Effectiveness of Customized Training Programs on Knowledge, Attitudes, and Practices (KAP) Related to Antimicrobial Resistance (AMR) among Food Handlers in the Greater Manila Area, Philippines: A Quasi-experimental Study

Abstract

Background and Objectives. Antimicrobial resistance (AMR) constitutes an escalating global public health menace, intensified by the excessive utilization of antibiotics in human healthcare and agriculture. In the Philippines, the extensive misuse of antimicrobials in food production, especially in chicken, swine, aquaculture, and agriculture exacerbate AMR, presenting considerable threats to public health. Since the transmission of AMR is closely linked to food safety, food handlers play a critical role in mitigating its spread. This study evaluates the knowledge, attitude, and practices (KAP) of food handlers in the Greater Manila Area concerning AMR and the utilization of antimicrobials.

Methods. This quasi-experimental study involved developing and implementing a customized training program based on pre-training KAP questionnaires, featuring specialized training materials for fruits and vegetables sellers, meat handlers, seafood vendors, and street food vendors. The training, conducted in partnership with government entities and industry specialists, emphasized AMR awareness, food safety rules, and optimal procedures for reducing AMR hazards.

Results. The results showed statistically significant differences in pre- and post-intervention mean percentage scores in the participants’ knowledge, attitudes, and practices about food handling and AMR. There was also substantial improvement observed across all four occupational groups as post-test scores increased in comparison to their baseline scores. 

Conclusion. This study underscores the pivotal role of food handlers in combating AMR and stresses the necessity for a training program that is focused on AMR education within food safety initiatives. The training program should be customized, for example, according to the length of experience of the food handler, to either provide basic food safety measures or to improve and upgrade the acquired baseline knowledge and skills related to food safety. This particular study showed the importance of providing food handlers with essential knowledge and skills on food safety and proper food handling to aid in the mitigation of AMR transmission.