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Background: Foodborne illnesses have a significant global burden and can be life-threatening, but good food hygiene practice can prevent most. SafeConsume is an EU-funded, transdisciplinary project aiming to improve consumers’ food safety behaviour and reduce the burden of foodborne illness. Young people are at risk of foodborne illness and research indicates a lack of knowledge or concern about food hygiene. Educational settings provide an opportunity to influence behaviour; but for resources to be effective and implementable, they should be evidence-based and thoughtfully designed. Aim: To develop educational resources to teach food hygiene and food safety to school children aged 11-18 years old, through a user-based approach, specific to the educational setting. Methods: Development used a two-step process referred to as: the insight phase; and prototyping and refinement phase. This included using the findings of a needs assessment with students and educators based on the Theoretical Domains Framework (TDF) presented in earlier publications(Eley et al., 2021; Syeda et al., 2021). A user-centred approach to development was then taken, employing an iterative process of idea generation, consultation with a multidisciplinary steering group, and user testing. Results: The insight phase identified students’ and educators’ deficiencies in knowledge and skills, and cultural and social influences on food safety behaviours. This phase, including Curriculum analysis informed student learning objectives and educator training topics. Following a round of development and consultation, a total of seven teaching resources were developed, with four educator training modules to improve knowledge and confidence of educators. Conclusions: Behavioural theory is a useful foundation for the development of school-based health interventions, which aim to positively influence students’ knowledge, behaviour, and attitudes. To support educators’ uptake, materials should be aligned to the national curriculum and should consider practical factors like time and environmental factors. By working closely with stakeholders at all stages of development, barriers to use, implementation and efficacy can be identified and mitigated. &nbsp

Objective: e-Bug is a teaching resource that addresses the UK 5-year National Action Plan on antimicrobial resistance (AMR) that pledges to work with educators and local authorities to ensure young people understand infection prevention and control (IPC) and AMR. This study aimed to evaluate the effectiveness and acceptability of the e-Bug face-to-face train-the-trainer intervention with school and community educators. Design: Service evaluation of an educational intervention via surveys. Setting: Workshops were organised by Public Health England (PHE) and collaborators in seven regions of the UK during 2018–2019. Method: Pre- and post-intervention surveys measured satisfaction with training, knowledge of IPC and AMR, and confidence to teach others. Statistical analyses included multilevel and ordinal logistic regression models to measure change in educator knowledge and confidence. Results: In all, 262 educators participated: primary (46%), secondary (17%), college (2%), healthcare (29%) and community (7%). Educators had high pre-intervention knowledge of topics, with significant improvement ( p Conclusion: Confident and knowledgeable educators, achieved via e-Bug train-the-trainer workshops, will enhance education of IPC and AMR topics in schools and communities, and therefore support the UK 5-year AMR action plan. The intervention will be monitored with long-term follow-up surveys to explore how training has been disseminated and to evaluate long-term benefits.

Foodborne diseases are a global burden, are preventable, and young people are a key population for behaviour change as they gain autonomy. This study aimed to explore young people’s needs across several European countries in relation to learning about and implementing food hygiene and food safety. Qualitative focus groups and interviews were conducted in rural and city regions across England, France, Hungary and Portugal. Data were collected to attain data saturation, transcribed, thematically analysed, and mapped to the Theoretical Domains Framework. Twenty-five out of 84 schools approached (29.8%) participated, with data collected from 156 11–18-year-old students. Students had good knowledge of personal hygiene but did not always follow hygiene rules due to forgetfulness, lack of facilities or lack of concern for consequences. Students had limited understanding of foodborne microbes, underestimated the risks and consequences of foodborne illness and perceived the “home” environment as the safest. Young people preferred interactive educational methods. Addressing gaps in young people’s food safety knowledge is essential to improve their lack of concern towards foodborne illness and motivate them to follow food hygiene and safety behaviours consistently. Findings have been used to develop educational resources to address gaps in knowledge, skills, attitudes and beliefs.

ObjectiveIn June 2020, as COVID-19 lockdown measures were eased in the UK, this scoping exercise aimed to rapidly identify topics to cover within a children’s online storybook ‘My Back to School Bubble’, designed to support the return to school.MethodsAn email invitation was sent to 71 known contacts within networks across Public Health England, local authorities, health protection teams and contacts within the Department for Education. Following online publication of ‘My Back to School Bubble’, users were asked to provide informal feedback via an online survey to ask about their impressions of the story.ResultsFindings from the 31 responses highlighted that children are likely to hold differing feelings regarding COVID-19, depending on their own temperament and lockdown experiences, including changes in relationships with family and friends. Following the launch of ‘My Back to School Bubble’ e-storybook, 21 users provided feedback via survey. Fourteen respondents (67%) indicated that the storybook was a useful tool for providing support to children, and twelve (57%) reported that the resource helped children understand their own feelings.RecommendationsClear, accurate information about the new school environment should be provided in the context of COVID-19. It is especially important to support children with special educational needs and disabilities, including those with autism. Encouraging children to take ownership of their health and hygiene behaviours, such as handwashing, will help to normalise this and prevent the spread of infection. Lessons learnt from the development of ‘My Back to School Bubble’ online storybook suggest the clarity of imagery could be improved to better support children with autism. Future work should focus on longitudinal and qualitative research. This should include the long-term effects of the pandemic on children’s development and education, effects on mental health and resilience, peer socialisation, and ability to cope with life-changing events.

Peer education (PE) interventions may help improve knowledge and appropriate use of antibiotics in young adults. In this feasibility study, health-care students were trained to educate 16&ndash, 18 years old biology students, who then educated their non-biology peers, using e-Bug antibiotic lessons. Knowledge was assessed by questionnaires, and antibiotic use by questionnaire, SMS messaging and GP record searches. Five of 17 schools approached participated (3 PE and 2 control (usual lessons)). 59% (10/17) of university students and 28% (15/54) of biology students volunteered as peer-educators. PE was well-received, 30% (38/127) intervention students and 55% (66/120) control students completed all questionnaires. Antibiotic use from GP medical records (54/136, 40% of students&rsquo, data available), student SMS (69/136, 51% replied) and questionnaire (109/136, 80% completed) data showed good agreement between GP and SMS (kappa = 0.72), but poor agreement between GP and questionnaires (kappa = 0.06). Median knowledge scores were higher post-intervention, with greater improvement for non-biology students. Delivering and evaluating e-Bug PE is feasible with supportive school staff. Single tiered PE by university students may be easier to regulate and manage due to time constraints on school students. SMS collection of antibiotic data is easier and has similar accuracy to GP data.

Peer education (PE) has been used successfully to improve young peoples&rsquo, health-related behaviour. This paper describes a qualitative evaluation of the feasibility of university healthcare students delivering PE, covering self-care and antibiotic use for infections, to biology students in three UK schools (16&ndash, 18 years), who then educated their peers. Twenty peer educators (PEds) participated in focus groups and two teachers took part in interviews to discuss PE feasibility. Data were analysed inductively. All participants reported that teaching students about antibiotic resistance was important. PE was used by PEds to gain communication skills and experience for their CV. PEds confidence increased with practice and group delivery. Interactive activities and real-life illness scenarios facilitated enjoyment. Barriers to PE were competing school priorities, no antibiotic content in the non-biology curriculum, controlling disruptive behaviour, and evaluation consent and questionnaire completion. Participation increased PEds&rsquo, awareness of appropriate antibiotic use. This qualitative study supports the feasibility of delivering PE in schools. Maximising interactive and illness scenario content, greater training and support for PEds, and inclusion of infection self-care and antibiotics in the national curriculum for all 16&ndash, 18-year olds could help facilitate greater antibiotic education in schools. Simplifying consent and data collection procedures would facilitate future evaluations.

Supplemental material, HEJ-20-0169_Supplementary_(1) for Improving educator’s knowledge and confidence to teach infection prevention and antimicrobial resistance by Catherine Hayes, Charlotte Eley, Carla Brown, Rowshonara Syeda, Neville Q Verlander, Magda Hann and Cliodna McNulty in Health Education Journal

Aim: Foodborne illnesses have a significant global burden and can be life-threatening, with higher risk in vulnerable groups such as children. SafeConsume is an EU-funded, transdisciplinary project aiming to improve consumers’ food safety behaviour. Developing educational resources on food safety for use in schools has potential to improve teaching of our young consumers. The aim of this study was to explore school educators’ attitudes, behaviours and knowledge towards food hygiene, safety and education. Methods: Focus groups and interviews in England, France, Portugal and Hungary explored educator knowledge, skills, intentions and beliefs around educating young people (11–18 years) about food safety. Data were analysed using NVivo and emerging themes were applied to the Theoretical Domains Framework. Results: A total of 48 educators participated. Knowledge, confidence and skills to teach food safety to young people varied depending on background and training. Educators reported they had a role to teach food safety to young people, were positive about delivering education and optimistic they could improve students’ food safety behaviour. Barriers to teaching included lack of national curriculum coverage, limited time and money, and lack of facilities. Educators reported that social influences (family, celebrity chefs, public health campaigns and social media) were important opportunities to improve young peoples’ awareness of food safety and consequences of foodborne illness. Conclusion: Educator food safety expertise varied; training could help to optimise educator knowledge, confidence and skills. Ministries of Health and Education need encouragement to get food safety incorporated further into school curricula across Europe, so schools will be motivated to prioritise these topics.