Food Safety Educational Interventions for Food Handlers: Structured Evidence Update and Exploratory Meta-analysis with Public Health Implications
Keywords:
food safety, health education, food handling, small and medium-sized enterprises, public health, foodborne diseasesAbstract
Background: Food safety is a public health priority. Food-handler training is widely used, although increased knowledge does not always translate into sustained practices, particularly in small businesses and resource-constrained food services.
Objective: To synthesize recent evidence on food safety educational interventions for food handlers and explore pre-post changes in knowledge and practices, considering their applicability to SMEs, informal establishments, and food service settings.
Methods: A structured evidence update covering January 2020 through August 25, 2026 was conducted using PubMed/MEDLINE and PubMed Central, supplemented by reference tracking. Experimental, quasi-experimental, and pre-post studies were included. For compatible continuous outcomes, Hedges’ g was calculated using a random-effects model, assuming r=0.50 and sensitivity analyses from 0.30 to 0.70. Estimates were interpreted as exploratory temporal changes rather than comparative causal effects.
Results: Eleven studies were included in the narrative synthesis. Five studies involving 907 participants provided knowledge data and four involving 739 provided practice data. The pooled standardized change was large for knowledge (g=2.10; 95% CI 1.35-2.85; I²=98.4%) and practices (g=1.61; 95% CI 0.65-2.57; I²=98.6%), with extreme heterogeneity. Practical, tailored interventions incorporating follow-up showed more consistent results.
Conclusions: Educational interventions were associated with improved knowledge and practices, but extreme heterogeneity and the predominance of uncontrolled designs limit causal interpretation. For SMEs, findings favor recurrent, context-specific programs linked to resources and supervision.
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The extraction matrix, calculations used in the exploratory meta-analyses, and search strategies are retained as supporting documentation and may be made available in accordance with AHRIE’s editorial policy.
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Copyright (c) 2026 Carlos Andrés Ramirez González (Autor/a)
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