Herbert Linda J, Cooke Frances, Chazoom Adi, Sigel Sabrina, Ramos Ashley
From the Division of Psychology & Behavioral Health, Children's National Hospital, Washington, D.C.
Department of Pediatrics, George Washington University School of Medicine, Washington, D.C.
J Food Allergy. 2024 Aug 1;7(1):33-38. doi: 10.2500/jfa.2025.7.240065. eCollection 2024 Aug.
Parents are primary caregivers for young children with food allergy. Although food allergy-related caregiver stress is well documented, little is known about caregivers' daily food allergy management behaviors such as identifying safe foods and epinephrine availability.
This study characterized caregivers' daily food allergy management behaviors and identified potential areas of food allergy education and intervention.
Eighty-three primary caregivers (91% women) of young children (mean ± standard deviation age 3.16 ± 1.33 years; 37% girls, 65% White), diagnosed with an immunoglobulin E-mediated food allergy, were recruited from pediatric food allergy clinics. Participants completed two separate food allergy management 24-hour recall-caregiver interviews. Summary statistics were calculated to characterize overall caregiver food allergy management behaviors with regard to their young children's snacks and meals.
The majority of meals and/or snacks were eaten at home (64.4%) or daycare and/or school (23.4%). Adults observed 99.4% of meals and/or snacks (70.1% by parents). Epinephrine autoinjectors were available for 95.8% of meals and/or snacks, usually in a nearby room (82.1%). Most foods and/or beverages (87.8%) were prepared at home and, for most (98.2%), the caregiver did not take a specific action that day to ensure the food was allergen-free, but some caregivers checked the ingredients on an earlier date (21.3%) or on the general product (30.3%).
Analysis of results indicated frequent epinephrine availability but infrequent use of behaviors that verify foods as allergen-free when the food is ingested, which may place children at risk of allergic reactions and indicates a need for clinician education on food safety decision-making. The findings highlight the need for support for primary caregivers, who are preparing the majority of children's meals and/or snacks, and education and/or policy for daycare and/or schools where many meals are ingested.
父母是患有食物过敏的幼儿的主要照顾者。虽然与食物过敏相关的照顾者压力已有充分记录，但对于照顾者日常的食物过敏管理行为，如识别安全食物和肾上腺素的可获取性，我们却知之甚少。
本研究描述了照顾者日常的食物过敏管理行为，并确定了食物过敏教育和干预的潜在领域。
从儿科食物过敏诊所招募了83名幼儿（平均年龄±标准差为3.16±1.33岁；37%为女孩，65%为白人）的主要照顾者（91%为女性），这些幼儿被诊断为免疫球蛋白E介导的食物过敏。参与者完成了两次单独的食物过敏管理24小时回忆式照顾者访谈。计算汇总统计数据，以描述照顾者对幼儿零食和正餐的总体食物过敏管理行为。
大多数正餐和/或零食是在家中（64.4%）或日托中心和/或学校（23.4%）食用的。成年人观察了99.4%的正餐和/或零食（70.1%由父母观察）。95.8%的正餐和/或零食备有肾上腺素自动注射器，通常放在附近的房间（82.1%）。大多数食物和/或饮料（87.8%）是在家中准备的，并且对于大多数（98.2%）情况，照顾者在当天没有采取特定行动来确保食物无过敏原，但一些照顾者在更早的时候（21.3%）或查看一般产品（30.3%）时检查了成分。
结果分析表明，肾上腺素的可获取性较高，但在食物摄入时很少使用验证食物无过敏原的行为，这可能使儿童面临过敏反应的风险，并表明临床医生需要接受关于食品安全决策的教育。研究结果凸显了对主要照顾者提供支持的必要性，他们准备了大多数儿童的正餐和/或零食，同时也凸显了对日托中心和/或学校进行教育和/或制定政策的必要性，因为许多餐食是在这些地方食用的。
