Ciliberti Ashley, Zaslavsky Justin, Morcott Tegan, Bozen Alexandria, Samady Waheeda, Lombard Lisa, Nimmagadda Sai, Nadeau Kari, Gupta Ruchi, Tobin Mary
Division of Allergy and Immunology, Rush University Medical Center, Chicago, Ill.
Center for Food Allergy and Asthma Research, Northwestern University Feinberg School of Medicine, Chicago, Ill.
J Allergy Clin Immunol Pract. 2023 Apr;11(4):1162-1168.e7. doi: 10.1016/j.jaip.2023.01.016. Epub 2023 Jan 27.
The prevalence of pediatric food allergy (FA) has increased in the past 2 decades. The previous literature suggests that FA presents burdens, both economically and psychosocially, to children and their caregivers, especially families in lower-income strata. Using data from a previously published needs assessment, the Food Allergy Management in Low-Income Youth study, the FA Passport and Workbook tools were developed to address identified needs.
This study evaluated the utility of the FA Passport in helping families insured by Medicaid to manage FA better and improve quality of life.
Families insured through Illinois Medicaid were recruited from two Chicago-based allergy clinics. Caregivers of children with FA completed a pretest evaluating knowledge, attitudes, beliefs, and practices regarding FA management. A clinician guided caregivers through the FA Passport. The caregivers then completed a posttest immediately afterward and again 3 months later. Changes were evaluated from baseline responses and direct feedback was elicited about the tool.
The FA Passport successfully improved caregiver-reported confidence with epinephrine autoinjector use (from 69% to 93%), caregiver anaphylaxis recognition (from 66% to 73%), and reported quality of life, and it nearly doubled caregiver comfort regarding leaving the child in the care of others (from 40% to 75.7%). Caregivers rated the FA Passport tool as extremely helpful overall (9.4 out of 10).
The FA Passport is a novel FA clinical support tool that addresses barriers to proper FA management described in previous studies. It proved effective at improving caregiver comfort with regarding leaving the food-allergic children with other caregivers, increasing FA knowledge, and improving the quality of life in families affected by FA.
在过去20年中，儿童食物过敏（FA）的患病率有所上升。先前的文献表明，食物过敏给儿童及其照顾者，尤其是低收入阶层的家庭带来了经济和心理社会负担。利用先前发表的需求评估数据，即低收入青少年食物过敏管理研究，开发了食物过敏护照和工作手册工具来满足已确定的需求。
本研究评估了食物过敏护照在帮助医疗补助保险家庭更好地管理食物过敏和改善生活质量方面的效用。
从芝加哥的两家过敏诊所招募参加伊利诺伊州医疗补助保险的家庭。食物过敏儿童的照顾者完成了一项预测试，评估有关食物过敏管理的知识、态度、信念和行为。一名临床医生指导照顾者使用食物过敏护照。照顾者随后立即完成了一项后测试，并在3个月后再次进行测试。根据基线反应评估变化情况，并收集对该工具的直接反馈。
食物过敏护照成功提高了照顾者报告的使用肾上腺素自动注射器的信心（从69%提高到93%）、照顾者对过敏反应的识别能力（从66%提高到73%），并提高了报告的生活质量，而且照顾者让孩子由他人照顾时的舒适度几乎提高了一倍（从40%提高到75.7%）。照顾者对食物过敏护照工具的总体评价是非常有帮助（满分10分，得9.4分）。
食物过敏护照是一种新型的食物过敏临床支持工具，解决了先前研究中描述的食物过敏正确管理的障碍。它被证明在提高照顾者让食物过敏儿童由其他照顾者照顾时的舒适度、增加食物过敏知识以及改善受食物过敏影响家庭的生活质量方面是有效的。
