Objectives: This study aimed to assess the improvement of teachers' sanitation performance and food distribution environment at Centers for children's food service management after a sanitation education program. Methods: The subjects were 119 teachers working at child care centers registered in the Daejeon Center for Children's Foodservice Management in Dongu and Jung-gu, Daejeon. The sanitation education was provided three times from March to August in 2014, and the survey questionnaires were distributed before and after the education. The sanitation status of food service environment of the centers was examined by ATP(adenosine-5'triphosphate) bioluminescence. Results: After the sanitation education, the teachers showed higher levels of sanitation knowledge. Also, sanitation performance and recognition level of the importance of it significantly improved after the education program. The mean variation scores of importance and performance after the education were 0.14 and 0.23. According to the Importance-Performance Analysis (IPA) results of 26 sanitation attributes about the food service environment, the selection attributes with relatively low performance and importance were mostly distributed in the children's and distributer's personal hygiene management area. However, all attributes except using a personal water bottle and cup were moved to high performance and importance level. Also, the ATP examination results showed that the sanitation status of the food service environment was improved after the education program. Conclusions: The sanitation education program was effective in improving the recognition of the importance of sanitation and its performance with regard to food service management.
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