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The hand hygiene behavior of 400 middle school students (grades 1-3) in Seoul and Gyeonggi-Do was studied to determine how stages of change were affected by food safety education, focusing on hand hygiene and general food safety. Subjects were 51.3% male and 44.3% of study subjects were first graders of middle school. Approximately 40% of subjects were at the stage of action, 42.7% were at the stage of contemplation, and 16.4% were at pre-contemplation. The most important factor that influenced proper hand washing was self efficacy (P &lt; 0.001). Proper hand washing was also correlated significantly with positive belief (P &lt; 0.01) and stages of change (P &lt; 0.01). After food safety education by high-school mentors, middle-school students who were in the stages of pre-contemplation (11.1%) and contemplation (88.9%) showed significant progression toward the action stage (P &lt; 0.001). Proper hand washing (P &lt; 0.01) and food safety knowledge (P &lt; 0.05) were also significantly increased after educational intervention.

The effects of food safety education on adolescents' hand hygiene behavior: an analysis of stages of change