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Purpose/Objectives: The purpose of this study was to assess the current practices used in school nutrition programs to prevent intentional acts of food contamination or tampering with food. Methods: A convenience sample of school districts (n=2023) was randomly selected, representing two states from each of the seven USDA regions. School food authorities from 320 districts in 14 states participated in a live structured interview guided by a questionnaire consisting of 31 questions concerning food defense practices. The researchers conducted the interviews with videoconferencing technology or telephone and entered responses directly into an online survey to collect the data. Descriptive statistics included frequencies, percentages, and means. Results: Results suggest that many school nutrition programs have room to improve food defense programs, practices, and understanding about food defense in their districts. Almost 68% of districts and 66% of school nutrition programs reported not having a food defense plan. While the opportunity for improvement was evident in several areas, some practices to prevent an intentional food defense incident were also reported. Training was reported as lacking by 44% of the sample. Application to Child Nutrition Professionals: Results from this study can be used to bring awareness about food defense practices in the school environment, especially where practices may not be evident through existing food safety plans. It is important that school nutrition programs follow recommended standards to reduce risks and develop best practices for overall safety. Stakeholders involved in school nutrition programs can support the prevention of intentional food contamination by advocating for district and staff training and by calling attention to practices that might represent a high risk for the school nutrition program.

Purpose/Objectives: The purpose of this study was to collect current baseline data about food allergy management in school districts. The guiding objectives included determining the extent of food allergy accommodations and frequency of allergic reactions in schools, in addition to assessing management strategies implemented by school nutrition programs. Methods: The research design included an online questionnaire designed to address the research objectives. It was distributed to a randomized national sample of child nutrition program directors (n = 5,592). Results: Participants responded to pre-screening and various conditional branching questions. Usable survey responses totaled 480. Responses represented demographic and operational diversity. Nearly all reporting school districts provided meals to students with allergies to peanuts (97%) and milk (94%), followed closely by tree nuts (77%), wheat (77%), and eggs (71%). About 79% of the school districts reported maintaining appropriate documentation for students with food allergies, with school nurses (58%) primarily responsible for maintaining said documentation. Approximately 74% of the respondents indicated that their district had a plan for managing food allergies, and of those, most (74%) indicated their plans were about 76% complete. Applications To Child Nutrition Professionals: A school district's ability to provide allergen-free meals to children with food allergies requires attention and effective communication among many internal and external stakeholders. Food allergy management in schools is also uniquely multidisciplinary as it involves parents, school nutrition staff who prepare and serve food, school nurses who may be responsible when an allergic reaction occurs, teachers, and food manufacturers and suppliers. [This research was funded, in part, with federal funds from the U.S. Department of Agriculture through the Center for Food Safety in Child Nutrition Programs.]

PURPOSE/OBJECTIVES The purpose of this study was to identify farm to school nutrition program coordinators perceptions about the food safety of produce in farm to school activities. METHODS A three-phase Delphi technique with school nutrition personnel who actively manage existing farm to school initiatives was utilized for this study. Descriptive statistics included frequencies, percentages, and means. RESULTS Produce coming from local farmers was perceived as safe by most of the respondents; although when asked about the food safety of produce depending on the source, participants were only slightly confident in the safety of produce, regardless of the source. Farm size, Good Agricultural Practices (GAP) certification, cleanliness of incoming food, and internal school refrigeration were the factors that participants brought up most often related to ensuring produce safety in farm to school activities. Most participants suggested that GAP certification would influence their decision to purchase produce from local farms, and that the safest produce came from local farms with GAP certification. APPLICATIONS TO CHILD NUTRITION PROFESSIONALS Results from this study identified school nutrition operators perceptions about the food safety of produce in programs participating in farm to school initiatives; this information can be used to bring awareness about factors that can impact produce safety in farm to school activities and guide the development of interventions related to improving farm to school produce safety. When developing interventions, child nutrition programs and state agencies should focus on topics such as GAP certification, farmers' knowledge on food safety requirements, and school nutrition staff knowledge about produce safety. Training should be customized for different audiences such as distributors, school nutrition employees, and farmers. [ABSTRACT FROM AUTHOR]

Purpose/Objectives: The purpose of this study was to determine how school districts have implemented food safety programs based on HACCP principles. Specific objectives included: (1) Evaluate how schools are implementing components of food safety programs; and (2) Determine foodservice employees food-handling practices related to food safety. Methods: The study included a national sample of 34 school districts in eight states, including 11 small, 9 medium, 6 large, and 8 mega districts. Six researchers collected data on-site in each of the school's food production facilities. Data collection instruments included a "Facility Observation Form", a "Food Safety Observation Form", and a "Hazard Analysis Critical Control Points (HACCP) Verification Checklist". All instruments were pilot tested prior to use. The research protocol was reviewed and approved by the University's Institutional Review Board prior to data collection. Data were summarized using descriptive statistics. A recent health inspection report was collected from each school and qualitative data were also compiled. Results: Of 34 schools visited, food safety plans were available in 33 schools, although few were customized to the specific school. Most of the recommended standard operating procedures related to HACCP were used. However, researchers found few records of corrective actions. The health inspection scores for most schools were high, which reflects that food safety practices had been adequately operationalized. Overall, school facility observations were positive. Approximately 60% of employees failed to wash their hands as recommended by the "2009 Food Code". Most employees washed their hands before preparing food, but many times, improper hand washing procedures were used. Applications to Child Nutrition Professionals: School foodservice employees performed well, but there are opportunities for food contamination to occur. Directors and managers can utilize this data to evaluate their food safety programs and practices to assure they are achieving their intended goal to serve safe and wholesome food to schoolchildren.

Purpose/Objectives: The purpose of this study was to explore school nutrition directors' attitudes and behaviors about food recalls. Specific objectives included: 1) Determine current food recall attitudes and the relationship between demographics and these attitudes; 2) Determine current practices of school nutrition directors related to food recalls and the relationship between demographics and these behaviors; 3) Examine school nutrition directors' level of confidence in responding to a recall; 4) Determine current food recall communication systems and practices in school nutrition operations. Methods: An online survey was used for data collection and consisted of three sections: attitudes, self-reported behaviors, and demographics. To ensure content validity of the instrument, three experts reviewed the survey prior to pilot testing. The survey was then pilot tested with 14 school nutrition directors and state agency personnel. The survey was randomly distributed to 4,049 school nutrition directors across the United States. Statistical analysis was completed using SPSS (v. 20.0). Results: A total of 567 (14%) usable surveys were collected. Perceived importance was rated very high, while perceived likelihood of possessing a recalled product was rated fairly low. Predictors of attitudes were found to be certification, work experience, and prior experience with a food recall. Respondents reported positive food recall behaviors. Predictors of behaviors were found to be perceived likelihood of possessing a recalled product, educational level, prior experience with a food recall, and size of district. Respondents were confident that their district can adequately respond to a food recall. Communication about food recalls was reported to most often occur through the state agency. Application to Child Nutrition Professionals: Child nutrition professionals can use the results of this study for improving recall practices in schools. These results will also create awareness for food recalls systems that are available to child nutrition professionals.

PURPOSE/OBJECTIVES The purpose of this study was to assess the current practices used in school nutrition programs to prevent intentional acts of food contamination or tampering with food. METHODS A convenience sample of school districts (n=2023) was randomly selected, representing two states from each of the seven USDA regions. School food authorities from 320 districts in 14 states partcipated in a live structured interview guided by a questionnaire consisting of 31 questions concerning food defense practices. The researchers conducted the interviews with videoconferencing technology or telephone and entered responses directly into an online survey to collect the data. Descriptive statistics included frequencies, percentages, and means. RESULTS Results suggest that many school nutrition programs have room to improve food defense programs, practices, and understanding about food defense in their districts. Almost 68% of districts and 66% of school nutrition programs reported not having a food defense plan. While the opportunity for improvement was evident in several areas, some practices to prevent an intentional food defense incident were also reported. Training was reported as lacking by 44% of the sample. APPLICATION TO CHILD NUTRITION PROFESSIONALS Results from this study can be used to bring awareness about food defense practices in the school environment, especially where practices may not be evident through existing food safety plans. It is important that school nutrition programs follow recommended standards to reduce risks and develop best practices for overall safety. Stakeholders involved in school nutrition programs can support the prevention of intentional food contamination by advocating for district and staff training and by calling attention to practices that might represent a high risk for the school nutrition program. [ABSTRACT FROM AUTHOR]

Purpose/Objectives This study explored food traceability systems in school foodservice in the United States and the potential benefits and challenges to their implementation. Methods An online questionnaire was developed and used to collect data. A mixed-mode approach was followed to recruit the participants. A convenience sample of 500 school nutrition professionals from Qualtrics® panel was targeted for data collection with the goal of having responses from 300 participants. Due to low response rate from the initial panel, the contact information of a second convenience sample of 200 child nutrition professionals with no geographic representation was obtained from the National Center for Education Statistics database. The individuals were invited to participate by email with a link to the questionnaire. Data was analyzed using SPSS. Descriptive statistics were computed to screen and summarize the data. Factor analysis was performed to categorize and identify potential benefits of, and challenges to implementing food traceability systems in school foodservice. Results A total of 427 respondents accessed the questionnaire. Only 124 completed questionnaires were retained for a response rate of 24.8%. The findings showed that traceability systems in the investigated districts involve either paper-based or manually entered data systems. The top identified benefits of implementing food traceability systems were supporting food safety, preventing bioterrorism, and cost reduction. Among the top reported challenges to implementing food traceability systems were the unexpected substitution of food by vendors and high cost of implementing advanced traceability systems. Applications to Child Nutrition Professionals The results of the study suggested that school nutrition authorities need to continue to document and track their food supplies to ensure food safety in all stages of production, processing, and service in their districts. School foodservice operations are also encouraged to implement a traceability system that is compatible with the food products, the production process, and budget in order to respond effectively to food-related incidents and protect safety of food served. [ABSTRACT FROM AUTHOR]

Purpose/Objectives The purpose of this study was to collect current baseline data about food allergy management in school districts. The guiding objectives included determining the extent of food allergy accommodations and frequency of allergic reactions in schools, in addition to assessing management strategies implemented by school nutrition programs. Methods The research design included an online questionnaire designed to address the research objectives. It was distributed to a randomized national sample of child nutrition program directors (n = 5,592). Results Participants responded to pre-screening and various conditional branching questions. Usable survey responses totaled 480. Responses represented demographic and operational diversity. Nearly all reporting school districts provided meals to students with allergies to peanuts (97%) and milk (94%), followed closely by tree nuts (77%), wheat (77%), and eggs (71%). About 79% of the school districts reported maintaining appropriate documentation for students with food allergies, with school nurses (58%) primarily responsible for maintaining said documentation. Approximately 74% of the respondents indicated that their district had a plan for managing food allergies, and of those, most (74%) indicated their plans were about 76% complete. Applications To Child Nutrition Professionals A school district's ability to provide allergen-free meals to children with food allergies requires attention and effective communication among many internal and external stakeholders. Food allergy management in schools is also uniquely multidisciplinary as it involves parents, school nutrition staff who prepare and serve food, school nurses who may be responsible when an allergic reaction occurs, teachers, and food manufacturers and suppliers. [ABSTRACT FROM AUTHOR]

Purpose/Objectives: The purpose of this study was to explore school nutritiondirectors' attitudes and behaviors about food recalls. Specific objectives included: 1) Determine current food recall attitudes and the relationship between demographics and theseattitudes; 2) Determine current practices of school nutritiondirectors related to food recalls and the relationship between demographics and these behaviors; 3) Examine school nutritiondirectors' level of confidence in responding to a recall; 4)Determine current food recall communication systems and practices in school nutritionoperations. Methods: An online survey was used for data collection and consisted of three sections: attitudes, self-reported behaviors, and demographics. To ensure content validity of the instrument, three experts reviewedthe survey prior topilot testing. The survey was then pilot tested with 14 school nutritiondirectors and state agency personnel. The survey was randomly distributed to 4,049 school nutritiondirectors across the United States. Statistical analysis was completed using SPSS (v. 20.0). Results: A total of 567 (14%) usable surveys were collected. Perceived importance was rated very high, while perceived likelihood of possessing a recalled product was rated fairly low. Predictors of attitudes were found to be certification, work experience, and prior experience with a food recall. Respondents reported positive food recall behaviors. Predictors of behaviors were found to be perceived likelihood of possessing a recalled product, educational level, prior experience with a food recall, and size of district. Respondentswere confident that their district can adequately respond to a food recall. Communicationabout food recallswas reported to most often occur through the state agency. Application to Child Nutrition Professionals: Child nutrition professionals canuse the results of this study for improving recall practices in schools. These results will also create awareness for food recalls systems that are available tochild nutrition professionals. [ABSTRACT FROM AUTHOR]

Research Objectives Listeria monocytogenes (Lm), a foodborne pathogen with high mortality, is known to contaminate foods served in schools. This exploratory research assesses Lm risk in child nutrition programs by examining adherence to operating procedures known to control Lm, and measuring hygiene of kitchen surfaces through microbial analysis. Methods Kitchen managers from four schools from one Midwestern district were interviewed using a 65- question checklist covering product handling, temperature control, cross-contamination, verification, cleaning/sanitizing, recall plans, and Lm control programs. One school was selected for microbial analysis of surfaces. Surfaces (n=67) corresponding to zones 1-4 (1=food contact surfaces; 2=non-food surfaces contact adjacent to 1; 3=non-food contact surfaces distant from 1; 4=non-food contact outside of the production area) were sampled. Aerobic plate count (APC) and E. coli/coliform counts were used as indicators of hygiene, which may correspond to potential areas of Lm contamination. Surface samples were collected using buffered peptonewater moistened sponges, serially diluted and plated onto APC and E. coli/coliform PetrifilmTM plates for enumeration. Results Highest scores on the checklist were achieved on cleaning/sanitizing (M=52%±14) and crosscontamination control (M=48%±5). Schools scored lowest on recall plans (M=5%±11), and no schools had Lm control plans. Microbial analysis showed non-food contact surfaces in zones 2 and 3 demonstrated the highest levels of microbial contamination. Zone 3 surfaces were least hygienic, with 38.8% of samples harboring APC populations of >1.3 Log10 CFU/cm2, and coliform /E. coli counts were obtained from 16.6% and 11% of samples, respectively. Application of Results Poor sanitation in zones 2 and 3 increases the likelihood of cross-contaminating food contact surfaces, which is especially problematic in schools serving ready to eat foods, because of their likelihood to support the growth of Lm. Sanitation practices targeting Lm control could reduce the likelihood of contaminating foods, and adopting these practices as standard operating procedures lowers Lm risk in schools. [ABSTRACT FROM AUTHOR]

Tracee Watkins, MBA, Michelle Alcorn, MS, Kerri Cole, Kevin Roberts, PhD and Kevin Sauer, PhD; Center for Food Safety in Child Nutrition Programs, Manhattan, KS. Research Objectives Determine commonly used milk service procedures for breakfast outside the cafeteria; measure internal milk temperatures maintained by these procedures under high and low ambient temperatures. Methods School Nutrition Directors in each USDA region were surveyed to determine procedures for milk service during breakfast outside the cafeteria. Common holding conditions were simulated. Thirty single milk servings of different packaging types (carton, bottle, pouch) were placed in containers (milk crate, sheet pan, steam-table pan, soft-side cooler, hard-side cooler) with no ice (all containers), loose ice (steam-table pan, soft-side cooler, hard-side cooler) or ice-sheets (sheet pan, steam-table pan, soft-side cooler, hard-side cooler). Packed containers were exposed to high (89°F) and low (74°F) ambient temperatures for four hours; data loggers tracked milk temperatures at five minute intervals. Data were analyzed using SPSS MIXED procedure. Results Milk temperature varied by container and cooling method (P<0.05), but not milk packaging. Hard and soft coolers (used by 58% of respondents) maintained the lowest temperatures, followed by service pans and milk crates, which were used by 5% of respondents. Sheet pans were least effective (P<0.05). Loose ice was the most effective cooling method (P<0.05). Ice sheets were used by 33% of respondents, but were less effective than loose ice (P<0.05). A majority of respondents restocked unused milk (59%); 64% indicated they checked the milk temperature within one hour of its return to the cafeteria. Application of Results Because most unused milk is restocked, effectively packing milk for service outside the cafeteria is important for quality and safety. Though ice-packs and sheets are the most commonly used, loose ice was found more effective in maintaining temperature. Soft-side and hard-side coolers maintained the lowest temperatures. When ice and insulated containers are not available, leaving milk in the original crate or placing it in a steam-table pan is preferable to serving from a sheet pan. [ABSTRACT FROM AUTHOR]

This research used the Theory of Planned Behavior to investigate school nutrition employees' beliefs about three food safety practices: proper cleaning/sanitizing of food contact surfaces, proper handwashing, and using a thermometer. Barriers within the school environment were explored and used to describe practical recommendations. Methods Questionnaires (n=3,850) were mailed to child nutrition directors in 163 randomly chosen school districts in seven states and distributed to employees. The questionnaire was developed based on the results of an elicitation study and included 31 questions to gather data on employees' attitudes, social pressures, perceived behavioral controls, beliefs, and demographics. Principle axis factor analysis and multiple regressions were used for data analysis. Results A total of 408 questionnaires (10.6%) were completed. Results indicated that child nutrition employees have very high intention to properly clean/sanitize work surfaces (M=6.9±0.31), wash hands (M=6.9±0.40), and use a thermometer (M=6.9±0.37). Employees had positive attitudes towards cleaning/sanitizing (M=6.8±0.47), handwashing (M=6.9±0.40), and thermometer use (M=6.9±0.37). Employees place high importance on identified social pressures for cleaning/sanitizing (M=6.8 ±0.40), handwashing (M=6.8 ±0.37), and thermometer use (M=6.8±0.45). Employees also perceived high levels of control for cleaning/sanitizing (M=6.4±1.07), handwashing (M=6.6±0.86), and thermometer use (M=6.5±1.06). Social pressures and perceived behavioral control significantly predicted behavioral intention (p≤0.001) for each of the three behaviors. However, attitude did not significantly predict cleaning/sanitizing (p=0.63), handwashing (p=0.721), and using a thermometer (p=0.463). Application of Results Based on the results, training interventions should be developed and/or modified to improve food safety behaviors of employees to prevent foodborne illness by focusing on social pressures and perceived barriers identified in the study. Training effectiveness could be evaluated by assessing perceived social pressures to engage or not engage in food safety behaviors properly and behavioral controls to perform the practice. [ABSTRACT FROM AUTHOR]

Research Objectives: To identify the specific content, structure and feasibility of a HACCP workshop intended to improve on-site food safety plans and training in school nutrition programs. Methods: Structured discussions were conducted via online videoconferences or telephone calls with directors and managers of school nutrition programs and state agency staff. The participants were recruited from graduates of Serving up Science, a food safety immersion course offered by the Center of Excellence for Food Safety Research in Child Nutrition Programs. Each session included two to six participants and was guided by a research facilitator using a predetermined script. Audio recordings of the sessions were transcribed; key points and themes were identified and prioritized by the research team. Results: The discussions included 14 participants representing 11 states. There was unanimous agreement that an in-depth on-site HACCP workshop would be valuable for school nutrition personnel. The most frequently mentioned topics that a workshop would need to address included monitoring and documentation of Standard Operating Procedures (SOPs), reiterating the concept and specific purposes of HACCP-based food safety plans and developing SOPs into functional HACCP programs. Some discussion entailed the use of computer software for food safety programs. Participants also indicated factors that would encourage workshop attendance, such as paid expenses, professional networking opportunities and improved food safety training acumen. Perceived barriers to attending included excessive time away from work, with two to three days indicated as an ideal length of time. Application of Results: School nutrition leaders often express the desire to customize their HACCP plans and to enhance their internal training methods to motivate positive employee behavior change. This project provided specific insight about ideal and specific forms of HACCP education, which can be bridged directly into operations. Collaboration among stakeholders in the development of a focused HACCP workshop could enhance existing school food safety programs. [ABSTRACT FROM AUTHOR]

Purpose/Objectives: The purpose of this study was to determine how school districts have implemented food safety programs based on HACCP principles. Specific objectives included: 1. Evaluate how schools are implementing components of food safety programs and 2. Determine foodservice employees food-handling practices related to food safety. Methods: The study included a national sample of 34 school districts in eight states, including 11 small, 9 medium, 6 large, and 8 mega districts. Six researchers collected data on-site in each of the school's food production facilities. Data collection instruments included a Facility Observation Form, a Food Safety Observation Form, and a Hazard Analysis Critical Control Points (HACCP) Verification Checklist.  All instruments were pilot tested prior to use. The research protocol was reviewed and approved by the University's Institutional Review Board prior to data collection.  Data were summarized using descriptive statistics. A recent health inspection report was collected from each school and qualitative data were also compiled Results: Of 34 schools visited, food safety plans were available in 33 schools, although few were customized to the specific school. Most of the recommended standard operating procedures related to HACCP were used. However, researchers found few records of corrective actions.  The health inspection scores for most schools were high, which reflects that food safety practices had been adequately operationalized. Overall, school facility observations were positive. Approximately 60% of employees failed to wash their hands as recommended by the 2009 Food Code. Most employees washed their hands before preparing food, but many times, improper hand washing procedures were used. Applications to Child Nutrition Professionals: School foodservice employees performed well, but there are opportunities for food contamination to occur.  Directors and managers can utilize this data to evaluate their food safety programs and practices to assure they are achieving their intended goal to serve safe and wholesome food to schoolchildren. [ABSTRACT FROM AUTHOR]