Food Protection Trends - July/August 2018 - 267

INTRODUCTION
With the "go local" movement, interest in agricultural
products from small farms and local producers has increased.
There was a large (218%) increase in direct-to-consumer
marketing-the main sales outlet for the small farmer-from
$551 million in 1997 to $1.2 billion in 2007 (20) in the
United States, followed by an another significant increase
(8%), to $1.3 billion, in 2012 (4). One of the factors driving
this trend is the perception by consumers that local foods
are "fresher, safer, and support family farmers," in contrast to
foods that are "industrially produced," or those that support
large corporations, and are perceived to be "unhealthy"
(28). These local food sources, such as farmers markets and
on-farm sales, are undoubtedly a major source of revenue
for farmers and provide a choice of foods for consumers. In
recognition of the increasing importance of these sources,
public health agencies and academia have begun to focus on
the inherent food safety risks associated with this relatively
unregulated side of the food industry (10, 29, 36).
Interest has also grown in identifying food safety risks
associated with foods produced from small farms, including
farmstead cheese processors. The American Cheese Society
states that for cheese to be classified as "farmstead," it must
be made with milk from the farmer's own herd, or flock, on
the farm where the animals are raised (8). In this study, for
lack of a better term, participating farms will be referred to in
general as farmstead farms, even if some of the farms bought
their milk from other local dairy farms. In Pennsylvania,
farmstead cheese production on family owned/operated
dairy farms typically seems to utilize farmers' markets,
on-farm sales, and other direct-to-consumer approaches as
their primary sales outlets (19). These farms employ a small
number of people who are involved in the cheesemaking
procedures on site and are inspected twice a year by the
Pennsylvania Department of Agriculture (PDA) or a local
health department (7).
Previously, publications have addressed needs assessment
(19) and microbiological aspects (18) of farmstead cheesemaking. However, there is no research addressing food
safety knowledge, behavior, attitudes, and skills of farmstead
cheesemakers in the U.S. There is some evidence that food
handlers in small food businesses lack basic knowledge of
food hygiene (37). A recent comprehensive-needs assessment (19) indicated that basic food safety and sanitation
gaps exist for farmstead cheese processors, even though most
participants (65%) reported having sufficient knowledge, as
well as positive behavior and attitudes about food safety and
sanitation.
These gaps may be addressed through educational training.
For decades, the retail food industry has used employee
food safety education and training as critical components
of ensuring a successful and safe retail food business (29).
Effective food safety training has been shown to increase food
safety-related knowledge and attitudes while improving skills

and behaviors of employees (21, 33) and may even improve
inspection outcomes in restaurants (22). The evidence of the
efficacy of well-established food safety training methods is
vast. However, retail food safety training programs, such as
ServSafe® or SafeMark©, may not be appropriate to address
the unique food-safety and sanitation needs of this audience
in Pennsylvania or of similar audiences across the country.
Given the lack of food safety and sanitation training for
this audience, the purpose of this study was to develop
and evaluate the impact of a customized food safety and
sanitation-training program on the knowledge, attitudes,
behavior, and skills of farmstead cheesemakers in
Pennsylvania.
MATERIALS AND METHODS
The experimental design was previously reported by
these authors (18). Briefly, out of 55 small dairy plants in
PA that were potential participants, 17 agreed to participate
in this study. The majority of participants were located
between the central and southeastern areas of PA, in the
Lancaster County region, with one participant based in
the northwestern area. This distribution of participants
matches the distribution of small dairy farms in the state
(14). This study used an adaptation of a pre-test/post-test,
experimental control group design (12). The participating
dairy plants (n = 17) were randomly assigned (RA) to
either the control group (n = 7), the treatment 1 group
(×1; n = 5) or the treatment 2 group (×2; n = 5) by a true
experimental design. Random assignment to the control
and treatment groups was done using the tool "Integer Set
Generator" available at Random.org (6).
An assessment was developed for food safety and
sanitation knowledge, attitudes, behavior and skills and
administered as a pre-test (E1) to treatment groups 1 and
2 (Fig. 1). Following the training intervention, the same
assessment was administered as a post-test (E2 and E3) for
treatment groups 1 and 2, respectively. The same assessment
was given to the control group labeled pre-test (E4) and
post-test (E5) with no training intervention, in an effort to
assess the impact of training on the two treatment groups.
Demographic questions were included in the pre-tests (E1
and E4), and a program evaluation was included in the posttests for treatment groups only (E2 and E3).
There were a total of 31 individual participants, as follows:
control group (n = 12), treatment group 1 (n = 9) and
treatment group 2 (n = 10) (Table 1). Three participants
in the control group and three participants in treatment 2
group did not have their handwashing skills assessed because
of technical problems during the recording of handwashing
skills. One participant in the control group partially filled out
the behavior portion of the survey and was excluded from the
analysis of that attribute.
The experimental design used controls for all internal
validity threats (history, maturation, testing, instrumentation,

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