To identify factors related to food worker hand hygiene practices, we collected (i) observational data on food worker (n = 321) hand hygiene practices (hand washing and glove use) and (ii) observational and interview data on factors related to hygiene behavior, such as worker activity, restaurant characteristics, worker food safety training, and the physical and social environment. Results indicated that hand washing and glove use were more likely to occur in conjunction with food preparation than with other activities (e.g., handling dirty equipment) and when workers were not busy. Hand washing was more likely to occur in restaurants whose food workers received food safety training, with more than one hand sink, and with a hand sink in the observed worker's sight. Glove use was more likely to occur in chain restaurants and in restaurants with glove supplies in food preparation areas. Hand washing and glove use were also related to each other--hand washing was less likely to occur with activities in which gloves were worn. These findings indicate that a number of factors are related to hand hygiene practices and support suggestions that food worker hand hygiene improvement requires more than food safety education. Instead, improvement programs must be multidimensional and address factors such as those examined in this study.