The DOI matches its Crossref record; 77 of the 78 references it cites were found in a registry or an index.
Meta-Analysis of Food Safety Training on Hand Hygiene Knowledge and Attitudes among Food Handlers
Open accessAbstract
Research has shown that traditional food safety training programs and strategies to promote hand hygiene increases knowledge of the subject. However, very few studies have been conducted to evaluate the impact of food safety training on food handlers' attitudes about good hand hygiene practices. The objective of this meta-analytical study was to assess the extent to which food safety training or intervention strategies increased knowledge of and attitudes about hand hygiene. A systematic review of food safety training articles was conducted. Additional studies were identified from abstracts from food safety conferences and food science education conferences. Search terms included combinations of "food safety," "food hygiene," "training," "education," "hand washing," "hand hygiene," "knowledge," "attitudes," "practices," "behavior," and "food handlers." Only before- and after-training approaches and cohort studies with training (intervention group) and without training (control group) in hand hygiene knowledge and including attitudes in food handlers were evaluated. All pooled analyses were based on a random effects model. Meta-analysis values for nine food safety training and intervention studies on hand hygiene knowledge among food handlers were significantly higher than those of the control (without training), with an effect size (Hedges' g) of 1.284 (95% confidence interval [CI] ∼ 0.830 to 1.738). Meta-analysis of five food safety training and intervention studies in which hand hygiene attitudes and self-reported practices were monitored produced a summary effect size of 0.683 (95% CI ∼ 0.523 to 0.843). Food safety training increased knowledge and improved attitudes about hand hygiene practices. Refresher training and long-term reinforcement of good food handling behaviors may also be beneficial for sustaining good hand washing practices.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source doesn’t support the claim as written.
In the citing paper
“Considering the summarized effect size, a SMD = 0.28 suggests a moderate effect for the positive attitude of food handlers; this is similar to previous studies [57,58,66].”
From A Systematic Review and Meta-Analysis of the Effects of Food Safety and Hygiene Training on Food Handlers (2020) · cites this paper as [58]
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“However, the only meta-analysis of interventions to train food handlers, found trained handlers had around 30% improvement in knowledge over controls (n = 9 studies) and 70% improvement in practices, but this was based on self-reported practices, which are prone to exaggeration [106].”
From Food Safety in Low and Middle Income Countries (2015) · cites this paper as [106]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“This result is consistent with previous studies [58,107], and a significant amount of information is available, so it is probably easier to measure knowledge than attitude or practice.”
From A Systematic Review and Meta-Analysis of the Effects of Food Safety and Hygiene Training on Food Handlers (2020) · cites this paper as [58]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Despite the effort made [57,58], further evidence of the effects of training interventions on the knowledge, attitudes and practices toward food safety and hygiene of food handlers from different processes along the food supply chain is needed.”
From A Systematic Review and Meta-Analysis of the Effects of Food Safety and Hygiene Training on Food Handlers (2020) · cites this paper as [58]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Measuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000100 · Cited by 28,164
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2009.06.006 · Cited by 10,578
Borenstein, M., Hedges, L. V., Higgins, J. P. T., & Rothstein, H. R. (2021) · doi:10.1002/9781119558378 · Cited by 9,799
Primary, Secondary, and Meta-Analysis of Research
GLASS, G. V. (1976) · Educational Researcher · doi:10.3102/0013189x005010003 · Cited by 4,890 · cited 1×
“The term ‘‘metaanalysis’’ was coined in 1976 in the social science literature (28).”
BackgroundThe Handbook of Research Synthesis and Meta-Analysis
(2019) · doi:10.7758/9781610448864 · Cited by 4,553
Systematic Reviews in Health Care : Meta-Analysis in Context
Egger, M., Smith, G. D., & Altman, D. G. (2000) · Cited by 2,312
Publication and related bias in meta-analysis
Sterne, J. A. C., Gavaghan, D., & Egger, M. (2000) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(00)00242-0 · Cited by 2,282
Deeks, J. J., Altman, D. G., & Bradburn, M. J. (2001) · Systematic Reviews in Health Care · doi:10.1002/9780470693926.ch15 · Cited by 2,163
Systematic Reviews in Health Care: Meta‐Analysis in Context
(2001) · doi:10.1002/9780470693926 · Cited by 1,693
Fewtrell, L., Kaufmann, R. B., Kay, D., Enanoria, W. T. A., Haller, L., & Colford, J. M. (2004) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(04)01253-8 · Cited by 1,690
THEORY AT A GLANCE: A GUIDE FOR HEALTH PROMOTION PRACTICE
Croyle, R. T. (2005) · Cited by 1,396
Review papers : The statistical basis of meta-analysis
Fleiss, J. (1993) · Statistical Methods in Medical Research · doi:10.1177/096228029300200202 · Cited by 1,286
Effect of washing hands with soap on diarrhoea risk in the community: a systematic review
Curtis, V., & Cairncross, S. (2003) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(03)00606-6 · Cited by 1,208
Meta‐Analysis Of Controlled Clinical Trials
Whitehead, A. (2002) · doi:10.1002/0470854200 · Cited by 827
Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis
Aiello, A. E., Coulborn, R. M., Perez, V., & Larson, E. L. (2008) · American Journal of Public Health · doi:10.2105/ajph.2007.124610 · Cited by 796 · cited 1×
“Meta-analyses of the effects of hand hygiene on infectious diseases have revealed that hygiene education reduced the risks of diarrheal illness (2, 17, 24) and respiratory infections (2, 54).”
Background(2009) · Cited by 670
Summing up evidence: one answer is not always enough
Lau, J., Ioannidis, J. P. A., & Schmid, C. H. (1998) · The Lancet · doi:10.1016/s0140-6736(97)08468-7 · Cited by 655
Handwashing and risk of respiratory infections: a quantitative systematic review
Rabie, T., & Curtis, V. (2006) · Tropical Medicine & International Health · doi:10.1111/j.1365-3156.2006.01568.x · Cited by 556
Social Desirability Response Effects: Three Alternative Models
Ganster, D. C., Hennessey, H. W., & Luthans, F. (1983) · Academy of Management Journal · doi:10.2307/255979 · Cited by 506
Understanding adherence to hand hygiene recommendations: The theory of planned behavior
O’Boyle, C., Henly, S. J., & Larson, E. (2001) · American Journal of Infection Control · doi:10.1067/mic.2001.18405 · Cited by 463
An Introduction to Meta–Analysis
Konstantopoulos, S. (2008) · Sage eBooks · doi:10.4135/9781412995627.d15 · Cited by 434
Food handlers' beliefs and self-reported practices
Clayton, D. A., Griffith, C. J., Price, P., & Peters, A. C. (2002) · International Journal of Environmental Health Research · doi:10.1080/09603120120110031 · Cited by 399
A review of food safety and food hygiene training studies in the commercial sector
Egan, B., Raats, M. M., Grubb, S. M., Eves, A., Lumbers, M., Dean, M., & Adams, M. R. (2006) · Food Control · doi:10.1016/j.foodcont.2006.08.001 · Cited by 322
Luby, S. P., Agboatwalla, M., Painter, J., Altaf, A., Billhimer, W. L., & Hoekstra, R. M. (2004) · JAMA · doi:10.1001/jama.291.21.2547 · Cited by 309 · cited 1×
“Some studies were excluded because they were focused on quantification of pathogenic bacteria before and after intervention (60) or reduction of the number of diarrheal cases (40) or not enough information was provided and we were unable to contact the author(s) (4, 19, 61).”
BackgroundPatil, S. R., Cates, S. C., & Morales, R. A. (2005) · Journal of Food Protection · doi:10.4315/0362-028x-68.9.1884 · Cited by 256
Todd, E. C. D., Greig, J. D., Bartleson, C. A., & Michaels, B. (2007) · Journal of Food Protection · doi:10.4315/0362-028x-70.9.2199 · Cited by 246
Systematic reviews in health care a practical guide
Glasziou, P. (2001) · Cited by 227
Evaluation of the food safety training for food handlers in restaurant operations
Park, S.-H., Kwak, T.-K., & Chang, H.-J. (2010) · Nutrition Research and Practice · doi:10.4162/nrp.2010.4.1.58 · Cited by 168
Food safety training and foodservice employees' knowledge and behavior.
Roberts, K. R., Barrett, B. B., Howells, A. D., Shanklin, C. W., Pilling, V. K., & Brannon, L. A. (2008) · K-State Research Exchange (Kansas State University) · Cited by 159
Medeiros, C. O., Cavalli, S. B., Salay, E., & Proença, R. P. D. C. (2011) · Food Control · doi:10.1016/j.foodcont.2011.02.008 · Cited by 158
Chapman, B., Eversley, T., Fillion, K., Tanya, M., & Powell, D. (2010) · Journal of Food Protection · doi:10.4315/0362-028x-73.6.1101 · Cited by 140
The management of food safety—the role of food hygiene training in the UK service sector
Seaman, P., & Eves, A. (2005) · International Journal of Hospitality Management · doi:10.1016/j.ijhm.2005.04.004 · Cited by 136
Self-citationEvaluation of a food hygiene training course in Scotland
Ehiri, J. E., Morris, G. P., & McEwen, J. (1997) · Food Control · doi:10.1016/s0956-7135(97)00005-4 · Cited by 125
Food service workers’ self-reported food preparation practices: an EHS-Net study
Green, L., Selman, C. A., Banerjee, A., Marcus, R., Medus, C., Angulo, F. J., Radke, V., & Buchanan, S. D. (2005) · International Journal of Hygiene and Environmental Health · doi:10.1016/j.ijheh.2005.01.005 · Cited by 116
An illustrated guide to the methods of meta‐analysis
Sutton, A. J., Abrams, K. R., & Jones, D. R. (2001) · Journal of Evaluation in Clinical Practice · doi:10.1046/j.1365-2753.2001.00281.x · Cited by 106
Food safety training and evaluation of handwashing intention among fresh produce farm workers
Soon, J. M., & Baines, R. N. (2012) · Food Control · doi:10.1016/j.foodcont.2011.08.012 · Cited by 99
Self-citationMeta-analysis: Methods, strengths, weaknesses, and political uses
Noble, J. H. (2006) · Journal of Laboratory and Clinical Medicine · doi:10.1016/j.lab.2005.08.006 · Cited by 94
Hand Washing Compliance among Retail Food Establishment Workers in Minnesota
Allwood, P. B., Jenkins, T., Paulus, C. J., Johnson, L., & Hedberg, C. W. (2004) · Journal of Food Protection · doi:10.4315/0362-028x-67.12.2825 · Cited by 94
The hygiene training of food handlers at a teaching hospital
Acikel, C. H., Ogur, R., Yaren, H., Gocgeldi, E., Ucar, M., & Kir, T. (2008) · Food Control · doi:10.1016/j.foodcont.2007.03.008 · Cited by 89
Effectiveness of Public Health Interventions in Food Safety: A Systematic Review
Campbell, M. E., Gardner, C. E., Dwyer, J. J. M., Isaacs, S., Krueger, P. D., & Ying, J. (1998) · Canadian Journal of Public Health · doi:10.1007/bf03404474 · Cited by 88
Pilling, V. K., Brannon, L. A., Shanklin, C. W., Howells, A. D., & Roberts, K. R. (2008) · Journal of the American Dietetic Association · doi:10.1016/j.jada.2008.03.014 · Cited by 88
Nieto-Montenegro, S., Brown, J. L., & LaBorde, L. F. (2008) · Food Control · doi:10.1016/j.foodcont.2007.07.005 · Cited by 87
Shojaei, H., Shooshtaripoor, J., & Amiri, M. (2005) · Food Research International · doi:10.1016/j.foodres.2005.10.007 · Cited by 85
Food Safety in Catering Establishments
Griffith, C. J. (2000) · CRC Press eBooks · doi:10.1201/9781482270228-15 · Cited by 83
Donkor, E. S., Kayang, B. B., Quaye, J., & Akyeh, M. L. (2009) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph6112833 · Cited by 82
Choudhury, M., Mahanta, L. B., Goswami, J. S., & Mazumder, M. D. (2011) · Food Control · doi:10.1016/j.foodcont.2011.01.023 · Cited by 75
Introduction: Rationale, Potentials, and Promise of Systematic Reviews
Egger, M., Smith, G. D., & O’Rourke, K. (2001) · Wiley eBooks · doi:10.1002/9780470693926.ch1 · Cited by 74
Evaluation of Food Hygiene Education
Rennie, D. M. (1994) · British Food Journal · doi:10.1108/00070709410074650 · Cited by 73
Factors influencing the prevalence of Salmonella spp. in swine farms: A meta-analysis approach
Sánchez, J., Dohoo, I. R., Christensen, J., & Rajić, A. (2007) · Preventive Veterinary Medicine · doi:10.1016/j.prevetmed.2007.04.005 · Cited by 63
Intervention improves restaurant employees' food safety compliance rates
York, V. K., Brannon, L. A., Shanklin, C. W., Roberts, K. R., Barrett, B. B., & Howells, A. D. (2009) · International Journal of Contemporary Hospitality Management · doi:10.1108/09596110910955703 · Cited by 60
A survey of food hygiene and safety training in the retail and catering industry
Worsfold, D., & Griffith, C. J. (2003) · Nutrition & Food Science · doi:10.1108/00346650310466655 · Cited by 58
Human Salmonellosis: Estimation of Dose‐Illness from Outbreak Data
Bollaerts, K., Aerts, M., Faes, C., Grijspeerdt, K., Dewulf, J., & Mintiens, K. (2008) · Risk Analysis · doi:10.1111/j.1539-6924.2008.01038.x · Cited by 56
(2005) · PubMed · Cited by 51
Patil, S. R., Morales, R. A., Cates, S. C., Anderson, D., & Kendall, D. L. (2004) · Journal of Food Protection · doi:10.4315/0362-028x-67.11.2587 · Cited by 47
(2000) · CRC Press eBooks · doi:10.1201/9781482270228 · Cited by 46
Malhotra, R., Lal, P., Prakash, S., Mk, D., & Kishore, J. (2008) · Asia Pacific Journal of Public Health · doi:10.1177/1010539508322242 · Cited by 45
Food hygiene on merchant ships: the importance of food handlers' training
Capunzo, M., Cavallo, P., Boccia, G., Brunetti, L., Buonomo, R., & Mazza, G. (2004) · Food Control · doi:10.1016/j.foodcont.2004.01.010 · Cited by 39
Gonzales‐Barron, U. A., Soumpasis, I., Butler, F., Prendergast, D. M., Duggan, S. J., & Duffy, G. (2009) · Journal of Food Protection · doi:10.4315/0362-028x-72.2.274 · Cited by 36
Totton, S. C., Farrar, A. M., Wilkins, W. L., Bucher, O., Waddell, L. A., Wilhelm, B. J., McEwen, S. A., & Rajić, A. (2011) · Food Research International · doi:10.1016/j.foodres.2011.09.005 · Cited by 35
COSTELLO, C., Gaddis, T., Tamplin, M. L., & MORRIS, W. (1997) · Foodservice Research International · doi:10.1111/j.1745-4506.1997.tb00230.x · Cited by 30
Statistical Considerations in Meta-analysis
Barza, M. J., Trikalinos, T. A., & Lau, J. (2009) · Infectious Disease Clinics of North America · doi:10.1016/j.idc.2009.01.003 · Cited by 29
Vialette, M., Pinon, A., Leporq, B., Dervin, C., & Membré, J. (2005) · Risk Analysis · doi:10.1111/j.0272-4332.2005.00568.x · Cited by 26
A Meta-Analysis Study of the Effect of Chilling on Prevalence of Salmonella on Pig Carcasses
Gonzales‐Barron, U. A., Bergin, D., & Butler, F. (2008) · Journal of Food Protection · doi:10.4315/0362-028x-71.7.1330 · Cited by 25
Martin, K. E., Knabel, S., & Mendenhall, V. T. (1999) · Journal of Extension · doi:10.66752/1077-5315.7880 · Cited by 24
Fenton, G. D., LaBorde, L. F., Radhakrishna, R. B., Brown, J. L., & Cutter, C. N. (2006) · Journal of Food Science Education · doi:10.1111/j.1541-4329.2006.00001.x · Cited by 20
Nieto-Montenegro, S., Brown, J., & LaBorde, L. F. (2005) · Food Control · doi:10.1016/j.foodcont.2005.04.017 · Cited by 19
Fillion, K., KuKanich, K. S., Chapman, B., Hardigree, M. K., & Powell, D. (2011) · American Journal of Infection Control · doi:10.1016/j.ajic.2010.09.016 · Cited by 16
Anding, J. D., Boleman, C. T., & Thompson, B. M. (2007) · Journal of Food Science Education · doi:10.1111/j.1541-4329.2007.00036.x · Cited by 15
Leibovici, L., & Falagas, M. E. (2009) · Infectious Disease Clinics of North America · doi:10.1016/j.idc.2009.01.002 · Cited by 14
AN EVALUATION OF FOOD SAFETY TRAINING USING VIDEOTAPED INSTRUCTION
Smith, K. L., & SHILLAM, P. (2000) · Foodservice Research International · doi:10.1111/j.1745-4506.2000.tb00003.x · Cited by 14
de Vergara, P. V. G., Revuelta, C. C., & Majem, L. S. (2000) · PubMed · Cited by 9
Systematic Reviews in Health Care: A Practical Guide
Coughlin, S. S. (2002) · Epidemiology · doi:10.1097/00001648-200209000-00018 · Cited by 8
SINGH, M. S. (2004) · Nursing Journal of India · doi:10.48029/nji.2004.xcv602 · Cited by 6
Identifying Risk Factors for Infections: The Role of Meta-analyses
Tacconelli, E., & Cataldo, M. A. (2009) · Infectious Disease Clinics of North America · doi:10.1016/j.idc.2009.01.011 · Cited by 5
Chapman, B. (2009) · The Atrium (University of Guelph) · Cited by 2
Nieto-Montenegro, S. (2006) · Cited by 1
Cited by
Sorted by citations
Food Safety in Low and Middle Income Countries
Grace, D. (2015) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph120910490 · Cited by 544
Insfran-Rivarola, A., Tlapa, D., Limon-Romero, J., Baez-Lopez, Y., Miranda-Ackerman, M., Arredondo-Soto, K., & Ontiveros, S. (2020) · Foods · doi:10.3390/foods9091169 · Cited by 160
“This is in accordance with a previous study which found that the most frequently reported settings were restaurants and street food establishments [58].”
BackgroundResultInfluentialLin, N., & Roberts, K. R. (2020) · International Journal of Hospitality Management · doi:10.1016/j.ijhm.2020.102612 · Cited by 139
Predicting adolescents' safe food handling using an extended theory of planned behavior
Mullan, B. A., Wong, C. L., & Kothe, E. J. (2012) · Food Control · doi:10.1016/j.foodcont.2012.10.027 · Cited by 121
The level of food safety knowledge in food establishments in three European countries
Šmigić, N., Djekic, I. V., Martins, M. L., da Rocha, A. M. C. N., Sidiropoulou, N., & Kalogianni, E. P. (2015) · Food Control · doi:10.1016/j.foodcont.2015.11.017 · Cited by 93
Metadata
- Authors
- SOON, J. M., BAINES, R., & SEAMAN, P.
- Affiliations
- Universiti Malaysia Kelantan (MY)
- Royal Agricultural University (GB)
- Corresponding author
- SOON, JAN MEI
- ORCID
- SOON, JAN MEI
- Venue
- Journal of Food Protection
- Publisher
- Elsevier BV
- Published
- 2012-04
- Volume
- 75
- Issue
- 4
- Pages
- 793-804
- ISSN
- 0362-028X (ISSN-L)
- OpenAlex
- W2328770276
- Cited by
- 127
- References
- 78
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 8 · 2023: 11 · 2022: 6 · 2021: 13 · 2020: 14 · 2019: 15 · 2018: 13 · 2017: 8 · 2016: 6 · 2015: 7 · 2014: 6 · 2013: 6 · 2012: 1
- FWCI
- 0.83
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Food Protection (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ministry of Higher Education, Malaysia
- Topics
- Life Sciences › Agricultural and Biological Sciences › Food Science › Food Safety and Hygiene
- Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
- Life Sciences › Agricultural and Biological Sciences › Food Science › Salmonella and Campylobacter epidemiology
- Keywords
- food safety training, hand hygiene, food handlers, hand washing, knowledge, attitudes, food handler education, refresher training, food handling behavior
- MeSH terms
- Workforce, Food Handling, Food Services, Hand Disinfection, Health Education, Humans, Hygiene, Health Knowledge, Attitudes, Practice, Personnel Management, Food Safety
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
