PROBLEMSTATEMENTS
Theagriculturalrevolutionhasbroughtalargeamountof food,rationsforhumana n d improvedlaborer’shealth,afundamentalfactorofhumancapita l.Therefore,foods a f e t y1p r o b l e mwouldgivenegativeimpactto thesustainabled evelopmentofd e v e l o p i n g c o u n t r i e s asw e l l a s t h e n a t i o n a l ’ s s e c u r i t y T h e f a c t t h a t m a n y d i s e a s e s r el at ed tofooddemonstratedrecentlyhasdrivenmanyco untries’attentionfromfoodq u a n t i t y tofoodsafety.
Theus a g e o f p e s t i c i d e s , c h e m i c a l f e r t i l i z e r a n d fee dst uf f improvea g r i c u l t u r e ’ s capacity.H o w e v e r , t h e o v e r u s e a n d misuseo f t h e m a f f e c t t h e q u a l i t y o f f o o d I n addition,thepreservationandprocessingmethodaswellasfoodad ditiveexploitationb o t h makefood becomelesssafety.AccordingtoWHO(2015),themainfactorscausef o o d - b o r n e diseasearebacteria,virus,parasites,chemicalsandtoxins.Themostdedicatedpe opleoffood-borneillnessarechildren,pregnantwomenandtheelder.
Duet o t h e d e v e l o p m e n t o f t r a n s p o r t a t i o n a n d i n t e r n a t i o n a l t r a d e , f o o d s a f e t y issue isnotonlytheproblemof anycountriesbutalsoaglobalproblem.Forexamples:C h i n e s e milkscandal,NewZeala ndmaterialmilkcrisiscausedanenormouslossfort h e manufacturerandimpingeonother countriesaswellasconsumer’shealth.
HealthOrganization(WHO)a n d Fooda n d AgricultureOrganization(FAO)defined:“ F o o d sa fetyistheassurancethatfoodwillnotcauseharmtotheconsumerwhenitispreparedandeatenaccordingtoitsi ntendeduse”(WHOandFAO,2009, p.6).
0 Global total Eastern MediterraneaEurope Western Pacific America South East Asia Africa
FBDoccurinallcountriesintheworld.However,thedevelopingregions,suchasS o u t h E a s t A s i a a n d A f r i c a , d i s t r i b u t e d t h e m a j o r i t y o f f o o d - b o r n e c a s e s w h i l e t h e d e v e l o p e d a r e a s , s u c h a s E u r o p e a n d A m e r i c a , h a d t h e l e a s t n u m b e r o f f o o d - b o r n e cases.AnunexpectedresultisthatalthoughAfricancountriesarelackoffoodso urcea n d foodsafetycontrol,thisregionhadlessamountoffood- borneillnesscasesthantheS o u t h EastAsianregion.Thereasonsofthisphenomenonmay beduetothediversityo f highnutritionfoodandthetropicalweatherintheAsianarea.These twofactorsaretheidealconditionforbacteriaandotherfoodriskyfactorstoaffectthehumanheal th.
WHO( 2 0 1 5 ) e s t i m a t e d t h a t e v e r y yearf o o d - b o r n e d i s e a s e c a u s e a l m o s t 1 0 % g l o b a l populationstofallillandresponsiblefor420,000deaths(onethirdarechildren).Amonga l l F B D , d i a r r h e a l d i s e a s e s a r e t h e mostc o m m o n i l l n e s s e s r e s u l t i n g f r o m
Global total Eastern MediterraneaEurope Western Pacific America South East Asia Africa unsafefood,accountedforhalfofglobalburdenofFBDandmade550millionpeoplef a l l i n g il l(including220millionchildren),cause230,000deaths(96,000children’s)
Similarwiththenumberoffood- bornecases,thenumberofdeathcausedbyFBDs h o w e d thesametrend.SouthEastAsian andAfricanregionscontinuedtodistributet h e l a r g e s t n u m b e r o f d e a t h c a s e s w h i l e t h e E u r o p e a n a n d A m e r i c a n h a d t h e l e a s t amo u n t ofdeathbyFBD. TheAfricanregionalsohadlessnumberofdeathcasethantheS o u t h E a s t A s i a n
T h i s c o n s e q u e n c e m a y b e t h e e f f e c t o f m a n y internationalmedicalsuppo rtstotheAfricathantheAsian.Inaddition,thedistinctionofphysicalstrengthoflocal populationbetweenthesetworegionsisanotherfundamentalreason.
TheFBDcausedtheburdenabout33millionDALYs 2 Diarrhealdiseasesagentsw e r e thelargestcontributors,accountedfor18millionDALYs,54%oftotal.Allthree
Disability- adjustedlifeyear,ahealthgapmeasurethatcombinestheyearsoflifelostduetoprematuredeath(YLL)andt h e years livedwithdisability(YLD)froma diseaseorcondition,for
However,despiteofthenumberofdeathcasesinAfricawaslessthanAsia,theb u r d en ofFBDinthisareawasalmosttwicethantheSouthEastAsianandmuchmorethanotherare as.TheEuropean,WesternPacificandAmericantotalburdenwasalmoste q u a l totheSouthEast Asia’sandhalfthantheAfrica’sburden.Thesefiguresexposedthed i s t a n c e o f t h e h e a l t h c a r e f a c i l i t i e s a s w e l l a s t h e f o o d s a f e t y co n t r o l l e d policyb e t w e e n eachareasandt heirimpactofpopulation’shealthoutcomes.
Figure1.3:TheburdenofFBD(WHO,2015) varying degreesofseverity,making timeitselfthecommonmetricfordeathanddisability.OneDALYequatestooneyearofhealthylifelost(WHO,2015).
The World Health Organization (WHO) categorizes Vietnam within the Western Pacific region, where food-borne illness rates are considered to be at a moderate level globally Vietnam's situation mirrors the diverse landscape of this region, which encompasses both developed countries like Australia, Japan, and South Korea, as well as developing nations such as Cambodia and the Philippines Consequently, the contributions and health challenges faced by each country vary significantly Detailed information regarding Vietnam's specific circumstances is presented in Chapter 4.
Althought h e d e v e l o p i n g c o u n t r i e s s u f f e r themostfromF B D , thed e v e l o p e d c o u n t r i e s alsohavedifficulty withfood- borneillness.AccordingtoCenterforDiseaseControlandPrevention(CDC),The
USAhad864food- bornediseaseoutbreaks,r e s u l t i n g i n 1 3 , 2 4 6 i l l n e s s e s , 7 1 2 h o s p i t a l i z a t i o n s , c a u s e d 2 1 d e a t h s , a n d 2 1 f o o d recallsin2014.Indetail,themajorityof thefoodpoisoningcasesoccurredinr e st a u r an t (485cases,accountedfor65%),follow edbyprivatehome(86cases,a cco u n t ed f o r 1 2 % ) T h e mostp o p u l a r c a u s e s o f f o o d - b o r n e i l l n e s s i n 2 0 1 4 w a s b a c t e r i a ( 1 4 9 c a s e s , c o n f i r m e d a n d s u s p e c t e d ) d i s t r i b u t e d 2 2 % o f t o t a l c a s e s T h o s e figuresprovedthateventhecountry withwell-organizedhealthcaresystemandpolicyh a s tostrugglewithfoodpoisoning.
CDCalsopredictedthatfood safety issuewouldcontinueemerge i nthefu ture d u e to:
Despiteo f t h e w a v e o f immigrants,t h e i n c r e a s e o f t r a d e exchange,theg l o b a l i z a t i o n problem,the food-bornediseaseis nottheattentionofanysinglecountryb u t itistheissueofthemodernworld.
RESEARCHOBJECTIVESANDRESEARCHQUESTIONS
The diversity of food and food marketing in Vietnam provides convenience for households, leading many Vietnamese to cook and eat at home at least one meal per day This behavior is influenced by various factors, including socio-economic status, individual characteristics, and living conditions Additionally, the tradition of cooking within Vietnamese communities has been passed down through generations, deeply rooted in Asian culture and agricultural practices This cultural heritage significantly impacts household cooking behaviors, shaping knowledge in food processing, preservation, and kitchen practices.
SomeresearchabouttheKnowledge,AttitudeandPractice(KAP)ofthepeople in ThuaThienHueprovince(Duong,2013),HoChiMinhcity(Nguyen,2010)bot hindicatethecorrelationbetweenknowledge,attitudetowardfoodsafetyandthefoo ds a f e t y practiceofindividualatfoodfactory,restaurantaswellashousehold.Accordingtothe
“10goldenprinciplesinfoodprocessing”(MOH,2005),thefoodsafetyb e h a v i o r s incl ude:
Thesegoldenprincipleswereusedfrequently inmanyresearchesinVietnamandw e r e t h e o u t c o m e b e h a v i o r i n t h i s t h e s i s.H o w e v e r , m o s t o f t h e s e r e s e a r c h e s w e r e medicalperspectivesothesocio- economicstatementandindividualcharacteristicsaren o t wellconsidered.Asaresult,the effectofthesefactorsonfoodsafetybehaviorshasn o t assessedexplicitly.
Ont h e o t h e r h a n d , t h e f i n d i n g o f t h o s e r e s e a r c h m e r e l y i n d i c a t e d t h e c u r r e n t statementoffoodsafetyissue inthecommunitywithouttherelativeanalyzingofmultif a c t o r s toconfirmtheir impact. Moreover,the participantsoftheaboveresearchdi dn o t participateintheannu alsurvey.Inconsequence,theeffectofgovernmentpolicya n d activitiesdidnotmentioni ntheresearch.
Ino r d e r t o r e v i e w a n d c o n f i r m t h e f a c t o r s w h i c h h a v e i m p a c t o n f o o d s a f e t y b e h a v i o r , thisthesis’sobjectiveisdeterminingthesefactorsaswellasestimati ngtheireffecto n i n d i v i d u a l b e h a v i o r a n d p r e d i c t t h e i r f o o d - b o r n e d i s e a s e p o s s i b i l i t y Thesep o ten ti al factorsincludethesocio- economicstatus,theknowledgeaboutfoodsafety,t h e p e r c e p t i o n a n d t h e inform ations o u r c e o f e a c h i n d i v i d u a l Whethert h e p e r s o n a l c a u s e s aredetermined,th egovernmentcoulddevelopthecompatiblestrategytoadjustthe people’sbehavior,prev entthoseriskyones,minimizedtheindividualfood- borned i s e a s e s possibilityinthepublicanditsburden.
SCOPE OFRESEARCH
Theth esis use d t h e dataf ro m t h e surveyaboutI nd iv id ua l FoodP o i s o n i n g a n d K n o wl ed g e , Attitude,PracticeofhouseholdinHoChiMinhCity(2013).Thissurv eyorganizedin2 4 d i s t r i c t s o f H o C h i M i n h C i t y fromM a r c h t o A p r i l o f 2 0
Althought h e s u r v e y int h i s t h e m e h e l d a n n u a l l y , thek i n d o f p a r t i c i p a n t s isdistinctineveryyear,varyfromthehouseholder(in2010and2013)tother estaurantwor ker(in2012,2014,2015,2016).Inaddition, thespecificresponde rsinthesamek i n d isdifferentfromyears,thusthelatestdataforthehouseholdisin2013an disnotc o n n e c t e d withthe2010surveysothesisisnotabletocreatethepaneldatatoanalyze.
Basingonthissecondarydata,thescopeofresearch isthebehaviorandacute fo o d poisoningstatementofthecommunityinHoChiMinhCityintheperiodfro mM ar c h toAprilof2013toevaluatetheimpactofthefactors.Besidesthedescrip tivestatistics,ec on ome tr ic t o o l s a r e them a i n methodsus ed i n th et hesi s, s u c h as: f ac t o r analysis,multivariateprobit,propensityscorematching.
THESISSTRUCTURE
- Chapter 1: Introductionabout the researchproblem,the benefit and thescopeofresearch.ThischapterpresentthegeneralviewofFBDanditsburdeninthew orldasw ell astheoutlineandobjectiveofthethesis.
- Chapter2:Literaturereview.Thischapterreviewtheconcept’s definition andthepreviousresearchaboutthefactorsandmodelsusedinresearchwhicharethebasetoc reatetheanalyticframeworkandmethodtoanalyzetheeffectofeachcomponent.
- Chapter3:R e s e a r c h m e t h o d o l o g y T h i s c h a p t e r p r o v i d e t h e f r a m e w o r k a n d econometrict o o l s w h i c h u s e d i n t h e r e s e a r c h I n a d d i t i o n , t h e d a t a s o u r c e a n d i t s c o l l e c t i n g methodarepresentedinthischapteraswellasthe variables’description.
- Chapter4:Researchresult.Thischapter analyzesthedataaswellasindicatether e s u l t findingandcompareitwithotherresults. Thedescriptive statisticofvar ia bl es arealsopresentedinthischapter
- Chapter5 : C o n c l u s i o n a n d p o l i c y i m p l i c a t i o n s T h i s c h a p t e r c o n c l u d e s t h e r e s e a r c h finding,providesimplication,furthersuggestionaswella stheresearchlimitations
FOODSAFETYANDFOOD-BORNEDISEASES
AccordingtoWHO(2007,p.11),“Food- bornediseases(FBD)canbedefinedasthose conditionsthatarecommonlytransmittedth roughingestedfood.FBDcomprisea b r o a d g r o u p o f i l l n e s s e s c a u s e d bye n t e r i c p a t h o g e n s , p a r a s i t e s , c h e m i c a l co n ta m in an t s a n d b i o t o x i n s T w o m e t h o d o l o g i c a l a p p r o a c h e s f o r f o o d - b o r n e d i s e a s e b u r d e n e s t i m a t i o n e x i s t Firstly,t h e e t i o l o g i c a g e n t ( o r r i s k a s s e s s m e n t ) a p p r o a c h w h i c h c o m m e n c e s w i t h t h e e x p o s u r e a n d i d e n t i f i e s t h e e x p o s u r e l e v e l s o f a g e n t s commonlytransmi ttedthoughfood,whichisfollowedbydeterminingtheproportionth at i s f o o d - b o r n e S e c o n d l y , t h e s y n d r o m i c ( o r e p i d e m i o l o g i c a l ) a p p r o a c h , w h i c h commencesw i t h t h e outcomea n d e s t i m a t e s i n c i d e n c e o f d i s e a s e s y n d r o m e s ( e g g a s t r o e n t e r i t i s orchemicallyinducedanaphylaxis),followe dbyattributingaproportiont o f o o d - b o r n e a g e n t s A c o m p r e h e n s i v e b u r d e n o f d i s e a s e a s s e s s m e n t w i l l r e q u i r e a co mb in at io n ofbothapproaches”.
WHO( 2 0 1 5 , p X ) a l s o e s t i m a t e d t h e r e w e r e a b o u t 6 0 0 m i l l i o n f o o d - b o r n e illnessesand420,000deathsin2 0 1 5 d u e t o 3 1 food- borne ha z a r d s, a n d 4 0 % o f thefood- bornediseaseburden was among children under 5yearsof age.H o w e v e r , thed a t a thatisusedinthethesis,wascollectedbyinterviewingtheparticipantsthroughaquestion nairea n d n o t i n c l u d i n g anyf o o d t e s t i n g T h e r e f o r e , t h e FBDd i a g n o s e w a s d ep en d ed o n t h e r e s p o n d e r s ’o w n e s t i m a t i o n c o m b i n e w i t h t h e a s s e s s m e n t o f t h e medicalstaffthroughindividualdescriptionsymptom.
Ontheotherhand,Foodsafetyis“theassurancethatfoodwillnotcauseharmtohuman’ shealthorlife”(VietnamMinistryofHealth,2010).Thisdefinitionisnotass p e c i f i c a s W H O ’ s , h o w e v e r i t c o v e r s t h e w h o l e p r o c e d u r e o f g r o w i n g , h a r v e s t i n g , preserving,processingoffoodinsteadofonlypreparingandeating.Duetoth ewide coverageofVietnamMinistryofHealthandthespreadingofFoodSafetyRegulatoryinVietnamesepopulation,thethesisusedthisdefinitionastheconceptofFoodSafety.
THEHEALTHBELIEFMODEL
TheHBMwasinitiallyderivedfromthetheoryofpsychologyandbehaviorofi ndividual(MaimanandBecker,1974)makingdecisioninuncertaintyc o n d i t i o n , w h e r e theirbehaviorwerepredictedbyevaluatingthe“value– expectancy”ofpossibleoutcome.Adapting thistheory in healtharea, themodelassumes thatindividualhighlya s s e s s e s illnesspreventionandhealthstatusimprovement.Asaresult ,theyexpecttheirs p e c i f i c actionwouldpreventdisease,improvetheirhealth.Thate xpectationisaffectedbyi n d i v i d u a l ’ s c a l c u l a t i o n a b o u t t h e i r s e n s i b i l i t y t o i l l n e s s , s e r i o u s n e s s o f d i s e a s e aswellasthepossibilityofgettingsickbytheir behavior.AccordingtoGlanzetal(2008,p.47-48),themaincomponentsofHBMinclude:
Perceivedsusceptibility Beliefaboutthechancesof experiencingariskorg ettingaconditionordi sease
Perceivedbenefits Beliefinefficacyofthe advisedactiontoreduceri skorseriousnessofimpact Perceivedbarriers
Defineactiontotake:how, where,when;clarifythepo si t iv eeffectstobeexpected Identifyandreduceperceive dbarriersthroughreassuran ce,correctionofmisinform ation,incentives,assistance Providehow- toinformation,promoteaw areness,useappropriaterem indersystems
Useprogressivegoalsetting. Giveverbalreinforcement.De monstratedesiredbehavio rs.
Thesec o m p o n e n t s c o m b i n e w i t h o t h e r i n d i v i d u a l c h a r a c t e r i s t i c s t h e n d i v i d e i n t o threegroupsoffactorsincluded:modifyingfactors,individualbeliefan daction.Ther e l at i o n , componentsandimpactofeachgroupsshowedinthefigurebelow:
Perceived susceptibility to and severity of disease Perceived threat
Perceived barriers Perceived self-efficacy
ManyresearchimplementedHBMinanalyzingfoodsafetybehavioramongv a ri o u s kindofresponders,forinstance:restaurantworkers(Choetal,2010),primaryfoodp reparersinfamilywithyoungchildren(Lum,2013; Me ysen bu rg etal,2013), o l d e r adults(HansonandBenedict,2002).Allthesepapersshowthatthecomponentsi n
HBMinteractwithother,affectonindividual’sbehavior,especiallythefoodsafetyknow ledgehadstrongimpacttotheirperceptionaboutfoodsafety.
EMPIRICALREVIEWSONDRIVERSOFFOODSAFETYPRACTICES
Theparticipantswhohadcollegedegreeorhigherdegreegotabetterscoreinfoods a f e t y knowledgeandfoodsafetybehaviorthanothers(Meysenburgetal,2013).Thea u t h o r groupusedtheHealthBeliefModelwiththemixedmethodanalysistoanalyzeth e sampleo f72participantsbyscriptinterviewandgroupdiscussion.Anotherfinding ofUnusan(2005)determinedapositiveeffectofeducationleveltotheconfidencei nfoodsafetypractice.Furthermore,highereducationlevelgroupsgetlessriskbehaviort h a n thelowerones.However,thisresearchfoundthatsocio- economicstatusdoesnotcorrelatew i t h i n d i v i d u a l f o o d s a f e t y practice.I n t h i s r es ea r c h , U n u s a n c o l l e c t e d t h e d a t a fromTurkishhouseholdsandanalyzedusingMAN OVAs.
Ontheotherhand,Unusan’sresearchindicatedtheimpactofgenderandeducationlevelt othefoodsafetyknowledge.Thereasonforthisfindingisquiteacceptableduet o mostoft heprimaryfoodpreparersinhouseholdarewomen,andthehigheducatedo n e s l i k e l y paymorea t t e n t i o n o n i n f o r m a t i o n B y r d -
B r e d b e n n e r e t a l ( 2 0 0 7 ) a n d M u l l a n etal(2014)foundthesimilarresulta fterreviewingmanyresearchesinfoodsafetyissue.Theirresearch alsoshowedthatageaffecttofoodknowledge,forinstancet h e o ld er t e n d toge t h i g h e r sco re i n f o o d k n o w l e d ge I n a d d i t i o n , womenw o u l d b e moreresponsiblein foodsafetyissuethanmen(Jevsnik et al, 2006).This consequenceconcludedfromtheinvestigationofparticipantsbyanalyzingusingANOVA.
Anotherr e s e a r c h l e a d i n g byL a n g i a n o e t a l ( 2 0 1 2 ) f i g u r e d o u t t h a t t h e marriedp art i ci p an ts h a d morep r e c i s e f o o d b e h a v i o r t h a n t h e s i n g l e s
Foodpreparersmainlystudyfoodprocessknowledgefromfamily’smembersand r e l a t i v e s ( M e y s e n b u r g e t a l , 2 0 1 3 ) O t h e r r e s e a r c h a l s o i n d i c a t e d f a m i l y a s a f o o d safety knowledgeresourcewhichaffectsindividualbehavior(Kwonet al,2008;T r e p k a etal,2006).KwoninvestigatedparticipantsoftheSpecialSupplement alNutrition ProgramforWoman,Infants,andChildrenwithaquestionnaireaboutf oodk n o w l e d g e an d b e h a v i o r t o co nc lu de t h e res ul t byANOVAa n a l y z i n g.F u r t h e r m o r e , respondentswithexcellentfoodknowledgewouldbehavepreciselyinf oodpracticing
(T.H.Voetal,2015).Theseauthorsgroupinvestigatedinthecanteens’andrestau r an t’ s workersbyusinglogisticregressionmodeltogetthisfinding.
However,t h e f i n d i n g o f C h o e t a l ( 2 0 1 0 ) s h o w t h a t f o o d safetyk n o w l e d g e ofp ar t i ci p an t s donotinfluencetheirfoodpractice.Thisresearchfocusedonresta urant’sw o r k e r withthemultipleregressionandmaximumlikelihoodestimation. Inaddition,R o b er t s e t al (2008)prove thatthere isonlyl i m i t e d d i s t o r t i o n in foodworkers’behavioreventhoughtheyhavejusttrained,educatedinfoodsafety.
Thehighself- efficiencyisconfidentthattheycanpreventhealththreataswellasF B D whenhand lingfoodwasintheircontrol(Meysenburgetal,2013).Thiscon fiden ce woulddec reasewhetherthefoodwerepreparedbyothers.Inaddition,onesh a d s u f f e r f o o d - b o r n e i l l n e s s o r c a u s e d t h e i l l n e s s f o r f a m i l y memberd u e t o t h e i r improp erhandlingfoodalsowerelessconfidentintheirfoodprepare.
Manystudiesh a v e s h o w n mixedr es u l t s o n f o o d s a f e t y perceptiona n d b e h a v i o r N e s b i t t e t a l ( 2 0 1 3 ) f o u n d t h a t m a n y con su mer s f e l t t h a t f o o d c o n t a m i n a t i o n o c c u r s beforefoodreachestheirkitchenandmajorityofthosewhoexperiencedF BDfeltthattheirillnesswascausebyfoodpreparedoutsidethehome.However,Unusa n’sr esear ch (2007)i n d i c a t e d thatc o n s u m e r d i d n o t r ec o g n i z e f o o d p ois on in g/
FB Da s ahealthproblem,theyevenacknowledgeditasanormalissue.Thismisleadi nga w a r e n e s s leadstothefactthattheyrarelytendtoadjustfoodsafetybehaviororp ayattentiononfoodsafetyissue.
Jevsnike t a l ( 2 0 0 6 ) f o u n d thef a c t t h a t t h e h o u s e h o l d c o o k p r e f e r r e d farmer’sproductt o t h e i n d u s t r i a l f a c t o r i e s T h e y b e l i e v e d t h a t t h e f o o d p r o d u c e d byfarmerw o u l d besafer.However,theconsumerssaidthattheywerenot responsibleforfoods a f e t y butclaimthisisfoodhandler(farmer,foodfactory,retaili ng,catering)andthe government.T h e r e s e a r c h a l s o f i g u r e d o u t t h a t t h e u n d e r 30g r o u p r e g u l a r l y self- ev alu at ed theirabilityinhandlingfoodsafelyhighly,thoughthefactwasnot(Byr d-B r e d b e n n e r etal,2007).
AresearchbyT.H.Voetal(2015)provedthecorrelationbetweenthefoodsafetyknow ledgea n d i n d i v i d u a l a t t i t u d e a b o u t f o o d s a f e t y p r o b l e m w h i l e t h e r e l a t i o n o f attitudea n d f o o d p r a c t i c e w a s i n s i g n i f i c a n t M o r e o v e r , C h o e t a l (
2 0 1 0 ) f o u n d t h a t r e s p o n d e r s w i t h g o o d k n o w l e d g e a b o u t foods a f e t y w o u l d p e r c e i v e w e l l a b o u t t h e s e v e r i t y andprobabilityoffoodpoisoning.Inad dition,precisefoodknowledgeconsumerss e l d o m s t r u g g l e d w i t h b a r r i e r s , d i f f i c u l t i e s w h e n h a n d l i n g f o o d safely.H o w e v e r , t h i s paperdidnotfigureoutanydirectimpactofknowledgetoperceptionofF B D prevention aswellasindividual’sbehavingfoodpracticesafely,thoughitfoundt h a t t h e b e n e f i t p e rc e p t i o n a f f e c t t o i n d i v i d u a l s a f e t y foodb e h a v i o r T h e r e s p o n d e r s w h o ac knowledgedtheadvantagesofnotsufferingfoodpoisoningwouldbehavefoodsafetyprac ticebetterandmorefrequently.
Ontheotherhand,HansonandBenedict(2002)demonstratedthegoodawareness aboutFBDseverity wouldimproveindividualbehaviorswhilethecorrelationbetweentheperceptionofFBDh azardandfoodsafetypracticewasnotstrong.Theresultwascal cu l at ed t h r o u g h t h e nonparametrics t a t i s t i c s w i t h S p e a r m a n r a n k c o r r e l a t i o n c o e f f i c i e n t s
Choe t a l ( 2 0 1 0 ) f o u n d t h e s t r o n g c o r r e l a t i o n o f c u e s t o individualf o o d s a f e t y p racti ce OneswhousedtosufferFBDweremorelikelytoperform safefoodhandlingp r a c t i c e ( L u m , 2 0 1 0 ) H o w e v e r , L u m i n d i c a t e d t h a t e x p e r i e n c i n g s y m p t o m s o f a n illnessdoesnotalwaysleadtofavorablebehavior.
AsimilarresultfromHansonandBenedict(2002)showedthatthecue,contentofc o m m u n i c a t i o n , educationmaterialhadimpacttosafetyfoodpracticeofrespond ers.
Thispaperalsofoundthatmalesarelessaffectfromeducationthanfemaleswhiletheo l d e r agegotstrongerimpactfromeducation.Thisinfluencevariedaccordingtothe f oo d handlingfrequencyofindividual.
Bredbenner etal(2013)indicated thatthe messages ofriskyf o o d o r o r i e n t e d p r a c t i c e s , w h i c h a r e p r i n t e d o n t h e f o o d l a b e l s , h a d p o s i t i v e e f f e ct toind ividualpractice.Furthermore,thisresearchalsofiguredouttheconsumersinvariousage bothconcernedaboutfoodsafetyknowledge.However,eachagewasonlysuscep tibleandconcernedwhentheinformationwasspecificallycommunicatedf o r theirg roup.
Ontheotherhand,Mu ll an etal(2014)showedthat pastbehavior o r habitsis animportantpredictorofcurrentbehavior.Habitsareformedthroughtherepetitionof abehaviorina c o n s i s t e n t c o n t e x t o r i n r e s p o n s e t o a c u e I n d i v i d u a l s m a y n o t bepract icin g foodsafetybehaviorintheirhomesduetoalackofcuetoactionthat remindt h e m todoso.
ANALYTICFRAMEWORK
Consultingfromotherrelatingresearch, thesisimplemented theHBMframeworkw i t h t h e c o m p o n e n t s e v a l u a t e d t h r o u g h s p e c i f i c v a r i a b l e s f o r foods a f e t y behaviors T h e modifyingfactorsincludeindividualanddemog raphiccharacteristicofp a r t i c i p a n t s andtheirfamilywhilsttheknowledgefocuses aboutthefoodsafetyissueonly.Inaddition, theindividualbeliefmeasured bythe attitude, awareness of r e s p o n d e r s a b o u t f o o d s a f e t y r e l a t i n g i s s u e O n t h e o t h e r h a n d , i n d i v i d u a l ’sa c t i o n s ev al uat edthrougharangeoffoodsafetypra cticeswhilethecuesforthesebehaviorsa r e theinformationsource.
- Modifyingfactors:age,gender,residentiallocation,occupation,educationlevel,numbero ffamily’smemberandtheknowledgeaboutfoodsafetyissue
- Individualbelief:theawarenessaboutthefoodsafetyproblem,riskygroupandr ea s o n o f f o o d p o i s o n i n g ; attitudea b o u t f o o d s e l e c t i o n a n d p r o c e s s i n g ; f o o d s o u r c e c h o s en
Perceived susceptibility to and severity of disease
- Hygiene kitchen practice Process, preserve practice Hygiene individual practice
Attention about food safety problem Reason of food poisoning Risky group Demographic characteristic:
Job, Education Food expenditure, Number of family’s member
Perceived benefits Food safety knowledge: Attitude about food selection-
Food processing, preserving Food safety information approach:-
+ TV, newspaper + Local food safety communicator
ECONOMETRICMODELS
Thesisa p p l i e d t h e m u l t i v a r i a t e p r o b i t model( M V P ) i n o r d e r t o a nalysist h e in f l u e n c e ofindependentvariablestoeachbehaviorgroup.Thedatainclu de3aspectso ffoodsafetybehaviorsuchashygienekitchenpractice,processandpreservepractic e,hygienei n d i v i d u a l p r a c t i c e , s o t h i s p a p e r w o u l d u s e t h e M V P w i t h 3 e q u a t i o n s t o im predictthedependentvariables.Accordingto Cappellari andJenkins (2003), thetrivariateprobitmodelis: y ∗ =β m X i m
+ϵ im ,m=1,2,3 yim=1ifyim*>0andyim=0otherwise ϵim,m=1,
… 3areerrortermsdistributedasmultivariatenormaleachwithameano f z e r o , a n d v a r i a n c e – covariancem a t r i x V , w h e r e V h a s v a l u e s o f 1 o n t h e leadingdiagonalandcorrelati onsρjk=ρkjasoff-diagonalelements. by:
Whereωiisiisanoptionalweightforobservationi=1,…,N,andϕ𝑖=1 3i sthetrivariate standardnormaldistributionwithargumentsàiandΩ,where
WithKik=2yik–1,foreachI,k=1, …,3 MatrixΩhasconstituentelementsΩjk, where: Ωij/orj=1,
The dependent variable comprises nine food safety practices categorized into three behavior groups, each exhibiting distinct behaviors Each practice is assigned a binary value: 1 for correct practices and 0 for incorrect ones The study defines correct practice as the presence of precise behaviors within each group, while any deviation is considered incorrect The three behavior groups are labeled as "kprac" for kitchen hygiene practices, "pprac" for process and preservation practices, and "iprac" for individual hygiene practices These behaviors align with the "10 golden principles of food processing," specifically highlighting the importance of maintaining a clean kitchen and separating cooked and raw foods during processing and preservation, which are further broken down into four evaluable behaviors for ease of assessment.
- “sex”is thedummyvariableindicatethesexualityof participant,0 formaleand
1f o r female T h e ex p e c t e d r e g r e s s i o n c o e f f i c i e n t o f t h i s variablei s p r e d i c t e d insignificant,duetothefactthatmostoftheresponderswerefemales;
- “loc”i s d u m m y v a r i a b l e i n d i c a t e t h e l o c a t i o n o f r e s p o n d e r , 0 f o r s u b u r b a n p a r t i c i p a n t (include12districts:BinhTan,BinhChanh,ThuDuc,GoV ap,9,12,6,8,NhaBe,CanGio,CuChi,HocMon)and1forurbanparticipant(include12d istricts:1 , 2,3,4, 5,7,10,11, PhuNhuan,TanBinh, TanPhu,BinhThanh) T h e ex pectedr e g r e s si o n coefficientofthisvariableispredictedtogetthepositivevalue,t hatmeantheurbanparticipantgetthehigherprobabilitytobehavepreciselythanthes uburbanones;
V N D ) , t h e n u m b e r o f family’smember,respectively.Theexpectedregressioncoefficientsofthe sevariables arepredictedgettingthepositivevalues.However,thethesisusedthenaturallogarithmo f age(lna ge)andexpenditure(lnexp)toestimatethecoefficientssoastoadjustthesevariablestoget normaldistribution.
- “job”a n d “edu”a r e c a t e g o r y v a r i a b l e s s h o w t h e p r o f e s s i o n a l ( o f f i c e c l e r k , retirement,householdlady,physicallabor,farmer)and theeducati onlevel(primary,j u n i o r h i g h , h i g h s c h o o l , c o l l e g e – university,b e l o w p r i m a r y ) o f t h e r e s p o n d e r s I n o r d e r toreducethenumberofdu mmyvariableaswellaseasiertointerpret,thethesisusethetransformedvariableof“edu”(t heschoolingyears)andjob(onlyhouseholder-h h o l d e r , commonlabor–com_laborandother)
- “know”istheexaminingresultaboutfoodsafetyknowledgeofparticipant.Thisv ar i ab le i s r e c o r d e d t h r o u g h t h e q u e s t i o n n a i r e f o l l o w e d W H O ’ s F o o d safetyknowledge,d i v i d e i n t o 2 g r o u p : k n o w l e d g e a b o u t safetyf o o d s e l e c t i o n , k n o w l e d g e a b o u t foodprocessingandpreserving.Thevalueofthisvariabl eisthescorethattheparticipantsgetthroughthesurveyquestions.Thatscorewas estimatedbythed i f f i c u l t y indexmethod(Collen,2006,p.98–100):
- “per”istheindicatorofparticipant’sperception,estimatingbythequestionnaireo fattitu dea b o u t foodsafetyissues,include4groups:perceptionaboutsusceptibilityt o andseveri tyofFBD,perceptionaboutbenefits,perceptionaboutbarrierandp er cep t io n abouts elf- efficacy.However,inspiteofthelimitedofthedata,thethesisappliedFactorAnalysis methodtofigureouttheperceptionfactorfrom3of4groups,e x c e p t theperceptionaboutbe nefits.
- “cue”isthecategoryvariableshowtheinformationsourceaboutfoodsafetyofr e sp o n d e r s (TV,radio,newspaper,localmedicalstaff,fooddocumentary).Inordertoanalysi s,the thesisusethe dummyvariable ofthesecues(TV,radio,news, local_staff,f o o d _ d o c respectively).Allvariableswhichareusedinthemodelaredesc ribedinthetablebelow:
Job Occupationofparticipant Categoryvariable:common labor,householder,other
Knowledge Foodsafetyknowledge Foodsafetyknowledge point Perception Awarenessaboutfoodsafetyissue 3pointLikert’sscale
Cuetoaction Foodsafetyinformationsource Categoryvariable:TV, radio,newspaper,local medicalstaff,food documentary
Multicollinearityisthesituationthattheexplanatory variablesintheregressionm odelhave the linear relationship.There aretwotypesofmulticollinearity:theperfect multicollinearitya n d i m p e r f e c t m u l t i c o l l i n e a r i t y I f m u l t i c o l l i n e a r i t y i s p e r f e c t , t h e regressioncoefficientsofthedependentvariablesareindeter minateandtheirstandarde r r o r s areinfinite.Ifmulticollinearityislessthanperfect ,theregressioncoefficients,althoughd e t e r m i n a t e , p o s s e s s l a r g e s t a n d a r d e r r o r s ( i n r e l a t i o n tot h e c o e f f i c i e n t s t h e m s e l v e s ) , whichmeansthec oefficientscannotbeestimatedwithgreatprecisionora c c u r a c y (Gujarati,2004).
ThepaperofChoetal(2010)andT.H.Voetal(2015)found outtherelationbe tween k n o w l e d g e a n d p e r c e p t i o n a b o u t f o o d safety.T h e p e r c e p t i o n v a r i a b l e w a s measuredbyLikertscale,thatmeanitscoefficientdoesnotshowtheextent butonlythetrendofperception’simpacttobehavior.Duetothisreasonandthelargenu mbero f o b s e r v a t i o n ( a b o v e 1 0 0 0 ) , t h e e f f e c t o f m u l t i c o l l i n e a r i t y i n t h e r e g r e s s i o n m o d e l woulddecrease.However,thethesisalsousedthereducedformofM VPaswellastheor i g in al formtoestimatetheregressioncoefficient.
Accordingt o C h o w a n d M u l l a n ( 2 0 0 9 ) , t h e p a s t b e h a v i o r w a s a s i g n i f i c a n t p r ed i ct o r off o o d safety behaviors o theysuggestprovid inga cue t o carry outf o o d - s a f e t y behaviorsandmadethosebecomeindividualhabitsinordertochangeprimaryc o o k behaviors.Moreover,theconsumersregularly arenotawareabouttheirro leinfo o d s a f e t y ch a i n ( J e v s n i k e t a l , 2 0 0 7 ) a n d p r e v e n t i n g F B D ( B y r d -
Ontheotherhand,individualsuserationalitywhentheyareawareofandhav esomeknowledgeaboutthecause- effectrelationshipbetweenthecorrectbehaviorandt h e healthbenefits (Mari etal2008).Butitmightbedifficultfor thehousehold cooktofigureo u t t h e w r o n g p r a c t i c e w h i c h l e a d themt o t h e F B D I n a d d i t i o n , t h e f o o d p o i s o n i n g informationinthedataonlycoveredthehealthstate mentfor2weeks,thus this paperassume thatthefood poisoning incident didnotaffectto individual behaviorandu s i n g i n d i v i d u a l b e h a v i o r toe s t i m a t e t h e f o o d p o i s o n i n g p r o b a b i l i t y byP S M method.
Khandker et al (2009) define Propensity Score Matching (PSM) as a statistical method that creates a comparison group based on the likelihood of participating in a treatment, determined by observed characteristics Participants are matched to nonparticipants according to this probability, known as the propensity score To assess the impact of food practices on the risk of food poisoning, this thesis employed PSM in four distinct steps.
- Step1:establishthelogitregressionmodelwiththedependentvariablereceiveva lu e as“0”iftheparticipanthadnotsufferFBDwithin2weekatthesurveytime,and“1”otherwise. Theexplanatoryvariablesareindividualfoodsafetybehaviors.
DATA
Thesisu s e d t h e d a t a fromi nv est iga ti on a b o u t i n d i v i d u a l f o o d p o i s o n i n g inH o C h i MinhCitysurvey(2013)andKnowledge,Attitude,Practice(KAP)infoodsafe tyo f HoChiMinhCity’sHouseholdsurvey(2013).
+P a r t 1 i s t h e i n v e s t i g a t i o n i n i n d i v i d u a l f o o d p o i s o n i n g a n d t h e r e l e v a n t symptoms,included:individualcharacteristic,demograp hicinformation,foodp o is o n in g statementandclinicalsymptoms.
+Part2istheKAPsurveyofprimarycookofhousehold,included:individualcha racteristic,f o o d s a f e t y k n o w l e d g e , f o o d s a f e t y a t t i t u d e a n d e x a m i n i n g t h e f o o d s a f e t y practicingofprimarycook.
- Sizeofsamples:1,174householdsand4,593individualparticipateinthesurvey.T h e h o u s e h o l d s w e r e c h o s e n byP r o b a b i l i t y P r o p o r t i o n a l t o Sizesamplin gtechnique(PPS):
In a study conducted across 319 wards in Ho Chi Minh City, researchers randomly selected 30 wards for investigation Within each ward, the surveyor began by examining the first household and then interviewed the next 39 households to gather data using four questionnaires These questionnaires focused on acute food poisoning, food knowledge, attitudes towards food safety, and an evaluation of food practices The food practices checklist was completed by the surveyor, while the other questionnaires were answered by the respondents Local medical staff responsible for food safety in each selected ward conducted the research.
Households participating in the survey were required to meet specific criteria: all members must have resided at the same location for at least six months prior to the investigation Additionally, participation in the survey had to be approved by the household, which consists of individuals living at the same address, sharing at least one meal together, and having similar relationships and household choices If a household is unapproachable for three consecutive attempts, it will be replaced by another household.
+Theindividualparticipateinthesurveydonothavementalillness,deafnessordumb.The childrenwhojoinedinthesurveymustfrom6monthsoldatleastbecauset h e i n f a n t ’ s f o o d i s m o s t l y lacf e m i n n u m T h e a n s w e r o f t h e c h i l d r e n u n d e r 1 0 w a s confirme dbytheirmotherortheprimarycustodian.
+Thesymptomstodiagnose foodpoisoningcase:after havingmeal,thepatienth ad thestomach- intestinesymptoms(colic,vomit,diarrhea…),nervesymptoms( s t i f f e n tongue,i llusion,lessvisible,delirium,convulsion…)orothersymptomsd ep en d onthepoisoni ngpathogen.However,thefoodpoisoningcaseonlycountedift h e r e s p o n d e r s h a d u s e d t h e meala t homeb e f o r e t h e f i r s t s y m p t o m o c c u r r e d A h o u s e h o l d hadsufferedfoodpoisoningwhentheprimarycookoranyofthefamily’smemb ershadthesymptomsafterhavingmealathome.
Thesisc o m b i n e d twop a r t s o f t h e d a t a t o evaluatet h e r e l e v a n t ofk n o w l e d g e , percep tion about food safety andindividual behavioraswellas estimatingtheeffectoff o o d safetybehaviorofindividualtotheirfoodpoisoningprobability.
FOODSAFETYPROBLEMSINVIETNAM
WHO(2016)estimatedthefood- bornediseases burdeninVietnamare about1 b il li on U S D p e r year( 2 % o f G D P ) , i n c l u d i n g t h e t o t a l c os t s o f l o s t w o r k t i m e , l o s t productivityduetoillnessan drelatedmarketlosses.Ontheotherhand,accordingtoVietnamFoodAdministrat ion’s(VFA)statisticsfrom2007to2015,thereare150to2 5 0 massf o o d p o i s o n i n g o u t b r e a k s i n V i e t n a m e a c h year,i m p a c t t o a b o v e 5 , 0 0 0 p e o p l e annu ally.A l t h o u g h t h e N a t i o n a l S t r a t e g y onF o o d s a f e t y h a s a l r e a d y b e e n i m p l e m e n t e d from2006andthestrategyintheperiod2011–
Thereasonforthisstagnantmaybetheslacknessoflegacyinstitution.TheLawo fF oodSafetywaspromulgatedin2011,effectivesince2011buttheotherregulatorydocumen tsr e l a t e d t o , a r e i n a d e q u a t e t o meett h e a c t u a l n e e d s , t h e r e f o r e t h e F o o d
S a f e t y Departmentdonothavetheinstitutiontoadministratewhilethemanufacturersa n d consumersdonothaveenoughinformationandinstructionsto applyfoodsafet yp r a c t i c e I n a d d i t i o n , t h e F o o d S a f e t y A d m i n i s t r a t i o n n e t w o r k i s co mplexw i t h t h e involvingo f m a n y M i n i s t r i e s , D e p a r t m e n t s Furthermore, t h e t r o p i c a l climatea n d climatechangeproblemcreateopportunitiesforfoodpoisoningo ccurred.Thediversityo f Vietnamesef o o d c o m b i n e w i t h t h e l i m i t e d k n o w l e d g e o f c o n s u m e r , e n h a n c e t h e p o s s i b i l i t y o f F B D D e s p i t e o f t h e s t a b i l i t y o f f o o d p o i s o n i n g c a s e s , t h e numbero f death droppeddownslowlyandhalfofthatisduetona turaltoxic(Nguyen,2016)
InH o C h i M i n h City,t h e f o o d p o i s o n i n g i n c i d e n t s t r e n d t o d e c r e a s e a n n u a l l y withtotal20incidentsinthe period2012-2016andnodeath case.Nineteen oftwentyincidentswerecausedbybacterium,andtheotherisnon-identifiedcause.
Thef i g u r e o f f o o d p o i s o n i n g c a s e s i n V i e t n a m a n d H o C h i M i n h C i t y d o n o t includetheindividualincidentsduetothelackofattentionfromthegovernmentandr e s e a r c h e r s tothisissue.Asaresult,therearefewprogramstoeducateandevaluatethea c c u r a t e o f householdfood preparing and cooking.M o s t o f the resources ofthegovernmenta r e s p e n d i n g o n managingt h e manufacturersa n d merchandising.
H o w e v e r , thefindingfromthesurveyin2013showthattheindividualfoodpoisonin gr a t i o is2.18%.Thatfigureimpliesthehighpossibilityofpopulationwithfood- borned i s e a s e s
Duet o t h e l a c k a t t e n t i o n o f t h e V i e t n a m e s e g o v e r n m e n t o n t h e f o o d s a f e t y i n h o u seh o l d , t h e p r i m a ryc o o k ‘ s p r a c t i c e i s c o n s i d e r e d badly.A c c o r d i n g t o t h e investigation ofSafetyHygieneFoodBranchofHoChiMinhcity(2010),there’sonly
HoChiMinhcitybehaveaccuratelyincooking.ThefiguresforL a o CaiprovinceandDongTha pProvinceare67.7%and76%,respectively(Nguyen,2 0 1 6 )
Researchers have highlighted the need for specific education programs for household cooking to improve behaviors, yet most communication and education strategies primarily target food producers and workers Additionally, the risk of food poisoning in households appears to be lower than in schools and factories Due to the pressures of work and transportation in urban areas, consumers often eat outside their homes at company canteens, schools, or other food establishments As a result, the significance of household cooking practices is often underestimated, leading to minimal governmental efforts to enhance these practices.
DESCRIPTIVE STATISTICS
Table4.1:Demographiccharacteristicsofparticipants(categoryvariables)De mo g ra p h i c characteristics Numberofparticipants(n) %
Thedat a s h o we d t h a t t h e m a j o r i t y oft h e p r i m a r y cooko f h o u s e h o l d is fe male( a c c o u n t e d for93.02%).Inaddition,householderdominatedintheoccup ationofther esponders (69.78%).However,exceptcommonlaborandhouseholder,th enumberofotheroccupationisinappreciable.Thus,in theregressionanalyzing,thesistransformthenumberofthisvariableintothreevalues:householder,commonlaborand others.
The education levels of participants varied across the education system, with the majority being Junior and High school graduates The sampling method resulted in a nearly equal distribution of urban (53.53%) and suburban (46.47%) respondents Television emerged as the primary source of information for households (87.31%), followed by newspapers as the second most favored source However, only 24.19% of respondents received food safety information from local medical staff Additionally, the food poisoning rate in households was recorded at 5.11%, compared to 2.18% for individuals, highlighting that some households experienced multiple food poisoning cases.
Variables Mean SD Min Max
The average age of the primary cook in households is 47 years, indicating that food preparation is primarily the responsibility of middle-aged women, as is typical in traditional Vietnamese families Additionally, households in Ho Chi Minh City average just over four members, aligning with government population policies On average, families spend nearly 100,000 VND per day on food, while the mean knowledge score for food safety is 9.46 out of 14.04, suggesting that primary cooks generally possess basic knowledge in this area However, the knowledge assessment from a 2010 survey, based on the percentage of correct answers, prevents a direct comparison of results between the two periods.
Accordingt o t h e H e a l t h B e l i e f M o d e l , thep e r c e p t i o n v a l u e i n c l u d e d 5 latentvariables:p e r c e i v e d s u s c e p t i b i l i t y , p e r c e i v e d severity,p e r c e i v e d b e n e f i t s , p e r c e i v e d b a r r i e r s , perceivedself- efficacy.Duetothedata’slackofinformation,thethesisonlyevaluated 4 o f 5 p e r c e p t i o n c o m p o n e n t : p e r c e i v e d s u s c e p t i b i l i t y (3q u e s t i o n s ) , p erceiv ed bene fits(3questions),perceivedbarriers(1question),perceivedself- e f f i c a c y (11questions).Thecorrelationcoefficients(Appendix1)rangefrom- 0.0004t o 0.8587showedthatthereisrelationshipamongtheseitems.Inaddition ,whisttheKai se r -M ey e r-
Olk i n (KMO)value(0.947)alsoindicatedastrongcorrelationbetweenitems.Similarl y,thedeterminantofcorrelation coefficientsmatrixis notequal0(p- v a l u e |z| [95%Conf.Interval] kitc perc_f1 tv radio newsd oc loc_staff
2756593 1964591 5623144 1793413 -.082692 1812815 1.058655 proc perc_f1 tv radio newsd oc loc_staff
6650862 2645881 7215597 040721 3383889 -.1696861 1.110831 indi perc_f1 tv radio newsd oc loc_staff
4049802 2067088 344885 0090418 0614635 -.0650677 1.372465 /atrho21 659449 0598651 11.02 0.000 5421155 7767824 /atrho31 4935782 0578527 8.53 0.000 3801891 6069673 /atrho32 5218016 0602191 8.67 0.000 4037743 6398289 rho21 5779966 0398654 14.50 0.000 4945877 650856 rho31 4570518 0457674 9.99 0.000 3628716 5419888 rho32 4790893 0463972 10.33 0.000 3831738 564783 Likelihoodratiotestof rho21= rho31= rho32= 0:chi2(3)=
Multivariate probit(MSL,# draws=5) Numberofobs = 1147
The analysis reveals significant findings related to various factors influencing the outcomes measured Specifically, the variable "kitc know2" shows a positive coefficient of 0.0667, with a p-value of 0.001, indicating a strong relationship Similarly, "f_mem" has a coefficient of 0.0673 and a p-value of 0.005, suggesting its relevance as well In contrast, the variables "sex" and "job_new1" show no significant impact, with p-values of 0.906 and 0.399, respectively Notably, "perc_f1" demonstrates a substantial positive effect with a coefficient of 0.1365 and a p-value of 0.004 Among media variables, "radio" stands out with a coefficient of 0.3582 and a p-value of 0.001, while "tv" shows no significant effect Furthermore, "loc_staff" has a negative coefficient of -0.1598, indicating a potential detriment, though not statistically significant Overall, the results underscore the importance of certain factors like "perc_f1" and "radio" in influencing the outcomes, while highlighting the lack of significance in others.
Loglikelihood = -2627.7535 PseudoR2 = 0.0100 count Coef Std.Err z P>|z| [95%Conf.Interval] know2 0098917 004481 2.21 0.027 0011092 0186742 f_mem 00365 0045554 0.80 0.423 -.0052784 0125783 sex 0126925 0364342 0.35 0.728 -.0587172 0841023 edu 0097375 0097973 0.99 0.320 -.0094648 0289399 job_5 -.0173529 0296353 -0.59 0.558 -.0754371 0407313 job_4 -.0224146 0341957 -0.66 0.512 -.089437 0446078 lnage 015889 0337333 0.47 0.638 -.0502271 0820051 lnexp -.0051244 0205234 -0.25 0.803 -.0453495 0351006 loc_dum 0327238 019411 1.69 0.092 -.005321 0707687 perc_f1 0449872 009692 4.64 0.000 0259911 0639833 tv 0051544 0277787 0.19 0.853 -.0492909 0595996 radio 0403983 0212309 1.90 0.057 -.0012136 0820101 news -.0023822 0203121 -0.12 0.907 -.0421931 0374287 doc -.0341781 0305385 -1.12 0.263 -.0940326 0256763 loc_staff -.0411455 0249034 -1.65 0.098 -.0899552 0076643_cons 2.258058 2828686 7.98 0.000 1.703646 2.81247
A5)Trìnhđộhọcvấn:K hôn g Cấp1 Cấp2 Cấp3 Đạihọc
TV ĐàiPT Báochí Sáchvở CBYT Khác
B4)Theoanh chị, làmthếnào đểphòngngừangộđộcthựcphẩmchogia đình :
THỰCPHẨM(7Câu)C1) Anhchịthườngđichợ nào ? vì sao ?
Thườngxuyên Thỉnhthoảng Giámắc Giárẻ ATTP Tiệnlợi(ghirõ)
Màu Mùi Độchắc Mắt Mang Da Mua Muađồ Khác người tươi quen sống
Toànvẹn(khôngbịtrầyxướt,dậpnát,gọtvỏ,xắtmỏng, )
C4)Khichọnmuathựcphẩmbaogóis ẵ n , đồhộp,anhchịcóđọcnhãnkhông? Có Không
Bộtnổi(làmbánh bônglan , làm mềm thịt )
-Bếpđiện Bếpga Bếpdầu Bếp than
C6)Ngoài việcđọcnộidungnhãn ,Anhchịcònđểý điều gì ?
C7)Anhchịcó sử dụngcácloại phụ gia sautrongchếbiến thứcănchogia đình
E1)Mặtbếpnhà anhchịđượcxây dựngnhưthếnào và bếp sửdụnglàloại gì?
-Gạchmen Ximăng Gỗ Đất Bếpcủi
E2)Anhchịthườngvệsinhnhàbếp(mặt,váchbếp,bếpnấu)khinào?
E5)NhàAnhchịcóbaonhiêucáithớt?……cái.Cóphânbiệtsống,chín(*) Không
E7)Baolâugiặtkhănlauchénbátmộtlần?mỗingàyvàingàytuần/lầnKhác E8)Anhchịxửlý rauquả (ăn sống)bằngcáchnàođểbảo đảmsạchvà an toàn :
- Rửa nướcthuốc Rửa nướcmuối Khác
Thức ănchongười lớn Thức ănchotrẻem( ≤ 5tuổi )
Treo(đểtrần ) Treo(cóbao bọc)
E9)Giađìnhanhchịthườngbắt đầu ăn vàolúcnào, sau khit h ứ c ănđãn ấ u chín?
E10)Thứcănđểnguội(>2giờ),trướckhiănanhchịcóhâmlạikhông?CóKhông
E11)Khônghâmlại,vìsao? MấtcôngThấykhôngsao Khác
E12)Cóhâmlạinhưthếnào:HâmnóngNấuvừasôiNấusôikỹ>2phút Khác
Luônđểlại Tùymónđểlại Luônbỏđi Đểlạidùngbằngcáchnào?Đ ể riêng,hâmlại Trộnvớithứcănmới,hâmlại
E14)Anh,chịthườnggiữthứcănsaukhin ấ u chín(để1buổi)nhưthếnào?
E15)Anhchịcótrữ thựcphẩmkhô(bánhtráng,lạpxưởng,mựccákhô )Có Không
Theoanh/ chịlàmthếnàođểngườidântíchcực,mạnhdạn,pháthiệnvớicá chànhviviphạmvềVSAT TP?
STT NỘIDUNGTHỰC HÀNH ĐẠT KHÔNG ĐẠT
3 Có dụngcụchứachất thải kín,cónắpđậy
6 Rửa rauq u a 3 lầnhoặcrửatrực tiếpdướivòi nướcsạch
7 Khôngsửdụngphụgia thực phẩmngoàidanh mục,thựcphẩmhếthạndùngđểchếbiếnthức ăn.
1 Córửataysạchtrướckhivàochếbiến,sau khi đi vệsinhv à trướckhi ăn
2 Khôngđeo đồtrangsức,giữmóngtayngắn,sạchsẽ,khôngsơn móngtay.
10 Trongvòng2tuầntrởlạiđây,Anh/ chịcótriệuchứngbấtthườngxảyrasauk h i ănuống(có liên quan đếnăn uống cácloại thực phẩm trướcđó)nhưbuồnn ô n , nôn,đaubụng,tiêuchảynhiềulầntrong24-
48giờhaybấtkỳmộtkhóchịunàoởruột,dạdàysaukhiănuống)? có:1 không:2,(kếtthúcphỏngvấn,chuyểnđiềutrakiếnthức)
14 Anh/ chịxuấthiệnnhữngtriệuchứngbấtthườngvềđườngtiêuhóacóliênquanđếnănuống : hiện có không khôngrõ thờik h o ảngx u ất
17 Anh/chịcóphảinhậpviệnvìbệnhnàykhông? có:1(xuống19) không:2, 3.Khám,lấythuốcrồivề 18.Nhậpbệnhviệnvàokhoa/bệnhviện:
22 SaukhithamgiabữaănngườiđócótriệuchứngbấtthườnggiốngAnh/ chịkhông? có:1 không:2, Khôngbiết:3
23 NhữngngườicùngănvớiAnh/chịcóđibệnhviệnkhông? có:1 không:2, Khôngbiết:3
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