Exploring hand hygiene practices in food businesses using the capability, opportunity and motivation for behaviour change (COM-B) model

Hand hygiene compliance in food service and manufacturing businesses is important for mitigating the risk of foodborne illness and ensuring the safety of the food produced for consumers. Hence, food handler compliance with hand hygiene requirements recommended by international guidelines is crucial. To target behavioural change, factors such as capability, opportunity and motivation may help facilitate or impede food handler hand hygiene. A total of 23 semi-structured interviews were conducted with representatives from the food service and manufacturing industries to explore perceptions of food handlers' hand hygiene behaviour. Through integration of the COM-B model in analysis, key psychological capabilities (e.g. habit, previous experience, memory and attention, and perceived importance) and physical capabilities (e.g. skin irritation) were identified. Additionally, physical opportunities (e.g. monitoring, training, resources, time, and business size) and social opportunities (e.g. peer and production pressure, language, and food safety culture) were addressed to impact hand hygiene behaviour. Both automatic and reflective motivators, such as reinforcement, rewards and recognition, consequences, responsibility and improvements, were highlighted as driving factors for hand hygiene compliance. Findings from this study provide insights into the key opportunities necessary to increase food handlers’ capability of engaging in effective hand hygiene practices, as well as what motivates them to maintain and improve these practices.