Knowledge and Behaviors of Mothers about Food Safety in a Selected Villages at Minia City

Introduction:

Safe food is one of the most important human rights and in developed society's protection from diseases and improvement of human health is of primary important, and is important for both governments and industries but also for consumers themselves (Zeeshan C., 2017).  The paragraph not suffient add another paragraph

Food safety include all conditions and measures that are necessary during production, processing, storage, distribution and preparation of food to ensure that is safe and fit for human consumption according to world health organization (Basavanthappa B.T., 2016). The paragraph not suffient add another paragraph  

The changes in food production, handling and preparation techniques as well as eating habits, the fact remains that food is the source for microorganisms that can cause illness. The United States Centers for Disease Control and Prevention revealed that the outbreaks of diseases which resulted from consumption of unsafety foods of animal origin had caused approximately 76 million illness, 325,000 hospitalizations and 5000 deaths each year (Gemeda, et al., 2018).

Improving the feeding knowledge of households is a way to improve household food security. On the other hand, at the household level, food security has different components and the amount of food being purchased and consumed is a major element (Mutisya M, et al 2016)

Community health professionals, with their considerable knowledge and unique roles within the local communities they serve, have long been identified as being in an ideal position to be at the forefront of initiatives to tackle healthy lifestyles and inequalities They possess an abundance of knowledge about the health and social needs of their communities and about how those needs can be met. Their everyday experience of home visiting and their long-term knowledge of individuals, families and networks built up over time are valuable resources. As a result, they are well placed to identify community leaders and build alliances with local groups. Community health practitioners also have a role to play in the recruitment and support of lay health workers from the local community who are key players in community health development programs. (Sines, et al., 2013)

Significance of the study

Good nutrition means maintaining a nutritional states that enables us to grow well and enjoy good health. Traditionally, health care has been concern primarily with healing the sick and helping them to maintain health, but the present days, more emphasis is being given on illness prevention and community health. So a good nutrition is considered as a basic component of health. For which, people should eat hygienic food for maintaining good health (Basavanthappa BT., 2016).

Safe food is one of the most important human rights and in developed society's protection from diseases and improvement of human health is of primary important, and is important for both governments and industries but also for consumers themselves (Zeeshan C., 2017).  

Consumers in many societies seemed to be unfamiliar with the ideal refrigeration temperature. Large numbers of consumers did not use a thermometer during food preparation, most consumers lack awareness of the different classes of bacteria and especially the pathogenic ones. Food safety has become a major issue of public concern as bacterial outbreaks, and assumed reduced consumer confidence in the healthiness of food products (Zeeshan C., 2017) , it is important تکملة 

It is important for people to understand how their behavior and activities contribute to the safety of food and how they can decrease the risk of food borne illness. From processes on the farm to practices in the kitchen, human activities play an important role in food safety. (Scallan., et al., 2015)

Aim of the study:-

Assess knowledge and behaviors of mothers about food safety at a Selected Villages in Minia City.

Research Questions

1. What are the levels of knowledge and behaviors of mothers regarding food safety?
2. Is there a relationship between levels of knowledge and behaviors of mothers regarding food safety?
3. Is there a relationship between levels of mothers’ knowledge and behaviors regarding food safety and their demographic variables?

Subject and methods

Research Design

Descriptive cross-sectional research design was utilized in this study.

Setting:   Need more details

The study was conducted in four villages in Minia City on (2019), Minia city divided into four sectors (North, South, East, and West)  then selected one by using a simple random sample from each sector from the total of 42 villages which component of Minia City as a whole, these villages are (Bani-Ahmed, Maqousa , Sawada and Alborgaya).

Sample:

By using the Epi-info computer software program the required sample size was (240) will be selected randomly as follows: The houses of each village were numbered, and then the first house was randomly chosen, 67mothers were assessed from Alborgaya village, 57mothers from Maqousa village, 36 mothers from Sawada village, and 80 mothers from Bani-Ahmed village to cover the total sample size which is 240 mothers. The data collection was continued over four months, starting from August 2019 to December 2019 until the total sample was collected.

Data Collection Tools: Data was collected through three tools: these tools structured and developed by the investigator after a literature review these include:

Tool І: "Interviewing structured questionnaire" developed by the investigator: to assess mothers’ socio-demographic characteristics" such as age, social status, educational level, income, employment, number of family members and if the mother was taken any training or lectures about food safety before.

Tool ІІ: Assessment questionnaire of mothers’ knowledge about food safety, it includes two parts:

Part (1): "General knowledge about food safety", it developed by the investigator and consists of 23 multiple-choice questions such as, the source of knowledge for the mother regarding food safety, what is the definition of food safety and the used methods to ensure food safety.

Part (2): Assessment questionnaire of knowledge about food safety": adapted from (Kendall, Mitakakis et al., 2004) and modified by the investigator, it consists of 23 multiple-choice questions these questions specifically dealt ?? with respondents’ knowledge of personal hygiene, cross-contamination, food-borne diseases, microorganisms, temperature control and hygienic practices.

Scoring system:

 The total score 23 grades, score of one was given for correct answer and score of zero for an incorrect answer or don’t know the answer, and categorized as the following:

• Good knowledge: was considered if scoring more or equal than ≥ 75% of the total score.
• Satisfactory knowledge: was considered if scoring from 50% to less than< 75% from total score.
•  Poor knowledge: was considered if scoring less than <50% of the total score.

Tool ІII "Assessment questionnaire of mothers’ behaviors about food safety": adapted from (Kendall, Mitakakis et al., 2004) and modified by the investigator, it consists of 27 questions.

Scoring system: The total score 27 grades, score of one was given for correct answer and score of zero for an incorrect answer or don’t know the answer, and categorized as the following:

• Good knowledge: was considered if scoring more or equal than ≥ 75% of the total score.
• Satisfactory knowledge: was considered if scoring from 50% to less than < 75% of the total score.
•  Poor knowledge: was considered if scoring less than <50% of the total score.

The Validity of the Tool:

The study tools were designed after extensive reviewing of literature. The content and validity were done to identify the degree to which the used tools measure what was supposed to be measured. The tools were examined for content coverage, the sequence of items, clarity, relevance, applicability, wording, length, format, and overall appearance. The developed tools were tested by Jury committee consist of five academic experts in field of thesis. They offered a complete assessment of the content and face validity of the instruments.

Reliability of the tool:

The reliability of the tool was performed to confirm the consistency of the tool. The internal consistency measured to identify the extent to which the items of the tool measured what it was intended to measure. The internal consistency of the tool was assessed with the Cronbach's alpha coefficient.

Cronbach's alpha coefficient of 0.00indicates no reliability and a coefficient of 1.00 indicates perfect reliability. However, a reliability coefficient of 0.70 is acceptable.

The internal consistency was assessed and showed a reliability rate by using cronbach's Alpha test.

3- Pilot study:

The pilot study was conducted before starting actual data collection. It was done on 24 participants (10%) of participants who were included in the study after having the ethical approval and permission to access the home visit, to examine the clarity and adequacy of the study tools and estimate the time required for fulfilling it. Depend on the result of the pilot study no modifications or refinements were done, and the participants were included in the actual sample.

Data Collection Procedure:

• All needed sheets of the tool were printed, and each assessment sheet was coded anonymously.
• Oral permission for voluntary participation was obtained from the participants and the nature and the objectives of the study were explained.
• The investigator met participants in their homes at times that were convenient for them.
• All respondents were interviewed by the investigator to explain nature and purpose of the study and participated voluntarily.
• Data were collected three days per week from (10am to 3pm) at homes through about four months from 20 August 2019 to 20 December 2019.
• Face-to-face interviews were conducted using a structured questionnaire to collect information on the knowledge and behaviors of mothers about food safety.
• Data was assured for confidentiality.
• Each participant from the study group was assessed using tool I, II, III in the first interview. Measures were taken to protect the ethical rights of the participants.
• The time spent for each home visit to fill the questionnaire ranged from 30:45 minutes or according to the level of understanding of every participant and the needed explanation.
• After completing, fill out the questionnaire the investigator clarified the correct information about knowledge and behaviors of the participants in case their answers were wrong.

Administrative design:

• Permission from ethical committee from Minia faculty of nursing to conducted the study.
• Approval from the Mayor of each village were taken.
• Mother's agreement will be a pre request to be included in the study.
• Before carrying out the study the investigator was clarify the aim of the study and it`s expected outcomes.
• When it is possible the study participant were provided with feedback about the research outcomes

Ethical Consideration:

• Authoritative permission to conduct the study was obtained from the research ethics committee of the Faculty of Nursing at Minia University, Dean of nursing faculty and agreement from Egypt academic for research center and technology at Minia University to carry out this study.
• Oral permission was obtained by the investigator from the participants and anonymity and confidentiality were applied by coding all data and protecting the obtained data.
• Participants were acquainted that their data will not be used at any further researches without a second oral consent.
• Each involved participant was acquainted with the objectives, procedure, benefits and nature of the study and that she had the right to withdraw from the study at any time without any rational.

Statistical design: 

The obtained data were summarized, tabulated, and presented using descriptive statistics. Statistical package for the social science (SPSS), version (20) was used for statistical analysis of the data, quantitative data were expressed in the form of mean and standard deviation for measuring dispersion while qualitative data presented as frequency distribution. Chi-square and Fisher exact were used to compare qualitative data and One-way ANOVA tests and independent-sample t-test were used for quantitative data. Correlation between variables was assessed using Pearson correlation coefficients and grade of r was calculated as the following r: 0.00 - 0.24 no or week correlation, 0.25 - 0.49 faire, 0.50 - 0.74 moderate and ≥ 0.75 strong, P value of less than 0.05 considered as cut off for significance, the test of significance < 0.05 was considered significant is the result (*), <0.001 was considered highly significant (**) and coefficient was done by using person correlation test. Fisher's Exact Test is a way to test the association between two categorical variables. When in case of small cell sizes (expected values less than5).

Results:-

Table (1): Percentage and Distribution of demographic data of the studied mothers (N= 240).

Table (1): This table show thatmore thantwo third of the studied mothers (73%) with age ranged from 18:39 with mean age (Mean ± SD 35.05 ± 9.900). Most of the studied participant were married (90.4%)and about half of them ( 50%) were illiterate, and about (7%) of them were university education, more than half of the studied women (83%) were house wives, and more than half with incomemore than 1000:2000 L.E ( 58.8%) and about one third of  them (35.8%) with income from 2000:3000 L.E, and nearly to half (44.6%) with family members ranged from 3:4 members.

Table (2): Percentage Distribution of the studied mothers as regards to exposure to knowledge sources or events related to food safety (N= 240).

Table (2) This table show that the majority of sample of the studied mothers (90%) are not enrolled in any training, lectures or seminars about food safety, and (90%) of them have not any information resources as for food safety, and (72%) of mothers that have information resources come from the media, and the majority of the studied mothers (73.3%) have no any food poisoning cases in the households.

Table (3): Mean score of knowledge for studied mothers regarding food safety (N=240):

• Max. score = Number of items in each category.

Table (3): This table mentioned thatknowledge about hygiene during food separation represented the highest knowledge for studied mothers regarding food safety with mean age 4.81±2.01 and knowledge about food poisoning represented the lowest knowledge for studied mothers regarding food safety with ( Mean ± SD 3.05±3.57).

Table (4): Mean score of behavior of studied mothers regarding food safety (N=240):

• Max. score = Number of items in each category × number of maximum response

Table (4): This table mentioned that hygiene behavior during food preservation represented the highest behavior of studied mothers regarding food safety with Mean ± SD 18.60±3.22 and behavior during cooking food represented the lowest behavior of studied mothers regarding food safety with Mean ± SD 30.54±2.11

Table (5): Percentage and distribution of the studied mothers regarding the total level of knowledge and behavior in food safety (N=240):

Table (5): show that more than half of the studied mothers have poor knowledge level (57.90%).with (Mean%± SD66.23±15.94). More than half of the studied mothers (55.4%) have poor behavioral level with (Mean%± SD 74.44±12.70).

Table (6): Relationship between some socio demographic characteristics of the studied mothers and their total level of knowledge regarding food safety (N=240)

χ² Chi-square test                                     * Statistical significant difference (P < 0.05)

* P- value is significant

^a P-value for either Chi-square (Number of cases > 5) or Fisher exact test (for otherwise).

Table (6): This table showed that there was a statistical significant relation between total level of knowledge and marital status with (p-value =0.013), educational level with (p-value =0.012), and any source of information with (p-value=0.019), and source of information from media with (p-value 0.003). And there is no statistical relation between level of knowledge and other socio demographic characteristics.

Table (7): Relationship between some socio demographic characteristics of the studied mothers and their total level of behavior regarding food safety (N=240)

χ² Chi-square test                                     * Statistical significant difference (P < 0.05)

* P- value is significant

^a P-value for either Chi-square (Number of cases > 5) or Fisher exact test (for otherwise).

Table (7): This table showed that there was a statistical significant relation between total level of behavior and number of family members (p-value =0.021) and food poisoning case = (0.005) and there is no statistical significant relation between total level of behavior and other socio-demographic characteristics.

Figure (1): Correlation between scores of knowledge and the reported behavior of the studied mothers in food safety.

Fig (3): It was found that there was positive low correlation (0.38) between knowledge score and reported behavior score of the studied mothers in food safety.