Produce Safety Behaviors, Motivators, Barriers, and Beliefs in Pediatric Cancer Patient Caretakers

Cancer patients, who face increased foodborne illness susceptibility and severity, are often placed on neutropenic diets (NDs), which eliminate the consumption of fresh produce, among other foods perceived as high-risk. Such diets are clinically disputed because they have never been proven effective...

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Main Authors: Carly B. Gomez, Tyler J. Stump, Monique M. Turner, Jade Mitchell, Bradley P. Marks
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Journal of Food Protection
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Online Access:http://www.sciencedirect.com/science/article/pii/S0362028X24001844
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author Carly B. Gomez
Tyler J. Stump
Monique M. Turner
Jade Mitchell
Bradley P. Marks
author_facet Carly B. Gomez
Tyler J. Stump
Monique M. Turner
Jade Mitchell
Bradley P. Marks
author_sort Carly B. Gomez
collection DOAJ
description Cancer patients, who face increased foodborne illness susceptibility and severity, are often placed on neutropenic diets (NDs), which eliminate the consumption of fresh produce, among other foods perceived as high-risk. Such diets are clinically disputed because they have never been proven effective in reducing foodborne illness, leading to unstandardized dietary guideline content, format, and delivery methods. To inform a strategic communication approach, this study explored the produce safety handling behavior, barriers, motivators, and beliefs of pediatric cancer patient caretakers using a mixed methods convergent parallel design. A quantitative survey revealed high frequencies (>60%) for generally recommended produce safety behaviors, such as rinsing produce and washing cutting boards, and more mixed responses for restrictive produce safety behaviors, such as peeling produce and avoiding precut, self-serve, and school cafeteria produce. Total produce safety frequency scores were not significantly affected by demographic factors or Child Vulnerability Scale (CVS) scores. Qualitative interviews established a wide domain of caretaker produce safety experiences and beliefs, finding that eight of seventeen interview participants from different hospitals received produce restrictions typical of the ND. Ultimately, five caretaker archetypes were identified, with common motivators and barriers linked to materials received, child’s health and perceived susceptibility, and self-efficacy beliefs. Finally, response-driven communication strategy improvements were recommended. Although sample sizes in this work were small, and further validation is advised, this work highlights the inconsistent use of the restrictive ND, advances understanding of the drivers of produce safety behaviors in cancer patient caretakers, and supports future endeavors to streamline communication strategy interventions.
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spelling doaj-art-5da023d8226f4bf08a66765152cffa2d2025-08-20T02:19:51ZengElsevierJournal of Food Protection0362-028X2024-12-01871210040010.1016/j.jfp.2024.100400Produce Safety Behaviors, Motivators, Barriers, and Beliefs in Pediatric Cancer Patient CaretakersCarly B. Gomez0Tyler J. Stump1Monique M. Turner2Jade Mitchell3Bradley P. Marks4Department of Biosystems and Agricultural Engineering, Michigan State University, 524 S. Shaw Lane, East Lansing, MI 48824, USA; Corresponding author.Department of Engineering Education, Ohio State University, 174 W. 18th Ave, Smith Laboratory 3042, Columbus, OH 43210, USADepartment of Communication, Michigan State University, 404 Wilson Rd. #473, East Lansing, MI 48824, USADepartment of Biosystems and Agricultural Engineering, Michigan State University, 524 S. Shaw Lane, East Lansing, MI 48824, USADepartment of Biosystems and Agricultural Engineering, Michigan State University, 524 S. Shaw Lane, East Lansing, MI 48824, USACancer patients, who face increased foodborne illness susceptibility and severity, are often placed on neutropenic diets (NDs), which eliminate the consumption of fresh produce, among other foods perceived as high-risk. Such diets are clinically disputed because they have never been proven effective in reducing foodborne illness, leading to unstandardized dietary guideline content, format, and delivery methods. To inform a strategic communication approach, this study explored the produce safety handling behavior, barriers, motivators, and beliefs of pediatric cancer patient caretakers using a mixed methods convergent parallel design. A quantitative survey revealed high frequencies (>60%) for generally recommended produce safety behaviors, such as rinsing produce and washing cutting boards, and more mixed responses for restrictive produce safety behaviors, such as peeling produce and avoiding precut, self-serve, and school cafeteria produce. Total produce safety frequency scores were not significantly affected by demographic factors or Child Vulnerability Scale (CVS) scores. Qualitative interviews established a wide domain of caretaker produce safety experiences and beliefs, finding that eight of seventeen interview participants from different hospitals received produce restrictions typical of the ND. Ultimately, five caretaker archetypes were identified, with common motivators and barriers linked to materials received, child’s health and perceived susceptibility, and self-efficacy beliefs. Finally, response-driven communication strategy improvements were recommended. Although sample sizes in this work were small, and further validation is advised, this work highlights the inconsistent use of the restrictive ND, advances understanding of the drivers of produce safety behaviors in cancer patient caretakers, and supports future endeavors to streamline communication strategy interventions.http://www.sciencedirect.com/science/article/pii/S0362028X24001844Cancer patientsFoodborne illnessImmunocompromisedNeutropenic dietProduceRisk communication
spellingShingle Carly B. Gomez
Tyler J. Stump
Monique M. Turner
Jade Mitchell
Bradley P. Marks
Produce Safety Behaviors, Motivators, Barriers, and Beliefs in Pediatric Cancer Patient Caretakers
Journal of Food Protection
Cancer patients
Foodborne illness
Immunocompromised
Neutropenic diet
Produce
Risk communication
title Produce Safety Behaviors, Motivators, Barriers, and Beliefs in Pediatric Cancer Patient Caretakers
title_full Produce Safety Behaviors, Motivators, Barriers, and Beliefs in Pediatric Cancer Patient Caretakers
title_fullStr Produce Safety Behaviors, Motivators, Barriers, and Beliefs in Pediatric Cancer Patient Caretakers
title_full_unstemmed Produce Safety Behaviors, Motivators, Barriers, and Beliefs in Pediatric Cancer Patient Caretakers
title_short Produce Safety Behaviors, Motivators, Barriers, and Beliefs in Pediatric Cancer Patient Caretakers
title_sort produce safety behaviors motivators barriers and beliefs in pediatric cancer patient caretakers
topic Cancer patients
Foodborne illness
Immunocompromised
Neutropenic diet
Produce
Risk communication
url http://www.sciencedirect.com/science/article/pii/S0362028X24001844
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