Foodborne diseases are a significant cause of morbidity and mortality worldwide. Studies have shown that the knowledge, attitude, and practices of food handlers are important factors in preventing foodborne illness. The purpose of this research is to assess the effects of training interventions on knowledge, attitude, and practice on food safety and hygiene among food handlers at different stages of the food supply chain. To this end, we conducted a systematic review and meta-analysis with close adherence to the PRISMA guidelines. We searched for training interventions among food handlers in five databases. Randomized control trials (RCT), quasi-RCTs, controlled before–after, and nonrandomized designs, including pre–post studies, were analyzed to allow a more comprehensive assessment. The meta-analysis was conducted using the random-effects model to calculate the effect sizes (Hedges’s g) and 95% confidence interval (CI). Out of 1094 studies, 31 were included. Results showed an effect size of 1.24 (CI = 0.89–1.58) for knowledge, an attitude effect size of 0.28 (CI = 0.07–0.48), and an overall practice effect size of 0.65 (CI = 0.24–1.06). In addition, subgroups of self-reported practices and observed practices presented effect sizes of 0.80 (CI = 0.13–1.48) and 0.45 (CI = 0.15–0.76) respectively.
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IssueIn the Netherlands, the National Public Health Foresight Study (PHF) is published every 4 years, as starting point for national and local public health policy development. As these policies impact citizens’ health and lives, it is important to include their voices. We piloted an approach to strengthen this engagement to learn and to inspire PHF in other (country) settings.Problem descriptionPHF is usually expert-based. Citizen engagement, beyond consultation, is not yet common practice. In the Dutch PHF-2024, we engage citizens both as advisors (citizen council, N = 30 and panel, N = 500) and as target group (focusgroups N = 40). Intentionally the scope is diffuse, allowing for unexpected input. What can we learn from this approach, and how do the citizens contribute to the PHF?Results- Citizens of all ages, backgrounds and education types are well able to discuss health (determinants), data and indicators;- They have intrinsic motivation to contribute to better knowledge, feel responsible for effective engagement and are eager to engage across different backgrounds and population groups;- Integration of outcome into the PHF process is valuable, enriching scientific with experiential knowledge and facilitating results communication;- Fundamental questions, e.g., about foresight time frames (“why look so far ahead as the world is in crisis right now!”) are raised by the citizens, showing that these need to be better addressed in order to make PHF relevant for a broader public.Lessons- More permanent engagement of the citizens is needed to enable learning and development;- earlier engagement in the PHF process may enable joint development of core questions and issues to be addressed;- The results are highly encouraging; piloting this approach in other foresight types and in various contexts is therefore needed to refine and further develop it.Key messages• Citizen engagement can and should be strengthened to include citizen voices in the PHF process, informing policies that impact on their lives.• Citizens of all backgrounds, with their experiential knowledge, can be valuable partners in PHF, that provide important input.
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