Infant Peanut Allergy Prevention: Understanding and Supporting Caregivers to Achieve Adherence

婴儿花生过敏预防：理解并支持护理人员实现依从性

• 批准号: 10668951
• 负责人: Waheeda Samady
• 金额: $ 19.01万
• 依托单位: LURIE CHILDREN'S HOSPITAL OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-20 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10668951
• 关键词: 3 year old; Addendum; Address; Adherence; Affect; Age Months; Allergens; Allergic Disease; Allergic Reaction; Allergy to eggs; Allergy to peanuts; Automobile Driving; Behavior Therapy; Behavioral Sciences; Caregiver support; Caregivers; Child; Childhood; Chronic; Clinic; Clinical; Data; Data Analyses; Development; Disease; Eczema; Evaluation; Exposure to; Focus Groups; Food; Food Hypersensitivity; Fright; Future; Goals; Guideline Adherence; Guidelines; Horns; Illinois; Immune; Immune response; Infant; Ingestion; Internet; Intervention; Interview; Knowledge; Learning; Life; Mentors; National Institute of Allergy and Infectious Disease; Pathway interactions; Physicians; Prevalence; Prevention; Prevention Guidelines; Prevention approach; Prevention strategy; Process; Proteins; Public Health; Publishing; Qualitative Research; Reaction; Recommendation; Reporting; Research; Research Personnel; Risk; Science; Social Network; Surveys; Testing; Time; Training; Uncertainty; United States; Writing; acceptability and feasibility; behavior test; caregiver interventions; clinical decision support; combat; effectiveness evaluation; effectiveness study; experience; feeding; gastrointestinal system; high risk infant; improved; infancy; non-compliance; novel; nutritional guideline; parent grant; pediatrician; pilot test; prevent; promoter; prototype; randomized, clinical trials; skills; skin barrier; support tools; theories; uptake; willingness

PROJECT SUMMARY Peanut allergy (PA) is the most common food allergy in the US; it is also one of the least frequently outgrown and the leading cause of fatal food-allergic reactions. The landmark Learning Early About Peanut study found that the ingestion of peanut products in infancy can decrease PA development by over 81%. Thus, in 2017 the NIAID published the Prevention of Peanut Allergy (PPA) Guidelines. However, implementation of these guidelines is unique in that they are a reversal of previous guidelines, posing additional challenges for all stakeholders. For caregivers of young infants specifically, compliance with the PPA guidelines requires them to understand the changing science around food allergy development, participate in early peanut feeding during short time window (4-6 months of age), and accept the risks involved with feeding their infant a potentially allergenic food. While studies involving pediatricians and allergists have been conducted, our current understanding of caregiver opinions PPA guidelines and our interventions to support caregivers to adhere to early peanut introduction are limited. Utilizing an established clinical network of over 30 pediatric clinics in Illinois (primary mentor’s parent grant iREACH), this proposal will evaluate caregiver barriers and facilitators to the PPA guidelines and investigate the key driving factors for adherence and nonadherence by conducting qualitative interviews with caregivers of young children. This data will be incorporated into building a distinct interactive intervention: iCARE (Intervention to Improve Caregiver Adherence Regarding Early Peanut Introduction). Using web-, mobile-, and/or video-based applications, the goal of iCARE will be to address caregiver barriers and unmet needs to facilitate early peanut introduction. After following an iterative prototyping process to develop iCARE with stakeholders and experts, it will be tested among caregivers to understand its efficacy, acceptability, and feasibility. This will provide preliminary data for an R01 proposal studying the effectiveness of iCARE in a randomized clinical trial. As caregivers are the ultimate drivers of PPA guideline implementation, this project addresses a gap in our current approach to PA prevention. This K23 proposal addresses multiple gaps in Dr. Samady’s research skillset, providing additional training in: 1) qualitative data analysis, 2) behavioral science training, 3) development and evaluation of novel behavioral interventions. Her primary mentor, Dr. Gupta is a national leader in food allergy prevention studies, her co- mentor Dr. McGee is a leading expert in qualitative research and professional development, and her co- mentors Drs. Van Horn, and Pongracic have additional expertise in developing and evaluating behavioral interventions. Completion of these aims and training goals will support Dr. Samady’s long-term goal of become an independent investigator and national leader studying infants with atopic disease, focused on improving the implementation of current food allergy prevention efforts and identifying new prevention strategies.

项目摘要 花生过敏（PA）是美国最常见的食物过敏；它也是最不频繁的人之一 以及致命的食物过敏反应的主要原因。关于花生研究的早期学业学习发现 在婴儿期摄入花生产品可以使PA的发展降低超过81％。那在2017年 Niaid发表了预防花生过敏（PPA）指南。但是，实施这些 指南的独特之处在于它们与以前的准则相反，为所有人带来了其他挑战 利益相关者。特别是针对年轻婴儿的护理人员，遵守PPA指南需要他们 了解食物过敏开发周围不断变化的科学，参加早期花生喂养 短时间窗口（4-6个月大），并接受喂养婴儿涉及的风险 过敏性食物。尽管已经进行了涉及儿科医生和过敏症患者的研究，但我们的当前 了解照顾者意见PPA指南和我们的干预措施，以支持护理人员遵守 早期花生的介绍是有限的。利用伊利诺伊州30多个儿科诊所的已建立的临床网络 （主要导师的父母授予IREACH），该提案将评估护理人员的障碍和促进者 PPA指南并通过进行依从性和不遵守的关键驱动因素 对幼儿的照顾者进行定性访谈。这些数据将纳入建立一个独特的 互动干预：ICARE（干预以提高照顾者遵守早期花生的依从性 介绍）。使用Web-，Mobile-和/或基于视频的应用程序，ICARE的目标是解决 护理人员的障碍和未满足的障碍需要促进早期花生的介绍。经过迭代之后 与利益相关者和专家一起开发ICARE的原型过程，将在护理人员之间进行测试 了解其效率，可接受性和可行性。这将为R01提案提供初步数据 在一项随机临床试验中研究ICARE的有效性。因为护理人员是PPA的最终驱动力 指南实施，该项目解决了我们当前预防PA的方法的差距。 这项K23提案解决了Samady博士的研究技能中的多个差距，提供了其他培训： 1）定性数据分析，2）行为科学培训，3）新行为的发展和评估 干预措施。她的主要导师古普塔（Gupta）博士是食品过敏研究的全国领导者，她的共同 Mentor McGee博士是定性研究和专业发展的领先专家，她的共同 导师博士。 Van Horn和Pongracic在制定和评估行为方面具有更多的专业知识 干预措施。这些目标和培训目标的完成将支持Samady博士的长期目标 成为独立研究者和国家领导者，研究患有特应性疾病的婴儿，重点是 改善当前食品过敏的实施，并确定新的预防 策略。