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: 10371770
• 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/10371770
• 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; Nutritional; Pathway interactions; Physicians; Pre-Post Tests; Prevalence; Prevention; Prevention Guidelines; Prevention approach; Prevention strategy; Process; Proteins; Public Health; Publishing; Qualitative Research; Randomized Clinical Trials; Reaction; Recommendation; Reporting; Research; Research Personnel; Risk; Science; Social Network; Surveys; Testing; Time; Training; Uncertainty; United States; acceptability and feasibility; base; behavior test; caregiver interventions; clinical decision support; combat; effectiveness evaluation; effectiveness study; experience; feeding; gastrointestinal system; high risk infant; improved; infancy; non-compliance; novel; parent grant; pediatrician; pilot test; prevent; promoter; prototype; 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.

项目概要 花生过敏 (PA) 是美国最常见的食物过敏，也是最不常见的食物过敏之一。 具有里程碑意义的“尽早了解花生”研究发现，这是导致致命食物过敏反应的主要原因。 婴儿期摄入花生制品可使 PA 发育减少 81% 以上，因此，2017 年 NIAID 发布了《预防花生过敏（PPA）指南》，但这些指南的实施。 该指南的独特之处在于它们与之前的指南相反，给所有人带来了额外的挑战 特别是对于幼儿的照顾者来说，遵守 PPA 指南要求他们： 了解有关食物过敏发展的不断变化的科学，参与早期花生喂养 短时间窗口（4-6 个月大），并接受喂养婴儿可能存在的风险 虽然已经进行了涉及儿科医生和过敏症专家的研究，但我们目前的情况是。 了解护理人员的意见 PPA 指南和我们支持护理人员遵守的干预措施 早期花生的引进是有限的，利用伊利诺伊州 30 多个儿科诊所的既定临床网络。 （主要导师的家长资助 iREACH），该提案将评估看护者的障碍和促进因素 PPA 指南并通过进行以下研究来调查依从性和不依从性的关键驱动因素 对幼儿照顾者的定性访谈将被纳入建立独特的调查中。 互动干预：iCARE（提高护理人员对早期花生依从性的干预措施 iCARE 的目标是使用基于网络、移动和/或视频的应用程序来解决问题。 照顾者和未满足的需求促进早期花生引入。 与利益相关者和专家一起开发 iCARE 的原型流程，将在护理人员中进行测试 了解其有效性、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 的最终推动者。 指南的实施，该项目解决了我们当前 PA 预防方法中的差距。 这项 K23 提案解决了 Samady 博士研究技能方面的多个差距，提供了以下方面的额外培训： 1) 定性数据分析，2) 行为科学培训，3) 新行为的开发和评估 她的主要导师 Gupta 博士是食物过敏预防研究领域的全国领导者，她的合作者 导师 McGee 博士是定性研究和专业发展方面的领先专家，她的合作者 导师 Van Horn 博士和 Pongracic 在开发和评估行为方面拥有额外的专业知识 完成这些目标和培训目标将支持 Samady 博士的长期目标。 成为研究患有特应性疾病的婴儿的独立研究者和国家领导者，重点关注 改进当前食物过敏预防工作的实施并确定新的预防措施 策略。