Parent perspectives on school food allergy policy

Abstract

BackgroundFood allergy affects up to 8% of children in the U.S. There is minimal research to date on food allergy policies that are currently in place in schools and the opinions of parents of children with food allergy on the effectiveness of or need for these policies.MethodsAn electronic survey was disseminated to parents of children with food allergy. Frequencies were calculated to describe respondent characteristics and responses. Chi-square tests were performed to examine associations between school and child characteristics and outcomes.ResultsOf the 289 parent respondents, 27.4% were unsure or felt school was unsafe for their child with food allergy. While the majority felt that the polices in their child’s school were helpful, most also believed that implementation of additional polices was necessary, including availability of stock epinephrine (94.2%), lunch menus with allergen information (86%), ingredient labels on food items (81%), and direct food allergy education for students (86%). There were significant differences in school food allergy policy depending on the age of the student body, private versus public school, and geographic location.ConclusionsWhile most schools reportedly have one or more food allergy policies in place, many parents have concerns over the safety of their child at school and feel that additional policies are necessary to improve the safety of the school environment for children with food allergy. The availability of stock epinephrine, improved allergen labeling of food and menus and increased food allergy education may be key policy areas on which to focus.

Food Allergy Management at School

“…This paper is the largest qualitative study to‐date to report school‐related food allergy management challenges among students and families. While the existing research has reported on disease management strategies, variation in policies in the school setting, and lack of preparedness of school staff to address food allergies, few studies describe the impact of school food allergy policies on affected students and families from their own perspectives . As our participants described, they largely carry the burden of food allergy management, especially when school policies are poorly articulated or underdeveloped.…”

Barriers to and Facilitators of School Health Care for Students with Chronic Disease as Perceived by Their Parents: A Mixed Systematic Review

“…Third, parents perceived unclear roles in terms of the responsibility among school staff. Parents of children with a food allergy reported that a diverse school staff carries epinephrine on field trips and after-school activities and travels with every group [ 38 ]. Parents experienced lack of teacher involvement [ 36 ] in managing diseases.…”

“…Parents reported the occurrence of incorrect insulin administration [ 37 ]. Second, parents perceived a lack of confidence among teachers regarding emergency response procedures [ 7 , 9 , 33 ], lack of equipment such as a refrigerator to store glucagon [ 12 ], and limited availability of emergency medication [ 27 , 38 ]. Third, they perceived a limited allergen-free environment.…”

Food allergy and food-induced anaphylaxis in children: an increasing critical public health issue

“…Regarding the acute onsite management of FA, the intramuscular injection of epinephrine is the first-line treatment for acute severe systemic reactions such as anaphylaxis. For children ≥15 kg who are diagnosed to food-induced anaphylaxis, self-injectable/auto-injectable epinephrine prescriptions are strongly recommended to ensure the proper management of future occurrences [1,3,5].…”

“…Despite growing awareness and the availability of general guidelines, the optimal elimination of causative food and control/prevention of FA reactions by meal services is not practically easy [1,5]. The special aspect of school meal services, the government, and school requires policies and standardized protocols for the effective prevention and preparedness strategies for FA and food-induced anaphylaxis.…”