching kitchens are physical and virtual forums that foster practical life skills through participation in experiential education. Given the well-supported connection between healthy eating patterns and the prevention and management of chronic diseases, both private and public organizations are building teaching kitchens (TKs) to enhance the health and wellness of patients, staff, youth, and the general community. Although implementation of TKs is becoming more common, best practices for starting and operating programs are limited. The present study aims to describe key components and professionals required for TK operations. Surveys were administered to Teaching Kitchen Collaborative (TKC) members and questions reflected seven primary areas of inquiry: (1) TK setting(s), (2) audiences served, (3) TK model(s), (4) key lines of operations, (5) team member who manages or directs the TK, (6) team member(s) who performs key operations and other professionals or partnerships that may be needed, and (7) the primary funding source(s) to build and operate the TK (among various other topics). Findings were used to articulate recommendations for organizations seeking to establish a successful TK as well as for TKs to expand their collective reach, research capacity, and impact.

Enhancing Chronic-Disease Education through Integrated Medical and Social Care: Exploring the Beneficial Role of a Community Teaching Kitchen in Oregon.

Teaching kitchens (TKs) are rapidly being utilized as models to integrate culinary education and chronic-disease education into healthcare settings. Our observational study details the structure and organizational processes (e.g., referral, services, medical and social care integration) of the Community TK at Providence Milwaukie Hospital in Portland, OR. We utilize electronic medical-record data from engaged TK participants (n = 3077) to evaluate between the association of engagement and clinical outcomes (e.g., HbA1c, blood pressure, weight and cholesterol). Mean baseline HbA1c of Highly Engaged TK patients with diabetes (n = 88) reduced from 9.8% to 8.6% at 6 months (p < 0.0001) and sustained significant reductions at 12, 18, 24, 30, and 36 months (p < 0.05). Highly Engaged patients with hypertension (n = 152) had significant, sustained reductions in blood pressure (p < 0.0001). Engaged patients in the same high-risk groups also had significant improvements in HbA1c and blood pressure. Both engagement subgroups had moderate improvements in weight change and cholesterol. This study shows promising associations of TK services that promote chronic-disease self-management with improved clinical outcomes among higher risk patients (e.g., high blood pressure, high HbA1c, high low-density lipoprotein) with different medical issues (e.g., diabetes, obesity) and social barriers (e.g., food insecurity).

Food Is Medicine for Individuals Affected by Homelessness: Findings from a Participatory Soup Kitchen Menu Redesign.

Health disparities among people experiencing homelessness are likely exacerbated by limited access to healthy, fresh, and minimally processed foods. Soup kitchens and shelters serve as essential food safety nets for preventing hunger in this population, and community interest is growing in the potential of "food is medicine" interventions to improve the mental and physical wellbeing of people who receive meals from these providers. This study describes our two-phase approach to first identify and prioritize nutrition needs within an urban soup kitchen community and then test and implement new recipes and menu guidelines to help the standard soup kitchen menu better align with those priorities. We began by first conducting a nutrition needs assessment, including a collection of intercept surveys from a convenience sample of soup kitchen guests to better understand their nutrition-related health needs, dental issues, food preferences, and menu satisfaction (n = 112), as well as a nutrition analysis of the standard menu based on seven randomly selected meals. Most respondents reported at least one chronic health condition, with depressive disorders (50.9%) and cardiovascular diseases (49.1%) being the most common. Nearly all guests requested more fruits and vegetables at mealtimes, and results from the menu analysis revealed opportunities to lower meal contents of sodium, saturated fat, and added sugars and to raise micronutrient, fiber, and omega-3 content. We then applied these nutrition needs assessment findings to inform the second phase of the project. This phase included the identification of new food inventory items to help support cardiovascular and mental health-related nutrition needs, taste test sampling of new healthy menu items with soup kitchen guests, and hands-on culinary medicine training to kitchen staff on newly-developed "food is medicine" guidelines to support menu transformation. All taste tests of new menu items received over 75% approval, which exceeded satisfaction ratings of the standard menu collected during the phase 1 needs assessment. Findings from this community-based participatory research project confirm the great potential for hunger safety net providers to support critical nutrition needs within this vulnerable population through strategic menu changes. However, more research is needed on the longitudinal impacts of such changes on health indicators over time.

Beyond a neoliberal critique of hunger: a genealogy of food charity in Aotearoa New Zealand.

Since the 1980s, foodbanks have become a widespread solution to addressing hunger within high-income countries. The primary reason for their establishment has been widely recognised as neoliberal policies, particularly those that led to massive cuts in social welfare assistance. Foodbanks and hunger have subsequently been framed within a neoliberal critique. However, we argue that critiques of foodbanks are not unique to neoliberalism but have deeper historical roots, meaning that the part neoliberal policies have played is not as clear-cut. In order to understand the normalisation of foodbanks within society, and gain a more extensive understanding of hunger and appreciation as to how this issue could be addressed, it is therefore important to gain a historical understanding of food charity development. In this article, we achieve this by presenting a genealogy of food charity within Aotearoa New Zealand, which witnessed a fluctuation in the use of soup kitchens during the nineteenth and twentieth centuries, and a rise of foodbanks in the 1980s and '90 s. Highlighting the historical parallels and major economic and cultural shifts that have allowed for the institutionalisation of foodbanks, we explore the patterns, parallels and differences exposed, and how they yield an alternative understanding of hunger. Using this analysis, we then discuss the wider implications of the historical foundations of food charity and hunger to better understand the role neoliberalism has played in the entrenchment of foodbanks, and advocate the importance of looking beyond a neoliberal critique in order to entertain alternative solutions to addressing food insecurity.

Evaluation of dietary habits and cooking confidence using virtual teaching kitchens for perimenopausal women.

BACKGROUND: The transition to menopause is a time when women are at increased risk for chronic and cardiovascular diseases, and weight gain. This study evaluates the efficacy of virtual teaching kitchen (TK) interventions on cooking confidence and consumption of a healthy diet in women over 45. METHODS: This teaching kitchen intervention is a synchronous online series of classes for perimenopausal women, with 45 min of live cooking and 15 min of nutrition discussion. From September 2020 through January 2022, participants completed online pre- post-intervention surveys addressing weight, eating habits, cooking confidence and self-efficacy. Analysis used paired samples t-test and Wilcoxon signed rank sum test for normally and non-normal distributed data respectively. RESULTS: Of the 609 unique participants, 269 women completed both pre and post surveys after attending classes. Participants self-reported a statistically significant decreased weight (p < 0.001), increased daily consumption of fruit/vegetables (p < 0.039), fish (p < 0.001) and beans (p < 0.005), and decreased daily consumption of red meat (p < 0.001), sugary beverages (p < 0.029) and white grains (p < 0.039). There was significant improvement in cooking self-efficacy and confidence. CONCLUSIONS: Virtual teaching kitchens were effective in improving culinary and dietary habits among peri- and post-menopausal women. This early evidence suggests that teaching kitchens can effectively reach larger populations for healthy behavioral modification. TRIAL REGISTRATION: Study obtained IRB exemption.

Job burnout is associated with poorer hand-washing behaviors among restaurant kitchen chefs: evidence from Jiangsu Province, China.

Inadequate hand-washing among chefs is a major contributor to outbreaks of foodborne illnesses originating in restaurants. Previous studies have found that mental health influences hygiene behaviors among food handlers, who have a high rate of job burnout. However, it is still unclear whether job burnout leads to restaurant kitchen chefs' poor hand washing behaviors (HWBs). In this study, we interviewed 453 restaurant kitchen chefs in Jiangsu Province, China regarding job burnout and HWBs during the summer (July-August) of 2020. The aims were to investigate job burnout (an individual internal motivation factor), identify determinants of job burnout, and examine the association between job burnout and HWBs. Variance analysis, post hoc multiple comparisons, linear regression models, and structural equation modeling were used to analyze the response data. This study revealed that chef age and the scale of the restaurant were significantly and negatively associated with reduced professional efficacy. Combined cuisine and pastry chefs had a more positive perception of their own professional efficacy than the other kitchen chefs, whereas the incidence of exhaustion was significantly higher in pastry chefs than in cuisine chefs and kitchen hands. Reduced professional efficacy was significantly and negatively associated with HWBs for all chefs. To improve the level of hand hygiene among chefs, measures should be taken to enhance chefs' professional efficacy. Furthermore, close attention should be paid to chefs in small-scale restaurants, younger chefs, cuisine chefs, pastry chefs, and kitchen hands.

Food waste reduction and economic savings in times of crisis: The potential of machine learning methods to plan guest attendance in Swedish public catering during the Covid-19 pandemic.

Food waste is a significant problem within public catering establishments in any normal situation. During spring 2020 the Covid-19 pandemic placed the public catering system under greater pressure, revealing weaknesses within the system and generation of food waste due to rapidly changing consumption patterns. In times of crisis, it is especially important to conserve resources and allocate existing resources to areas where they can be of most use, but this poses significant challenges. This study evaluated the potential of a forecasting model to predict guest attendance during the start and throughout the pandemic. This was done by collecting data on guest attendance in Swedish school and preschool catering establishments before and during the pandemic, and using a machine learning approach to predict future guest attendance based on historical data. Comparison of various learning methods revealed that random forest produced more accurate forecasts than a simple artificial neural network, with conditional mean absolute prediction error of < 0.15 for the trained dataset. Economic savings were obtained by forecasting compared with a no-plan scenario, supporting selection of the random forest approach for effective forecasting of meal planning. Overall, the results obtained using forecasting models for meal planning in times of crisis confirmed their usefulness. Continuous use can improve estimates for the test period, due to the agile and flexible nature of these models. This is particularly important when guest attendance is unpredictable, so that production planning can be optimized to reduce food waste and contribute to a more sustainable and resilient food system.

Food Safety Issues Related to Eating In and Eating Out.

Because of growing urbanization and lack of time to prepare meals at home, eating out or getting food delivered have become common trends for many people. The consumption of food from unknown sources may impose an increased chance of contamination with microbiological hazards, especially if sanitary conditions are not met. We evaluated data from health surveillance agencies and scientific articles on foodborne diseases (FBD) reported internationally according to the exposure sites. We observed that the data are influenced by cultural, political, and socioeconomic differences. For instance, in New Zealand, Australia, United States, Denmark and India, the occurrence of FBD outbreaks was greater from foods prepared in commercial establishments and street vendors than from households. Conversely, in China, countries of the European Union and Brazil, the results are the opposite. Additionally, the pandemic imposed new eating behavior patterns, increasing delivery services and foods prepared in so-called "Dark Kitchens". The underreporting and heterogeneity of data among countries prevented a precise conclusion to the question of whether homemade foods are inherently safer than foods prepared out. Nevertheless, a lower level of development in a country influences its sanitation conditions, as well as the number of street food vendors, the search for cheaper foods, and insufficient knowledge of the population on good hygiene practices, which can all increase the chances of FBD cases.

Understanding the Online Environment for the Delivery of Food, Alcohol and Tobacco: An Exploratory Analysis of 'Dark Kitchens' and Rapid Grocery Delivery Services.

Online spaces are increasingly important in the sale of food, alcohol and tobacco. This analysis focuses on two developments in online food delivery: delivery-only 'dark kitchens' and rapid grocery delivery services (RGDS), with the aim to understand and assess the availability of health harming and health promoting products through these services. Data was collected for one metropolitan local authority in London, UK, using publicly available online sources. Being explorative in nature, the analysis includes descriptive statistics and qualitative assessment. Three dark kitchens (renting kitchens to 116 food businesses), three grocery delivery apps, and 76 grocery businesses available through online delivery platforms were identified. Most businesses renting dark kitchen space were 'virtual restaurants' (52%) selling fast food (47%) or dessert (21%) through online delivery platforms. RGDS sold a variety of items, with a focus on pre-packaged foods high in fat, salt and sugar, alcoholic beverages and tobacco. These items were also most likely to be promoted through offers and promotional language. Fruits and vegetables were less commonly available and mainly on grocery delivery apps. Online delivery services increase the temporal and geographic availability and promotion of many unhealthy products. Research expanding on the geographic area of interest is needed.

Public infrastructure for food and nutrition security in brazil: fufilling the constitutional commitment to the human right to adequate food.

Food insecurity is a critical global problem with social and public health consequences. In Brazil, access to adequate food is a fundamental human right guaranteed under the country's Constitution since 2010. As such, the State assumes the distinct and complementary obligations to respect, protect, promote and provide the Right to Adequate Food. The aim of this study is to present actions related to the "provision" dimension that have been developed as part of a network of public infrastructure strategies for food and nutrition security in Brazil. Through an exploratory, analytical literature review, the paper focuses on the operational designs and logistics of three main strategies: Food Banks, Community Kitchens, and Popular Restaurants. The Brazilian experience indicates that public actions are necessary, especially considering the urgency for those groups living with hunger and poverty. While similar programs can be found in other countries in South and North America, they are mostly offered by civil society organizations, and have not advanced toward public institutionalization. In fact, private programs are criticized for negating governments' obligation and responsibility in this area. Brazil's experience sheds light on public initiatives in meeting the State's obligations towards the Right to Adequate Food. Supplementary Information: The online version contains supplementary material available at 10.1007/s12571-022-01272-1.

An appraisal of air quality, thermal comfort, acoustic, and health risk of household kitchens in a developing country.

Few studies have documented the air quality, noise, thermal comfort, and health risk assessment of household kitchens related to Sub-Sahara Africa. In this paper, air quality (CO and PM2.5), thermal comfort (relative humidity (RH) and temperature), noise, and health risk in urban household kitchens with kerosene-fueled stoves were presented. This study was carried out during the dry season (summer) in the Southwestern part of Nigeria. At the breathing zone, PM2.5 and CO concentrations in the assessed kitchens were measured. In addition, the noise level, RH, and air temperature in the assessed kitchens were also determined. Furthermore, an evaluation of the heat index and health risk of the exposed population to the kerosene-fueled stove kitchens was carried out. During cooking, average CO and PM2.5 concentrations were 24.77 ± 1.05 ppm and 138.10 ± 2.61 µg/m3, respectively, while the RH was 68.34 ± 0.73%, noise level was 51.14 ± 1.08 dB, and temperature was 29.86 ± 0.23 °C. The CO and noise levels were relatively slightly lower and PM2.5 was significantly higher than the thresholds recommended by World Health Organisation. In most of the kitchens, the heat index evaluation revealed the possibility of heat exhaustion, heat cramps, and sunstroke with prolonged exposure of the vulnerable group. The air quality index depicted unhealthy (CO exposure) and very unhealthy (PM2.5 exposure) while the hazard quotient (> 1) implied possible health risk concerning exposure by inhalation. Better design of kitchen with adequate ventilation and improved stoves are suggested.

Particulate matter exposure in biomass-burning homes of different communities of Brahmaputra Valley.

Biomass burning for cooking prevalent in the developing countries is an issue which has been a concern for the past several decades for the noxious emissions and subsequent effects on the health of women and children due to the exposure of particulate matter (PM) and other gases. In this study, PM (PM1, PM2.5, and PM10) were measured in biomass-burning households for different communities of Brahmaputra Valley region northeast India by a 31-channel aerosol spectrometer. The levels of emission of PM in the case of different community households were found to be significantly different. Also, the emission characteristics of different cooking time of the day were found to be different across communities. The emission levels in the biomass-burning households were compared with emission in household using "clean" LPG fuel, and it was found that the biomass fuels emitted 10-12 times more PM2.5 and 6-7 times more PM10. The number densities of the emission were found to be more with smaller sizes of particulates which could explain why such biomass-burning emissions can pose with greater health risks. The exposure doses were calculated and were found to be about three times higher in biomass-burning houses than "clean" LPG fuel. It is important to note that the exposure from biomass burning while cooking has a gender perspective. The woman of the house generally takes care of the activities in the kitchen and get exposed to the noxious PM and the gases. Children often accompany their mothers and face the same fate.

Hand Hygiene Knowledge and Self-Reported Hand Washing Behaviors among Restaurant Kitchen Chefs in Jiangsu Province, China.

Inadequate hand washing among chefs is a major contributor to outbreaks of foodborne illnesses originating in restaurants. Although many studies have evaluated hand hygiene knowledge (HHK) and self-reported hand washing behaviors (HWBs) in restaurant workers in different countries, little is known about HHK and HWBs in restaurant kitchen chefs, particularly in China. In this study, we interviewed 453 restaurant kitchen chefs in Jiangsu Province in China regarding their HHK and HWBs and used Chi-square tests (Fisher exact tests), pairwise comparisons, and linear regression models to analyze the responses and identify determinants of HHK and HWBs. Results reveal that less frequent hand washing after leaving work temporarily and after touching used cutlery were the main issues among restaurant kitchen chefs in Jiangsu Province. Kitchen hands had lower levels of HHK and engaged less frequently in good HWBs than the other type of chefs. Furthermore, working in a large restaurant and having worked in the restaurant industry for a longer amount of time were correlated with better HHK and HWBs. These findings suggest that close attention should be paid to the HWBs of chefs during food preparation, that kitchen hands are the key group of restaurant kitchen workers who need training in HHK, and that regulatory activities should focus on small-scale restaurants.

Food Safety and Sanitation Implementation Impasse on Adolescents in Kenyan High Schools.

The ability to combat food-borne illnesses in food facilities and institutional catering units require sufficient knowledge on food safety and sanitation standards by food producers and consumers. The aim of the study was to investigate the food safety and sanitation knowledge of food handlers in Kenyan high schools. A cross-sectional study was carried out among 204 food handlers in 50 schools. Questions about knowledge and practice toward food safety and sanitation were asked. Respondents were the most knowledgeable on food contamination (93%), while participants were the least knowledgeable on the importance of protective attire when distributing foods to learners (50%). One-way ANOVA revealed a significant difference between gender and food handlers' behavior and practice (F = 19.886, ρ = 0.00 < 0.05) as well as between job tenure and practice of food safety and sanitation (F = 17.874, ρ = 0.00 < 0.05). Multiple regression analysis established that knowledge contributed to 44.1% of the behavior and practice of the food handlers. It is concluded that food handlers have a fair knowledge despite lack of training, motivation, and facilities to maintain quality standards. It is recommended that the Kenyan Government develop and implement guidelines through school feeding policy that would ensure that food safety and sanitation practices are implemented and utilized by Kenyan high schools.