Structural Equation Modeling of the Relationships Between Food Safety Knowledge, Attitudes, and Practices Among Older Adults in Dhaka, Bangladesh

Assessing food safety perceptions among older adults is crucial because their increased susceptibility to foodborne illnesses is primarily attributed to a decline in immune function. This study aimed to investigate the knowledge, attitudes, and practices (KAPs) related to food safety among older adults in Bangladesh, with a focus on understanding the relationships between these factors. A cross-sectional study was conducted from January 2024 to February 2024 to evaluate food safety KAP among 389 participants (mean age 67.70 ± 7.132) in various areas of Dhaka, Bangladesh, through structured, face-to-face interviews. Exploratory Factor Analysis and Structural Equation Modeling were used to validate the model, while Confirmatory Factor Analysis was conducted using the extracted valid items for KAP. Overall, older adults exhibited a moderate level of knowledge; however, gaps were identified in specific areas, as more than half of the respondents were unaware of proper cooking temperatures, reheating guidelines, and cross-contamination. However, a large proportion of the respondents demonstrated a positive attitude toward food safety. Overall, self-reported food safety practices among older adults were adequate, as most respondents followed good hygiene practices and reheated cooked food after removal from the refrigerator. Both knowledge of food safety and attitudes toward food safety had a positive and significant impact on the self-reported food safety practices of the respondents. Knowledge and attitude towards food safety were also correlated with each other, and if food safety knowledge increased in these respondents, attitudes toward food safety would also improve. All of our hypotheses (H1, H2, and H3) were supported by the findings of this study. In conclusion, enhancing knowledge and attitudes toward food safety can lead to improved food safety practices among older adults, helping them prevent foodborne illnesses.