Young People’s Views on Food Hygiene and Food Safety: A Multicentre Qualitative Study

Round 1

Reviewer 1 Report

The paper is written in a clear and complete way. The experimental design is consistent with the investigation tools used. The unpublished material, but attached to the manuscript, helps to understand the tools used to support an in-depth exploration of students' knowledge, skills, attitudes and beliefs of food hygiene. The same materials also allow us to better understand some results.

However, some weakness can be found in the description of the results and in the explanation the link between them and the conclusions.

I would like to discuss this with the authors.

Although the title and purpose of the paper make explicit the qualitative nature of the research, although furthermore the standardized protocols were developed, reviewed and agreed between the experts involved, the absence of numerical data does not allow to verify the evidence of the significance of hypotheses formulated as these can cover a central or completely marginal place, compared to the responses of the students involved. In particular, the results of FGs and interviews at the schools are not described at all. The choice of highlighting some student quotes does not seem to be sufficiently explained. For example, how many classmates have shared the quote? From a methodological point of view, it might be accepted not to apply in-depth statistical methods, but the lack of dimension of the parameters invalidates the scientific value of the research.

 

80 or until data saturation was reached

Could you better clarify the meaning of this passage? Which and how many places are there to saturate?

 

87-89: The project team collaborated to create an interview/FG schedule informed by the Theoretical Domains Framework (TDF), a tool to inform interventions and evaluation 88 frameworks, to support an in-depth exploration of students’ knowledge, skills, attitudes and beliefs of food hygiene (supplementary 1).

I would ask the authors to explain by what criteria the TDF led to the selection of the results described in Table S2 and Table 2 (Main themes, Key Findings, Student Quotes).

 

204 Table 2. Summary of relevant TDF domains, themes and sample quotes from focus groups and interviews with students. Detail can 203 be found in table S2.

I would advise the authors to correct Table 2, assigning the relative value obtained for each main theme and Student Quote

Author Response

1. Although the title and purpose of the paper make explicit the qualitative nature of the research, although furthermore the standardized protocols were developed, reviewed and agreed between the experts involved, the absence of numerical data does not allow to verify the evidence of the significance of hypotheses formulated as these can cover a central or completely marginal place, compared to the responses of the students involved. In particular, the results of FGs and interviews at the schools are not described at all. The choice of highlighting some student quotes does not seem to be sufficiently explained. For example, how many classmates have shared the quote? From a methodological point of view, it might be accepted not to apply in-depth statistical methods, but the lack of dimension of the parameters invalidates the scientific value of the research.

We would like to thank the reviewer for their comments about the manuscript and suggested improvements. We would like to explain why these methods are used in qualitative research in the following responses with the hope this will alleviate the reviewer’s concerns. As the reviewer appreciates, this is a qualitative study design and therefore the results reflect themes identified in the data rather than quantities or numerical values. In this context the qualitative research design does not aim to prove a hypothesis but to deeply explore the behaviours, attitudes and knowledge of the participants.

The results of the FGs and interviews are the themes described in the results section – this is the result of a rigorous method of thematic analysis whereby researchers draw out the patterns and meanings (themes) in the data. The quotes from students are included as an example to reflect the themes and are chosen carefully for their representativeness to the theme described i.e. to help the reader understand the content of that theme. The value of a theme is more about how it explains the most important findings in the data, rather than the number of times that it was mentioned.

We thank the reviewer for their comments and have expanded on the aims of the thematic analysis in the methods section, including how quotes were selected to represent the themes. We hope this is much clearer.

2. 80 or until data saturation was reached. Could you better clarify the meaning of this passage? Which and how many places are there to saturate?

Thank you for this comment, we have expanded in the methods section the meaning of this term with a reference for the reader. This term relates to data or theme saturation, whereby researchers believe that subsequent interviews and focus groups are not bringing any new themes/data to the analysis. Due to the inductive nature of the research, researchers use theme saturation as a point to determine where data collection should stop.

3. 87-89: The project team collaborated to create an interview/FG schedule informed by the Theoretical Domains Framework (TDF), a tool to inform interventions and evaluation 88 frameworks, to support an in-depth exploration of students’ knowledge, skills, attitudes and beliefs of food hygiene (supplementary 1). I would ask the authors to explain by what criteria the TDF led to the selection of the results described in Table S2 and Table 2 (Main themes, Key Findings, Student Quotes).

Thank you, we hope to make this clearer in the manuscript and to better explain why the TDF was used. The TDF is a framework used in behavioural science and intervention studies to identify determinants of behaviour change. In this context the TDF was used to support the design of interview questions (to ensure all behavioural determinants were explored) and it was then used again at the end of analysis to support presentation of themes. For the latter, the themes emerging from the thematic analysis were mapped onto the behavioural determinants of the TDF. There are several strengths to this; it supports interpretation of the rich analysis in the context of behavioural determinants and it can be subsequently used to support development of interventions to change behaviour. This is in line with how the developers of the TDF suggested its’ use.

4. 204 Table 2. Summary of relevant TDF domains, themes and sample quotes from focus groups and interviews with students. Detail can 203 be found in table S2. I would advise the authors to correct Table 2, assigning the relative value obtained for each main theme and Student Quote

Thank you for the suggestion, however as described in a previous response, the aims of the qualitative methods are to describe the themes emerging from participant experience and the value is not in quantifying the themes or quotes for this type of analysis.   

Reviewer 2 Report

This is potentially an interesting study. However, a few things should be worked on.

1. Title needs to be made shorter, and there is no need to include countries in it.
2. Please modify the abstract to begin with the background, which should be 1-2 sentences. The problem needs to be stated clearly and succinctly in the background of your abstract.
3. The abstract should have the following structure: background; methodology; findings; and practical implications.
4. For the introduction, first, you need to properly define the research gap and need for your study by referring to the appropriate literature. Is there really a need for this study in Western Europe? Your introduction should make that clearer.
5. Moreover, you should clearly state the research questions of your study in the introduction, preferably in point form if possible.
6. Please justify the choice of the various countries included in the study. Were they chosen out of convenience or was there a particular reason for choosing these countries?
7. The last paragraph in the introduction should describe briefly what is included in the subsequent sections of the article.
8. Main findings need to expand with more descriptions. Only one paragraph is included, which lacks of the depth of research outcome/findings. This is the major weakness of the study.
9. Your study limitations and strengths should be listed after the discussion section.

Other points that should be considered are as follows:

• Table 1 is not necessary and appears to be too simple. Think of excluding it.
• Figure 1 should be turned into a proper flow chart. Think of using Microsoft Visio to develop a proper flowchart.
• Include future study directions in your conclusion
• You should include more current studies
• Considering the fact that hand-washing is closely associated with Covid-19 prevention, can a greater link be made in that regard?

Author Response

This is potentially an interesting study. However, a few things should be worked on.

1. Title needs to be made shorter, and there is no need to include countries in it.

 

Thank you for this suggestion, we have removed the countries and changed the title to: ‘Young people’s views on food hygiene and food safety: A multicentre qualitative study’

 

1. Please modify the abstract to begin with the background, which should be 1-2 sentences. The problem needs to be stated clearly and succinctly in the background of your abstract.
2. The abstract should have the following structure: background; methodology; findings; and practical implications.

 

Thank you, we have updated the abstract accordingly.

 

1. For the introduction, first, you need to properly define the research gap and need for your study by referring to the appropriate literature. Is there really a need for this study in Western Europe? Your introduction should make that clearer.

 

Thank you for this suggestion, we have expanded the introduction to discuss the research gap.

 

1. Moreover, you should clearly state the research questions of your study in the introduction, preferably in point form if possible.

 

Thank you we have added the research questions to the end of the introduction.

 

1. Please justify the choice of the various countries included in the study. Were they chosen out of convenience or was there a particular reason for choosing these countries?

 

This study was part of the EU-funded SafeConsume project, which included collaboration across 14 European countries. The four countries involved in this research had the interest and expertise to be involved this study which was led by the UK research team. This rationale has been added to the method section.

 

1. The last paragraph in the introduction should describe briefly what is included in the subsequent sections of the article.

 

We thank you for this suggestion, however to keep the paper as concise as possible we feel this is not needed as the section titles are clear, and the abstract provides enough summary. We also feel the expanded aims and research question covers this.

 

1. Main findings need to expand with more descriptions. Only one paragraph is included, which lacks of the depth of research outcome/findings. This is the major weakness of the study.

 

The thematic analysis of this study is discussed in detail in the results section and there are supplementary files with other themes not as pertinent to the research question. The ‘main findings’ section of the discussion summarises the themes of the qualitative analysis before going on to discuss the findings in light of previous research and implications for practice and future research. We respectfully feel that further elaboration in the discussion section is not necessary and would lead to repetition.

 

1. Your study limitations and strengths should be listed after the discussion section.

Thank you this has been moved to the end of the discussion.

10. Other points that should be considered are as follows:

• Table 1 is not necessary and appears to be too simple. Think of excluding it.

 

Thank you for this suggestion, however this table covers the educational curriculum in several European countries, which has implications for intervention development and implementation of education. There is a more detailed table in the supplementary files that provides further information on the national curriculum.

• Figure 1 should be turned into a proper flow chart. Think of using Microsoft Visio to develop a proper flowchart.

 

Thank you for this suggestion, the figure has been recreated in Visio.

 

• Include future study directions in your conclusion

Future research section is included at the end of the ‘comparison to other research’ section and has been expanded.

 

• You should include more current studies

Thank you we have referenced more studies through the expanded introduction and discussion.

 

• Considering the fact that hand-washing is closely associated with Covid-19 prevention, can a greater link be made in that regard?

 

Thank you for this suggestion. Implications for covid-19 are included at the end of the ‘implications for schools’ section. A future research direction added is to look at the effect of COVID-19 measures on student hand washing and food hygiene behaviour.

Reviewer 3 Report

Dear Sir or madam,

First at all, I would like to thank the authors for this interesting and important subject. I really enjoyed read this research. In the following some remarks to be considered please.  

Line 44: Please add the link of the e-bug site in the reference or in the text, and a brief definition of this site. I propose to modify the sentence as follow “e-Bug, which is a free educational resource operated by Public Health England, develop educational materials for 4-18-years olds about …”.

Line 203: Please try to put all the table (2) in the same page.

 

Thanks

Author Response

1. First at all, I would like to thank the authors for this interesting and important subject. I really enjoyed read this research. In the following some remarks to be considered please.  
2. Line 44: Please add the link of the e-bug site in the reference or in the text, and a brief definition of this site. I propose to modify the sentence as follow “e-Bug, which is a free educational resource operated by Public Health England, develop educational materials for 4-18-years olds about …”.
3. Line 203: Please try to put all the table (2) in the same page.

We would like to heartily thank the reviewer for their kind comments to the manuscript and have included their two suggestions improvements.

Round 2

Reviewer 2 Report

This version is much improved. Good work!

Suggestion for a minor modification:

1. Please add suggestions for future studies toward the end of the manuscript.
2. Separate 4.4 Strengths and Limitations into two different sub-sections. These are very different aspects which should not be put together.

 

Author Response

We would like to thank the reviewer for their kind comments and excellent suggestions. 

1. Please add suggestions for future studies toward the end of the manuscript.

Thank you, we have expanded on the future research directions and put this under its own subheading '4.3 Future research directions'.

1. Separate 4.4 Strengths and Limitations into two different sub-sections. These are very different aspects which should not be put together

Thank you, these have been split into two subheadings at the end of the manuscript.