Implications of Social Support and Parenting Self-Efficacy for Food Allergy-Related Parenting Practices

Interventions to Promote Food Allergy Literacy in Childhood: A Systematic Scoping Review

BACKGROUND

This article introduces the concept, food allergy literacy (FAL), which encompasses the knowledge, behaviors, and skills needed to manage a food allergy and is thus critical to child safety. Yet, there is limited clarity on how to promote FAL in children.

METHODS

Twelve academic databases were systematically searched to identify publications on interventions to promote FAL in children. Five publications met the inclusion criteria, which involved children (3 to 12 years), their parents, or educators and tested the efficacy of an intervention.

FINDINGS

Four interventions were for parents and educators, while 1 intervention was for parents with their children. The interventions were educational and focused on promoting participant knowledge and skills of food allergy, and/or psychosocial in nature, promoting coping, confidence, and self-efficacy in managing children's allergies. All interventions were deemed effective. Only 1 study used a control group, and none assessed the long-term benefits of the interventions.

IMPLICATIONS FOR SCHOOL POLICY, PRACTICE, AND EQUITY

The results can enable health service providers and educators to design evidence-based interventions to promote FAL. This might involve designing, implementing, and evaluating curricula and play-based activities, therein, that award greater attention to food allergy-its consequences, risks, skills to prevent risk, and managing food allergy in educational settings.

CONCLUSIONS

There is limited evidence on child-focused interventions that promote FAL. There is, therefore, considerable opportunity to co-design and test interventions with children.

Parenting and childhood atopic dermatitis: A cross-sectional study of relationships between parenting behaviour, skin care management, and disease severity in young children

BACKGROUND

The development of child behaviour and parenting difficulties is understood to undermine treatment outcomes for children with atopic dermatitis. Past research has reported on correlates of child behaviour difficulties. However, few research studies have sought to examine parenting confidence and practices in this clinical group.

OBJECTIVES

To examine relationships between child, parent, and family variables, parent-reported and directly-observed child and parent behaviour, parents' self-efficacy with managing difficult child behaviour, self-reported parenting strategies, and disease severity.

DESIGN

Cross-sectional study design.

PARTICIPANTS

Parent-child dyads (N=64) were recruited from the dermatology clinic of a paediatric tertiary referral hospital in Brisbane, Australia. Children had a diagnosis of atopic dermatitis of ≥3months and no other chronic health conditions except asthma, allergic rhinitis, or allergy.

METHODS

Parents completed self-report measures assessing child behaviour; parent depression, anxiety, and stress; parenting conflict and relationship satisfaction; self-efficacy with managing difficult child behaviour, and use of ineffective parenting strategies; and self-efficacy for managing atopic dermatitis, and performance of atopic dermatitis management tasks. The Scoring Atopic Dermatitis index was used to assess disease severity. Routine at-home treatment sessions were coded for parent and child behaviour.

RESULTS

Pearson's and Spearman's correlations identified relationships (p<0.05) between self-efficacy with managing difficult child behaviour and child behaviour problems, parent depression and stress, parenting conflict and relationship satisfaction, and household income. There were also relationships between each of these variables and use of ineffective parenting strategies. Greater use of ineffective parenting strategies was associated with more severe atopic dermatitis. Using multiple linear regressions, child behaviour and household income explained unique variance in self-efficacy for managing difficult child behaviour; household income alone explained unique variance in use of ineffective parenting strategies. Self-efficacy for managing difficult child behaviour and self-efficacy for managing atopic dermatitis were positively correlated (rho=0.48, p<0.001), and more successful self-reported performance of atopic dermatitis management tasks correlated with less permissive (r=0.35, p=0.005) and less authoritarian (r=0.41, p=0.001) parenting. Directly observed aversive child behaviour was associated with more severe atopic dermatitis, parent stress, and parent-reported child behaviour problems.

CONCLUSION

This study revealed relationships between parents' self-efficacy and parenting practices across the domains of child behaviour management and atopic dermatitis management. Parents of children with more severe atopic dermatitis may have difficulty responding to child behaviour difficulties appropriately, potentially impacting on illness management. Incorporating parent and parenting support within treatment plans may improve not only child and family wellbeing, but also treatment outcomes.