Food workers' perspectives on handwashing behaviors and barriers in the restaurant environment.

Food handler focus groups in two Oregon counties discussed knowledge, practices, and barriers related to handwashing in the restaurant environment. Current knowledge-based handwashing training programs do not address the internal and external barriers that affect handwashing practice. According to the focus groups, important barriers were time pressure, inadequate facilities and supplies, lack of accountability, lack of involvement of managers and coworkers, and organizations that were not supportive of handwashing. Because barriers to handwashing are multi-dimensional in nature, the authors recommend that future educational and training programs include 1) a hands-on training program that orients new employees to correct handwashing practice and more advanced education about foodborne illness; 2) involvement of both managers and coworkers in the training; 3) easily accessible hand-washing facilities stocked with necessary supplies; 4) continued handwashing training and support involving the food service industry, managers, and coworkers; and 5) involvement of health departments and inspectors in providing managers and food workers with advice and consultation on improvement of handwashing practice.