RESEARCH

Implementation of HACCP and prerequisite programs

in school foodservice
SUKYUNG YOUN, MS; JEANNIE SNEED, PhD, RD

ABSTRACT
Objective The objective of this study was to determine food
safety procedures and practices related to the hazard analysis
critical control point (HACCP) program and prerequisite program implementation in school foodservice.
Design This descriptive study used a mailed questionnaire to
determine procedures and practices related to HACCP and
prerequisite programs implemented in schools. Demographic
questions related to school foodservice directors and districts
were included.
Subjects/settings The questionnaire was mailed to a national random sample of 600 district school foodservice directors, all 536 district school foodservice directors in Iowa, and
33 directors of school districts known to have centralized
foodservice systems.
Statistical analyses Descriptive statistics were used to summarize data. Principal component factor analysis with varimax rotation identified underlying factors for HACCP procedures and practices items. Cronbachs alpha determined
reliability for items within a factor. Multiple linear regression
determined relationships among variables, and independent t
tests were used to compare centralized and conventional
foodservice systems.
Results Of 1,169 questionnaires mailed, 414 school foodservice directors responded (35.4% response rate). HACCP programs were implemented in 22% of school districts. Two
thirds of the directors had food safety certification. Centralized systems implemented more food safety procedures
(21.45.6, 20.45.1, P.04) and practices (26.13.5,
24.84.5, P.002) than did conventional systems. Having
one or more employees with primary responsibility for food
safety resulted in a higher number of procedures and practices implemented (P.031).
Applications/conclusions School districts need to implement prerequisite programs so that they are ready for
HACCP implementation. There are opportunities for dietitians to provide consulting, training, and technical assistance to schools on HACCP implementation. J Am Diet
Assoc. 2003;103:55-60.

ood safety has received much emphasis by government

agencies and food-related professional associations because of the potential health and economic impact of
foodborne illnesses. It is estimated that 76 million illnesses, 325,000 hospitalizations, and 5,000 deaths are attributed to foodborne illnesses in the United States each year (1).
Recent US General Accounting Office (2) testimony indicates
that school-related foodborne illness outbreaks increased
about 10% per year in the 1990s, which is comparable to the
increase in outbreaks in general.
Safe food is one attribute of quality food emphasized by Gilmore, Brown, and Dana (3) in their study of school foodservice
operations. They stated that quality food may be defined as
food that is selected, prepared, and served in a way so that it
retains its natural flavor and identity, is nutritious and is free of
unsafe bacteriological or chemical contaminations (p 47).
Food safety is important to school foodservice professionals.
One recent national study found that nearly 90% of district
school foodservice directors believe that checking on food
safety was an important part of their job, and 82% indicated
that it was important for them to learn more about food safety
issues (4).
According to the General Accounting Office (5), 8 of 20 foodborne outbreaks reported to the Centers for Disease Control
and Prevention (CDC) in 1997 were associated with school
meal programs. School outbreaks related to salmonella (6) and
Escherichia coli (7,8) illustrate the health and financial impact of school-related foodborne illness.
To provide safe food and prevent foodborne illness outbreaks, hazard analysis critical control point (HACCP) programs are recommended. The National Advisory Committee on
Microbiological Criteria for Foods (9) defined HACCP as a

S. Youn is a former student at Iowa State University

who now resides in Seoul, South Korea. J. Sneed is an
associate professor, Hotel, Restaurant, and Institution
Management, Iowa State University, Ames.
Address correspondence to: Jeannie Sneed, PhD, RD,
Iowa State University, Hotel, Restaurant, and Institution
Management, 4 MacKay Hall, Ames, IA 50011-1120.
Copyright 2003 by the American Dietetic Association.
0002-8223/03/10301-0004$35.00/0
doi: 10.1053/jada.2003.50002
Journal of THE AMERICAN DIETETIC ASSOCIATION / 55

RESEARCH

management system in which food safety is addressed through

the analysis and control of biological, chemical, and physical
hazards from raw material production, procurement and handling, to manufacturing, distribution, and consumption of the
finished product (p 1,248).
HACCP programs are important for maintaining food safety
in school foodservice, yet it seems that HACCP programs are
not implemented widely. Further, prerequisite programs, defined as those procedures that address operational conditions
providing the foundation for the HACCP system (9, p 1,247),
may not be in place. Prerequisite programs would include such
things as supplier control, written specifications, written cleaning and sanitation procedures, and documented employee
training. Hwang, Almanza, and Nelson (10) reported that the
majority (87%) of Indiana school foodservice directors have
not implemented HACCP programs. In a national study, Giampaoli, Sneed, Cluskey, and Koenig (4) found that 70% of school
foodservice directors do not have comprehensive HACCP programs in place.
In addition, many basic food-handling practices are not implemented in school foodservice. Research by Gilmore and colleagues (3) showed that air circulation in freezers was not adequate because of tight packing in freezers. Food handlers
often did not restrain hair and had poor personal hygiene practices such as inadequate hand washing. Employee food-handling practices in 15 on-site school kitchens were examined
recently (11), and it was found that most poor food-handling
practices related to time and temperature. Only 8 of 15 on-site
kitchens routinely used thermometers. The failure to transfer
food to cold storage during preparation steps was identified.
Hand washing was another problem identified.
Hwang, Almanza, and Nelson (10) found that the level of
school foodservice managers sanitation knowledge, certification, sanitation training program availability, sanitation practices, and size (number of breakfasts and lunches served per
day) were related positively to operations that implemented
HACCP programs. There has been no research related to prerequisite program implementation in school foodservice.
The purpose of this research was to determine food safety
procedures and practices used in school foodservice related to
HACCP and prerequisite programs. In addition, these factors
were compared for centralized and conventional foodservice
systems because there are no data available on differences between these two foodservice systems.
METHODOLOGY
Sample Selection
A national random sample of 600 district school foodservice
directors, purchased from Market Data Retrieval (Shelton,
CT), and all Iowa school foodservice directors (n536) were
included in the study sample. To ensure representation of
school districts with centralized foodservice systems, a list of
foodservice directors (n33), acquired through the school
foodservice listserv, MealTalk, was included.
Questionnaire Design
A written questionnaire was developed for this study. Part I
included 34 questions related to food safety procedures, including implementation of a HACCP plan and prerequisite programs such as standard operating procedures, sanitation and
hygiene procedures, and procedures for receiving and storage.
56 / January 2003 Volume 103 Number 1

Yes/no responses were given for each question. Scores were

assigned as a 1 (yes) or 0 (no).
Part II of the questionnaire consisted of a list of 18 practices
that would indicate the presence of HACCP prerequisite programs. Specific questions related to steps in the flow of food
(purchasing, receiving, storage, production, and service) were
included. Four questions about delivery methods were asked of
directors in centralized foodservice systems. For each practice,
respondents indicated the frequency that the practice was followed in their schools using the scale always/daily, sometimes,
and never, which were scored 3, 2, and 1, respectively.
Items included in parts I and II were developed based on
guidelines of the National Advisory Committee on Microbiological Criteria for Foods (9) and the ServSafe course book (12).
Questions were grouped by prerequisite program area to ensure coverage of all areas. All questions are included in Tables
1 and 2.
Part III consisted of 17 items for obtaining demographic
characteristics of respondents (education level, age, gender,
number of years employed in foodservice operations, number
of years employed in school foodservice operations, and food
safety certification) and the school district (number of students, number of students participating in the meal programs,
and number of employees). The first question in this part determined the type of food production system, and respondents
circled all that applied to their district: 1. On-site (food cooked
and served at same school); 2. Regional or base kitchen (food
cooked at one site and served at that site and at least one other
site/school); 3. Central bakery; and 4. Central kitchen (food
cooked at a central kitchen and transported to other sites for
service). The questionnaire and study protocol were reviewed
and approved by the Human Subjects Committee of the Institutional Review Board (Iowa State University, Ames).
Pilot Test
The questionnaire was pilot tested by graduate students with
foodservice experience, Child Nutrition Program state agency
staff, and school foodservice directors. Items were added to
ensure adequate coverage of areas and reworded to increase
clarity based on recommendations of the pilot test groups.
Data Collection
The questionnaire, a cover letter that explained the purpose of
the study and encouraged participation, and a postage-paid
return envelope were mailed to the study participants. Three
weeks after the initial mailing, a follow-up postcard was sent as
a reminder. A second questionnaire was sent to directors who
did not respond within 7 weeks of the initial mailing.
Data Analyses
SPSS for Windows software (version 10.0, 1999, SPSS, Inc,
Chicago, IL) was used for all data analyses. Respondents could
answer more than one category for type of foodservice system.
For data analysis purposes, responses were divided into two
categories. Directors of 193 districts who checked only conventional (on-site) foodservice system were placed in that category. Directors of 213 school districts who checked either centralized or regional foodservice systems were categorized as
centralized foodservice systems.
Frequency distributions were computed for all variables.
Principal component factor analysis with varimax rotation was

RESEARCH

Table 1
Food safety procedures related to prerequisite programs and HACCP program components implemented in centralized (N213) and
conventional (N193) school foodservice systems
Food safety procedures

Centralized,
yes

4
HACCP (0.86)a,b
Procedures to periodically take and record the temperatures of all potentially hazardous foods as they
flow through the operation
A linear product and traffic flow (eg, food is received, placed in storage, prepared, and served with little
crossing of paths between steps) that minimizes cross-contamination
Temperature logs for all cooling equipment (refrigerators, freezers, and chillers)
Written specifications for all ingredients and food products
Standardized recipes with critical control points
Preventive maintenance schedules
Standardized recipes with instructions for handling leftovers
Procedures in place to check temperatures of refrigerated and frozen foods at receiving
Equipment calibration schedules (ie, checking temperature accuracy of ovens)
Written procedures for cleaning and sanitizing all equipment
Written procedures for cleaning the facility
Temperature logs for heating equipment (eg, cook tank)
Assurance or documentation from suppliers that they follow a HACCP program
Procedures to save samples of prepared food for analyses if required
Procedures for checking the condition of the suppliers delivery trucks (eg, sanitation, temperature)
Food product flow charts (listing of steps of food flow from receiving to service)
A comprehensive HACCP plan
Procedures for sending food product samples to laboratory for bacterial testing
A HACCP team
Procedures for taking swabs of food production equipment and counters to determine bacterial count
Standard operating procedures (0.79)
Procedures implemented for properly thawing foods (eg, thaw in refrigerator or under cold running water)
Procedures in place to check the final internal temperature of cooked foods
Standard operating procedures for food storage
Standard operating procedures for chemical storage
Standard operating procedures for cleaning and sanitation
Standard operating procedures for handling leftovers
Training (0.78)
All employees trained on personal hygiene
All food-handling employees trained on appropriate food-handling procedures
All employees trained on cleaning and sanitation
Storage (0.58)
Thermometers in all freezers
Thermometers in refrigerators
A pest control program
Miscellaneous items
Employees who follow cleaning and sanitation procedures
Thermometers in dry storage

Conventional,
yes

n (%)

155 (73)

129 (67)

153 (72)
145 (68)
139 (65)
134 (63)
115 (54)
115 (54)
110 (52)
107 (50)
98 (46)
94 (44)
77 (36)
59 (28)
59 (28)
59 (28)
74 (35)
52 (24)
31 (15)
28 (13)
15 (7)

135 (70)
112 (58)
91 (47)
118 (61)
96 (50)
91 (47)
90 (47)
102 (53)
76 (39)
78 (40)
55 (29)
48 (25)
46 (24)
43 (22)
39 (20)
36 (19)
17 (9)
17 (9)
11 (6)

206 (97)
202 (94)
193 (91)
193 (91)
193 (91)
193 (91)

188 (97)
180 (93)
184 (95)
182 (94)
180 (94)
179 (93)

203 (95)
199 (93)
201 (94)

185 (96)
179 (93)
180 (93)

209 (98)
210 (99)
200 (94)

189 (98)
189 (98)
178 (92)

201 (94)
148 (70)

178 (92)
126 (65)

HACCPhazard analysis critical control point.

a
The regression model examining the relationship of school district characteristics and the HACCP factor score was significant (P.001). The number of
students and having an employee with primary responsibility for food safety were positively related to the factor score.
b
Comparison by t test revealed that the HACCP score was higher for centralized (8.54.7) than conventional (7.44.4) foodservice systems. A total factor score
of 20 was possible.

done for food safety procedures items and for practices items.
Based on a minimum eigenvalue of 1.0 and an examination of a
scree plot to determine the point of discontinuity, the number
of factors was selected. A Cronbach alpha reliability coefficient
was calculated to determine the reliability for the items in each
factor (13).
A total score and factor scores for both food safety procedures and practices were calculated by summing responses to
all items. For food safety procedures, the total score could be 0
to 34. The food safety practices total score could have a low of
12 to a high of 36. Independent t tests were conducted to
compare the total score and factor scores means for conventional and centralized foodservice systems. Multiple linear re-

gression was done to determine relationships between the total

score and factor scores, and school foodservice directors and
district characteristics. A probability of equal or less than .05
was considered significant.
RESULTS
A total of 1,169 questionnaires were mailed to the national
random sample, all Iowa directors of school foodservice, and
directors known to have centralized foodservice systems. A
total of 414 questionnaires were returned, for a 35.4% response
rate. Of 536 questionnaires sent to the Iowa sample, 218 questionnaires were returned, a 40.7% response rate. Of the 633
questionnaires sent to the national sample of school foodserJournal of THE AMERICAN DIETETIC ASSOCIATION / 57

RESEARCH

Table 2
Food safety practices implemented in centralized (N213) and conventional (N193) school foodservice systems
Food safety practices

Always/daily
Centralized

Sometimes

Conventional
n (%)

Measuring and recording safe food handling practices (0.81)a,b

Take and record end-point temperatures
of all cooked foods
137 (64)
81 (42)
Take and record temperature of food on
the serving line
119 (56)
73 (38)
Check concentration of sanitizing
solutions used for sanitizing work
surfaces or items washed in the pot
and pan sink
104 (49)
83 (43)
Take and record milk temperature in the
milk cooler
89 (42)
74 (38)
Take and record dish machine
temperatures
88 (41)
77 (40)
Take and record milk temperature upon
receiving
52 (24)
40 (21)
Storing food properly (0.47)a
Store prepared foods tightly wrapped in
clean and moisture-proof materials
187 (88)
170 (88)
Label all items for storage with the
production date or the use-by date to
ensure proper stock rotation
158 (74)
147 (76)
Calibrate thermometers on a daily basis
35 (16)
25 (13)
Ensuring food safety (0.31)a
Follow appropriate personal hygiene
practices
204 (96)
184 (94)
Take swabs of food production
equipment and counters to determine
bacterial count
1 (1)
1 (1)
Send food product samples to a
laboratory for bacterial testing
2 (1)
0 (0)

Centralized

Never

Conventional
n (%)

Centralized

Conventional
n (%)

51 (24)

72 (37)

23 (11)

31 (16)

69 (32)

70 (36)

23 (11)

42 (22)

87 (41)

82 (43)

18 (9)

22 (11)

89 (42)

76 (39)

32 (15)

33 (17)

69 (32)

57 (30)

46 (22)

46 (25)

84 (39)

71 (37)

76 (36)

75 (39)

23 (11)

18 (9)

3 (1)

1 (1)

47 (22)
116 (54)

39 (20)
92 (48)

7 (3)
59 (28)

5 (3)
71 (37)

8 (4)

6 (3)

0 (0)

0 (0)

16 (7)

12 (6)

193 (91)

178 (92)

19 (9)

7 (4)

190 (89)

183 (95)

Regression models relating school district characteristics and factor scores were significant (P.01), and having an employee with primary responsibility for
food safety was positively related to the factor score.
b
Comparison by t test showed that centralized foodservice systems had a higher factor score for the measuring and recording safe food-handling practices
factor than conventional foodservice systems (16.53.4, 15.33.9, P.001). Scores for this factor could range from a low of 7 to a high of 21.

vice directors and those with centralized foodservice systems,

196 questionnaires were returned, for a 31% response rate.
Demographic Information
Demographic information related to characteristics of school
foodservice directors and districts is presented in Table 3. Over
90% of school foodservice directors were female. Two thirds of
the respondents reported that they held food safety certification. Fifty percent of the directors estimated that less than 25%
of their employees were certified in food safety, and 54% indicated that more than 75% of their managers were certified.
There were 213 centralized and 193 conventional foodservice systems included in the study. Among school districts with
centralized foodservice systems, 125 transported food in bulk,
whereas 13 preplated foods. The majority (n111) transported food hot, and 27 transported food chilled.
The majority of school districts employed 20 or fewer managers or supervisors, and 56% had 20 or fewer employees. In
response to food safety training and certification information,
30% of the districts had one or more employees whose primary
responsibility was implementing and monitoring food safety in
the foodservice system. Approximately two thirds provided the
opportunity to attend a food safety training program in the past
2 years, and 40% provided a food safety training program annually. Half of these school districts had more than 75% of
58 / January 2003 Volume 103 Number 1

managers certified in food safety, whereas only 14% indicated

that the number of employees certified in food safety was more
than 75% of total employees.
Food Safety Procedures Related to HACCP and
Prerequisite Programs
Food safety procedures were categorized into four factors
(HACCP, standard operating procedures, training, and storage) based on factor analysis. Responses to these questions are
summarized in Table 1.
In the HACCP category, 22% of the directors had implemented a comprehensive HACCP plan and 11% had a HACCP
team. All items in the standard operating procedures, training,
and storage categories were implemented by more than 90% of
school foodservice directors.
Multiple linear regression models testing the relationship between the total and four factor scores and school foodservice
directors characteristics were not significant. Models testing
the relationship between total score and factor scores and
school foodservice districts characteristics were significant for
the total score (F13.14, P.001) and for the HACCP factor
(F14.65, P.001). Both models showed positive relationships between the number of students and the number of food
safety procedures. Districts with an employee(s) who had pri-

RESEARCH

Table 3
Demographic characteristics of the school directors and districts in
centralized (N213) and conventional (N193) foodservice systems
Characteristics
Age
30 years or younger
31-50 years
51-65 years
Older than 65 years
Education level
High school
Some college
Bachelors degree
Graduate degree
Years in school foodservice
5 years or fewer
6-15 years
16-25 years
26 years or more
Number of students
Fewer than 500
501-1,000
1,001-2,000
2,001-4,000
4,001-8,000
8,001-20,000
More than 20,000
Number of employees
Managers/supervisors
20 or fewer
21-50
51 or more
Employees
20 or fewer
21-50
51-100
More than 100

Centralized

Conventional

n (%)a

6 (2.8)
100 (46.9)
101 (47.4)
3 (1.4)

3 (1.6)
102 (52.8)
83 (43)
4 (2.1)

57 (26.8)
56 (26.3)
60 (28.2)
37 (17.4)

68 (35.2)
68 (35.2)
26 (13.5)
27 (14)

36 (16.9)
85 (39.9)
65 (30.5)
24 (11.3)

35 (18.1)
93 (48.2)
47 (24.4)
16 (8.3)

14 (7.6)
43 (21.7)
34 (17.2)
40 (22.2)
26 (13.1)
22 (11.1)
18 (9.1)

59 (33.0)
37 (20.8)
25 (14.1)
30 (16.8)
13 (7.3)
8 (4.5)
6 (3.4)

189 (91.3)
9 (4.4)
9 (4.4)

180 (97.8)
3 (1.5)
1 (0.5)

111 (48.6)
49 (23.5)
31 (14.9)
27 (13)

131 (72)
30 (16.5)
17 (9.3)
4 (2.0)

Percentages do not always total 100% because of nonresponse to questions.

mary responsibility for food safety implemented more food

safety procedures than districts that did not.
Comparison of Food Safety Procedures for Centralized
and Conventional Foodservice Systems
Comparisons by t test were conducted to determine differences for each factor between centralized and conventional
foodservice systems. Results of the t test comparisons showed
that the total score and the HACCP factor score were different
for conventional and centralized foodservice systems. For
the overall score, conventional foodservice systems scored
20.45.1 and centralized foodservice systems scored 21.45.6
(P.040). Centralized foodservice systems had a higher mean
score (8.54.7) for the HACCP factor, compared with 7.44.4
for conventional foodservice systems (P.013).
Food Safety Practices
Responses to food safety practice items were grouped into
three factors (measuring and recording safe food-handling
practices, storing food properly, and ensuring food safety)
based on factor analysis (Table 2). In the measuring and recording safe food-handling practices category, taking and recording end-point temperatures of all cooked foods was the
only practice that over 50% of school foodservice directors

always implemented. Two storage practices, storing prepared

foods tightly wrapped in clean and moisture-proof materials
and labeling all items for storage with the production date or
the use-by date to ensure proper stock rotation, were done by
88% and 76% of all school foodservice directors, respectively.
In the ensuring food safety category, the majority (95%) of
school foodservice directors reported following appropriate
personal hygiene practices.
Multiple linear regression models testing the total and factor
scores for food safety practices and school foodservice directors characteristics were significant for the total score
(F3.35, P.010) and the first factor, measuring and recording safe food-handling practices (F4.74, P.001). Among
school foodservice directors characteristics, education was the
only significant characteristic for the total score (0.142,
P.001).
The models testing the relationship between the total and
factor scores and school districts characteristics were significant for the total score (F4.35, P.001) and all three factors:
measuring and recording safe food-handling practices
(F4.68, P.001), storing food properly (F2.71, P.007),
and ensuring food safety (F4.74, P.001). Districts that had
an employee(s) with primary responsibility for food safety had
a higher total score and score for all three factors than districts
that did not have such an employee. For the third factor, ensuring food safety, there was a positive relationship between
number of students and factor score. The number of managers
was negatively related to all three factors.
Comparison of Food Safety Practices in Centralized
and Conventional Foodservice Systems
Comparisons by t test indicated that the mean scores were
different for the total score and the first factor (measuring and
recording safe food-handling practices) for the two systems.
Centralized foodservice systems scored 26.13.5, whereaas
conventional foodservice systems scored 24.84.5 for the total
score (P.002). Centralized foodservice systems had a higher
mean score (16.53.4) compared with conventional foodservice systems (15.33.9) for measuring and recording safe
food-handling practices (P.001).
DISCUSSION
There have been no studies examining the extent to which food
safety prerequisite programs are implemented in school foodservice; therefore, findings of this study will be helpful in determining where to start with HACCP training and implementation. One prerequisite program is training, and we would
expect that a high number of foodservice directors, managers,
and employees would have food safety certification. Two thirds
of the directors were certified, a number similar to the 71% of
foodservice directors who had food safety certification in the
study by Giampaoli and colleagues (4). The numbers of managers and employees reported to be certified is lower, indicating a need to conduct basic food safety training and certification for all levels of school foodservice employees.
In this study, 22% of school foodservice directors reported
that they had implemented HACCP programs. This is slightly
higher than the 14% of school foodservice directors in Indiana
who had HACCP programs in place (10) and slightly lower than
the 30% reported in a recent national study (4). Eleven percent
reported to have a HACCP team, and 30% reported to have a
person with primary responsibility for HACCP implementation.
Journal of THE AMERICAN DIETETIC ASSOCIATION / 59

RESEARCH

Thus, education is needed on both why and how to implement

HACCP programs.
Many food safety procedures are reported to be implemented, yet the programs are not compliant with HACCP requirements for documentation. For example, more than 90% of
directors reported to have standard operating procedures for
thawing foods, taking temperatures, storing food and chemicals, cleaning and sanitizing, and handling leftovers. More than
half of these directors do not have written procedures for any of
these processes, which is a requirement for HACCP programs.
Many food safety practices, such as calibrating thermometers and taking and recording temperatures, are done only
sometimes. Giampaoli and colleagues (11) also found that
cooking temperatures were not taken and temperature logs
were not maintained in a small sample of school foodservice
operations.
Little research has been done to compare food safety procedures and practices related to HACCP and prerequisite programs in centralized and conventional foodservice systems.
Kim and Shanklin (14) conducted a study in a school district
changing from a conventional to a centralized cook-chill foodservice system. They found inconsistencies in serving temperatures in both systems, although there were more inconsistencies with the use of cook-chill, and recommended that standard
operating procedures were needed to ensure consistency. The
results of this study indicate that foodservice directors of centralized foodservice systems are implementing more food
safety procedures and practices than their counterparts in conventional foodservice systems. It should be noted that the difference, although significant, is a small difference that may be
of little practical importance. We would expect to see this difference to be greater because there are more critical control
points in centralized systems; however, these procedures and
practices are important for both foodservice systems.

APPLICATIONS
HACCP implementation needs to be emphasized in school
foodservice. The current 22% of districts reporting to have
HACCP programs is insufficient to ensure food safety for school
children.
The items included in the questionnaire can be used by
school foodservice directors as a self assessment of the use of
prerequisite programs. Results of this study can serve as a
benchmark for directors to compare their operation with a national sample of operations. This self-assessment tool also
could be used by a school districts HACCP team to evaluate
current practices and establish areas where improvement is
needed.
Larger school districts implemented more food safety practices and procedures than did smaller districts. Directors of
small districts need to explore ways that they can implement
prerequisite programs and move toward HACCP implementation.
School districts that had one or more employees with primary
responsibility for food safety implemented more food safety

60 / January 2003 Volume 103 Number 1

procedures and practices than those who did not. School districts are encouraged to consider giving one or more employees
specific responsibility for providing leadership for prerequisite
programs and HACCP implementation to ensure that implementation occurs.
Consultant dietitians with expertise in food safety may use
results of this study to identify areas in which operational resources are needed. For example, there seems to be a need for
written standard operating procedures that include food safety
components and a need for resources such as temperature
logs. These could be developed and marketed by a dietitian.
Consultant dietitians may identify areas in which they can
develop services that can be marketed to school foodservice
related to training and prerequisite and HACCP program development and implementation.
References
1. Mead PS, Slutsker L, Dietz V, McCaig LF, Bresee JS, Shapiro C, Griffin PM,
Tauxe RV. Food-related illness and death in the United States. Available at:
http://www.cdc.gov/ncidod/eid/vol5no5/pdf/v5n5.pdf. Accessed September
7, 2001.
2. Dyckman LJ. Continued vigilance needed to ensure safety of school meals.
Washington, DC: US General Accounting Office; 2002. GAO-02-669T.
3. Gilmore SA, Brown NE, Dana JT. A food quality model for school foodservices. J Child Nutr Mgt. 1998;22:32-39.
4. Giampaoli J, Sneed J, Cluskey M, Koenig HF. School Foodservice directors attitudes and perceived challenges to implementing food safety and
HACCP programs. J Child Nutr Mgt. 2002; vol 26. Available at: http://www.asfsa.org/childnutrition/jcnm/02spring/giampaoli1/. Accessed June 20,
2002.
5. General Accounting Office. School meal programs: few outbreaks of foodborne illness reported. Available at: http://schoolmeals.nal.usda.gov:8001/
safety/. Accessed February 25, 2000.
6. Centers for Disease Control and Prevention. Epidemiological notes and
reports: salmonellosis in a school systemOklahoma. Available at: http://
www.cdc.gov/mmwr/preview/mmwrhtml/00000868.htm. Accessed May 12,
2001.
7. Cable News Network (CNN). Beef link in Georgia E. coli outbreak. Available
at: www.cnn.com/HEALTH/9807/24/3coli.water.park/index.html. Accessed
February 25, 2000.
8. Cary A. $4.75 million awarded in E .coli case. Available at: http://www.tricityherald.com/news/2001/0217/story1.html. Accessed October 15, 2001.
9. National Advisory Committee on Microbiological Criteria for Foods. hazard
analysis and critical control point principles and application guidelines. J Food
Protection 1998;61:1246-1259.
10. Hwang JH, Almanza BA, Nelson DC. Factors influencing Indiana school
foodservice directors/managers plans to implement a Hazard Analysis Critical Control Point (HACCP) program. J Child Nutr Mgt. 2001;25:24-29.
11. Giampaoli J, Cluskey M, Sneed J. Developing a practical audit tool for
assessing employee food handling practices. J Child Nutr Mgt. 2002; vol 26.
Available at: http://www.asfsa.org/childnutrition/jcnm/02spring/giampaoli2/.
Accessed June 20, 2002.
12. The Educational Foundation of the National Restaurant Association. Serving Safe Food: A Practical Approach to Food Safety. Chicago, IL: The Educational Foundation of the National Restaurant Association; 1995.
13. Cronbach L. Coefficient alpha and the internal structure of tests. Psychomoetrika.1951;16:297-334.
14. Kim T, Shanklin CW. Menu item acceptability in conventional and cookchill food production systems. J Child Nutr Mgt. 1999;23:61-66.

This research was supported by the Food Safety Consortium and the ISU College of Family and Consumer Sciences. The authors wish to recognize these funding
sources and to thank all of the school foodservice directors
who were willing to participate in this study.