Associations of Food Allergy-Related Dietary Knowledge, Attitudes, and Behaviors Among Caregivers of Black and White Children With Food Allergy.

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Publisher: Elsevier Science Publishers
Document Type: Report
Length: 906 words

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Keywords Food allergy; Race; Dietary knowledge; Attitudes; Behaviors Abstract Background The increasing prevalence of pediatric food allergy (FA) in the United States has disproportionately affected non-Hispanic Black youth. However, racial and other socioeconomic disparities in FA management among caregivers of children with FA remain unclear. Objective To determine associations between socioeconomic, clinical, and health care factors and FA-related knowledge, attitudes, and behaviors among caregivers of Black and White children with FA. Design Cross-sectional survey analysis from the Food Allergy Outcomes Related to White and African American Racial Differences Study. Participants/settings Longitudinal cohort of caregivers of 385 Black and White children with FA ages birth to 12 years residing in Chicago, Illinois, Cincinnati, Ohio, and Washington, DC from 2017 to March 2021. Main outcome measures There were 3 primary outcomes of interest: (1) FA knowledge assessed by scores from the Knowledge Survey, (2) FA-related attitudes assessed by newly developed survey, and (3) food-related behaviors assessed by the FORWARD Diet and Purchasing Habit Surveys completed 6 months postenrollment. Analyses Multivariable linear and logistic regression. Results The overall response rate to the 6-month postenrollment survey was 51.3% (385 of 751). White caregivers represented 69.4% of the participants. Black race was associated with a 1.5-point mean decrease in FA knowledge score (95% CI: -2.2 to -0.7) compared with White caregivers, and a graduate degree or bachelor's degree was associated with associated with a 1.7-point mean increase (95% CI: 0.8-2.7) and 1.1-point mean increase (95% CI: 0.2-2.0) in FA knowledge score, respectively, compared with caregivers who had less than a bachelor's degree. Multiple FAs and ever visited the emergency department for a food-related allergic reaction were also associated with higher levels of FA knowledge. Ever visited the emergency department for FA was also associated with higher odds of 2 measures of FA attitudes reflecting parental anxiety. Greater FA knowledge scores were consistently associated with lower odds of several FA-related food purchasing and eating behaviors assumed to have elevated risk of FA. Eating food prepared at school was the only FA behavior associated with race. Compared with White children, Black children were 2.5 times more likely to eat school-prepared foods (95% CI: 1.2-5.6). Conclusions Findings from this study identified socioeconomic, racial, and clinical factors associated with caregivers' FA-related knowledge, attitudes, and behaviors, but further research is warranted to better understand these relationships. Author Affiliation: (1) Northwestern University Feinberg School of Medicine, Center for Food Allergy and Asthma Research, Chicago, Illinois (2) Johns Hopkins All Children's Hospital, St Peterburg, Florida (3) University of Illinois at Chicago, Chicago, Illinois (4) Division of Allergy and Immunology, Children's National Health Systems, Washington, DC (5) Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington DC (6) Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois (7) Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (8) University of Cincinnati, Cincinnati, Ohio (9) Department of Internal Medicine, Division of Allergy & Immunology, Rush University Medical Center, Chicago, Illinois * Address correspondence to: Eileen Vincent, MS, RDN, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Dr. Suite 1400, Chicago, IL 60611. Article History: Received 30 November 2020; Accepted 30 November 2021 (footnote) https://orcid.org/0000-0001-7608-3197(https://orcid.org/0000-0001-7608-3197) (footnote) STATEMENT OF POTENTIAL CONFLICT OF INTEREST R. S. Gupta is a medical consultant/advisor for Aimmune Therapeutics, Before Brands, AllerGenis LLC, Kaléo Inc, DBV Technologies, Pfizer, DOTS Technology, and Food Allergy Research and Education (FARE); has received grants from the National Institutes of Health (NIH) (R21 ID # AI135705, R01 ID# AI130348, U01 ID # AI138907), Food Allergy Research Education (FARE), Rho Inc, Melchiorre Family Foundation, Sunshine Charitable Foundation, Walder Foundation, UnitedHealth Group, Thermo Fisher Scientific, Genentech, and the National Confectioners Association; is employed by Ann & Robert H. Lurie Children's Hospital of Chicago; and is professor of pediatrics and medicine at Northwestern University Feinberg School of Medicine. L. A. Bilaver has received grants from NIH, Rho Inc, Thermo Fisher Scientific, FARE, Genentech, National Confectioners Association, and Before Brands. A. A. Pappalardo has worked with Boehringer-Ingelheim on their speaker's bureau and in consultation in the past, starting in 2016 and ending August 2017. From August 2014 through July 2017, A. A. Pappalardo met with pharmaceutical representatives who provided lunch. A. A. Pappalardo serves a consultant for OptumRx/United Health Group. The remaining authors report no relationship or financial interest with any entity that would pose a conflict of interest with the subject matter of this article. (footnote) FUNDING/SUPPORT FORWARD (NIH number: R01AI130348). M. Mahdavinia is also supported by KL2TR002387-02 from NIH and Brinson Foundation grant. (footnote) AUTHOR CONTRIBUTIONS A. Robinson, J. Choi, J. Jiang, and H. Hultquist collected the data. J. L. Fierstein performed the data analysis. E. Vincent, L. A. Bilaver, and J. L. Fierstein wrote the first draft with contributions from A. A. Pappalardo, A. Coleman, H. P. Sharma, and A. Brewer. All authors reviewed and commented on subsequent drafts of the manuscript. Byline: Eileen Vincent, MS, RDN [evincent@northwestern.edu] (1,*), Lucy A. Bilaver, PhD (1), Jamie L. Fierstein, PhD (2), Neil Thivalapill, MS (1), Andrea A. Pappalardo, MD (3), Amaziah Coleman, MD (4,5), Adam Robinson, BS (4), Hemant P. Sharma, MD, MHS (4,5), Audrey Brewer, MD (1,6), Amal H. Assa'ad, MD (7,8), Jialing Jiang, BS (1), Haley W. Hultquist, BS (1), Ashwin J. Kulkarni, BS (1), Johnathan Choi, BS (1), Mahboobeh Mahdavinia, MD, PhD (9), Jacqueline Pongracic, MD (1,6), Mary C. Tobin, MD (9), Christopher Warren, PhD (1), Ruchi S. Gupta, MD, MPH (1)

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Gale Document Number: GALE|A697070980