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Improving food safety often requires individuals or groups to adopt new food safety behaviors. Understanding individuals’ perceptions of food safety is an important step in creating programs that enable the adoption of such behaviors. To inform the design of food safety programs in Cambodia, this study measured perceptions of vegetable safety among vegetable growers (n = 69; Battambang, Siem Reap) and vendors (n = 31; Phnom Penh) involved in Cambodian informal vegetable markets using a quantitative questionnaire. The majority of respondents (≥ 62.7%, lower bounds of 95% confidence intervals at least 46.2%) across all groups (growers and vendors) were at least “moderately concerned” (scale: “extremely concerned,” “moderately concerned,” “slightly concerned,” “not concerned at all”) about the safety of vegetables sold in Cambodia. However, the mean estimated probability of respondents reporting that chemical contamination was of greater concern than microbial contamination was 84.9% [76.0, 90.9]%. Most respondents reported familiarity with the health effects of consuming chemically (71.4% [61.5, 79.6]%) or microbially (57.3% [47.2, 66.9]%) contaminated vegetables. However, less than half (between 7.3% and 48.4%) of all respondents provided a commonly recognized example of such health effects. Across all groups, respondents most frequently perceived contamination of vegetables as occurring primarily “at the farm” (≥ 76.7%, lower bounds of 95% confidence intervals at least 61.5%, and ≥ 39.3%, lower bounds of 95% confidence intervals at least 21.2%, respectively). Additionally, most respondents (≥ 51.6%, lower bounds of 95% confidence intervals at least 34.0%) perceived “vegetable farmers” as primarily responsible for preventing chemical contamination. Perceptions of responsibility for preventing microbial contamination varied across groups (p = 0.02). Of the vendors in Phnom Penh, growers in Battambang, and growers in Siem Reap involved in this research, 22.6%, 39.0%, and 53.6%, respectively, described at least one commonly accepted contamination prevention practice. These results suggest that food safety programs for each of the described groups should include efforts to increase participants’ understanding of the health impacts of consuming contaminated vegetables. However, specific emphasis should be placed on increasing awareness on the health impacts of consuming vegetables contaminated with microbial pathogens as respondents were generally less aware and concerned with microbial vs. chemical contamination of vegetables. Additionally, programs targeting vegetable growers could leverage growers’ sense of personal responsibility for both contamination and contamination prevention, while programs for vegetable vendors may need to emphasize the importance of vendors in ensuring vegetable safety.

IntroductionSeveral Cambodian initiatives seek to improve nutritional outcomes via increased production and consumption of nutrient-dense foods, including vegetables. However, food safety gaps in informal markets, where most vegetables are purchased, allow for the transmission of foodborne pathogens and threaten the positive nutritional outcomes associated with vegetable consumption.MethodsThis study describes a tool used to measure perceptions of Cambodians involved with informal vegetable markets regarding their capabilities, opportunities, and motivations to implement food safety practices. The quantitative tool could also be used to assess capability, opportunity, and motivation to adopt a behavior in a wide range of development contexts. To these ends, a questionnaire assessing these perceptions was developed using the Capability, Opportunity, Motivation-Behavior (COM-B) model of behavior and the Theoretical Domains Framework (TDF).ResultsThe questionnaire was piloted with vegetable vendors in Phnom Penh (N = 55), revised, and subsequently implemented in the provinces of Battambang and Siem Reap with vegetable producers, distributors, and vendors (N = 181). Confirmatory factor analysis resulted in a nine-factor model corresponding to TDF constructs with a comparative fit index of 0.91, a Tucker-Lewis index of 0.89, and a root mean square error of ~0.05. Further analysis indicated that vegetable vendors and distributors typically had significantly higher (p < 0.05) levels of perceived motivation and capability to implement the target food safety practice (washing surfaces that come in contact with vegetables with soap and water every day) compared to their perceived opportunity to do so. Among farmers, however, levels of perceived motivation were significantly higher (p < 0.05) than levels of perceived opportunity and capability. In addition, vendors in Battambang had significantly higher (p < 0.05) levels of perceived capability, opportunity, and motivation to implement the target food safety practice in comparison to farmers in either province. Vendors in Battambang had significantly higher (p < 0.05) levels of perceived opportunity and motivation than vendors in Siem Reap.ConclusionsThese data suggest that efforts to bolster vegetable vendors' and distributors' perceived opportunity and vegetable farmers' perceived opportunity and capability to implement food safety practices could increase the likelihood of adoption of the target food safety practice.