Winnipeg-based elementary school teachers' perspectives on food allergy management: a qualitative analysis

BACKGROUND

Food allergy affects 7-8% of children worldwide. Teachers supervise children in school, where most children spend their day. Yet, teachers have variable food allergy-related knowledge.

OBJECTIVE

We aimed to identify how Winnipeg-based elementary school teachers manage food allergy and prevent food-triggered allergic reactions in their classrooms and schools.

METHODS

Kindergarten-Grade 6 public and private school teachers, from Winnipeg, Canada, were interviewed virtually upon providing written informed consent. Interviews were recorded and transcribed verbatim. The study followed a pragmatic framework. Data were analysed via thematic analysis by multiple researchers.

RESULTS

We interviewed 16 teachers, who primarily identified as female (87.5%). Most teachers worked in public schools (87.5%) and, on average, had 5.8 years of teaching experience. We identified four themes within the data. Most teachers (68.9%) had direct or indirect experience with food allergy. Theme 1 described the minimal standardization and inconsistent enforcement of food allergy policies between and within schools. Teachers also had varied food allergy knowledge. Theme 2 reflected teachers' variable confidence/perceived knowledge towards food allergy management, including feeling of stress and anxiety. Theme 3 captured the lack of standardized food allergy education for teachers, and concerns about the adequacy of the current provincial program. Theme 4 described how teachers spoke of relying on other school staff, families and students to have effective communication.

CONCLUSION

Teachers' food allergy management was informed by their knowledge and lived experience, guided by their school policies and individualized students' needs. Teachers identified gaps in knowledge and communication, and desired more training and resources.

Investigating Motivators for Managing Customers with Food Allergies in Ethnic Restaurants

ABSTRACT

Food allergic reactions frequently occur in ethnic restaurants. However, effective training materials specific to food allergies have not been readily available to employees. The objectives of the study were to investigate employee self-efficacy, perceived susceptibility, and commitment on the basis of individual and operational factors and what variables, among self-efficacy, perceived susceptibility, and commitment, are associated with the employee's intention to reduce risky behavior when handling food allergies in ethnic restaurants. A total of 256 employees who had or are currently working in ethnic restaurants and had direct contact with food or customers participated in this study through the Amazon Mechanical Turk Web site from October 2020 to April 2021. The statistical analysis results showed that employee self-efficacy, perceived susceptibility, and commitment vary on the basis of gender, food safety certification, training, and availability of menu items for customers with food allergies. In addition, employee self-efficacy, perceived susceptibility, and commitment are positively correlated with employee's risk reduction behavior for food allergies. The results of the study will provide practical guidelines for developing more multidimensional training programs specific to food allergies in ethnic restaurants.

HIGHLIGHTS

Advancing Food Allergy Through Epidemiology: Understanding and Addressing Disparities in Food Allergy Management and Outcomes

Epidemiological studies have been pivotal in advancing understanding of the etiology of food allergy and in guiding the development of evidence-based guidelines for food allergy prevention and clinical management. In recent years, as research into the population-level distribution and determinants of food allergy has accumulated, data indicate that substantial differences in food allergy outcomes and management exist across racial/ethnic and other socioeconomic strata. This clinical commentary aims to provide a review of existing epidemiological studies and shed valuable light on the disparate burden of food allergy. Emerging methods to quantify environmental exposure and food allergy outcomes are detailed, as are specific areas in which future research is warranted. We also highlight the role that epidemiology plays in advancing health equity and provide a framework as to how it can effectively inform health policy at all phases of the policy cycle-from initial population health assessment to the evaluation and refinement of specific health policies (ie, national guidelines to promote earlier introduction of peanut-containing foods for allergy prevention).

Post-transplantation Development of Food Allergies

PURPOSE OF REVIEW

The development of food allergies is increasingly being recognized as a post-solid organ transplant complication. In this article, we review the spectrum of post-transplant food allergy development and the proposed mechanisms for de novo food allergies and the clinical significance they pose.

RECENT FINDINGS

The development of new food allergies is disproportionately associated with pediatric liver transplants, where it occurs in up to 38% of select populations. The mechanism of food allergy development is not completely understood; however, it is likely promoted by unbalanced immune suppression. De novo food allergy development is a common complication of solid organ transplants with the highest risk occurring in pediatric liver transplant recipients. There are likely multiple mechanisms for food allergy development including passive transfer of membrane-bound IgE and lymphocytes from donor to recipient, as well as loss of food tolerance and active development of new food allergies. The optimal management of food allergies following organ transplants has not been well researched but may include changing the immune suppression regimen if the food allergy does not resolve without intervention.