Food Safety Education Program Research Articles

Efficacy of a Virtual Food Safety Education Program for Immunocompromised Hematopoietic Cell Transplant (HCT) Oncology Patients

Efficacy of a Virtual Food Safety Education Program for Immunocompromised Hematopoietic Cell Transplant (HCT) Oncology Patients

Food Safety Knowledge, Attitudes, and Practices Among Food Handlers in Jeddah, Saudi Arabia

Background: Several outbreaks of foodborne illness have recently occurred in Saudi Arabia, posing a public health concern, especially considering the increasing trend of food consumption at restaurants. Objectives: This study evaluates the food safety knowledge, attitudes, and self-reported practices among food handlers in Jeddah, Saudi Arabia, and their association with the food handlers’ sociodemographic characteristics. Methods: A cross-sectional study was performed for a convenience sample of 80 food handlers (15–65 years old), followed by face-to-face interviews. A validated questionnaire with 65 questions across four sections (sociodemographic characteristics, knowledge, attitudes, and practice related to food safety) was utilized for data collection. Data entry and analysis were conducted using the SPSS version 26 software. Results: Most of the participants exhibited moderate levels of food safety knowledge and practices and a high level of food safety attitudes. Food safety knowledge was significantly greater among the oldest participants (>45 years old), those holding valid health cards, and those who had attended training courses (p<0.05). However, no significant differences in food safety attitudes and practices were found based on the sociodemographic characteristics of the participants (p>0.05). Food safety knowledge was found to be significantly correlated with the food safety attitudes of the participants (r= 0.379, p= 0.001), and food safety attitudes were significantly correlated with practices (r= 0.264, p= 0.018). Conclusion: This study revealed that continuous implementation of food safety educational and training programs is necessary to improve the knowledge of food handlers and transform it into appropriate attitudes and practices.

Assessment of Food Safety Knowledge Among Fresh Produce Growers and Extension Workers Before and After Training in Nepal

Access to safe food, including safe fresh produce, is essential to ensure healthy food and diets for the households and communities. However, there is limited awareness of food safety at household levels in Nepal. Food safety educational programs bridge the knowledge gap in addressing food safety. A pre- and post-assessment study was conducted during food safety trainings in five cities of Nepal to understand and evaluate the effectiveness of the trainings. Data from 102 fresh produce growers and 100 extension workers was collected through pre- and post- training responses. Questionnaires featuring 15 food safety statements were administered to the participants before and after the training. Then subsequent comparative analysis was done using the Wilcoxon signed ranks test, Mann Whitney test and Kruskal-Wallis test. The scores across subgroups: gender, age, respondent type and location were evaluated to test the significant differences. We found that the median knowledge score (indication of the knowledge or awareness level) elevated from 9.00 to 11.00 after the training. Our analysis suggested a statistically significant increase in food safety knowledge following the trainings (p<0.001). We found significant differences in the pre- and post-knowledge scores by gender (p<0.001), respondent type (p=0.005) and location (p<0.001). Our findings suggest that the targeted trainings to growers and extension workers could be an effective tool in enhancing food safety knowledge.

Effectiveness of Online Food-Safety Educational Programs: A Systematic Review, Random-Effects Meta-Analysis, and Thematic Synthesis.

Online food-safety educational programs are increasingly important to educate different populations as technology and culture shift to using more technology. However, the broad effectiveness of these programs has yet to be examined. A systematic review, random-effects meta-analysis, and thematic synthesis are conducted to identify the effect size of online food-safety educational programs on knowledge, attitudes, and practices of consumers, food workers, and students and their respective barriers and recommendations. Online food-safety education was found to be of moderate and low effectiveness, with attitudes being the lowest in all populations. Consumers struggled with staying focused, and it was found that messaging should focus on risk communication. Students struggled with social isolation and a lack of time, and it was recommended that videos be used. Food workers struggled with a lack of time for training and difficulty understanding the material, and future programs are recommended to implement shorter but more frequent trainings with simple language. Future online food-safety educational programs should focus on incorporating social elements, as they can remain a huge barrier to learning. They should also focus on changing the participant's attitude to risk perception and beliefs in the importance of food safety.

Food safety-related practices among residents aged 18–75 years during the COVID-19 pandemic: a cross-sectional study in Southwest China

BackgroundGood food safety practices are essential to minimizing foodborne diseases. The present study explored the food safety-related practices of residents during the COVID-19 pandemic in Southwest China and identified the impacting factors.MethodsResidents aged 18–75 years from Guizhou, Yunnan, Sichuan, and Chongqing, China, were included in our study. The convenience sampling method was used to select participants, and face-to-face surveys were conducted in households and communities to collect data. Descriptive statistics including sociodemographic characteristics of respondents and weighted percentages were obtained and the log-binomial regression was used to evaluate the influencing factors associated with food safety-related practices.ResultsOverall, 7,848 respondents were involved, with 97.5% efficacy. Disparities in food safety-related practices were observed between males and females, with the former performing poorer practices than the latter (70.5% vs. 68.0%, respectively). Notably, paying attention to nutrition labels when shopping for prepackaged foods was the worst practice. Age, ethnicity, region, occupation, education level, and income were identified as significant determinants of food safety-related practices. Moreover, in comparison to males, females were more likely to acquire pertinent knowledge from diverse sources, including social media, family members/ friends, books/ newspapers/ magazines, experts, and food sales staff (p < 0.05).ConclusionsMales performed inferior food safety-related practices than females during the COVID-19 pandemic in Southwest China. It is suggested that future food safety education programs should incorporate diverse targeted approaches, with emphasis on males. The role of mainstream media in promoting food safety practices should be expanded and prioritized in the forthcoming initiatives.

Evaluation of the Handling Practices and Risk Perceptions of Dried Wood Ear Mushrooms in Asian Restaurants in the United States

In late 2020, dried wood ear mushrooms, a low-moisture food ingredient that had been imported and sold to restaurants, were linked to a foodborne outbreak of Salmonella Stanley, which sickened 55 individuals across the United States. These mushrooms are commonly used in Asian cuisine. It is unclear if the contaminated dried wood ear mushrooms that caused the foodborne illnesses were improperly handled during preparation. The objectives of this study are to assess the handling practices, risk perceptions, and food recall experiences of dried wood ear mushrooms in restaurant kitchens among Asian restaurant managers and chefs. We conducted a series of telephone interviews with managers and chefs of Asian restaurants in the United States who used dried wood ear mushrooms in making dishes. After reaching information saturation, a total of 25 restaurant managers and chefs participated in the interview. Our results showed that 76% of the participants did not keep track of package information, such as expiration date and lot number, and many participants reported using cold water for rehydration. Wood ear mushrooms were blanched before being used in all cold dishes and most stir-fry dishes, but less commonly in stew or ramen. Some participants (16%) did not view dried wood ear mushrooms as a raw food ingredient, and 16% did not perceive that low-moisture food ingredients constituted microbiological food safety risks. The majority of the participants had heard of food recalls, but only 17% knew about the dried wood ear mushroom recall, and even fewer had heard of food recalls of other low-moisture foods, like nuts and seeds (9%), and flour (4%). While this study shares similarities with previously published studies evaluating the handling practices of consumers and restaurant employees with respect to meat and poultry, it makes a distinctive contribution to the field of food safety as the first-of-its-kind to study the handling practices of a low-moisture food ingredient: dried wood ear mushrooms. This unique ethnic food ingredient has been associated with a past outbreak and multiple recalls in the United States. The findings of the study show the need to develop food safety educational programs that are tailored toward Asian restaurant food handlers and provide guidance to develop risk communication strategies for this niche audience.

A Survey to Assess Food Safety Knowledge and Habits Among High School Students, Their Parents and Teachers in Pescara and Chieti Provinces, Abruzzo Region (Italy)

Food safety is a topic of increasing relevance in the European Union (EU). Ensuring safe food from farm to fork is one of the main objectives of EU policies. In our study, we conducted an online survey to assess the food safety knowledge and eating habits in various categories. For young people, we chose school students aged 15–19, based on their ability to cook autonomously after school. For adults, we choose a representative sample consisting of students’ parents and teachers in Chieti and Pescara Provinces of Abruzzo Region (Italy). The survey was structured in eight sections with particular attention to questions regarding risks associated with microorganisms (e.g., Salmonella spp.) and bacterial cross-contamination. Students represented 60.7% of all respondents (n = 290). Risk perception associated with microorganisms in food was significantly different among students and teachers (p < 0.05). Students indicated microorganisms as a food risk in 20.2% of cases, while environmental pollutants were considered the greatest problem for 71.7% of participants. Among teachers, results indicated that 55.1% considered microorganisms a food-associated risk. An adequate theoretical knowledge regarding safe cooking practices was demonstrated by the majority of participants. Acceptable knowledge regarding microbiologically safe cooking practices was also demonstrated by participants. Based on these results, we provide suggestions to improve food safety education programs including the use of social media, as well as by adjusting educational strategies according to the background of learners.

Comparative microbial analyses of hydroponic versus in-soil grown Romaine lettuce obtained at retail

The overarching goal of this study was to assess the microbiological profile of hydroponically grown Romaine lettuce and in-soil Romaine lettuce (organic and conventional). Thirty-six samples of hydroponic lettuce, seventy-two samples organic lettuce (thirty-six bagged lettuce and thirty-six non-bagged lettuce), and thirty-six conventionally grown lettuce was purchased from retail stores. A portion of each sample was analyzed for aerobic bacteria (APC), coliforms and E. coli, and yeasts and molds (YM). Another portion of each sample was enriched for Salmonella, E. coli O157:H7, Listeria monocytogenes, and Staphylococcus aureus, and confirmed with RT-PCR. No statistical differences were found in the microbial profile (P > 0.05) between the different farming practices. The APC, coliforms, E. coli, and YM counts were similar across bagged samples. The results demonstrated that APC and E. coli were significantly higher (P<0.05) in organic non-bagged samples compared to other practices. Salmonella and L. monocytogenes were detected in some organically and conventionally grown lettuce samples but were only detected in 3 hydroponically grown lettuce samples. This study indicated that hydroponically grown lettuce obtained at retail may have food safety risks similar to organic and conventional systems. These findings highlight the need for food safety training and educational programs.

Implementation of a dialogue-based food safety education program for low-income families

Foodborne illnesses can commonly happen in consumers' home kitchens because of improper food handling practices. Consumers from low-income families have higher risk of contracting foodborne illnesses due to their limited food safety knowledge, insufficient kitchen tools for safe food handling, a lack of access to safe foods, and some risky culturally unique behaviors. Thus, there is a continuing need to develop food safety education programs to improve the food safety knowledge, attitudes, and practices of low-income consumers. Traditionally, pre- and post-surveys are used to evaluate the effectiveness of an education program. Participants' reflections on the content throughout the programs are rarely reviewed. The objectives of this study are to showcase the implementation of a dialogue-based food safety education program that was developed for low-income consumers and explore participants' reflections through the lens of class discussion and take-home tasks. The food safety education program was designed to serve both English- and Spanish-speaking audiences. It included two 1-h virtual course sessions (one session per week for two weeks) and two take-home tasks. All course materials were developed based on the core four food safety practices of the Fight BAC! campaign. A total of 60 primary home food handlers (30 per language group) participated in this study. The implementation of the program was described. Participants’ reflections on produce washing, meat washing, use of a cooking thermometer, food storage, and use of a refrigerator thermometer were presented. This study offers insights for researchers, educators, and government agencies in the implementation of a dialogue-based education program and provides guidance for the development of next-generation food safety education programs.

Food Safety Education Needs Assessment for Small-Scale Produce Growers Interested in Value-Added Food Production

Production of value-added foods is of growing interest to small-scale produce growers. However, previous studies reported that they lack sufficient food safety awareness and have limited knowledge of applicable food safety regulations. Targeted food safety education can help to address these challenges. This study used focus groups and a combination of Web-based and printed surveys to evaluate growers' attitudes toward and knowledge of value-added business and to assess their food safety education needs. In total, 136 Indiana produce growers participated in the study, including 38 focus group participants and 98 survey participants. Overall, growers were aware of the importance of food safety, with 78% of the survey participants agreeing strongly that food safety was a top priority in value-added businesses. Most survey participants (82%) self-reported being knowledgeable about food safety. Most were confident in their ability to run a successful value-added business. The top two barriers that hindered growers from learning about food safety were time limitations and an overwhelming amount of information. Growers preferred to receive additional educational materials on selling non-home-based vendor products, communication strategies with regulators and inspectors, and marketing strategies; they trusted the information from extension educators and university extension publications the most. This study guides the development of future food safety education programs for small-scale growers who are interested in establishing a value-added business.

An Evaluation of a Virtual Food Safety Program for Low-Income Families: Applying the Theory of Planned Behavior.

Low-income families are reported to have a limited knowledge of food safety and resources to follow food safety practices compared with the rest of the population. This paper evaluated a virtual food safety educational program targeting food handlers in low-income families. Trained native speakers of English and Spanish delivered course materials in both languages. A total of 60 individuals participated in the program, with 30 participants in each language group. Most were female, and most had fewer than three children. After the program, participants’ food safety knowledge and self-reported safe food practice behavior scores increased significantly from 5.32 to 7.43 (out of 8.00) and from 24.78 to 29.30 (out of 35.00), respectively. The theory of planned behavior (TPB) was used to understand individuals’ behavior change intention of food safety practices. All the TPB constructs’ scores, including attitudes toward the behavior, perceived behavioral control, subjective norms, and behavior change intentions, were improved significantly; however, only the subjective norms and perceived behavioral control were significantly correlated with the behavior change intentions. This virtual educational program improved low-income individuals’ food safety knowledge and changed their food safety attitudes and behaviors, giving a path to develop and evaluate more virtual food safety educational programs in the future.

Food Safety Knowledge, Beliefs and Behaviour among Health Sciences-related Field Undergraduate Students at a Local University

Foodborne disease is among the primary illness that causes morbidity and mortality in the world. Several studies show that most students do not have adequate food safety knowledge to protect themselves against foodborne diseases. This study aimed to determine the food safety knowledge, behaviour, and beliefs among undergraduate students at a local university in Malaysia. This cross-sectional study involves 121 respondents from three health science-related faculties at the studied institution. The questionnaire was distributed via an online platform. This study used multiple-choiceformat questions for Food Safety Knowledge and a Likert type scale for Food Safety Behaviour and Belief question statements. Most of the respondents were female (78%). About 16% of the respondents have experience working / volunteering in food services, and half of them are involved in food handling during their services. This study recorded a moderate score in all sections (knowledge, behaviour, beliefs) with a total percentage score of 60.3%, 60.3%, and 66.1%, respectively. A strong but not significant correlation between food safety knowledge and beliefs (r = 0.69 p &gt; 0.05) and between food safety knowledge and behaviour (r = 0.83 p &gt; 0.05) were observed. This study is useful as a basis to develop a targeted food safety education program among undergraduate students. Students with high knowledge of food safety will increase food safety beliefs and behaviour, thus preventing them from getting any foodborne illness.

Young adult food safety knowledge gaps and perceptions of roommates’ food handling practices: A survey of university students in Indiana

A lack of safe food handling knowledge and practices can contribute to a higher risk of foodborne illnesses from meals prepared at home. Young adults, an important consumer group, can be at an increased risk for foodborne illness due to their risky food behaviors. This study surveyed university students, as examples of young adults, to identify food safety knowledge, reveal knowledge gaps, and explore perception change resulting from living with roommates. The survey included questions about food safety knowledge, self-efficacy of safe food handling practices, and participants' perceptions of their roommates' safe food handling capabilities. A total of 2678 students completed the survey. Gender, age, previous food safety training, college major, and ethnicity have a significant impact on students’ food safety knowledge. White (non-Hispanic) students had a higher knowledge score (7.68) than Asian (6.19) or Hispanic (6.57) students. Similarly, students in biology-focused majors had higher scores (7.78) than those not in biology-focused majors (7.11). Most students (65%) did not know that meat and poultry should not be washed under running water. Many students failed to practice food safety recommendations, such as using food thermometers, even if they knew it was the correct thing to do. Most students (57%) believed they did a better job of keeping the kitchen clean than their roommates (23%). As the number of roommates in the house increased, participants were 1.60 times more likely to believe that their kitchen would be in better condition if they did not have any roommates. Future food safety education programs should be developed to fill the knowledge gaps and address challenges facing young adults especially when living with roommates. Educators can create food safety materials for those who are entering university which will prepare them for ahead of time. Materials can also target current university students, those who are not in biology-focused majors, and those from a variety of ethnic backgrounds.

Foodborne diseases risk factors associated with food safety knowledge and practices of women in Sharjah-United Arab Emirate

Foodborne diseases are a worldwide public health issue, as they are responsible for large cases of sickness, deaths, and high financial losses. The objective of the current study was to identify the knowledge, practices, and risk factors of women in Sharjah-United Arab Emirates that can lead to foodborne diseases. The study was a cross-sectional survey, a total of 656 respondents completed a food safety questionnaire from January until April 2020. The total score of food safety knowledge, practices, and risk factors of participants in Sharjah was good (57.4%). In “cross-contamination” and “recognizing of foodborne diseases” sections, the respondents showed a high scale of knowledge and practices (80.0%). The respondents had good knowledge of “food purchasing” (67.5%), “cleaning and personal hygiene” (62.9%), and “food storage” (61.1%) aspects. Even though they lack knowledge of “cooking and food consumption” (28.0%) and “risk factors of foodborne disease” (20.0%), this indicated that the respondents might be under risk of food poisoning. There was a statistically significant (P ≤ 0.05) link between overall food safety knowledge and practices of participants with employment status and educational levels. To our knowledge, this is the first study to explore food safety knowledge, practices, and risk factors of women in Sharjah-United Arab Emirates that can lead to foodborne diseases. Design new food safety education programs for women and motivating women to participate in these programs is suggested.

Risk perceptions and food-handling practices in the home

Unsafe food-handling practices in the home are linked with foodborne illnesses that represent sizable costs on the US healthcare industry and welfare losses to households. Past consumer food-safety education programs have only been modestly successful. Optimism bias may distort food-safety risk perceptions encouraging participation in risky food behaviors. Using multiple years of the FDA Food Safety Survey data, we explore the link between behavior-specific risk perceptions and three food-handling practices: handwashing, avoiding cross-contamination, and proper refrigeration of cooked foods. This approach describes risk perceptions as endogenous variables and allows for the decomposition of factors that directly influence food-safety behaviors, from those that indirectly influence behavior by changing risk perceptions. Our results suggest well-designed targeted information campaigns aimed at improving people’s safe food-handling practices must first decrease people’s optimism in the safety of their current practices. Given the lack of regulatory options to influence behavior in the home, this may provide an effective tool to address issues in performing safe food handling.

P94 Making On-Farm Food Safety Easy Using an Online Application

<h3>Background</h3> Foodborne illness costs in the US are approximately $164 billion/year. In addition to public health costs, outbreaks pose huge risks and even jail time to the agricultural sector. Typical on-farm food safety trainings require all-day, lecture-based education that are costly and ineffective. Previous survey results show that 68% of 200 California farmers viewed laws and regulations as a barrier, 79% do not have documented food safety plans and 71% want practical food safety trainings. <h3>Objective</h3> The objective of this study was to develop, refine, and test the effectiveness of 13 on-farm food safety training videos which are a component of an interactive online food safety education program called EASY GAP. <h3>Study Design, Setting, Participants</h3> This study was a between-subjects design with 2 treatment groups comprised of California specialty crop farmers. Group #1 participants reviewed draft videos and Group #2 participants reviewed revised videos. Both groups completed a post survey. <h3>Measurable Outcome/Analysis</h3> Agreement statements were measured to determine the impact on knowledge and use of the videos. Additional questions captured participant feedback on the video training modules. Survey results were analyzed using SPSS (version 25) to assess differences between groups. A Mann Whitney Test was used to compare the survey responses between groups. <h3>Results</h3> There was a significant increase (<i>P</i> < .05) between group 1 (n = 34) and group 2 (n = 34) on how strongly they agree that the videos increased their knowledge pertaining to causes of foodborne illness and human risk. There was a significant increase (<i>P</i> < .05) between groups on how strongly they agree on ease of video use. There was a significant decrease (<i>P</i> < .05) between groups on how strongly they agree that the pace of the videos was too fast. <h3>Conclusions</h3> Overall, participants agreed that the revised videos provided more useful information and were easier to use compared to the draft videos.

Microbial Safety of Milk Production and Fermented Dairy Products in Africa

In Africa, milk production, processing and consumption are integral part of traditional food supply, with dairy products being a staple component of recommended healthy diets. This review provides an overview of the microbial safety characteristics of milk production and fermented dairy products in Africa. The object is to highlight the main microbial food safety hazards in the dairy chain and to propose appropriate preventive and control measures. Pathogens of public health concern including Mycobacterium bovis, Brucella abortus and Coxiella burnettii, which have largely been eradicated in many developed nations, still persist in the dairy chain in Africa. Factors such as the natural antimicrobial systems in milk and traditional processing technologies, including fermentation, heating and use of antimicrobial additives, that can potentially contribute to microbial safety of milk and dairy products in Africa will be discussed. Practical approaches to controlling safety hazards in the dairy chain in Africa have been proposed. Governmental regulatory bodies need to set the necessary national and regional safety standards, perform inspections and put measures in place to ensure that the standards are met, including strong enforcement programs within smallholder dairy chains. Dairy chain actors would require upgraded knowledge and training in preventive approaches such as good agricultural practices (GAP), hazard analysis and critical control points (HACCP) design and implementation and good hygienic practices (GHPs). Food safety education programs should be incorporated into school curricula, beginning at the basic school levels, to improve food safety cognition among students and promote life-long safe food handling behaviour.

Food safety knowledge and self-reported practices among school children in the Ga West Municipality in Ghana

BackgroundKnowledge in food safety influences food safety attitudes of people which could result in behavioural changes. Inadequate knowledge in food safety among consumers, especially children, increase their risk of getting foodborne diseases. Implementing food safety educational programs in schools is key in improving the food safety knowledge of the school children. This study is aimed at assessing the food safety knowledge and practice of students in the Ga West district of Ghana. MethodA cross-sectional study was conducted on food safety knowledge and practices of students in the basic schools in the Ga West District of the Greater Accra Region-Ghana. A total of 1500 questionnaires were self-administrated to students in the 104 schools. ResultOut of the 1343 respondents, 694 (51.7%) of them were female whiles 649 (48.3%) were male. The mean age of the students was 13years (Std Dev of ±1.9) with their ages ranging from 7 to 21 years. The food safety knowledge level of the students was inadequate with a mean score of 5.8 (std Dev ± 1.6) representing 64.08% of the maximum total food safety knowledge score. 59.6% (801) of the students had adequate level of food safety knowledge. The food safety practice among the respondents was generally appropriate with a mean score of 36.19 (std Dev ± 5.1) representing 80.4% of the maximum total food safety practice score. 90.2% (1211) of the students reported to be engaging in appropriate food safety practice. With the exception of the demographic characteristic ‘age’ and ‘class’ (p-value < 0.001), no statistical difference was observed in the level of food safety knowledge and practices among the various demographic characteristic of the student. There was a positive correlation between food safety knowledge and practices (coefficient of 0.2 and p-value < 0.001). Most of the students indicated that they first look out for the cleanliness of the surrounding of the vendor and then the vendors neatness before they buy or eat from a food vendor. ConclusionEven though the food safety knowledge level of the students was inadequate, the food safety practice was generally appropriate especially their hand washing practices.

Efektivitas Metode Pembelajaran terhadap Pengetahuan Keamanan Pangan Siswa Sekolah Tingkat Menengah

Food safety education program needs to be given to the high school community, especially for junior and senior high school students who are entering adolescence. Appropriate learning methods required in the delivery of food safety information. The aim of this study was determining the effect of the way food safety intervention with active and passive learning method to the food safety knowledge of high school students. Analysis of different test with independent t-test on both active and passive learning methods of intervention showed there was no different between both methods. The result of the effect of food safety intervention with active and passive learning methods by paired sample t-test showed increasing the average score of food knowledge (p≤0.05) between before and after the intervention of 2.18 and 2.54 %. Based on the distribution of score of knowledge, active learning method just increased significantly only for senior high school students in science program. Correlation analysis showed the higher school level did not ensure higher food safety knowledge as well.

Consumption of foods containing prohibited artificial colors among middle-school children in Nay Pyi Taw union territory, Myanmar

BackgroundFood safety control in Myanmar is regulated by the Department of Food and Drug Administration (FDA). FDA conducts food safety education programs in schools and regular market surveys of foods containing prohibited artificial colors. However, the consumption of foods containing FDA-prohibited artificial colors among school children is understudied. This study aimed to assess the consumption of foods containing FDA-prohibited artificial colors among middle-school children in Nay Pyi Taw Union Territory, Myanmar.MethodsA cross-sectional study was conducted at eight public schools in Nay Pyi Taw Union Territory in 2017. The schools were selected using simple random sampling with a drawing method. In total, 776 students (359 boys and 417 girls) participated in face-to-face interviews using a structured questionnaire and photos of foods containing artificial color published by FDA. A multiple logistic regression was performed to estimate adjusted odds ratio (AOR) for consumption of such foods.ResultsIn total, 519 (66.9%) children consumed foods with the FDA-prohibited colors. It was revealed that students at suburban schools were nearly five times more likely to consume foods containing FDA-prohibited artificial colors (AOR = 4.84; 95% confidence interval (CI) 2.99–7.82) compared to those at urban schools. In addition, being in the seventh grade (AOR = 3.38; 95% CI 2.30–4.98), availability of prohibited food in school canteen (AOR = 6.16; 95% CI 2.67–14.22), and having a less educated father (AOR = 1.76; 95% CI 1.06–2.92) were positively associated with consumption of the foods with the prohibited colors.ConclusionMore than half of the students consumed foods with the prohibited colors. Consumption was more frequent among students from suburban schools, those with unsafe foods accessible at their school canteen, seventh graders, and students with a less educated father. The findings highlighted that school food safety programs, which focus on preventing consumption of foods containing FDA-prohibited artificial colors, are urgently required. Food safety regulation is also required to ban the sale of unsafe food, especially in school canteens.