Evaluation of a Behavioral Intervention to Promote Food Allergy Self-Management Among Early Adolescents

促进青少年食物过敏自我管理的行为干预评估

基本信息

批准号：
10586326
负责人：
Linda Herbert
金额：
$ 56.53万
依托单位：
CHILDREN'S RESEARCH INSTITUTE
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：
2022-11-01 至 2027-10-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10586326
关键词：
Accidents Address Adherence Adolescence Adolescent Affect Age Allergens Allergic Reaction Anaphylaxis Anxiety Assertiveness Asthma Attenuated Award Baltimore Behavior Behavior Therapy Caregivers Child Health Chronic Disease Clinical Communication Development Early Intervention Eating Education Emergency Care Emergency Situation Emergency treatment Epinephrine Ethnic Origin Evaluation Exposure to Focus Groups Food Food Hypersensitivity Food Safety Fright Health Professional Health behavior Home Ingestion Intervention Knowledge Knowledge Management Life Minor National Institute of Allergy and Infectious Disease Outcome Parents Participant Patients Pilot Projects Population Probability Problem Solving Quality of life Race Randomized Reporting Research Research Project Grants Risk Risk Reduction Self Efficacy Self Management Social support Stress Training United States Variant Visit Work Youth acceptability and feasibility anxiety management arm bullying care systems comorbidity critical developmental period early adolescence emergency preparedness evidence base executive function experience follow-up food allergen group intervention health care service utilization health disparity high risk high risk population improved mental training novel peer peer support prevent primary caregiver programs psychosocial self-management program skills social skills socioeconomics treatment as usual treatment response young adult

项目摘要

PROJECT SUMMARY / ABSTRACT Food allergy is highly prevalent, burdensome, and stressful. Food allergy affects up to 7% of adolescents in the United States, or two adolescents in every classroom. Anaphylaxis, a multi-systemic allergic reaction, can be fatal if not treated with epinephrine quickly, and can only be prevented by strict allergen avoidance. The daily burden of allergen avoidance, fear about allergen exposure and emergency treatment, and food allergy-related bullying can incur stress and anxiety on patients and caregivers and is related to lower quality of life. Daily adherence to allergen avoidance and emergency preparedness is challenging, particularly during early adolescence when executive functioning skills are still developing, conformity to peer norms are predominant, and food allergy management responsibility shifts from caregiver to adolescent. Most fatal food-induced anaphylaxis cases occur during adolescence/young adulthood when allergens are unknowingly ingested away from home, treatment with epinephrine is delayed, and/or asthma is comorbid. Early adolescents need to be equipped with the skills and self-efficacy to engage in food allergy self-management behaviors that minimize accidental allergen exposures and increase the probability of prompt treatment. Behavioral interventions that promote illness self-management and adjustment are common in other chronic illness populations. However, there are no evidence-based behavioral interventions that promote early adolescent food allergy self- management. The proposed research project will evaluate a novel behavioral intervention that promotes early adolescent food allergy self-management and adjustment through 1) food allergy education, 2) problem-solving, communication, assertiveness, and anxiety management skill building, and 3) peer support. The Food Allergy Mastery (FAM) program is a 6-session food allergy self-management program that will be delivered to early adolescents with food allergy, a high-risk population that is growing in size, and a primary caregiver by a trained interventionist. The specific aims are: 1) To evaluate the intervention’s impact on food allergy knowledge and self-management skills, 2) To determine the intervention’s impact on food allergy self-management behavior and psychosocial functioning and healthcare utilization, and as an exploratory aim 3) to determine if early adolescents’ race/ethnicity moderates response to treatment, including food allergy knowledge, skills, self- management behavior, psychosocial functioning, and healthcare utilization. The study has the potential to positively impact the health care utilization of youth with food allergy by evaluating a scalable behavioral intervention for adolescents and their caregivers. The intervention will equip youth with food allergy knowledge and self-management skills by bolstering their food allergy-related knowledge and problem-solving, social skills, and social support and attenuating food allergy anxiety. Successful development and implementation of the FAM Program that promotes the attainment of integration of food allergy into daily life has the potential to decrease health care utilization reducing emergency visits and improve food allergy-related quality of life.

项目概要/摘要食物过敏非常普遍，给 7% 的青少年带来负担和压力。在美国，每间教室有两名青少年可能会出现过敏反应，这是一种多系统过敏反应。如果不迅速使用肾上腺素治疗，则致命，并且只能通过每天严格避免过敏原来预防。避免过敏原的负担、对过敏原暴露和紧急治疗的恐惧以及与食物过敏相关的欺凌会给患者和护理人员带来压力和焦虑，并导致日常生活质量下降。坚持避免过敏原和做好应急准备是具有挑战性的，特别是在早期青春期，执行功能技能仍在发展，遵守同侪规范占主导地位，食物过敏的管理责任从看护者转移到青少年身上。过敏反应病例发生在青春期/青年时期，此时过敏原在不知不觉中被摄入掉在家中，肾上腺素治疗被延迟，和/或青少年早期患有哮喘。具备进行食物过敏自我管理行为的技能和自我效能，以最大程度地减少食物过敏意外过敏原暴露并增加及时治疗的可能性。促进疾病自我管理和调整在其他慢性病人群中很常见。没有基于证据的行为干预措施可以促进青少年早期食物过敏的自我预防拟议的研究项目将评估一种促进早期管理的新型行为干预措施。青少年食物过敏的自我管理和调整通过 1) 食物过敏教育，2) 解决问题，沟通、自信和焦虑管理技能培养，以及 3) 食物过敏。掌握 (FAM) 计划是一项为期 6 期的食物过敏自我管理计划，将在早期实施患有食物过敏的青少年、规模不断扩大的高危人群以及由经过培训的主要护理人员干预主义者的具体目标是： 1) 评估干预措施对食物过敏知识和治疗的影响。自我管理技能，2) 确定干预措施对食物过敏自我管理行为的影响，以及心理社会功能和医疗保健利用，并作为探索性目标 3) 确定是否尽早青少年的种族/民族调节对治疗的反应，包括食物过敏知识、技能、自我该研究有潜力研究管理行为、心理社会功能和医疗保健利用。通过评估可扩展的行为，对患有食物过敏的青少年的医疗保健利用产生积极影响针对青少年及其照顾者的干预措施该干预措施将为青少年提供食物过敏知识。通过增强食物过敏相关知识和解决问题的能力、社交技能、社会支持并减轻食物过敏焦虑 FAM 的成功制定和实施。促进将食物过敏融入日常生活的计划有可能减少医疗保健的利用减少了紧急就诊并改善了食物过敏相关的生活质量。