Validation of the Finnish version of the food allergy quality of life questionnaire–parent form (F-FAQLQ-PF)

Aim: Specific questionnaires about food allergy and health-related quality of life (HRQoL) have been developed and validated in several languages, but not Finnish. We aimed to validate the Finnish Food Allergy Quality of Life Questionnaire-Parent Form (FAQLQ-PF) for children under age 13 years.Methods: The original FAQLQ-PF and Food Allergy Independent Measure (FAIM) were translated into Finnish per World Health Organisation guidelines and tested by 72 parents of children under age 13 years with suspected severe peanut or tree nut allergy who were recruited at Allergy Centre in Tampere University Hospital in Tampere, Finland. We calculated the construct validity of the questionnaire by calculating the coefficients between the two measures and used Cronbach's alpha to establish the internal consistency.Results: The FAQLQ-PF showed strong correlations with domain structure and internal consistency, based on Spearman's correlations (rho) for the HRQoL questions, FAIM questions and FAIM mean values. The total questionnaire score correlated significantly with the mean FAIM (rho = 0.95, p &lt; 0.001) and individual FAIM questions. The FAQLQ-PF and domains had good or excellent internal consistency (Cronbach's alpha &gt;0.70).Conclusion: The Finnish FAQLQ-PF demonstrated good construct validity and excellent internal consistency for measuring food allergy HRQoL in children under age 13 years.</p

Associations with food allergy‐related psychological distress in a global sample of adults, children and caregivers

Objective: Food allergy (FA) impacts health‐related quality of life and mental health. Understanding what variables are associated with psychological distress can help healthcare providers direct patients to appropriate support. As part of the study, Global Access to Psychological Services (GAPS) for FA and associations with FA‐related psychological distress were explored in adults with FA and caregivers of children with FA. Methods: Participants completed online surveys in seven languages. Participants reported the types of FA‐related distress they or their child experienced, along with demographic and FA‐related information. Associations with distress were analysed using regression models. Results: N = 1329 adults with FA and N = 1373 caregivers of children with FA from 27 countries participated. Of the 21 different types of distress selected, anxiety about an allergic reaction was the most common (62.5% adults; 72.6% caregivers). Females reported significantly more types of distress than males (p < 0.001). There were significant differences between countries (all p < 0.05‐0.001); participants in Australia, Brazil, Canada, and the United Kingdom consistently reported more types of distress than European countries or the United States. In regression models, country of residence, number of FAs, and symptoms were significantly associated with distress. Additional associations included adrenaline autoinjector (AAI) prescription, being female, anaphylaxis and comorbidities in adults; in caregivers having a younger child, longer time elapsed since FA diagnosis, being female, AAI prescription and anaphylaxis; and in children being older and living longer with FA. Conclusions: FA‐related distress is experienced differently across countries. Understanding associations with types of distress can help direct healthcare services and psychological support to where it is needed most

Winnipeg-based elementary school teachers’ perspectives on food allergy management: a qualitative analysis

Background Food allergy affects 7-8% of children worldwide. Teachers supervise children in school, where most children spend their day. Yet, teachers have variable food allergy-related knowledge. Objective We aimed to identify how Winnipeg-based elementary school teachers manage food allergy and prevent food-triggered allergic reactions in their classrooms and schools. Methods Kindergarten-Grade 6 public and private school teachers, from Winnipeg, Canada, were interviewed virtually upon providing written informed consent. Interviews were recorded and transcribed verbatim. The study followed a pragmatic framework. Data were analysed via thematic analysis by multiple researchers. Results We interviewed 16 teachers, who primarily identified as female (87.5%). Most teachers worked in public schools (87.5%) and, on average, had 5.8 years of teaching experience. We identified four themes within the data. Most teachers (68.9%) had direct or indirect experience with food allergy. Theme 1 described the minimal standardization and inconsistent enforcement of food allergy policies between and within schools. Teachers also had varied food allergy knowledge. Theme 2 reflected teachers’ variable confidence/perceived knowledge towards food allergy management, including feeling of stress and anxiety. Theme 3 captured the lack of standardized food allergy education for teachers, and concerns about the adequacy of the current provincial program. Theme 4 described how teachers spoke of relying on other school staff, families and students to have effective communication. Conclusion Teachers’ food allergy management was informed by their knowledge and lived experience, guided by their school policies and individualized students’ needs. Teachers identified gaps in knowledge and communication, and desired more training and resources

“It’s a Permanent Struggle to Manage It Really”: Psychological Burden and Coping Strategies of Adults Living With Food Allergy

Food allergy (FA) is a potentially life-threatening condition which is associated with poor quality of life and psychological distress in patients and caregivers. Although FA is often seen as a condition that affects children, increasing numbers of adults have FA, either as a condition they have grown up with or they were diagnosed as an adult. No recent research has explored the lived experiences of adults with FA and how they manage this condition. In response, this study aimed to qualitatively assess the current lived experiences of adults in the UK with FA, and how they manage this condition. Adults aged 18 years or over, with medically diagnosed FA, living in the UK were recruited through patient organisations and interviewed (n = 22). Data were analysed using template analysis. Two main themes were identified from the data. The first theme explores the influence of FA on the participants’ lives, in particular on their ‘psychological’ and ‘social’ well-being. The second theme unpacks the strategies participants employed to cope with and manage their FA, specifically participants’ deployment of ‘avoidance’, ‘control’, ‘self-monitoring’, and ‘adaptation’ to manage their FA and their anxieties around it. Clearly, FA has a profound, ongoing effect on the lives of adults. Few adults in this study were able to access any support to manage their FA and accompanying anxieties. Ways in which effective support can be made available to adults with FA must be identified and implemented

Global Availability and Uptake of Psychological Services for Adults, Caregivers and Children with Food Allergy

Background:     Food allergy (FA) is associated with poor health-related quality of life and high levels of psychological distress. Psychological support is extremely important but not always available. As part of the Global Access to Psychological Services for Food Allergy (GAPS) study, we aimed to assess psychological distress and service use among adults, caregivers and children with FA in a global survey. Methods: Participants (n = 1329 adults with FA; n = 1907 caregivers of children with FA) from >20 countries were recruited through patient organisations, social media advertisements and online survey panels to complete an online survey. Surveys were available in six languages. Results:  A total of 67.7% of adults and 77.2% of caregivers reported direct experience, and 51.6% of caregivers said their child had experienced FA-related psychological distress. The most commonly reported issue was anxiety about having an allergic reaction. Less than 20% had been assessed for FA-related psychological distress. There were significant differences across countries for levels of distress, screening for distress, seeing a mental health professional and being diagnosed with a FA-related mental health disorder (all p < .001). The United Kingdom, Australia and Brazil had the highest number of participants reporting distress. The most commonly reported barrier to seeing a mental health professional was cost. Conclusions: FA-related distress is common across countries, but with substantial country-to-country variability. Allergy providers are encouraged to routinely assess families for psychological distress and provide access to appropriate mental health resources. Development and implementation of evidence-based, patient-informed accessible, affordable FA interventions in multiple languages is urgently needed