Intercept 3.459 .063 .359
Educational level 4.055 .044 .229 .055 - .961
Knowledge 8.172 .004 11.704 2.167 - 63.217
practice to thaw a whole piece of food item but using only a portion
of it and refreezing the rest of the food to be used later. Thawing and
refreezing food increase the number of microorganism in the food
item. During thawing process, the temperature reaches a suitable
condition for bacteria multiplication and refreezing the food item
creates a dormant condition for this bacteria. If this process is
repeated several times, the number of bacteria will increase each
time and might cause hazards. Several studies by Buccheri et al.
(20 07)and Tokuç et al. (20 09) also report similar results.
The score for practice section is lower compared to knowledge
and attitude section ( Table 4). Most of the respondents have good
practice whereby all of the food handlers clean the working area
and wash their hands before they start working. However, 25% of
them use apron to clean hands and rub their hands on their body
parts while working. More than 40% wear jewelry while working
and use the same towel to clean many places. In addition, 73.4% of
the respondents refreeze defrosted food. The result shows that
even though the score for knowledge and attitude section was high,
the food handlers did not entirely perform hygiene practices.
Studies by Ansari-Lari et al. (2010) and Bas¸ et al. (20 0 6) show
relatively poor practices among the studied respondents.
There was no signi fi cant association between knowledge level
and the respondents ’ sociodemographic characteristics (Table 5).
This contradicts with a study bySiow and Norrakiah (2011) who
found out that there was a signi ficant relationship between the
respondents ’ knowledge level and their working experience.
Respondents working for more than six years have signi fi cantly
higher knowledge level compared to respondents that have less
than one year working experience. Martins et al. (2012)also
reported that average scores for knowledge, increases with the
level of education.
Educational and knowledge level showed signi ficant relation-ship with attitude level (p ¼ .0 08) In addition, there is a signi fi cant
relationship between the respondents’ attitude and knowledge
level ( p .0 01) (Table 6). Logistic regression shows that respon-
dents that have low educational level have .23 times less tendency
to obtain acceptable attitude level compared to the respondents
that have high knowledge level. In addition, the odds ratio reveals
that respondents that have acceptable knowledge level obtain 11.7
times of acceptable attitude level compared to the respondents that
have high knowledge level (Table 7). The study proves that even
though the respondents have high educational level, they do not
necessarily have excellent attitude. However, this association shows
that having good knowledge could lead to having good attitude in
food hygiene and sanitation among the respective food handlers. A
study by Ansari-Lari et al. (2010) found that there was a signi fi cant
positive correlation between knowledge and attitude. For example
a study byAcikel et al. (20 08)reported that knowledge help to
improve behavior regarding usage of jewelry while working.
Knowledge and attitude also showed signifi cant relationship
with practice level (Table 8 ). Logistic regression predicts that the
odds of getting poor practice level are 15.4 times higher for
respondents with acceptable knowledge level than they are for
respondents with excellent knowledge level (p ¼ .034) (Table 9).
These fi ndings support the evidence of having good knowledge and
attitude will lead to good practice measures. However this fi nding
contradicts with the study by Bas¸ et al. (20 0 6) who found out that
good knowledge on food safety does not necessarily leads to good
handling practices. In addition Ansari-Lari et al. (2010)revealed
a negative correlation between knowledge and practice and atti-
tude and practice. This study also shows that there is no signi fi cant
relationship between food handlers’ practices with gender
(p ¼ .306 ). However, Siow and Norrakiah (2011)found that female
respondents have signi fi cantly higher practice level compared to
male respondents.
In conclusion, this study suggests that even though the KAP
level of the food handlers was satisfactory, some of the hygiene
aspects need to be emphasized. Continuous education and training
should strengthen food handlers ’ knowledge in area which seems
Table 8
The relationship of food handlers’ practice level, and their sociodemographic characteristics and knowledge and attitude level.
Variables Practice level n (%) x2 p Prevalence ratio (C.I)
Poor Good
Gender
Male 0 (0) 16 (100) 16 (25) 1.049 .306 .938 (.871 -1.009)
Female 3 (6.2) 45 (93.8) 48 (75)
Age group
Adult 0 (0) 18 (100) 18 (28.1) 1.232 .267 1.070 (.991-1.155)
Youth 3 (6.5) 43 (93.5) 46 (71.9)
Educational level
Higher 2 (10) 18 (90) 20 (31.2) 1.838 .175 .209 (.018-2.456)
Lower 1 (2.3) 43 (97.7) 44 (68.8)
Experience level
Inexperienced 2 (8.7) 21 (91.3) 23 (35.9) 1.291 .256 3.810 (.326-44.495)
Experienced 1 (2.4) 40 (97.6) 41 (64.1)
Knowledge level
Excellence 1 (1.8) 54 (98.2) 55 (85.9) 7.207 .007 15.429 (1.234-192.964)
Acceptable 2 (22.2) 7 (77.8) 9 (14.1)
Attitude level
Excellence 1 (2.0) 50 (98.0) 51 (79.7) 4.178 .041 9.091 (.756-109.387)
Acceptable 2 (15.4) 11 (84.6) 13 (20.3)
Table 9
Logistic regression predicting food handlers’ practice with knowledge level as
independent variable.
Variable Wald x2 P value Adjusted 95% CI
odds ratio
Constant 15.623 .000 .019 -
Knowledge 4.506 .034 15.429 1.234-192.964
Intercept 3.459 .063 .359
Educational level 4.055 .044 .229 .055 - .961
Knowledge 8.172 .004 11.704 2.167 - 63.217
practice to thaw a whole piece of food item but using only a portion
of it and refreezing the rest of the food to be used later. Thawing and
refreezing food increase the number of microorganism in the food
item. During thawing process, the temperature reaches a suitable
condition for bacteria multiplication and refreezing the food item
creates a dormant condition for this bacteria. If this process is
repeated several times, the number of bacteria will increase each
time and might cause hazards. Several studies by Buccheri et al.
(20 07)and Tokuç et al. (20 09) also report similar results.
The score for practice section is lower compared to knowledge
and attitude section ( Table 4). Most of the respondents have good
practice whereby all of the food handlers clean the working area
and wash their hands before they start working. However, 25% of
them use apron to clean hands and rub their hands on their body
parts while working. More than 40% wear jewelry while working
and use the same towel to clean many places. In addition, 73.4% of
the respondents refreeze defrosted food. The result shows that
even though the score for knowledge and attitude section was high,
the food handlers did not entirely perform hygiene practices.
Studies by Ansari-Lari et al. (2010) and Bas¸ et al. (20 0 6) show
relatively poor practices among the studied respondents.
There was no signi fi cant association between knowledge level
and the respondents ’ sociodemographic characteristics (Table 5).
This contradicts with a study bySiow and Norrakiah (2011) who
found out that there was a signi ficant relationship between the
respondents ’ knowledge level and their working experience.
Respondents working for more than six years have signi fi cantly
higher knowledge level compared to respondents that have less
than one year working experience. Martins et al. (2012)also
reported that average scores for knowledge, increases with the
level of education.
Educational and knowledge level showed signi ficant relation-ship with attitude level (p ¼ .0 08) In addition, there is a signi fi cant
relationship between the respondents’ attitude and knowledge
level ( p .0 01) (Table 6). Logistic regression shows that respon-
dents that have low educational level have .23 times less tendency
to obtain acceptable attitude level compared to the respondents
that have high knowledge level. In addition, the odds ratio reveals
that respondents that have acceptable knowledge level obtain 11.7
times of acceptable attitude level compared to the respondents that
have high knowledge level (Table 7). The study proves that even
though the respondents have high educational level, they do not
necessarily have excellent attitude. However, this association shows
that having good knowledge could lead to having good attitude in
food hygiene and sanitation among the respective food handlers. A
study by Ansari-Lari et al. (2010) found that there was a signi fi cant
positive correlation between knowledge and attitude. For example
a study byAcikel et al. (20 08)reported that knowledge help to
improve behavior regarding usage of jewelry while working.
Knowledge and attitude also showed signifi cant relationship
with practice level (Table 8 ). Logistic regression predicts that the
odds of getting poor practice level are 15.4 times higher for
respondents with acceptable knowledge level than they are for
respondents with excellent knowledge level (p ¼ .034) (Table 9).
These fi ndings support the evidence of having good knowledge and
attitude will lead to good practice measures. However this fi nding
contradicts with the study by Bas¸ et al. (20 0 6) who found out that
good knowledge on food safety does not necessarily leads to good
handling practices. In addition Ansari-Lari et al. (2010)revealed
a negative correlation between knowledge and practice and atti-
tude and practice. This study also shows that there is no signi fi cant
relationship between food handlers’ practices with gender
(p ¼ .306 ). However, Siow and Norrakiah (2011)found that female
respondents have signi fi cantly higher practice level compared to
male respondents.
In conclusion, this study suggests that even though the KAP
level of the food handlers was satisfactory, some of the hygiene
aspects need to be emphasized. Continuous education and training
should strengthen food handlers ’ knowledge in area which seems
Table 8
The relationship of food handlers’ practice level, and their sociodemographic characteristics and knowledge and attitude level.
Variables Practice level n (%) x2 p Prevalence ratio (C.I)
Poor Good
Gender
Male 0 (0) 16 (100) 16 (25) 1.049 .306 .938 (.871 -1.009)
Female 3 (6.2) 45 (93.8) 48 (75)
Age group
Adult 0 (0) 18 (100) 18 (28.1) 1.232 .267 1.070 (.991-1.155)
Youth 3 (6.5) 43 (93.5) 46 (71.9)
Educational level
Higher 2 (10) 18 (90) 20 (31.2) 1.838 .175 .209 (.018-2.456)
Lower 1 (2.3) 43 (97.7) 44 (68.8)
Experience level
Inexperienced 2 (8.7) 21 (91.3) 23 (35.9) 1.291 .256 3.810 (.326-44.495)
Experienced 1 (2.4) 40 (97.6) 41 (64.1)
Knowledge level
Excellence 1 (1.8) 54 (98.2) 55 (85.9) 7.207 .007 15.429 (1.234-192.964)
Acceptable 2 (22.2) 7 (77.8) 9 (14.1)
Attitude level
Excellence 1 (2.0) 50 (98.0) 51 (79.7) 4.178 .041 9.091 (.756-109.387)
Acceptable 2 (15.4) 11 (84.6) 13 (20.3)
Table 9
Logistic regression predicting food handlers’ practice with knowledge level as
independent variable.
Variable Wald x2 P value Adjusted 95% CI
odds ratio
Constant 15.623 .000 .019 -
Knowledge 4.506 .034 15.429 1.234-192.964
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