Assessing Food Safety Knowledge, Skills, and Practices Among Handlers and Consumers in the Dominican Republic

Foodborne illnesses affect over 600 million people worldwide each year, disproportionately impacting low- and middle-income countries. Most of these cases are preventable through the adoption of safe food handling practices. This study evaluated food safety knowledge, skills, and self-reported behaviors among consumers and food handlers in the Dominican Republic and explored barriers and opportunities to improve food safety behaviors. A national, in-person survey was conducted with 521 participants across all ten regions of the country. Data were analyzed using a knowledge-skills-behavior framework grounded in social cognitive theory to identify gaps in understanding and beliefs that influence the adoption of food safety practices, as well as potential intervention strategies. Results revealed substantial discrepancies between perceived and actual food safety knowledge among both consumers and food handlers. Food handlers demonstrated no greater knowledge or skills than consumers, and participation in formal training was very limited across both groups. Although most participants expressed concern about food safety, this concern was not consistently reflected in their behaviors. Minimal variation across gender, geographic location, and market type indicates that these deficiencies are widespread. Peer-led, on-site demonstrations-especially in open markets-emerged as promising interventions; however, the costs associated with implementing safer practices may discourage adoption without adequate incentives. Overall, the pervasive gaps in knowledge and skills that drive unsafe food handling behaviors underscore the need for effective communication strategies, targeted training for food handlers, and strengthened regulatory oversight that minimizes financial burden for resource-limited groups.