1
|
Knibb RC, Jones CJ, Herbert LJ, Screti C. Psychological support needs for children with food allergy and their families: A systematic review. Pediatr Allergy Immunol 2024; 35:e14108. [PMID: 38528707 DOI: 10.1111/pai.14108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/23/2024] [Accepted: 02/28/2024] [Indexed: 03/27/2024]
Abstract
This systematic review aimed to review the evidence for psychological support for children with food allergies and their families, identify effective psychological interventions, and highlight the support needs for this group. A systematic search was undertaken across six databases (up to October 2023). Articles were checked by three reviewers for inclusion. Study data were extracted, and quality was assessed using the Mixed Methods Appraisal Tool. A narrative synthesis was undertaken. A total of 11 papers were included (n = 838 participants). Intervention types were based on cognitive behavioral therapy (CBT; n = 7); psycho-education (n = 1); peer mentoring (n = 1); self-regulation theory (n = 1); and coping (n = 1). Two interventions were for children only, three were for children and parents and six for parents only. Cognitive behavioral therapy-based interventions with highly anxious parents or children or those facilitated by a psychologist showed significant improvements with moderate-to-large effect sizes. The one self-help CBT-based online program showed no effects. Other intervention types reported mainly trends in improvement due to small sample sizes. Most interventions were aimed at supporting children or parents in day-to-day management of food allergy, measuring outcomes such as quality of life, self-efficacy, anxiety, worry, and depression. One intervention was designed to assist with oral immunotherapy outcomes. The majority of the studies had small sample sizes and were feasibility or proof-of-concept studies. Available research evidence points to effectiveness of facilitated CBT-based interventions for those that have high food allergy-related anxiety, but as many studies have small sample sizes and few report effect sizes, no firm conclusions can yet be drawn. A stepped care approach is likely to be useful for this population. Research using large interventional designs, particularly for children and adolescents, are needed.
Collapse
Affiliation(s)
- Rebecca C Knibb
- School of Psychology, College Health and Life Sciences, Aston University, Birmingham, UK
| | - Christina J Jones
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Linda J Herbert
- Division of Psychology & Behavorial Health, Children's National Hospital, Washington, District of Columbia, USA
- Department of Pediatrics, George Washington University School of Medicine, Washington, District of Columbia, USA
| | - Cassandra Screti
- School of Psychology, College Health and Life Sciences, Aston University, Birmingham, UK
| |
Collapse
|
2
|
Bingemann TA, LeBovidge J, Bartnikas L, Protudjer JLP, Herbert LJ. Psychosocial Impact of Food Allergy on Children and Adults and Practical Interventions. Curr Allergy Asthma Rep 2024; 24:107-119. [PMID: 38261244 DOI: 10.1007/s11882-023-01121-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2023] [Indexed: 01/24/2024]
Abstract
PURPOSE OF REVIEW IgE- and non-IgE-mediated food allergies are increasing in prevalence in children and adults worldwide. A food allergy diagnosis can be associated with a sense of overwhelm and stress and commonly has a negative impact on quality of life. RECENT FINDINGS While there is an increased recognition of the psychosocial effects of food allergy, the current research reflects the experience of mostly White, well-educated wealthier populations. Some studies have now explored the psychosocial impact among other populations; however, further study is needed. It is important that physicians and allied health professionals screen for the potentially negative psychosocial effects of food allergy and provide education to promote safety and self-efficacy at each visit; however, time may be a limiting factor. Numerous validated questionnaires are now available to help assess the psychosocial impact of food allergies. Allergy-friendly foods are typically more expensive, and thus, it is imperative that physicians screen for food insecurity as well. Educational resources should be offered regarding living well with food allergies at each visit. For patients and families experiencing anxiety or food allergy burden that is difficult to manage, referral to a mental health provider should be considered. Resources regarding programs to help accessing safe foods should also be available. Further research is needed among diverse populations focusing on interventions to best support patients and families with food allergy.
Collapse
Affiliation(s)
- Theresa A Bingemann
- Departments of Allergy, Immunology and Rheumatology and Pediatric Allergy and Immunology, University of Rochester School of Medicine, 601 Elmwood Ave, Box 695, Rochester, NY, 14642, USA.
| | - Jennifer LeBovidge
- Division of Immunology, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Lisa Bartnikas
- Harvard Medical School, Boston, MA, USA
- Department of Medicine, Division of Immunology, Boston Children's Hospital, Boston, MA, USA
| | - Jennifer L P Protudjer
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, MB, Canada
- George Fay Yee Centre for Healthcare Innovation, Winnipeg, MB, Canada
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Linda J Herbert
- Division of Psychology &, Behavioral Health, Children's National Hospital, Washington, DC, USA
- Department of Pediatrics, George Washington University School of Medicine, Washington, DC, USA
| |
Collapse
|
3
|
Baudino MN, Inverso H, Wang C, Tully C, Levy W, Clary L, Gallagher KA, Monaghan M, Streisand R, Hilliard ME. Satisfaction With Participation in the First STEPS Behavioral Intervention: Experiences of Parents of Young Children With Newly Diagnosed Type 1 Diabetes. J Pediatr Psychol 2023; 48:605-613. [PMID: 37344161 PMCID: PMC10544724 DOI: 10.1093/jpepsy/jsad039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 05/08/2023] [Accepted: 06/07/2023] [Indexed: 06/23/2023] Open
Abstract
OBJECTIVE Parents of young children with new-onset type 1 diabetes (T1D) often experience significant distress and struggle with T1D management during a challenging developmental stage. The First STEPS (Study of Type 1 in Early childhood and Parenting Support) trial evaluated a stepped-care behavioral intervention comprising increasingly intensive intervention steps (peer parent coach, cognitive-behavioral counseling, consultations with diabetes educator and psychologist) based on need. The intervention improved parental depressive symptoms compared to usual care. Subsequently, we examined parent satisfaction with the intervention to guide potential implementation and refinement for future trials. METHODS Participants were 157 parents of young children newly diagnosed with T1D. At 9 months post randomization, n = 153 completed satisfaction questionnaires and n = 17 completed qualitative interviews. Satisfaction ratings about trial procedures and each intervention step were summarized. We used thematic analysis with the interview transcripts to generate themes related to participants' experiences in the trial overall and intervention specifically. We explored differences in themes between participants who did versus did not respond to the intervention and among those who experienced different intervention steps. RESULTS Most participants in both arms rated study participation and methods positively (>95%), and those completing interviews described high satisfaction with study procedures overall, retention incentives, and contact with study staff. Intervention participants' satisfaction ratings were high across steps. Two qualitative themes reflected satisfaction with the intervention enhancing self-efficacy and social support. CONCLUSIONS High satisfaction suggests implementing a stepped-care behavioral intervention as part of routine clinical care following T1D diagnosis would be well received.
Collapse
Affiliation(s)
- Marissa N Baudino
- Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, USA
| | - Hailey Inverso
- Clinical and Translational Research, Children’s National Hospital, USA
| | - Christine Wang
- Clinical and Translational Research, Children’s National Hospital, USA
| | - Carrie Tully
- Clinical and Translational Research, Children’s National Hospital, USA
- Department of Psychiatry, George Washington University School of Medicine, USA
| | - Wendy Levy
- Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, USA
| | - Lauren Clary
- Clinical and Translational Research, Children’s National Hospital, USA
- Department of Psychiatry, George Washington University School of Medicine, USA
| | - Katherine A Gallagher
- Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, USA
| | - Maureen Monaghan
- Clinical and Translational Research, Children’s National Hospital, USA
- Department of Psychiatry, George Washington University School of Medicine, USA
| | - Randi Streisand
- Clinical and Translational Research, Children’s National Hospital, USA
- Department of Psychiatry, George Washington University School of Medicine, USA
| | - Marisa E Hilliard
- Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, USA
| |
Collapse
|
4
|
Dhanjal R, Dine K, Gerdts J, Merrill K, Frykas TLM, Protudjer JL. An online, peer-mentored food allergy education program improves children's and parents' confidence. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2023; 19:47. [PMID: 37248523 DOI: 10.1186/s13223-023-00800-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 04/25/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND Children with food allergy, and their families experience substantial burdens because of efforts necessary to minimize the risk of anaphylaxis. To this end, peer-to-peer education is paramount. Food Allergy Canada offers an online, peer-to-peer mentoring program. However, the impact of this program has not previously been formally evaluated. OBJECTIVE To determine if Allergy Pals, an online, peer-to-peer mentoring program, for children aged 7-11 years, increased child and parental food allergy competency, and confidence. Our secondary aim was to qualitatively describe the experiences of the program. METHODS From May 2020-May 2021, children and their parents were invited to participate in an online, anonymous survey about Allergy Pals, at pre-program, and post-program. Primary outcomes, which were described and compared using chi2 or t-tests, as appropriate for the respective variables, included food allergy competence (epinephrine carriage, signs and symptoms of anaphylaxis) and food allergy confidence (e.g. comfort asking other for food allergy-related support). Secondary outcomes included child and parent perceptions of the program, which were analysed thematically. RESULTS Overall, 17 children completed the pre-program, and 11 completed the post-program survey. Corresponding numbers for parents were 25 and 23. Food allergy competence was high pre-program, and remained so post-program. Food allergy confidence improved from pre-program to post-program. E.g. Children tended to feel less left out (5/12, 41.7%; 3/10; 30.0%, respectively), a finding that was reflected also in parents' scores. Themes identified for child and parent perceptions further supported improved food allergy confidence. CONCLUSION Although food allergy competence was high pre-program, Allergy Pals improved food allergy confidence.
Collapse
Affiliation(s)
| | - Kyle Dine
- Food Allergy Canada, Toronto, ON, Canada
| | | | - Kaitlyn Merrill
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Tara Lynn M Frykas
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Jennifer Lp Protudjer
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada.
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada.
- George and Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, MB, Canada.
- Department of Foods and Human Nutritional Sciences, Faculty of Agriculture and Food Sciences, University of Manitoba, Winnipeg, MB, Canada.
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| |
Collapse
|
5
|
Cheon J, Cho CM, Kim HJ, Kim DH. Effectiveness of educational interventions for quality of life of parents and children with food allergy: A systematic review. Medicine (Baltimore) 2022; 101:e30404. [PMID: 36086727 PMCID: PMC10980392 DOI: 10.1097/md.0000000000030404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/26/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Educational intervention along with medical treatment is important to improve the quality of life of children with food allergies and their parents. This systematic review was designed to investigate the effects of education programs for parents and children with food allergies to provide a direction for developing an intervention program to improve their quality of life. METHODS A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant studies published between January 2010 and August 2021 were identified through a systematic search of 5 databases (PubMed, EMBASE, CINAHL, Cochrane Central Register of Controlled Trial, and Psycho Info). RESULTS A total of 2351 articles were identified. Of these, 9 met the inclusion criteria after duplicates were removed. Among these, only 2 studies, using the support and handbook provided, showed significant results on quality of life. DISCUSSION There is a lack of educational interventions for children with food allergies and their parents. Educational intervention, an essential intervention, can maximize medical treatment and improve overall quality of life. Hence, these interventions should be actively developed and applied in the future.
Collapse
Affiliation(s)
- Jooyoung Cheon
- College of Nursing, Sungshin Women’s University, Dobong-ro 76ga-gil, Gangbuk-gu, Seoul, Republic of Korea
| | - Chung Min Cho
- College of Nursing, Sungshin Women’s University, Dobong-ro 76ga-gil, Gangbuk-gu, Seoul, Republic of Korea
| | - Hyo Jin Kim
- College of Nursing, Seoul National University, 103, Daehak-ro, Jongno-gu, Seoul, Republic of Korea
| | - Dong Hee Kim
- College of Nursing, Sungshin Women’s University, Dobong-ro 76ga-gil, Gangbuk-gu, Seoul, Republic of Korea
| |
Collapse
|
6
|
Correa N, Protudjer JLP, Hsu E, Soller L, Chan ES, Kim H, Jeimy S. Canadian parent perceptions of oral food challenges: A qualitative analysis. Pediatr Allergy Immunol 2022; 33:e13698. [PMID: 34811822 DOI: 10.1111/pai.13698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 11/06/2021] [Accepted: 11/16/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Natasha Correa
- Division of Clinical Immunology and Allergy, Department of Medicine, Western University, London, ON, Canada
| | - Jennifer L P Protudjer
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada.,Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
| | - Elaine Hsu
- Division of Allergy and Immunology, Department of Pediatrics, University of British Columbia, BC Children's Hospital, Vancouver, BC, Canada
| | - Lianne Soller
- Division of Allergy and Immunology, Department of Pediatrics, University of British Columbia, BC Children's Hospital, Vancouver, BC, Canada
| | - Edmond S Chan
- Division of Allergy and Immunology, Department of Pediatrics, University of British Columbia, BC Children's Hospital, Vancouver, BC, Canada
| | - Harold Kim
- Division of Clinical Immunology and Allergy, Department of Medicine, Western University, London, ON, Canada.,Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Samira Jeimy
- Division of Clinical Immunology and Allergy, Department of Medicine, Western University, London, ON, Canada
| |
Collapse
|
7
|
Focusing on Young Children in Pediatric Psychology Research: Introduction to the Special Issue on Young Children. J Pediatr Psychol 2021. [DOI: 10.1093/jpepsy/jsab074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
This special issue focusing on pediatric psychology research in young children highlights 15 papers that focus on infants through preschoolers. Studies selected for inclusion cover a range of pediatric health conditions such as food allergy, medical trauma, injuries/traumatic brain injury, cancer, inflammatory bowel disease, pain, and sleep. The inherent challenges of researching young children are described, and studies vary in their methods for assessment and intervention; multiple studies include an observational component or developmental evaluation. Six of the studies employ diverse samples of children and/or parents and demonstrate the feasibility as well as importance of increasing our understanding of factors related to health disparities. Taken together, the special issue demonstrates the high quality of research focusing on young children. As the special issue editors, we hope this collection will spark an interest in others to focus on research with young children across pediatric populations.
Collapse
|