Food Allergy Management at School

Abstract

BACKGROUND: Approximately 8% of schoolchildren in the United States experience potentially life-threatening food allergies.They must diligently avoid allergenic foods and have prompt access to epinephrine to treat anaphylaxis. These prevention strategies must be sustained without interruption, posing a range of challenges at school. METHODS:We conducted semi-structured interviews with 178 participants about their experiences managing food allergies outside the home. Interviews were transcribed and analyzed using an iterative approach in NVivo 10. RESULTS:Participants reported highly varied school experiences across the ecological model. They described the need to be proactive and self-sufficient to manage food allergies. Whereas food allergy-related social exclusion was common, participants also described positive peer interactions, including intensive peer engagement and support. They perceived that formal school policies were limited in scope and inconsistently implemented. Prevention-oriented policies were more common in lower grades than in higher grades. CONCLUSIONS:Poorly defined and implemented policies disrupted students' social and educational experiences at school, families' relationships with school staff, and, ultimately, the safety and wellbeing of students with allergies. Given the high prevalence of food allergies among children, these findings demonstrate the need for multiple layers of support to facilitate safe, socially inclusive food allergy management at schools. F ood allergy prevalence is on the rise, and an estimated 8% of children ages 0-17 in the United States are affected. 1 Food-induced anaphylaxis, a severe, life-threatening allergic reaction, resulted in a 285% increase in pediatric (ages 5-17) emergency department visits between 2005 and 2014. 2 Food allergy management demands diligent avoidance of allergenic foods and uninterrupted access to life-saving epinephrine. Both strategies require sustained behavioral control, presenting particular challenges for adolescents. Approximately 18% of children with food allergies experience a reaction at school over

Implementing information and communication technology education on food allergy and anaphylaxis in the school setting

“…Although there have been diverse educational strategies to prevent, recognize, and apply proper treatment of allergic reactions, 37 studies have shown that school staff are still insufficiently prepared to deal with FA events, including the administration of adrenaline. 38,39 However, Shah et al found that even a 1-h educational intervention significantly increased teachers' knowledge of FA causes, symptoms, and treatment of reactions in educational settings with different socioeconomic situations. 40 Additionally, Ruíz-Baqués et al 41 found that parents' and caregivers' understanding of children with FAs improved by 50% after taking an online FA educational program.…”

“…Because the included participants voluntarily attended the course, it is possible that they were more likely to develop increased self-efficacy since they may have been more willing to learn the material. 38 Further studies that include a control group may clarify whether compulsory EIs would have similar outcomes. It would also be interesting to investigate the durability of the increased self-efficacy after participants complete the digital EI.…”

Latest Developments in the Management of Nut Allergies

“…Consideration of wearing medical alert jewelry is also suggested. In a large qualitative review of 178 participants in the USA, one of the key themes to emerge was the lack of trust with school meals and needing to rely on food from home, which may place an additional load on those on lower incomes [ 28 ]. During the Covid-19 pandemic, there may be changes to school policies around mealtimes that may affect nut allergic children and create additional anxiety amongst a population that already has additional QoL burdens.…”

Pharmacology Update: School Nurse Role and Emergency Medications for Treatment of Anaphylaxis

“…Develop, implement, and evaluate anaphylaxis risk reduction strategies for areas inside and outside the school building . Develop multiple check systems to identify and minimize anaphylaxis triggers (Dupuis et al, 2020). For example, involve parents in checking food ingredients used in the cafeteria, fundraisers, and class projects.…”

“…Minimize resistance through education and support (Dupuis et al, 2020; Mustafa et al, 2018; Rotter & Pistiner, 2018). School staff may be reticent to be involved in anaphylaxis prevention and preparedness.…”