Food Allergy–Related Risk-Taking and Management Behaviors Among Adolescents and Young Adults

Background: Adolescence represents a vulnerable time for individuals with asthma and allergic conditions. They suffer an unexpected degree of morbidity. This systematic review aimed to understand the challenges faced by adolescents and young adults with these conditions. Methods: A systematic literature search was undertaken across eight databases. References were checked by two reviewers for inclusion. Study data were extracted, and their quality was assessed in duplicate. A narrative meta-synthesis was undertaken. Results: A total of 108 papers describing 106 studies were retrieved, most focused on asthma. Five themes were identified across studies: (a) Health-related quality of life-impairment was associated with poor disease control, psychosocial issues, adolescent-onset allergic disease and female sex; (b) Psychological factors-asthma and food allergy were associated with anxiety and depression, atopic dermatitis was associated with suicidal ideation, and that parental emotional support may be protective; (c) Adherence-suboptimal adherence was associated with older age, barriers to medication usage, poor symptom perception and failure to take responsibility, and positive factors were routines, simpler treatment regimes, better knowledge and perceptions about medications; (d) Self-management-facilitated by education, knowledge and a positive attitude; and (e) Supportive relationships-families could modify barriers to adherence and foster positive views about self-management, adolescents suggested that their peers should be more involved in supporting them, and adolescents also wished to have support from nonjudgemental healthcare professionals. Conclusions: We have some understanding of the challenges faced by adolescents with asthma, less so for other allergic conditions. This knowledge will be used to support guidelines for managing adolescents.

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“…83,84,94,95 Thus, risk-taking behaviours were less common in adolescents with an established education plan for their food allergy. 96…”

Section: Knowledge and Beliefsmentioning

confidence: 99%

“…80,81,98 Adolescents with asthma and food allergy reported valuing the need for exploration of knowledge and information about self-management in a nonjudgemental healthcare environment. 12,81,96…”

Section: Healthcare Professionalsmentioning

confidence: 99%

Understanding the challenges faced by adolescents and young adults with allergic conditions: A systematic review

Vazquez‐Ortiz

Angier

Blümchen

et al. 2020

Allergy

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“…Most of these (82%) were conducted in the USA (see Table 4). Five of these studies reported aspects of adaptation such as forward-back translations, content validity, item completeness, and cultural appropriateness but without reporting any psychometric data [44, 47–50]. Among those that reported psychometric data, only 6 studies [9, 18, 51–54] reported this data for an entire HRB tool or entire tool from which HRB items were borrowed while the rest reported only data for select items from the HRB tool.…”

Section: Resultsmentioning

confidence: 99%

Health risk behavior among chronically ill adolescents: a systematic review of assessment tools

Ssewanyana

Nyongesa

Baar

et al. 2017

Child Adolesc Psychiatry Ment Health

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BackgroundAdolescents living with chronic illnesses engage in health risk behaviors (HRB) which pose challenges for optimizing care and management of their ill health. Frequent monitoring of HRB is recommended, however little is known about which are the most useful tools to detect HRB among chronically ill adolescents.AimsThis systematic review was conducted to address important knowledge gaps on the assessment of HRB among chronically ill adolescents. Its specific aims were to: identify HRB assessment tools, the geographical location of the studies, their means of administration, the psychometric properties of the tools and the commonest forms of HRB assessed among adolescents living with chronic illnesses globally.MethodsWe searched in four bibliographic databases of PubMed, Embase, PsycINFO and Applied Social Sciences Index and Abstracts for empirical studies published until April 2017 on HRB among chronically ill adolescents aged 10–17 years.ResultsThis review indicates a major dearth of research on HRB among chronically ill adolescents especially in low income settings. The Youth Risk Behavior Surveillance System and Health Behavior in School-aged Children were the commonest HRB assessment tools. Only 21% of the eligible studies reported psychometric properties of the HRB tools or items. Internal consistency was good and varied from 0.73 to 0.98 whereas test–retest reliability varied from unacceptable (0.58) to good (0.85). Numerous methods of tool administration were also identified. Alcohol, tobacco and other drug use and physical inactivity are the commonest forms of HRB assessed.ConclusionEvidence on the suitability of the majority of the HRB assessment tools has so far been documented in high income settings where most of them have been developed. The utility of such tools in low resource settings is often hampered by the cultural and contextual variations across regions. The psychometric qualities were good but only reported in a minority of studies from high income settings. This result points to the need for more resources and capacity building for tool adaptation and validation, so as to enhance research on HRB among chronically ill adolescents in low resource settings.

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“…In addition, middle and high school students often change classrooms and teachers throughout the school day, which may dictate a stronger need for policies allowing selfcarrying of emergency medications. Factors such as a greater number of school-sponsored extracurricular activities for older students and an increase in risk-taking behaviors and first reactions during adolescence 17,18 may in part explain the increased rate of stock epinephrine availability during after school activities among middle and high schools.…”

Section: Discussionmentioning

confidence: 99%

School nurse perspectives on school policies for food allergy and anaphylaxis

Kao

Wang

Kagan³

et al. 2018

Annals of Allergy, Asthma & Immunology

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Food Allergy–Related Risk-Taking and Management Behaviors Among Adolescents and Young Adults

Cited by 43 publications

References 26 publications

Understanding the challenges faced by adolescents and young adults with allergic conditions: A systematic review

Understanding the challenges faced by adolescents and young adults with allergic conditions: A systematic review

Health risk behavior among chronically ill adolescents: a systematic review of assessment tools

School nurse perspectives on school policies for food allergy and anaphylaxis

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