The National Association of County and City Health Officials (NACCHO) recently published a study that was conducted in cooperation with the Conference for Food Protection (CFP), titled, “Analysis of Factors Impacting the Implementation of Effective Intervention Strategies.” The results of the study can serve as a foundation for progress toward achieving effective intervention strategies within the retail food industry.

The study assessed local retail food regulatory programs’ risk factor intervention strategies based on Standard 9 of the U.S. Food and Drug Administration’s (FDA’s) Voluntary National Retail Food Regulatory Program Standards (Retail Program Standards), which outlines the process a jurisdiction can use to measure the success of its retail food regulatory program in delivering positive food safety outcomes. To conform to Standard 9, jurisdictions must design targeted intervention strategies for food hazards based on a risk factor study, and then continue to evaluate the efficacy of employed intervention strategies by carrying out follow-up risk factor studies once every 60 months.

For the study, NACCHO and CFP conducted key informant interviews to identify and assess the implementation of risk factor interventions put in place by local retail food regulatory programs enrolled in the Retail Program Standards. The interviews identified several important considerations when selecting risk factors to target for improvement: resources, processes, collaboration, implementation, and interventions. Most jurisdictions targeted risk factors based on most frequently cited violations during inspections, and the most often targeted risk factor was poor personal hygiene. Interviewees elaborated that poor personal hygiene involved employees working with symptoms of illness or employees observed eating, drinking, or smoking while preparing food.

The study participants identified challenges to implementing target intervention strategies, as well as acknowledged factors that were critical to the success of intervention implementation. Notable challenges included: staff turnover, limited time and financial resources, and difficulty sustaining long-term behavioral change. However, the most commonly mentioned success factors were: robust training programs, tools, and resources, as well as staff willingness to participate in the intervention.

Finally, the study recommends several actions that can be taken by local, state, and federal leadership to reduce barriers to the successful implementation of targeted intervention strategies, for example: ensuring that retail program regulatory staff conduct uniform and consistent inspections; collaboration within states or larger regions for data sharing, best practices, buy-in from decision-makers, and making interventions fit into systems that are already in place; and establishing sustainability of intervention programs. The study stresses the importance of state, local, tribal, and territorial jurisdictions work toward conformance to Standard 9, as it provides a framework for alignment with the other eight Retail Program Standards.