Food Allergy Knowledge, Attitudes, and Practices Among Restaurant's Staff in Bangladesh: A Structural Modeling Approach.

Food-related allergic reactions are increasingly prevalent in restaurant settings, often leading to severe and life-threatening incidents. This study aimed to investigate the relationships among knowledge, attitudes, and management practices related to food allergies in restaurant staff in Bangladesh. A cross-sectional study conducted between January and May 2024 assessed food allergy knowledge, attitudes, and practices among 712 restaurant staff across eight divisional areas in Bangladesh, using structured face-to-face interviews. Descriptive and structural equation modeling (SEM) were applied to validate the hypothesized model and assess latent constructs. The proposed model met the criteria for goodness of fit indices, indicating an acceptable fit to the data. Overall, restaurant staff members demonstrated a relatively higher level of knowledge; however, a significant amount of uncertainty was observed in their attitudes. Despite implementing effective measures to prevent cross-contamination and safeguard against allergies, their management practices regarding customer communication and remaking meals following mistakes were insufficient for ensuring customer safety. Notably, knowledge had no significant impact on management practices, whereas attitudes toward food allergies had a strong and positive influence on how practices were implemented. There was also a positive association between knowledge and attitude, suggesting that a decline in knowledge is likely to correspond with a decrease in attitude scores. Two of our hypotheses (H2 and H3) were supported by the findings of this study. In conclusion, while restaurant staff exhibited a solid foundational knowledge and implemented effective practices to manage food allergies, gaps in attitudes and certain management practices highlight the need for enhanced training to ensure comprehensive allergy safety for all customers.