Objective To examine the prevalence and influencing factors of food hygiene related risk behaviors in home food processing among residents in Shanxi province and to provide targeted recommendations for improving home food processing to control food-borne diseases in home settings.

Methods We conduct a questionnaire survey among 3 500 community residents selected with stratified multistage random sampling at 60 study sites in 11 prefecture-level cities in Shanxi province from December 2017 to March 2018.

Results For the 3 283 respondents with valid information, the mean overall score for correct home food processing behavior was 116.05 ± 12.10 to a full score of 150, with the highest average domain score of 4.65 ± 1.10 for washing hands with soap or sanitizer and clean water and the lowest of 3.06 ± 0.82 for discarding residual leftovers having been reheated. Univariate analyses indicated that the respondents′ scores for home food processing behaviors differed significantly by age, education level, registered permanent residence, and monthly household income per capita (P < 0.001 for all). Multivariate linear regression analysis results revealed that the major factors influencing the respondents′ home food processing behavior included registered permanent residence (|βx| = 1.599, P < 0.001), education level (|βx| = 0.773, P = 0.011), age (|βx| = 0.667, P < 0.001), and monthly household income per capita (|βx| = 0.480, P = 0.004).

Conclusion Targeted food safety education focusing on clean processing, preventing cross-contamination, and handling leftovers properly should be carried out among community residents, especially among those living in rural area, with low education, having low income, and at young ages.