Informing food safety trainings in low- and middle-income countries: a novel evaluation of training materials and...

Over the past two decades, food safety training interventions in LMICs have increased significantly, yet improvements in food hygiene and safety outcomes remain inconsistent. This limited effectiveness may reflect a lack of contextual adaptation and a failure to align training materials with the socio-economic constraints of participants.

To evaluate LMIC food safety training interventions and their educational materials on a novel framework, and to propose a checklist for the efficacy of future programs.

Relevant literature on training interventions was systematically identified, and only studies with accessible training materials were included. Interventions were evaluated using a novel qualitative framework, encompassing image-text ratios, readability grade, training design, incentives, and outcome parameters. Novel concepts, 'Engagement features' and 'Contextual-fit factors' were also developed, and the correlations between them were tested.

A total of 28 studies met the inclusion criteria with available training materials. Infographics from 13 studies demonstrated a satisfactory balance of images and text. The readability assessment revealed an average result comparable to the US grade 6 level (5.90 ± 1.74), potentially hindering comprehension for low-literacy populations. Incentives were commonly used (n = 18), most frequently as non-cash economic incentives. Change in knowledge was the most measured outcome, and studies reporting null or negative results lacked several engagement and contextual-fit elements.

This study uses innovative methods to identify and shed light on the existing gaps in food safety trainings. Based on these findings, it proposes a 35-point checklist to support the development of more engaging, comprehensible, and contextually appropriate programs.