Eating Competence among a Select Sample of Brazilian Adults: Translation and Reproducibility Analyses of the Satter Eating Competence Inventory.

This study aimed to translate and validate the Satter Eating Competence Inventory (ecSI2.0TM) from English to Brazilian Portuguese. The process included three steps: (i) translation and back-translation of the original ecSI2.0TM to Brazilian Portuguese; (ii) evaluation of its reproducibility; (iii) a pilot study to validate the Brazilian version of the Satter Eating Competence Inventory (ecSI2.0TMBR) for a selected sample of the Brazilian adult population (internal consistency and factor validity). The reproducibility (test-retest reliability) was verified using the intraclass correlation coefficient (ICC) obtained by the responses of 32 Brazilian adults. All domains of the ecSI2.0TMBR and the total score showed ICC > 0.8. Considering the entire questionnaire, none of the domains presented significant divergences among the participants' responses (p < 0.001). In the pilot study with 662 individuals, 74.9% (n= 496) were female, mean age was 40.33 ± 12.55, and they presented a higher level of schooling and income. Analyses revealed Cronbach's alpha coefficients of 0.869 for the ecSI2.0TMBR total scale, 0.793 for Eating Attitudes, 0.527 for Internal Regulation, 0.728 for Food Acceptance, and 0.822 for Contextual Skills. In general, the ecSI2.0™BR presented good acceptability, showing total floor and ceiling effects of ≤0.6%. Factor validity was examined by confirmatory factor analysis. The four domains presented a good fit in the confirmatory factor analysis: RMSEA = 0.0123 (95% CI: 0-0.0266); CFI = 0.998; χ2 = 75.9; df = 69; p = 0.266. The ecSI2.0TMBR is the first tool designed to measure eating competence (EC) in the Brazilian population, showing good reproducibility and internal consistency. We expect the ecSI2.0TMBR will support innovative research to investigate the association of EC and health outcomes, as well as new strategies based on emerging behavioral theories to enhance nutritional education policy.

Food Safety Knowledge, Attitudes, and Practices of Brazilian Food Truck Food Handlers.

This study aimed to (i) compare the food safety knowledge, attitudes, and self-reported practices (KAP) and observed food safety practices of food truck (FT) food handlers, (ii) evaluate the microbiological quality of food and water samples collected from these vehicles, and (iii) establish a score classification for the KAP instrument according to the food contamination probability assessment. This study was conducted in three stages with 40 food truck food handlers conveniently sampled in the Federal District, Brazil, through structured interviews, application of an observational checklist for the assessment of handlers' practices and the collection of food and water samples for determination of microbiological quality. FTs that are likely to exhibit food contamination and are at a high risk of foodborne diseases if at least one of the following situations occur: (1) if a food handler scores ≤6 in the knowledge section; (2) if a food handler scores ≤5 in the attitudes section; or (3) if a food handler scores ≤6 in the self-reported practices section. On the other hand, FTs in which handlers score higher than the cutoff points in all the sections are unlikely to exhibit food contamination and are at a low risk of foodborne diseases. The findings of this study are the first step to understand food handlers' point of view and the initial diagnosis to guide educational strategies in the FT sector.

Brazilian Food Truck Consumers' Profile, Choices, Preferences, and Food Safety Importance Perception.

This study aimed to investigate food truck consumers' profile, choices, preferences, and food safety importance perception. We conducted structured interviews with a convenient sample of 133 food truck consumers in the Federal District, Brazil. Most of the participating consumers were married (52%) and female (56%), who had completed at least tertiary school (81%). The interviews revealed that most food truck consumers eat from food trucks once or twice a week (96%), usually near home (74%), and have an average per capita expenditure of approximately US $5 to US $9.99 (70%). Hamburgers and sandwiches are the most popular food among consumers (72%). Consumers indicated that taste (30%) was the most important reason to choose a food truck and that poor vehicle hygiene (30%) was the main point assigned for not opting for a food truck. Food hygiene and vendors' personal hygiene were considered important by consumers when eating from food trucks (78% and 80%, respectively). Considering all food truck consumers interviewed and the questions about food safety importance perception, the minimum score was 1 and the maximum was 2.9, with a mean score of 1.68 (SD = 0.46), indicating a high level of perceived importance. The instrument of food safety importance perception presented a Cronbach's alpha coefficient of 0.73, indicating good internal consistency. No significant differences were observed in the food safety importance perception scores in gender (0.192), marital status (0.418), level of education (0.652) or food safety training (0.166). However, significant differences were found in the food safety importance perception scores for age (0.026) and the presence of children (0.001). The findings of this study indicate that there remains the need for consumers to comprehend their role in the food supply chain. Food safety and food handling practices are of public concern, and strategies are required to prevent foodborne diseases. Future public health interventions aiming to increase consumer knowledge and awareness of food safety should be emphasized.

Food Trucks: Assessment of an Evaluation Instrument Designed for the Prevention of Foodborne Diseases.

This study aimed to validate an evaluation instrument for food trucks (FTs) regarding its internal consistency and to establish a score classification according to the food contamination probability assessment. The instrument was applied in 44 food trucks (convenience sample), along with microbial analysis, in the Federal District, Brazil. After its application, sample collection and statistical analysis, the evaluation instrument was reduced to a 22-item final version. FTs were divided into three groups according to their ready-to-eat foods. Food trucks from Group A (hot and cold sandwiches) presented the highest percentage of contamination. The lowest percentage of contamination was observed in food trucks from Group C (regional and international cuisine). The application of the validated evaluation instrument to the 44 food trucks revealed that none achieved 100% adequacy. The reproducibility analysis exhibited an Intraclass Correlation Coefficient (ICC) value of 0.780 (CI 95%: 0.597; 0.880), indicating good reproducibility of the instrument. The reliability assessment presented a Kuder⁻Richardson Formula 20 (KR-20) value of 0.627 and a Cronbach's alpha coefficient of 0.634, indicating good internal consistency. The proposed classification score was obtained by assigning 1 point for each item with an inadequate response, and the final score may vary between 0 and 20 points. Food trucks with up to 11 points exhibit low probability of contamination and low risk of foodborne diseases, while food trucks scoring 12 or more points exhibit a high probability of contamination and high risk of foodborne diseases. The evaluation instrument will allow effective assessment of the hygienic⁻sanitary practices and conditions of food trucks and potentially ensure consumers' access to safe food.

Development of a Brazilian Food Truck Risk Assessment Instrument.

This study aimed to develop and validate a checklist instrument as a first step for the risk assessment of the hygienic-sanitary practices and conditions of food trucks. We invited sixteen experienced experts in the food safety field to take part in the process. The checklist was designed based on the Codex Alimentarius, Brazilian resolutions Collegiate Board Resolution 216, Brazilian Collegiate Board Resolution 275, Brazilian Federal District Law no. 5.627 and Brazilian Federal District Normative Instruction 11. The preliminary version of the checklist-composed of 29 items (nine sections)-was evaluated by 13 experts. They evaluated the items regarding their importance (content validation) and clarity (semantic evaluation) by the Delphi technique. The criteria for the approval of the content validation (Likert scale from 1 to 5) and semantic evaluation (Likert scale from 0 to 5) processes were as follows: a minimum of 75% agreement among the experts (W-values ≥ 0.75) and a mean grade ≥ 4. We performed the complete validation process in three rounds. The final version of the assessment instrument comprised 39 items, following suggestions from experts to add or subdivide some questions. The checklist can be used to conduct inspections of food trucks by health surveillance auditors, of food truck vendors' decision-making processes and also as a diagnostic tool. The application of this checklist will allow the effective risk assessment of the hygienic-sanitary practices and conditions in food trucks and potentially ensure consumers' access to safe street food.

Gluten-Free Diet: From Development to Assessment of a Check-List Designed for the Prevention of Gluten Cross-Contamination in Food Services.

Gluten cross-contamination in gluten-free food may jeopardize treatment of celiac patients. Considering the deficit of appropriate instruments to enable the implementation of safe production practices for gluten-free food, this study aimed to evaluate the application of a check-list elaborated for gluten cross-contamination prevention in food services. The instrument was applied in 60 Brazilian food services. Interobserver reproducibility and internal consistency of the check-list were tested. A score classification was created for establishments according to the food contamination risk assessment. Subsequent to the application and statistical analysis, the original instrument was reduced to a 30-item check-list. In the reproducibility analysis, none of the 30 items showed significant divergence among the evaluators (p > 0.05 in the Cochran Q test). The 30-item version of the check-list presented Kuder⁻Richardson Formula 20 (KR-20) = 0.771, indicating good internal consistency. The proposed classification score is obtained by adding 1 point for each item with an "adequate" response; therefore, the final score may vary between 0 and 30 points. Establishments with up to 15 points exhibit risk of gluten contamination, while establishments with a score above 16 points exhibit low risk of contamination. The check-list displayed good reproducibility and internal consistency, suggesting that it could be a useful gluten contamination control instrument in food services.

Content Validation and Semantic Evaluation of a Check-List Elaborated for the Prevention of Gluten Cross-Contamination in Food Services.

Conditions associated to the consumption of gluten have emerged as a major health care concern and the treatment consists on a lifelong gluten-free diet. Providing safe food for these individuals includes adapting to safety procedures within the food chain and preventing gluten cross-contamination in gluten-free food. However, a gluten cross-contamination prevention protocol or check-list has not yet been validated. Therefore, the aim of this study was to perform the content validation and semantic evaluation of a check-list elaborated for the prevention of gluten cross-contamination in food services. The preliminary version of the check-list was elaborated based on the Brazilian resolution for food safety Collegiate Board Resolution 216 (RDC 216) and Collegiate Board Resolution 275 (RDC 275), the standard 22000 from the International Organization for Standardization (ISO 22000) and the Canadian Celiac Association Gluten-Free Certification Program documents. Seven experts with experience in the area participated in the check-list validation and semantic evaluation. The criteria used for the approval of the items, as to their importance for the prevention of gluten cross-contamination and clarity of the wording, was the achievement of a minimal of 80% of agreement between the experts (W-values ≥ 0.8). Moreover, items should have a mean ≥4 in the evaluation of importance (Likert scale from 1 to 5) and clarity (Likert scale from 0 to 5) in order to be maintained in the instrument. The final version of the check-list was composed of 84 items, divided into 12 sections. After being redesigned and re-evaluated, the items were considered important and comprehensive by the experts (both with W-values ≥ 0.89). The check-list developed was validated with respect to content and approved in the semantic evaluation.