Interventions to Promote Food Allergy Literacy in Childhood: A Systematic Scoping Review

BACKGROUND

This article introduces the concept, food allergy literacy (FAL), which encompasses the knowledge, behaviors, and skills needed to manage a food allergy and is thus critical to child safety. Yet, there is limited clarity on how to promote FAL in children.

METHODS

Twelve academic databases were systematically searched to identify publications on interventions to promote FAL in children. Five publications met the inclusion criteria, which involved children (3 to 12 years), their parents, or educators and tested the efficacy of an intervention.

FINDINGS

Four interventions were for parents and educators, while 1 intervention was for parents with their children. The interventions were educational and focused on promoting participant knowledge and skills of food allergy, and/or psychosocial in nature, promoting coping, confidence, and self-efficacy in managing children's allergies. All interventions were deemed effective. Only 1 study used a control group, and none assessed the long-term benefits of the interventions.

IMPLICATIONS FOR SCHOOL POLICY, PRACTICE, AND EQUITY

The results can enable health service providers and educators to design evidence-based interventions to promote FAL. This might involve designing, implementing, and evaluating curricula and play-based activities, therein, that award greater attention to food allergy-its consequences, risks, skills to prevent risk, and managing food allergy in educational settings.

CONCLUSIONS

There is limited evidence on child-focused interventions that promote FAL. There is, therefore, considerable opportunity to co-design and test interventions with children.

Development and Evaluation of a Mobile Web-based Food Allergy and Anaphylaxis Management Educational Program for Parents of School-aged Children with Food Allergy: A Randomized Controlled Trial

PURPOSE

This study aimed to develop a mobile web-based food allergy (FA) and anaphylaxis management educational program for parents of school-aged children with food allergies and evaluate its effectiveness.

METHODS

A mobile program was developed based on a web-based teaching-learning system model. Its effectiveness was subsequently evaluated using a parallel, randomized controlled pre- and post-test design. This study included 73 parents of school-aged children with food allergies. These parents were randomly assigned to either the experimental (n = 37) or control (n = 36) groups. The experimental group participated in a 2-week mobile web-based educational program that covered major topics in FA and anaphylaxis management. These topics included an understanding of food allergies and anaphylaxis, learning techniques for using an epinephrine auto-injector, and developing an emergency action plan. An educational booklet was provided to the control group. Participants completed a pre-test and two post-test questionnaires to evaluate the impact of the program. The assessment tools were the Food Allergy Knowledge Test, Food Allergy Self-Efficacy for Parents, and Food Management and Adaptation Scale. The data were analyzed using descriptive statistics, a test of homogeneity for the pre-test, an independent t-test, and repeated measures ANOVA.

RESULTS

The experimental group experienced greater improvement in the knowledge of FA (post-intervention t = 14.51, p < .001; 2 weeks post-intervention, t = 16.15, p < .001), FA self-efficacy (post-intervention t = 77.99, p < .001; 2 weeks post-intervention, t = 76.09, p < .001), and practice behavior in FA management (post-intervention t = 28.10, p < .001; 2 weeks post-intervention, t = 27.98, p < .001) after web-based FA education.

CONCLUSION

This study revealed improvements in the knowledge, self-efficacy, and practice behaviors of parents regarding FA and anaphylaxis management. Therefore, the mobile web-based educational program can contribute to the effective management of food allergies and anaphylaxis for parents of school-aged children. CRIS registration: KCT0007491.

The Food Allergy Parent Mentoring Program: A Pilot Intervention

OBJECTIVE

Parents of young children with newly diagnosed food allergy (FA) are at risk for poor psychosocial outcomes due to FA's life-threatening nature and demanding management routines. Presently, there are no interventions to support FA parents during this adjustment phase. This single-arm pilot study explores the feasibility, acceptability, and preliminary efficacy of a novel intervention using peer mentorship to improve psychosocial functioning in parents of young children with newly diagnosed FA.

METHODS

Parent mentors were trained in mentorship and ethics and then matched with a mentee for a 6-month intervention period. Mentees, parents of children (under age 5 years) diagnosed with FA within 1 year, completed baseline and follow-up questionnaires to assess demographic and medical characteristics, FA knowledge, quality of life, self-efficacy, and social support and a program evaluation. Follow-up focus groups with mentors and individual interviews with mentees were conducted.

RESULTS

Participants were 8 mentors and 10 mentees (Mage = 36.60 years, 80% Caucasian) of children ages 0-3 years (Mage = 16.15 months; 60% male). Mentees reported high acceptability for the intervention in program evaluation and interviews, noting improvements in their social support, FA-related stress, confidence in FA management, and positive changes in FA parenting behaviors.

CONCLUSION

This study supports the use of a peer mentorship program to support parents of children with newly diagnosed FA. Future research is needed to determine how to scale this intervention to meet the needs of a large medical division.

Examining Differences in Parent Knowledge About Pediatric Food Allergies

Objective

Pediatric food allergy (FA) is a serious health condition that has become increasingly prevalent. Parents often play a primary role in assessing and managing risk for their child’s FAs, making it critical that they remain informed of the most recent guidelines for FA management. This study aimed to examine if diagnostic source (i.e., pediatrician vs. allergist) and child- and parent-level variables predicted parental FA knowledge using a comprehensive measure.

Methods

The Food Allergy Knowledge Test (FAKT) was administered to parents (N = 518) of children aged 3–17 years with (n = 349) and without (n = 169; i.e., control group) FAs using internet-sampling procedures. The sample was further partitioned into parents of children diagnosed by an allergist or a pediatrician, and control group parents who did or did not endorse knowing someone with an FA.

Results

Significant group differences were found with respect to the overall FAKT score and diagnostic source. Among the FA group, parental relationship to child, income, identification with a minority status, parental anxiety, and child possession of an emergency action plan were significant predictors of FAKT scores.

Conclusions

Knowledge of FA was poor across all groups. Education for caregivers both with and without food-allergic children is important to ensure FA safety in multiple settings. Future directions and limitations are discussed.