Analysis of Factors Impacting the Implementation of Effective Intervention Strategies

An Analysis of Factors Impacting the Implementation of Effective Intervention Strategies identified and assessed the implementation of risk factor interventions currently employed by local retail food regulatory programs enrolled in the Voluntary National Retail Food Regulatory Program Standards (Retail Program Standards), with a focus on Standard 9. The study, conducted in 2021 by the National Association of County and City Health Officials (NACCHO) and the Conference for Food Protection (CFP) assessed how most jurisdictions targeted risk factors interventions, identified success factors and challenges, and developed recommendations to support the implementation of targeted interventions.


Key Takeaways

  • Most jurisdictions targeted risk factors based on violations most frequently cited during retail food regulatory inspections and the risk factor most often targeted by the study participants was poor personal hygiene.
  • Challenges with implementing intervention strategies included:
    • Lack of resources such as staffing, budget, and time; and
    • Staff acceptance of the intervention and willingness to participate.
  • Success factors that contributed to the effectiveness of intervention strategy implementation were:
    • Strong training programs, tools, and resources; and
    • The willingness of staff to participate in the intervention.
  • Recommendations to support the implementation of targeted interventions:
    • Ensure retail program regulatory staff conduct uniform and consistent inspections.
    • Use the system already in place.
    • Establish sustainability of the program.
  • 30% of highly successful jurisdictions had incomplete or missing risk factor studies, demonstrating that this requirement may not have the desired effect in local jurisdictions.
    • Creating a template or training programs aimed at standardizing the process of creating risk factor studies, identifying risk factors, and evaluating the effectiveness of effective intervention strategies, could help local food regulatory programs monitor their progress.


  • The five major risk factors associated with most foodborne illness outbreaks are:
  • To conform with Standard 9 of the Retail Program Standards, a jurisdiction must:
    • conduct a risk factor study,
    • analyze the data collected,
    • report the outcomes, and
    • design targeted intervention strategies to reduce the occurrence of the risk factors that were identified.
  • Tracking the occurrence of the five major risk factors and implementing targeted intervention strategies provides a reliable and consistent method for monitoring food safety risks and identifying trends over time.


  • Key informant interviews (KIIs) were conducted with local retail food regulatory programs enrolled in the Retail Program Standards.
  • Participants were asked about a variety of topics such as how they identified the risk factor(s) for their targeted intervention, the implementation of the intervention strategy, measurement of improvements resulting from the intervention, and challenges encountered.