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2011 Model Practice Application (Public)

Practice Title
Boston Community Based Food Safety Campaign
Submitting LHD/Agency/Organization
Boston Public Health Commission

Overview

Boston Community Based Food Safety Campaign
Responsiveness and Innovation
From 2004 through 2007, Boston residents who self identified as Asian had the highest rates of Salmonella infection. Between May and August 2007, 14 cases of an identical strain of Salmonella schwarzengrund were reported to the Boston Public Health Commission (BPHC). Of these 14 cases, half were underage of 4 years old and 11 cases were Chinese. BPHC investigation indicated that the common risk factors for illness included purchasing fresh chicken from a local live bird market and knowledge, attitudes and beliefs regarding food and in particular chicken. Home visits revealed evidence of poor food handling practices that could have contributed to illness. While Asians account for 8% of the Boston population, 23% of the Salmonella cases in 2007 occurred in Asians.
Agency Community Roles
The Boston Public Health Commission's Infection Disease Bureau is responsible for the investigation and control of communicable diseases in Boston. BPHC invited leaders from the Chinese community to discuss the epidemiologic findings indicating a high rate of disease in the Chinese community. BPHC was the lead organization in developing the educational materials. Bicultural and bilingual staff from the Infectious Disease Bureau wrote, starred in, and assisted in the production of the food safety "soap opera" video. In addition, the staff has provided ongoing community education on food safety and has fostered community relationships. BPHC has been the distributor of the material. Feedback was provided to Summit participants in February, a reportd which included the epidemiology findings and process measures was sent to Food Summit participants at the time of the Chinese New Year.
Costs and Expenditures
From 2004 through 2007, Boston residents who self identified as Asian had the highest rates of Salmonella infection. While Asians account for 8% of the Boston population, 23% of the Salmonella cases in 2007 occurred in Asians. Riskes for infestion were associated with knowledge, attitudes, and beliefs and food handling practices particularly regarding chicken. In October 2007, BPHC convened a food safety summit with community leaders. Participants identified the need for linguistic and culturally component educational materials. A video was recommended as a strategy to reach segments of the population for whom health literacy was a challenge. In July 2008, a multi-media campaign was launched which included a video in Mandarin and Cantonese, brochures in multiple languages and promotional items. The goal of the was to decrease food borne illness in the Asian population. The objectives were to 1. provide education and outreach to the community regarding safe food handling practices and 2. decrease the incidence of Salmonella infection in the Asian community. Educational packages contain DVDs, brochures, and cutting boards were sent to 200 sites. Also outreach was done at events such as the Chinese August Moon Festival and educational sessions for Chinese seniors who provide child care and food preparation for their families. All the objectives were met. Critical factors associated with the success of this initiative were community input and participation in the development of educational materials and the leadership of bicultural, bilingual public health staff.
Implementation
The tasks included convening a community meeting of key stakeholders from the community to discuss the issues. Outcomes from the meeting included the need for a linguistic and culturally appropriate food safety video using a soap opera format. BPHC developed the script, identified actors and actresses from the community (including BPHC employees) and oversaw the production of the video. BPHC created brochures and obtained cutting boards as give-aways for community events. Videos and other materials were sent to agencies serving Boston’s Chinese community. Additional education and outreach were also provided by BPHC bilingual/bicultural staff. The Communicable Disease Control Division investigated enteric infections and provided reports to the community. The timeframe for developing the materials was approximately 9 months and other activities including materials distribution, outreach and education, and surveillance are ongoing.
Sustainability
THE BOSTON COMMUNITY BASED FOOD SAFETY CAMPAIGN SEEKS TO INSTITUTIONALIZE FOOD SAFETY PRACTICES. THIS IS BEING ACHIEVED BY USING BOSTON’S OVERARCHING STAKEHOLDER PARTICIPATORY PROCESS. THE PROCESS INCLUDES RESPONSE AND MANAGEMENT TO EVENTS OF PUBLIC HEALTH SIGNIFICANCE INCLUDING INFLUENZA, HEPATITIS B INFECTION, PUBLIC HEALTH PREPAREDNESS AND TREATMENT OF LATENT TUBERCULOSIS INFECTION . The Boston Community Based Food Safety Campaign developed educational templates that can be updated and provided to the community at minimal cost. Also the educational video is available at no charge on U-tube. BPHC and its partners in this initiative continue to do outreach and education to the community using the tools that were developed for the Boston Community Based Food Safety Campaign.
Outcome Process Evaluation
Provide education and outreach to the community regarding safe food handling practices. In collaboration with SCCHC, BPHC developed: *Food Safety video in Mandarin and Cantones (http://www.youtube.com/BostonPublicHealth#p/u/102/Oask TvM_25E) *Food Safety brochure in multiple languages *Cutting boards to encourage use of separate cutting Outreach efforts have included: 1. 200 sites received educational packages (videos, brochures, and cutting boards) 2. Health care sites play the Food Safety video in their waiting areas 3. 200 people at 4 senior sites received food safety presentations 4. 500 attendees of Chinese August Moon Festival watched the video and received promotional cutting boards. Decrease the incidence of Salmonella infection in the Asian community. Information included demographics and risk factors for reported Salmonella cases was collected by the Boston Public Health Commission's Infectious Disease Bureau using standard communicable disease case investigation procedures. Sources of information included interviews with health care providers and cases and medical records. Since the launch of the Food Safety Campaign, Salmonella cases in the Asian community have declined. The number of reported cases among Asian decreased from 41 in 2007 to 11 in 2009. Asian Boston residents accounted for 15% of Salmonella cases under 10 years of age in 2009 compared to 41% in 2007.
Lessons Learned
Key Elements Replication