Evaluating the Food Allergy Passport: A Novel Food Allergy Clinical Support Tool

Ashley Ciliberti; Justin Zaslavsky; Tegan Morcott; Alexandria Bozen; Waheeda Samady; Lisa Lombard; Sai Nimmagadda; Kari Nadeau; Ruchi Gupta; Mary Tobin

doi:10.1016/j.jaip.2023.01.016

Evaluating the Food Allergy Passport: A Novel Food Allergy Clinical Support Tool

Ashley Ciliberti^*, Justin Zaslavsky, Tegan Morcott, Alexandria Bozen, Waheeda Samady, Lisa Lombard, Sai Nimmagadda, Kari Nadeau, Ruchi Gupta, Mary Tobin

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

Background: The prevalence of pediatric food allergy (FA) has increased in the past 2 decades. The previous literature suggests that FA presents burdens, both economically and psychosocially, to children and their caregivers, especially families in lower-income strata. Using data from a previously published needs assessment, the Food Allergy Management in Low-Income Youth study, the FA Passport and Workbook tools were developed to address identified needs. Objective: This study evaluated the utility of the FA Passport in helping families insured by Medicaid to manage FA better and improve quality of life. Methods: Families insured through Illinois Medicaid were recruited from two Chicago-based allergy clinics. Caregivers of children with FA completed a pretest evaluating knowledge, attitudes, beliefs, and practices regarding FA management. A clinician guided caregivers through the FA Passport. The caregivers then completed a posttest immediately afterward and again 3 months later. Changes were evaluated from baseline responses and direct feedback was elicited about the tool. Results: The FA Passport successfully improved caregiver-reported confidence with epinephrine autoinjector use (from 69% to 93%), caregiver anaphylaxis recognition (from 66% to 73%), and reported quality of life, and it nearly doubled caregiver comfort regarding leaving the child in the care of others (from 40% to 75.7%). Caregivers rated the FA Passport tool as extremely helpful overall (9.4 out of 10). Conclusions: The FA Passport is a novel FA clinical support tool that addresses barriers to proper FA management described in previous studies. It proved effective at improving caregiver comfort with regarding leaving the food-allergic children with other caregivers, increasing FA knowledge, and improving the quality of life in families affected by FA.

Original language	English (US)
Pages (from-to)	1162-1168.e7
Journal	Journal of Allergy and Clinical Immunology: In Practice
Volume	11
Issue number	4
DOIs	https://doi.org/10.1016/j.jaip.2023.01.016
State	Published - Apr 2023

Funding

Conflicts of interest: R. Gupta receives research support from the National Institutes of Health (R21 ID No. AI135705, R01 ID No. AI130348, and U01 ID No. AI138907), Food Allergy Research and Education, Melchiorre Family Foundation, Sunshine Charitable Foundation, The Walder Foundation, UnitedHealth Group, Thermo Fisher Scientific, and Genentech. She serves as a medical consultant/advisor for Genentech, Novartis, Aimmune LLC, Allergenis LLC, and Food Allergy Research and Education. She has ownership interest in Yobee Care, Inc. She is currently employed by Ann and Robert H. Lurie Children's Hospital of Chicago and is a professor of pediatrics and medicine at Northwestern University Feinberg School of Medicine. K. Nadeau reports royalty payments from patents from Stanford University; grants from the National Institute of Allergy and Infectious Diseases, and from Food Allergy Research and Education; cofounder of Alladapt, IgGenix, Latitude, and BeforeBrands, and she is on the Board of Scientific Counselors of the National Institutes of Health. The rest of the authors declare that they have no relevant conflicts of interest. This work was supported by the Sean N. Parker Center for Allergy and Asthma Research at Stanford Medicine. Conflicts of interest: R. Gupta receives research support from the National Institutes of Health (R21 ID No. AI135705, R01 ID No. AI130348, and U01 ID No. AI138907), Food Allergy Research and Education , Melchiorre Family Foundation, Sunshine Charitable Foundation, The Walder Foundation, UnitedHealth Group, Thermo Fisher Scientific , and Genentech . She serves as a medical consultant/advisor for Genentech, Novartis, Aimmune LLC, Allergenis LLC, and Food Allergy Research and Education. She has ownership interest in Yobee Care, Inc. She is currently employed by Ann and Robert H. Lurie Children's Hospital of Chicago and is a professor of pediatrics and medicine at Northwestern University Feinberg School of Medicine. K. Nadeau reports royalty payments from patents from Stanford University; grants from the National Institute of Allergy and Infectious Diseases , and from Food Allergy Research and Education; cofounder of Alladapt, IgGenix, Latitude, and BeforeBrands, and she is on the Board of Scientific Counselors of the National Institutes of Health . The rest of the authors declare that they have no relevant conflicts of interest. This work was supported by the Sean N. Parker Center for Allergy and Asthma Research at Stanford Medicine.

Keywords

Anaphylaxis
Education
Epinephrine
Food allergy
Food allergy action plan
Medicaid
Support tool
Teaching

ASJC Scopus subject areas

Immunology and Allergy

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10.1016/j.jaip.2023.01.016

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@article{c92fc7e3002c4035b00ee28d4fa100ea,

title = "Evaluating the Food Allergy Passport: A Novel Food Allergy Clinical Support Tool",

abstract = "Background: The prevalence of pediatric food allergy (FA) has increased in the past 2 decades. The previous literature suggests that FA presents burdens, both economically and psychosocially, to children and their caregivers, especially families in lower-income strata. Using data from a previously published needs assessment, the Food Allergy Management in Low-Income Youth study, the FA Passport and Workbook tools were developed to address identified needs. Objective: This study evaluated the utility of the FA Passport in helping families insured by Medicaid to manage FA better and improve quality of life. Methods: Families insured through Illinois Medicaid were recruited from two Chicago-based allergy clinics. Caregivers of children with FA completed a pretest evaluating knowledge, attitudes, beliefs, and practices regarding FA management. A clinician guided caregivers through the FA Passport. The caregivers then completed a posttest immediately afterward and again 3 months later. Changes were evaluated from baseline responses and direct feedback was elicited about the tool. Results: The FA Passport successfully improved caregiver-reported confidence with epinephrine autoinjector use (from 69% to 93%), caregiver anaphylaxis recognition (from 66% to 73%), and reported quality of life, and it nearly doubled caregiver comfort regarding leaving the child in the care of others (from 40% to 75.7%). Caregivers rated the FA Passport tool as extremely helpful overall (9.4 out of 10). Conclusions: The FA Passport is a novel FA clinical support tool that addresses barriers to proper FA management described in previous studies. It proved effective at improving caregiver comfort with regarding leaving the food-allergic children with other caregivers, increasing FA knowledge, and improving the quality of life in families affected by FA.",

keywords = "Anaphylaxis, Education, Epinephrine, Food allergy, Food allergy action plan, Medicaid, Support tool, Teaching",

author = "Ashley Ciliberti and Justin Zaslavsky and Tegan Morcott and Alexandria Bozen and Waheeda Samady and Lisa Lombard and Sai Nimmagadda and Kari Nadeau and Ruchi Gupta and Mary Tobin",

note = "Funding Information: Conflicts of interest: R. Gupta receives research support from the National Institutes of Health (R21 ID No. AI135705, R01 ID No. AI130348, and U01 ID No. AI138907), Food Allergy Research and Education, Melchiorre Family Foundation, Sunshine Charitable Foundation, The Walder Foundation, UnitedHealth Group, Thermo Fisher Scientific, and Genentech. She serves as a medical consultant/advisor for Genentech, Novartis, Aimmune LLC, Allergenis LLC, and Food Allergy Research and Education. She has ownership interest in Yobee Care, Inc. She is currently employed by Ann and Robert H. Lurie Children's Hospital of Chicago and is a professor of pediatrics and medicine at Northwestern University Feinberg School of Medicine. K. Nadeau reports royalty payments from patents from Stanford University; grants from the National Institute of Allergy and Infectious Diseases, and from Food Allergy Research and Education; cofounder of Alladapt, IgGenix, Latitude, and BeforeBrands, and she is on the Board of Scientific Counselors of the National Institutes of Health. The rest of the authors declare that they have no relevant conflicts of interest. This work was supported by the Sean N. Parker Center for Allergy and Asthma Research at Stanford Medicine. Funding Information: Conflicts of interest: R. Gupta receives research support from the National Institutes of Health (R21 ID No. AI135705, R01 ID No. AI130348, and U01 ID No. AI138907), Food Allergy Research and Education , Melchiorre Family Foundation, Sunshine Charitable Foundation, The Walder Foundation, UnitedHealth Group, Thermo Fisher Scientific , and Genentech . She serves as a medical consultant/advisor for Genentech, Novartis, Aimmune LLC, Allergenis LLC, and Food Allergy Research and Education. She has ownership interest in Yobee Care, Inc. She is currently employed by Ann and Robert H. Lurie Children's Hospital of Chicago and is a professor of pediatrics and medicine at Northwestern University Feinberg School of Medicine. K. Nadeau reports royalty payments from patents from Stanford University; grants from the National Institute of Allergy and Infectious Diseases , and from Food Allergy Research and Education; cofounder of Alladapt, IgGenix, Latitude, and BeforeBrands, and she is on the Board of Scientific Counselors of the National Institutes of Health . The rest of the authors declare that they have no relevant conflicts of interest. Funding Information: This work was supported by the Sean N. Parker Center for Allergy and Asthma Research at Stanford Medicine. Publisher Copyright: {\textcopyright} 2023 American Academy of Allergy, Asthma & Immunology",

year = "2023",

month = apr,

doi = "10.1016/j.jaip.2023.01.016",

language = "English (US)",

volume = "11",

pages = "1162--1168.e7",

journal = "Journal of Allergy and Clinical Immunology: In Practice",

issn = "2213-2198",

publisher = "American Academy of Allergy, Asthma and Immunology",

number = "4",

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TY - JOUR

T1 - Evaluating the Food Allergy Passport

T2 - A Novel Food Allergy Clinical Support Tool

AU - Ciliberti, Ashley

AU - Zaslavsky, Justin

AU - Morcott, Tegan

AU - Bozen, Alexandria

AU - Samady, Waheeda

AU - Lombard, Lisa

AU - Nimmagadda, Sai

AU - Nadeau, Kari

AU - Gupta, Ruchi

AU - Tobin, Mary

N1 - Funding Information: Conflicts of interest: R. Gupta receives research support from the National Institutes of Health (R21 ID No. AI135705, R01 ID No. AI130348, and U01 ID No. AI138907), Food Allergy Research and Education, Melchiorre Family Foundation, Sunshine Charitable Foundation, The Walder Foundation, UnitedHealth Group, Thermo Fisher Scientific, and Genentech. She serves as a medical consultant/advisor for Genentech, Novartis, Aimmune LLC, Allergenis LLC, and Food Allergy Research and Education. She has ownership interest in Yobee Care, Inc. She is currently employed by Ann and Robert H. Lurie Children's Hospital of Chicago and is a professor of pediatrics and medicine at Northwestern University Feinberg School of Medicine. K. Nadeau reports royalty payments from patents from Stanford University; grants from the National Institute of Allergy and Infectious Diseases, and from Food Allergy Research and Education; cofounder of Alladapt, IgGenix, Latitude, and BeforeBrands, and she is on the Board of Scientific Counselors of the National Institutes of Health. The rest of the authors declare that they have no relevant conflicts of interest. This work was supported by the Sean N. Parker Center for Allergy and Asthma Research at Stanford Medicine. Funding Information: Conflicts of interest: R. Gupta receives research support from the National Institutes of Health (R21 ID No. AI135705, R01 ID No. AI130348, and U01 ID No. AI138907), Food Allergy Research and Education , Melchiorre Family Foundation, Sunshine Charitable Foundation, The Walder Foundation, UnitedHealth Group, Thermo Fisher Scientific , and Genentech . She serves as a medical consultant/advisor for Genentech, Novartis, Aimmune LLC, Allergenis LLC, and Food Allergy Research and Education. She has ownership interest in Yobee Care, Inc. She is currently employed by Ann and Robert H. Lurie Children's Hospital of Chicago and is a professor of pediatrics and medicine at Northwestern University Feinberg School of Medicine. K. Nadeau reports royalty payments from patents from Stanford University; grants from the National Institute of Allergy and Infectious Diseases , and from Food Allergy Research and Education; cofounder of Alladapt, IgGenix, Latitude, and BeforeBrands, and she is on the Board of Scientific Counselors of the National Institutes of Health . The rest of the authors declare that they have no relevant conflicts of interest. Funding Information: This work was supported by the Sean N. Parker Center for Allergy and Asthma Research at Stanford Medicine. Publisher Copyright: © 2023 American Academy of Allergy, Asthma & Immunology

PY - 2023/4

Y1 - 2023/4

N2 - Background: The prevalence of pediatric food allergy (FA) has increased in the past 2 decades. The previous literature suggests that FA presents burdens, both economically and psychosocially, to children and their caregivers, especially families in lower-income strata. Using data from a previously published needs assessment, the Food Allergy Management in Low-Income Youth study, the FA Passport and Workbook tools were developed to address identified needs. Objective: This study evaluated the utility of the FA Passport in helping families insured by Medicaid to manage FA better and improve quality of life. Methods: Families insured through Illinois Medicaid were recruited from two Chicago-based allergy clinics. Caregivers of children with FA completed a pretest evaluating knowledge, attitudes, beliefs, and practices regarding FA management. A clinician guided caregivers through the FA Passport. The caregivers then completed a posttest immediately afterward and again 3 months later. Changes were evaluated from baseline responses and direct feedback was elicited about the tool. Results: The FA Passport successfully improved caregiver-reported confidence with epinephrine autoinjector use (from 69% to 93%), caregiver anaphylaxis recognition (from 66% to 73%), and reported quality of life, and it nearly doubled caregiver comfort regarding leaving the child in the care of others (from 40% to 75.7%). Caregivers rated the FA Passport tool as extremely helpful overall (9.4 out of 10). Conclusions: The FA Passport is a novel FA clinical support tool that addresses barriers to proper FA management described in previous studies. It proved effective at improving caregiver comfort with regarding leaving the food-allergic children with other caregivers, increasing FA knowledge, and improving the quality of life in families affected by FA.

AB - Background: The prevalence of pediatric food allergy (FA) has increased in the past 2 decades. The previous literature suggests that FA presents burdens, both economically and psychosocially, to children and their caregivers, especially families in lower-income strata. Using data from a previously published needs assessment, the Food Allergy Management in Low-Income Youth study, the FA Passport and Workbook tools were developed to address identified needs. Objective: This study evaluated the utility of the FA Passport in helping families insured by Medicaid to manage FA better and improve quality of life. Methods: Families insured through Illinois Medicaid were recruited from two Chicago-based allergy clinics. Caregivers of children with FA completed a pretest evaluating knowledge, attitudes, beliefs, and practices regarding FA management. A clinician guided caregivers through the FA Passport. The caregivers then completed a posttest immediately afterward and again 3 months later. Changes were evaluated from baseline responses and direct feedback was elicited about the tool. Results: The FA Passport successfully improved caregiver-reported confidence with epinephrine autoinjector use (from 69% to 93%), caregiver anaphylaxis recognition (from 66% to 73%), and reported quality of life, and it nearly doubled caregiver comfort regarding leaving the child in the care of others (from 40% to 75.7%). Caregivers rated the FA Passport tool as extremely helpful overall (9.4 out of 10). Conclusions: The FA Passport is a novel FA clinical support tool that addresses barriers to proper FA management described in previous studies. It proved effective at improving caregiver comfort with regarding leaving the food-allergic children with other caregivers, increasing FA knowledge, and improving the quality of life in families affected by FA.

KW - Anaphylaxis

KW - Education

KW - Epinephrine

KW - Food allergy

KW - Food allergy action plan

KW - Medicaid

KW - Support tool

KW - Teaching

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Evaluating the Food Allergy Passport: A Novel Food Allergy Clinical Support Tool

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