Liu Z, Mutukumira AN, Shen C (2021) Food safety knowledge, attitudes, and eating behavior in the advent of the global coronavirus pandemic. PLoS ONE 16(12): e0261832. doi: 10.1371/journal.pone.0261832
License: This is an open access document distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Created: October 09, 2021
Last Modified: January 02, 2022
Document Integer ID: 53941
Funders Acknowledgements:
Henan Association for science and technology
Grant ID: HNKJZK-2021-12B
Social Sciences at Universities of Henan Province
Grant ID: 2017-JD-02
Humanities and Social Science Project of Education Department of Henan Province
Grant ID: 2021-ZZJH-082
Abstract
The objective of this lab protocol was to evaluate the relationships among food safety knowledge, attitude and eating behavior of consumers during lockdowns in the advent of the COVID-19 pandemic. A total of 157 respondents completed the online survey using a structured questionnaire worldwide. Overall, the respondents exhibited good attitude and good knowledge towards public health including food safety especially on the importance of social distancing, mask wearing, well-balanced diet, physical exercise and personal hygiene, such as hand washing during the pandemic lockdowns. A Structural Equation Modeling (SEM) was established to test the relationships among food safety knowledge, attitude and behavior under the pandemic conditions. Results showed that attitude towards food safety under the coronavirus pandemic and lockdowns positively affected the eating behavior of the respondents, which exhibited a high β (0.686) among the variables tested (p<0.05). Food safety knowledge was apparently not affected by the food safety behavior of the respondents.
Food safety knowledge, attitudes, and eating behavior
under the global coronavirus pandemic
Zhe Liu a,, Anthony N. Mutukumira b, Cong Shen a
a School of Management, Henan University of Technology, Zhengzhou, 450001, P.R.China
b School of Food and Advanced Technology, Massey University, Auckland Campus, Private Bag 102 904, Auckland 0745, New Zealand
The objective of this lab protocol was to evaluate the relationships among food safety knowledge, attitude and eating behavior of consumers during lockdowns in the advent of the COVID-19 pandemic. A total of 157 respondents completed the online survey using a structured questionnaire worldwide. Overall, the respondents exhibited good attitude and good knowledge towards public health including food safety especially on the importance of social distancing, mask wearing, well-balanced diet, physical exercise and personal hygiene, such as hand washing during the pandemic lockdowns. A Structural Equation Modeling (SEM) was established to test the relationships among food safety knowledge, attitude and behavior under the pandemic conditions. Results showed that attitude towards food safety under the coronavirus pandemic and lockdowns positively affected the eating behavior of the respondents, which exhibited a high β (0.686) among the variables tested (p<0.05). Food safety knowledge was apparently not affected by the food safety behavior of the respondents.
The authors wish to acknowledge the funding from Henan Association for science and technology (HNKJZK-2021-12B) for the research upon which this paper is based. Also, this paper is supported by National Social Science Foundation of China (21BGL052), Humanities and Social Science Project of Education Department of Henan Province (2021-ZZJH-082) and Key Research Institute of Humanities and Social Sciences at Universities of Henan Province (2017-JD-02). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests
The authors declare that they have no competing interests.
Data availability
Metadata are available in this lab protocol.
Associated content
Manuscript Number PONE-D-21-16504.
Abstract
The objective of this study was to evaluate the relationships among food safety knowledge, attitude and eating behavior of consumers during lockdowns in the advent of the COVID-19 pandemic. A total of 157 respondents completed the online survey using a structured questionnaire worldwide. Overall, the respondents exhibited good attitude and good knowledge towards public health including food safety especially on the importance of social distancing, mask wearing, well-balanced diet, physical exercise and personal hygiene, such as hand washing during the pandemic lockdowns. A Structural Equation Modeling (SEM) was established to test the relationships among food safety knowledge, attitude and behavior under the pandemic conditions. Results showed that attitude towards food safety under the coronavirus pandemic and lockdowns positively affected the eating behavior of the respondents, which exhibited a high β (0.686) among the variables tested (p<0.05). Food safety knowledge was apparently not affected by the food safety behavior of the respondents.
1. Introduction
The COVID-19 pandemic that emerged in 2019 has imposed huge consequences on public health and economic losses, which are still affecting many aspects of our daily life throughout the world. The objective of the present study was to explore the relationships among food safety knowledge, attitude and eating behavior under the coronavirus pandemic and related lockdowns. In the present study, alternative hypotheses were formulated based on the relationships suggested by Schwartz [ ]:
H1: Food safety knowledge directly affects the healthy eating behavior under the coronavirus pandemic.
H2: Food safety attitude directly affects the healthy eating behavior under the coronavirus pandemic.
H3: There is a statistically significant relationship between food safety knowledge and attitude under the coronavirus pandemic.
COVID-19 has been the top food safety issue [ ], and there were many studies conducted by multiple research groups during the COVID-19 Pandemic, focusing on preventative measures, perception of risk, trust of food safety information, consumer willingness to pay (WTP), and etc [ , , ]. Also, there are several assessments of knowledge, attitude, and practices of residents and healthcare workers from China, Malaysia, Pakistan, Uganda, and etc [ , , , , ]. Those above literatures had a number of descriptive statistical analyses of knowledge, attitude and behavior, except the relationships among them. On the other hand, based on the cognitive-affective-behavior theory in the area of social psychology, there were numbers of studies on the relationships among knowledge, attitude and behavior after Schwartz [ , , , ].Thus, identifying the impacts of the COVID-19 pandemic on consumers’ food safety knowledge, attitude and eating behavior under lockdown or restricted movements may be necessary to carry out an effective inactivation strategy and generate data for future planning to combat similar pandemics.
Though the findings of this study will help the policymakers to pay more attention to the public’s attitude toward food safety, some limitations of this study should be considered in interpreting the results. Firstly, there was no confirmation that they were taken correctly during the completion of questionnaire, since the data collected fully relied on self-reporting from respondents. Secondly, this study was conducted among the respondents who were invited by email, Facebook, Wechat and other social media software. Limited to the researcher's background, although it took 8 months to collect data, most of the respondents were students or staff with higher education.
2. Materials and methods
This study was conducted online during the global coronavirus pandemic. The respondents were randomly selected through emails, social media platforms, personal contacts, as well as professional websites, and the response rate obtained in this study was 100%. Questionnaire was constructed and divided into 4 parts consisting of socio-demographic characteristics, food safety knowledge, attitude and eating behavior. Part I was used to collect data on gender, age, composition of household, employment status, level of education, and location of the participants. Part II on food safety knowledge included 9 questions that tested the knowledge of COVID-19 (5 items), and food safety (4 items) of the participants. Parts III and IV evaluated the food safety attitude using 14 questions on health issues under coronavirus pandemic, and 10 questions on changes in eating behavior of the participants, respectively. Each question consisted of 2 optional answers (“yes”, or “no”), which were intended to prevent the participants to select the correct answer by guessing. Each correct response or healthy habit was allocated 1 point and an incorrect response 0 point.
Part I Demographic characteristics
Gender
Male
Female
Age(years)
18-24
25-34
35-44
45-54
55-64
65-74
75-
Composition of household
Children under 18 years
No child
Employment Status
Employed, working full-time
Employed, working part-time
Not employed, looking for work
Not employed, not looking for work
Student
Retired
Highest Level of Education
Primary School or equivalent
Intermediate Diploma/Certificate or Equivalent
High School Diploma/Certificate or equivalent
Technical skills qualification or Equivalent
Bachelor’s Degree/Equivalent
Master’s Degree/Equivalent
Doctorates Degree (PhD)/Equivalent
Medical/Health Professional
Other qualifications
Part II Knowledge of Coronavirus COVID-19 & food safety
K7. The coronavirus COVID-19 can be easily transmitted between among humans.
K8. A person contaminated by coronavirus COVID-19 must undergo self-isolation, even without showing any symptoms.
K9. The vaccination against seasonal influenza is not effective against coronavirus COVID-19.
K10.The coronavirus COVID-19 on hands can be eliminated by hand-washing using ordinary soap.
K11. Coronavirus on food can be killed during cooking food.
K12. Coronavirus on surfaces can be killed by disinfectants.
K13. The coronavirus COVID-19 cannot be easily transmitted through contaminated food.
K14. Even when it is contaminated, food is not a health risk if it is thoroughly cooked.
K15. Humans can catch coronavirus by touching contaminated surfaces of food packaging box.
Part III Attitude and preparedness for COVID-19
A24. I ate a balanced diet.
A25. I ate sufficient amounts of fresh fruit and vegetables.
A26. I ate sufficient amounts of fresh meat and fish.
A29. Wash hands often.
A30. Avoid eating meat or fish not thoroughly cooked.
A31. Avoid eating fruit or vegetable not thoroughly washed.
A32. Exercise regularly.
A33. Maintain a well-balanced diet.
A34. Keep air circulating in rooms.
A35. Avoid shaking hands with others and touching packages with bare (unprotected) hands.
A36. Avoid going to crowded public areas.
A37. Wear masks in public areas.
A38. Social distancing always be observed.
A39. Working from home is the new normal.
Part IV Eating habits under COVID-19
B16. My eating habits did not change under the coronavirus covid-19 pandemic.
B17. I maintained the same eating habits by purchasing more takeaways or fast foods.
B18. I maintained the same eating habits by cooking more at home.
B19. I somehow ate more food under coronavirus covid-19.
B20. I somehow ate less food under coronavirus covid-19
B21. I somehow ate the same amount of food under coronavirus covid-19.
B22. I somehow ate food more frequently.
B23. I somehow ate food less frequently.
B27. I ate more canned foods.
B28. I ate foods with longer shelf life.
3. Results and discussion
Data collection was performed online using the survey platform of www.WJX.cn. The online questionnaire was available in two versions, in English and Chinese.The call for participation was made on social media. After 8 months, 157 sample data from 14 countries were collected, that is considered enough sample size for conducting SEM [ , , , ].
Data were analyzed by IBM SPSS (The Statistical Package for Social Sciences) for descriptive analysis, normality test, reliability analysis, Pearson's correlation coefficient analysis and Exploratory Factor Analysis (EFA). Confirmatory Factor Analysis (CFA) and structural equation modeling were conducted by MPLUS 8.3 with confidence level of 95%.
A total of 157 questionnaires were completed in 5 continents with the majority of the respondents being female (65.6%) (Table 1). The age group of the respondents peaked at 25-34 years, which accounted for 42.7%. Data showed that most respondents actually came from families without children (59.9%) and 40.1% had at least 1 child under 18 years. More than half of the respondents had full-time work (52.9%), and a third were students (33.1%). In terms of educational background, 95.5% of respondents had attained college education.
Table 2 shows that, the mean score of food safety knowledge was 6.64 (full score was 9), implying the food safety knowledge of the respondents on COVID-19 was rather high. Results also suggest that there was excessive worry on the health risk caused by contaminated food. The lowest score among food safety knowledge items was item K13, indicating that many respondents had great concern to the transmissibility of the coronavirus COVID-19 through contaminated food. Compared with disinfectants, the function of ordinary soap seemed to have been ignored by many respondents. Based on the mean scores obtained for food safety attitude (full score was 14), the respondents seemed to demonstrate poor attitude on the adequacy of the amounts of fresh meat and fish (A26) consumed and regular exercises conducted (A32). Results showed that, half of the respondents changed their eating habits and tended to consume more food under lockdowns. Based on the results of data collected, over 90% of the respondents maintained their eating habits by cooking at home. All items used in accessing healthy eating behavior showed that respondents had reasonably good behavior in eating practices with all the mean value scores higher than 70% of the full score.
The results shown in Figure 1 supported H2 (the healthy eating behavior, directly affected by food safety attitude) by revealing a significant (β=0.686, p<0.05) positive relation between food safety attitude and healthy eating behavior. In fact, food safety attitude was the most important factor claimed by the respondents to influence their eating behavior under the COVID-19 and lockdown as shown by the high standard of β (β=0.686) among the variables (at p< 0.05). Previous studies have confirmed that a positive attitude can lead to food safety behavior [ ],[ ], [ ]. Hence, positive attitude under COVID-19 and lockdown could be only achieved when one believed that balanced diet and regular exercise could reduce the long-lasting adverse health outcomes, such as anxiety, frustration, panic attacks, loss or sudden increase of appetite, insomnia, depression, mood swings, delusions, fear and suicidal tendencies [ ]. As illustrated in Figure 1, food safety knowledge and attitude of the respondents had very low correlations. The findings obtained in the present study were similar to the results of a study on relationships reported by Schwardtz (1975) where knowledge and attitude independently influenced behavior. However, most studies showed that there was either a positive or negative correlation of relationship between food safety knowledge and attitude [ ].
Ethics declarations
Collection of data using the online survey was covered by a Low Risk Ethics Application (Notification Number 4000022746) granted by Massey University Ethics Committee.
Acknowledgments
The authors wish to acknowledge the comments of reviewers. And, we would like to thank all the respondents for their replies, and call for more people to join the survey.
References
Schwartz NE. Nutritional knowledge, attitudes, and practices of high school graduates. Journal of Am Diet Assoc. 1975,66(1), 28-31.
International Food Infomation Council. 2020. COVID-19 pandemic transforms the way we shop, eat and think about food, according to IFIC’s 2020 Food & Health Survey. Available at: https://foodinsight.org/wp-content/uploads/2020/06/2020-Food-and-Health-Survey-.pdf. Accessed 10 June 2020.
Thomas M S , Feng Y . Food Handling Practices in the Era of COVID-19: A Mixed-Method Longitudinal Needs Assessment of Consumers in the United States[J]. Journal of Food Protection, 2021,84(7),1176-1187.
Thomas M S , Feng Y . Consumer Risk Perception and Trusted Sources of Food Safety Information During the COVID-19 Pandemic[J]. Food Control, 2021(1):108279.
Meixner O., Katt F. Assessing the Impact of COVID-19 on Consumer Food Safety Perceptions—A Choice-Based Willingness to Pay Study[J]. Sustainability, 2020, 12 (18), 7270.
Zhong B L , Luo W , Li H M , et al. Knowledge, attitudes, and practices towards COVID-19 among Chinese residents during the rapid rise period of the COVID-19 outbreak: a quick online cross-sectional survey[J]. International journal of biological sciences, 2020, 16(10):1745-1752.
Azlan A A , Hamzah M R , Sern T J , et al. Public knowledge, attitudes and practices towards COVID-19: A cross-sectional study in Malaysia[J]. PLOS ONE, 2020, 15(5):e0233668.
Ms A , Mmm B , Sur C , et al. Knowledge, attitude, practice and perceived barriers among healthcare workers regarding COVID-19: a cross-sectional survey from Pakistan[J]. Journal of Hospital Infection, 2020, 105( 3):419-423.
Olum R , Chekwech G , Wekha G , et al. Coronavirus disease-2019: knowledge, attitude, and practices of health care workers at Makerere University Teaching Hospitals, Uganda[J]. Frontiers in Public Health, 2020, 8(181).
Ferdous M Z , Islam M S , Sikder M T , et al. Questionnaire: Knowledge, attitude, and practice regarding COVID-19 outbreak in Bangladesh: An online-based cross-sectional study[J]. PLOS ONE, 2020, 15(10):e0239254.
Schwartz NE. Nutritional knowledge, attitudes, and practices of high school graduates. Journal of Am Diet Assoc. 1975,66(1), 28-31.
Abdul-Mutalib N., Abdul-Rashid M., Mustafa S. et al. Knowledge, attitude and practices regarding food hygiene and sanitation of food handlers in Kuala Pilah, Malaysia - ScienceDirect[J]. Food Control, 2012, 27( 2):289-293.
Lim TP , Chye FY, Sulaiman MR, et al. A structural modeling on food safety knowledge, attitude, and behaviour among Bum Bum Island community of Semporna, Sabah[J]. Food Control, 2015, 60:241-246.
Siddiky N A , Khan M , Sarker M S , et al. Knowledge, attitude and practice of chicken vendors on food safety and foodborne pathogens at wet markets in Dhaka, Bangladesh[J]. Food Control, 2021(2):108456.
Tinsley, H. E., & Tinsley, D. J. (1987). Uses of factor analysis in counseling psychology research. Journal of Counseling Psychology, 34, 414-424.
Anderson, J. C., & Gerbing D. W. (1988). Structural equation modeling in practice: A review and recommended two-step approach. Psychological Bulletin, 103, 411-423.
Ding L , Velicer W F , Harlow L L . Effects of estimation methods, number of indicators per factor, and improper solutions on structural equation modeling fit indices[J]. Structural Equation Modeling A Multidisciplinary Journal, 1995, 2(2):119-143.
Tabachnick, B.G., & Fidell, L.S. Using Multivariate Statistics. Pearson: Needham Heights, MA.2001.
Abdul-Mutalib, N. A., Abdul-Rashid, M. F., Mustaf, S., Amin-Nordin, S., Hamat, R. A., & Osman, M. Knowledge, attitude and practices regarding food hygiene and sanitation of food handlers in kuala pilah, malaysia - sciencedirect. Food Control. 2012, 27( 2), 289-293.
Buccheri, C. , Mammina, C. , Giammanco, S. , Giammanco, M. , & Casuccio, A.. Knowledge, attitudes and self-reported practices of food service staff in nursing homes and long-term care facilities. Food Control. 2010, 21(10), 1367-1373.
Lim, T. P. , Fook, Y. , Chye, Sulaiman, R. , & Lee, J. S. . A structural modeling on food safety knowledge, attitude, and behaviour among bum bum island community of semporna, sabah. Food Control. 2016, 60, 241-246.
Farsalinos K, Poulas K, Kouretas D, Vantarakis A, Leotsinidis M, Kouvelas D, Docea AO, Kostoff R, Gerotziafas GT, Antoniou MN, Polosa R, Barbouni A, Yiakoumaki V, Giannouchos TV, Bagos PG, Lazopoulos G, Izotov BN, Tutelyan VA, Aschner M, Hartung T, Wallace HM, Carvalho F, Domingo JL, Tsatsakis A.. Improved strategies to counter the COVID-19 pandemic: Lockdowns vs. primary and community healthcare. Toxicology Reports.. 2021,8:1-9.
Ansari-Lari, M., Soodbakhsh, S., & Lakzadeh, I. Knowledge, attitudes, and practices of workers on food hygienic practices in meat processing plants in Fars, Iran. Food control. 2010, 21, 260-263.