الفهرس 
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Abstract
Food safety is a constant public health concern supported by the fact that in both industrialized and developing countries, the rates of foodborne diseases are increasing and encompass a wide spectrum of illnesses. Several factors contribute to the spread of foodborne outbreaks such as improper practices and low level of knowledge among food handlers, food handling mistakes include, serving contaminated raw food; inadequate cooking; or reheating of foods, consumption of food from unsafe sources; cooling food inappropriately; and allowing too much of a time lapse. Other important contributors to the spread of foodborne outbreaks involve human foodborne pathogens. So, improving food safety is an essential element in improving food security which exists when populations have access to sufficient and healthy food.
This quasi-experimental study assessed the effect of applying a food safety program based on health belief model on the knowledge and practice of working females. Total number of the working females included in the present study was 144, their age range between 30 to 60 years in faculties of South Valley University in Qena and they had the responsibility of food preparation at their homes.
The present study hypothesized that working females who received the food safety program demonstrate increased knowledge and safe food practice than before it. Six tools of the study included: Tool (I) socio-demographic and clinical data structured interview schedule that used the scale for measuring the working female socioeconomic status through seven domains include education and cultural domain, occupation domain, family possessions domain, family domain, home sanitation domain, economic domain, and health care domain. Tool (II) food safety knowledge test which include 89 item consisting of 5 subscale: cross contamination prevention & disinfection procedures 29 item, safe times/temperatures for cooking/storing food 14 item, foods that increase risk of food borne disease 28 item, groups at greatest risk for food borne disease 10 item, and common food sources of food borne disease pathogens 8 item. Tool (III) food safety health belief scale which is composed of 27 Likert-type items divided into five subscales that include interest in learning about avoiding food poisoning, the importance of cleanliness and sanitation, susceptibility to food poisoning, the threat of food poisoning, and the personal threat of food poisoning. Tool (IV) food safety locus of control scale has three subscales include internal, external: powerful others, and external: chance with a total of 12 Likert- type items. Tool (V) food safety self-efficacy scale that include 24 Likert-type items. Tool (VI) food safety best practices questionnaire that developed by the researcher based on literature review related to purchasing, storage, preparation, cooking, reheating, and cooling food practices that include 95 items.
The food safety program were designed for the study group based on the current literature and the results of the assessment phase based on a Health belief model. The food safety program planning was implemented on the working females that divided into (18) groups, about (8) females in each group. Each group exposed to (6) sessions which include the basic rules for food safety knowledge and practices. Moreover, slide shows, short lectures, and group discussion were used as educational methods with teaching materials include posters, a booklet, and a pamphlet.
The main results of this study were as follows:
The majority of the working females (96.5%) were semi-professional/clerk and less than half (46.5%) of them had access to health information through printed material, TV and radio. Moreover, nearly three quarters (74.3%) of the working females were used more than one of the following services (free governmental health service, health insurance, and private health facilities) as a usual source of health care. On the other hand children, elderly persons, pregnant women, and immune-suppressed patients were vulnerable person at working females home (69.4%, 24.3%, 10.4%, and 2.1% respectively). Moreover, the majority of the working females (97.9%) had middle socioeconomic level.
Food safety knowledge was determined by responses of the working females to the five subscales. The result revealed a significant effect of program implementation on the working females regarding food safety knowledge. As in the preprogram phase, all of the working females (100.0%) had poor knowledge related to their food safety knowledge compared to more than three quarters of the working females (77.1%) had fair food safety knowledge and less than one quarter of them (22.9%) had good food safety knowledge after program implementation. In the follow up phase, 91.7% of the working females had fair knowledge and none of them had good knowledge. Only 8.3% of them had poor knowledge.
Additionally, the results indicated that in the three phases of preprogram, post program and follow up, there was significant effect of food safety health education program that based on Health Belief Model on working females’ responses regarding food safety health beliefs related to the interest in learning about avoiding food poisoning as indicated by (M + SD = preprogram 2.79 + 0.706; post program 4.84 + 0.106; and follow up 4.17 + 0.273).The importance of cleanliness and sanitation as reported by (M + SD = preprogram 3.23 + 0.494; post program 4.84 +.106; and follow up 4.17 + 0.236). Susceptibility to food poisoning as reported by (M + SD = preprogram 2.84 + 0.725; post program 4.39 + 0.484; and follow up 4.40 + 0.509).The threat of food poisoning as indicated by (M + SD = preprogram 3.21 + 0.448; post program 4.46 + 0.407; and follow up 4.54 + 0.125).The personal threat of food poisoning as stated by (M + SD = preprogram 3.03 + 0.586; post program 4.45 + 0.240; and follow up 4.52 +0.205).
Likewise, the results indicated that in the preprogram, post program and follow up there was significant influence of food safety health education program on working females’ own control regarding the internal locus of control as reported by (M + SD score 2.59 + 0.742; 5.35 + 0.434; and 4.70 + 0.385 respectively).Also, concerning to food safety external locus of control there were significant effects of health education program on working females’ responses as indicated by (M + SD score 3.53 + 0.668; 5.45 + 0.382; and 4.95 + 0.190 respectively) and chance locus of control as reported by (M + SD score 4.17 + 0.799; 5.61 + 0.458; and 5.25 + 0.266 respectively).
Regarding food safety self-efficacy scale in preprogram phase the result presented that the working females had low confidence in their ability to perform food safety health behavior or abstain from an unhealthy food safety behavior. However, the health education program had significant effect on working females’ confidence preprogram, post program and follow up as reported by (M + SD score 2.15+0.379; 4.65 + 0.190; and 4.19 + 0.155, respectively).
Furthermore, the results revealed significant effect of health education program on working females regarding the total score of food safety practices in the preprogram, post program and follow up phases with mean score (M + SD = 26.21+9.496 ; 87.73+15.143 ; and 84.26+22.893 respectively).
Likewise, the results indicated that there were statistically significant differences between the total scores of food safety knowledge subscales and all vulnerable persons present at working females’ home related to children, elderly persons, pregnant women, and immune-suppressed patients across the post program phase. Besides, there were statistically differences in post program and follow up stages between the total subscale of food safety health belief and the different age groups across the stage of post program and follow up among the working females. As well, the results revealed that no statistically significant differences were observed between the total score of food safety knowledge of the working females and total food safety correct practices across the follow up phase, while it shows statistically significant differences in the post program phase.
The main recommendations are:
1. Continuous education, attendance for different health education classes, conferences training and updating of knowledge for working females in the prevention of foodborne illnesses and food safety play an important role to change their behaviors related to certain cultures and belief that may be responsible for negative attitude towards food safety.
2. Increase public awareness through using mass media about current and emerging food borne illness, increased risk population, and knowledge and behaviors of proper food handling.
3. Special attention should be paid to promote Upper Egypt food safety awareness through participation of None Governmental Organization (NGO).
4. Health sector should develop surveillance and monitoring system for foodborne illness.
5. Further studies needs to be conducted to evaluate college female students, knowledge and practices for food safety in Upper Egypt (Qena city).