Lauren M Kao1, Julie Wang2, Olga Kagan3, Anne Russell4, S Shahzad Mustafa5, Diane Houdek1, Bridget Smith6, Ruchi Gupta7. 1. Center for Community Health, Northwestern University Feinberg School of Medicine, Chicago, Illinois. 2. Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York. 3. Malloy College, Rockville Center, New York, New York. 4. Food Allergy & Anaphylaxis Michigan Association, Ann Arbor, Michigan. 5. Rochester Regional Health, Rochester, New York. 6. Center for Community Health, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Center for Innovation in Complex Chronic Healthcare, Edward Hines Jr. VA, Hines, Illinois. 7. Center for Community Health, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois. Electronic address: r-gupta@northwestern.edu.
Abstract
BACKGROUND: Although school health care professionals are integral to the management of students with food allergy, their views on school food allergy policies have not yet been reported. OBJECTIVE: To characterize food allergy policies currently being used in schools and their utility and potential barriers to implementation from the perspective of school health care professionals. METHODS: An electronic survey was disseminated to school nurses at the 2016 National Association of School Nurses meeting and through the Allergy and Asthma Network listserv. Frequencies were calculated to describe participant characteristics and responses. Unadjusted associations were examined using χ2 tests; adjusted associations were examined using multiple logistic regression models. RESULTS: A total of 242 completed surveys were included in the analysis. Thirty-two percent of nurses reported an allergic reaction in their school in the past year. Most schools used a variety of policies, including anaphylaxis training for staff (96.7%), stock epinephrine availability (81.7%), designated lunch areas (62.2%), and food guidelines for classrooms (61.8%). Barriers to implementation included financial, time, and attitudinal considerations. Schools with pre-K or kindergarten students had higher odds of having designated lunch areas (adjusted odds ratio [OR], 2.1; 95% confidence interval [CI], 1.0-4.1; P < .05). The odds of having emergency epinephrine available were higher in schools with a full-time nurse (OR, 2.6; 95% CI, 1.1-6.3; P < .05) and in schools reporting at least 1 severe reaction in the past year (OR, 3.2; 95% CI, 1.2-8.5; P < .05). CONCLUSION: With one-third of school nurses reporting an allergic reaction in the past year, schools use many strategies to minimize allergen exposures and increase anaphylaxis preparedness. Most school nurses favor these policies and acknowledge barriers to implementation.
BACKGROUND: Although school health care professionals are integral to the management of students with food allergy, their views on school food allergy policies have not yet been reported. OBJECTIVE: To characterize food allergy policies currently being used in schools and their utility and potential barriers to implementation from the perspective of school health care professionals. METHODS: An electronic survey was disseminated to school nurses at the 2016 National Association of School Nurses meeting and through the Allergy and Asthma Network listserv. Frequencies were calculated to describe participant characteristics and responses. Unadjusted associations were examined using χ2 tests; adjusted associations were examined using multiple logistic regression models. RESULTS: A total of 242 completed surveys were included in the analysis. Thirty-two percent of nurses reported an allergic reaction in their school in the past year. Most schools used a variety of policies, including anaphylaxis training for staff (96.7%), stock epinephrine availability (81.7%), designated lunch areas (62.2%), and food guidelines for classrooms (61.8%). Barriers to implementation included financial, time, and attitudinal considerations. Schools with pre-K or kindergarten students had higher odds of having designated lunch areas (adjusted odds ratio [OR], 2.1; 95% confidence interval [CI], 1.0-4.1; P < .05). The odds of having emergency epinephrine available were higher in schools with a full-time nurse (OR, 2.6; 95% CI, 1.1-6.3; P < .05) and in schools reporting at least 1 severe reaction in the past year (OR, 3.2; 95% CI, 1.2-8.5; P < .05). CONCLUSION: With one-third of school nurses reporting an allergic reaction in the past year, schools use many strategies to minimize allergen exposures and increase anaphylaxis preparedness. Most school nurses favor these policies and acknowledge barriers to implementation.
Authors: Lisa M Bartnikas; Michelle F Huffaker; William J Sheehan; Watcharoot Kanchongkittiphon; Carter R Petty; Robert Leibowitz; Michael C Young; Wanda Phipatanakul Journal: J Allergy Clin Immunol Pract Date: 2019-07-15
Authors: Dannielle Brown; Olivia Negris; Ruchi Gupta; Linda Herbert; Lisa Lombard; Alexandria Bozen; Amal Assa'ad; Annika Chura; Aame B Andy-Nweye; Susan Fox; Mahboobeh Mahdavinia; Mary Tobin; Adam Robinson; Hemant Sharma; Amaziah Coleman; Jialing Jiang; Lucy Bilaver; Jamie L Fierstein; Isabel Galic; Pamela Newmark; Jacqueline A Pongracic; Andrea A Pappalardo; Christopher Warren Journal: Ann Allergy Asthma Immunol Date: 2020-11-04 Impact factor: 6.347
Authors: Michelle C Maciag; William J Sheehan; Lisa M Bartnikas; Peggy S Lai; Carter R Petty; Stephanie Filep; Martin D Chapman; Wanda Phipatanakul Journal: J Allergy Clin Immunol Pract Date: 2021-06-24