Date of Award


Document Type


Degree Name

Master of Science (MS)

Legacy Department

Food, Nutrition, and Culinary Science

Committee Chair/Advisor

Angela M. Fraser, Ph.D.

Committee Member

Julia L. Sharp, Ph.D.

Committee Member

Felix H. Barron, Ph.D.


Student absenteeism is a pervasive problem in the United States, causing a number of educational, economic, and institutional problems. Hand-hygiene interventions have been reported to be a method for reducing illness-associated student absenteeism. As an increasing number of schools offer self-service, including salad bars and bowls of whole fresh fruit, opportunities for the transmission of foodborne pathogens via hands could possibly increase illness-associated student absenteeism. To address this problem, we conducted a two-phase study. First, we conducted a systematic literature review to evaluate peer-reviewed studies (N=24) that reported an association between hand hygiene interventions and illness-associated absenteeism reduction in elementary schools. We concluded that hand-hygiene interventions were associated with reducing illness-related absenteeism reduction in elementary schools. Secondly, we administered a web-based survey to SC school foodservice managers (N=1231) to assess their perceptions and behaviors about hand hygiene in the school foodservice environment. Findings from the 403 eligible responses showed that school foodservice mangers perceived a low level of susceptibility to gastrointestinal diseases, a high level of perceived efficacy to protect self and others from getting gastrointestinal diseases, a high level of agreement with proper food-safety behaviors. Furthermore, there was an insignificant relationship between foodservice manger risk perceptions and food-safety behaviors. Our results will inform the development of a hand-hygiene intervention to be delivered in elementary schools in upstate South Carolina.

Included in

Food Science Commons



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