Preventing Peanut Allergy in Young Children: Identifying Barriers to Protocol Engagement and Adherence

预防幼儿花生过敏：识别协议参与和遵守的障碍

基本信息

批准号：
10459657
负责人：
Grace Cushman
金额：
$ 6.95万
依托单位：
RHODE ISLAND HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-07-12 至 2024-07-11
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10459657
关键词：
Accounting Adherence Adopted Adoption Affect Allergy to peanuts Attention Attitude Behavior Behavioral Caliber Caregivers Characteristics Child Child Development Childhood Chronic Disease Classification Clinical Consumption Data Development Disease Management Effectiveness Environment Family Family history of Fellowship Financial Hardship Food Hypersensitivity Future Goals Guidelines Health Personnel Hospitals Human Infant Infant Care Infant Food Ingestion Intervention Interview Knowledge Learning Measures Medical Methods Modeling National Institute of Allergy and Infectious Disease National Research Service Awards Outcome Parents Pattern Personal Satisfaction Prevalence Prevention Prevention Guidelines Prevention approach Process Proteins Protocols documentation Provider Psychiatry Psychosocial Factor Public Health Qualitative Research Recommendation Reporting Research Research Personnel Rhode Island Risk Risk Factors Social Environment Structure Surveys Time Training Training Activity Typology United States Universities base career clinical care design family support feeding food insecurity high risk improved interest medical schools novel strategies post-doctoral training prevent psychologic response risk perception social factors sociodemographic factors therapy design willingness

项目摘要

PROJECT SUMMARY/ABSTRACT This F32 National Research Service Award will support the applicant’s long-term career goal of becoming an independent investigator examining effective approaches to disease management in pediatric chronic illness. Consistent with this goal, the proposed study will focus on extending the applicant’s research to the examination of families’ barriers to initiating and adhering to NIAID guidelines to prevent the development of peanut allergy (PA). PA is the most commonly reported food allergy (FA), tends to develop early in childhood, and is rarely outgrown. PA poses serious medical risks, accounting for the majority of fatal anaphylactic responses. In 2015, the Learning Early about Peanut Allergy (LEAP) trial demonstrated the effectiveness and feasibility of preventing the onset of PA in infants at risk of developing PA; infants regularly ingesting peanut protein were less likely to develop a PA than those avoiding peanuts. Consistent infant consumption of peanuts has proven challenging, however, as early introduction studies report non-adherence ranging from 25-65%. Limited information is known about what factors impact families’ knowledge of guidelines for early introduction of peanut protein, willingness to initiate early introduction, and ability to initiate early introduction of peanuts, all of which are essential components of successful PA prevention. The aims of the study are to (1a) develop a typology of patterns of caregiver knowledge of, willingness to initiate, and means to initiate early introduction of peanuts for caregivers of young children at risk of PA; (1b) examine predictors of patterns of characteristics related to initiation of peanut early introduction; (2a) identify factors associated with initiation and adherence to early introduction of peanuts among families recommended PA prevention; (2b) identify contextual barriers and facilitators to early introduction initiation and adherence through in-depth qualitative interviews; and (3) integrate quantitative and qualitative outcomes to develop an understanding of factors impeding and facilitating initiation and adherence to early introduction of peanuts. The long-term goal of the proposed research is to design interventions to increase families’ abilities to follow through on treatment recommendations within FA protocols and improve long-term outcomes of children at risk of developing PA. A highly structured training plan will allow the applicant to conduct the proposed research and receive individualized training to facilitate her development as an independent researcher. Through the training activities provided by this fellowship, the applicant will (1) enhance her knowledge of the medical aspects of FA, (2) develop expertise in qualitative and mixed-methods approaches, (3) establish proficiency in classification modeling, and (4) advance her professional development. The applicant’s interests and training goals are an excellent fit for the Department of Psychiatry and Human Behavior at Brown University’s Alpert Medical School and Rhode Island Hospital, given the strength of the research environment, caliber of postdoctoral training, and availability of research and clinical care within FA.

项目概要/摘要该 F32 国家研究服务奖将支持申请人成为一名独立研究者正在研究儿童慢性病疾病管理的有效方法。与这一目标一致，拟议的研究将侧重于将申请人的研究扩展到检查家庭发起和遵守 NIAID 指南的障碍，以防止发展花生过敏（PA）是最常见的食物过敏（FA），有在儿童早期发生的趋势， PA 很少会造成严重的医疗风险，占致命过敏症的大多数。 2015 年，早期了解花生过敏 (LEAP) 试验证明了其有效性和有效性。定期摄入花生可预防有患 PA 风险的婴儿发生 PA 的可行性；与那些不吃花生的婴儿相比，摄入蛋白质的婴儿患 PA 的可能性更小。然而，事实证明这具有挑战性，因为早期的引入研究报告称，不遵守的比例为 25-65%。关于哪些因素影响家庭对早期引入指南的了解，目前所知的信息有限花生蛋白的含量、启动早期引入的意愿以及启动早期引入花生的能力，所有这些其中是成功预防 PA 的重要组成部分。该研究的目的是 (1a) 开发一种方法。护理人员知识模式的类型学、发起意愿以及发起早期引入的手段为有 PA 风险的幼儿的照顾者提供花生 (1b) 检查特征模式的预测因素；与开始花生早期引入相关；(2a) 确定与开始和坚持相关的因素；建议在家庭中尽早引入花生，以预防 PA；(2b) 确定背景障碍并通过深入的定性访谈促进早期引入和坚持；以及 (3) 整合和定性结果，以了解阻碍和促进的因素发起并坚持早期引进花生拟议研究的长期目标是设计干预措施以提高家庭遵循 FA 内治疗建议的能力方案并改善有 PA 风险的儿童的长期结果。高度结构化的培训计划将使申请人能够进行拟议的研究并获得个性化培训，通过培训促进她作为独立研究员的发展。通过该奖学金提供的活动，申请人将（1）增强其医学方面的知识 FA，(2) 发展定性和混合方法方面的专业知识，(3) 建立熟练程度分类建模，以及（4）促进申请人的专业发展。目标非常适合布朗大学阿尔珀特精神病学和人类行为系医学院和罗德岛医院，鉴于研究环境的实力、质量 FA 内的博士后培训以及研究和临床护理的可用性。