The role of theoretical food safety training on Brazilian food handlers' knowledge, attitude and practice

•In total, 183 randomly selected food handlers from different food businesses were enrolled.•Knowledge, attitudes, self-reported practices and observed practices were evaluated.•Trained food handlers presented more knowledge but no differences in other variables.•Variables associated with the observed practices were identified by multiple linear regression.•Theoretical training is not related to the attitudes and practices of food handlers.

The objectives of this study were 1. to identify the relationship of theoretical training with knowledge, attitudes, self-reported practices and observed practices and 2. to identify variables that influence observed practices. This study was cross-sectional and involved 183 randomly selected food handlers from different food businesses in Santos City, Brazil, as follows: street food kiosks, beach kiosks, restaurants, hospitals and school meal services. To evaluate knowledge, attitudes and self-reported practices, a structured questionnaire was used. Observed practices were evaluated using a checklist. A researcher observed and followed each food handler throughout the process of food handling/preparation during a workday. The majority of participants (68.3%) had participated in at least one food safety training session. The average percentage of correct answers on the knowledge questionnaire was 64%. Food handlers who had undergone training presented higher knowledge scores but did not differ from those who had not regarding attitudes, self-reported practices and observed practices. A regression model was used to study the variables associated with observed practices (p < 0.001). The variables related to observed practices were the knowledge score (β = 0.27, p < 0.01), experience (in years as a food handler) (β = 0.19, p = 0.01), the relationship between the number of meals and the number of food handlers (β = −0.19, p = 0.01), buildings and facilities adequacy (β = 0.20, p = 0.01) and the presence of a nutritionist (β = 0.42, p < 0.001). This study showed that training based on theoretical aspects is not related to the attitudes, self-reported practices and observed practices of Brazilian food handlers from different food services. However, training seems to be an effective tool for improving knowledge. The current wording of Brazilian legislation motivates food handlers to undergo training only for certification. Food safety laws should not only require certification but also enable the establishment of policies to monitor and ensure the adequacy of food services.