Current SOAAR Food Allergy Research
Here are some of the exciting food allergy research projects that the SOAAR team is managing.
Updating our landmark Prevalence, Severity and Distribution of Childhood Food Allergy in the United States study (2009-2010 National Food Allergy Survey)
In 2011, SOAAR published the most comprehensive and widely-cited estimate to date of the prevalence and severity of childhood food allergy in the U.S. The team surveyed a nationally-representative sample of 40,104 households with children.
Results: 8% of children (1 in 13) have a food allergy; 40% of these children have experienced a severe reaction. The study was published in the July 2011 issue of Pediatrics.
2017 Research: SOAAR is re-assessing the pediatric food allergy prevalence by systematically surveying another large, nationally-representative sample of U.S. households, while simultaneously examining the prevalence, severity, and distribution of food allergy among a sample of 40,000 U.S. adults.
To gain a better understanding of food-induced anaphylaxis, SOAAR developed anaphylaxis registries for schools, the general public, and emergency departments (ED) to systematically track and examine:
- The most common triggers of allergic reactions, including anaphylaxis,
- Where reactions are occurring, and
- The care that individuals experiencing anaphylaxis receive.
The team compiled data from approximately 280 patients. In this cohort, children with Medicaid were less likely to receive pre-ED epinephrine and diphenhydramine as treatment for anaphylaxis. Socioeconomic status was more strongly associated with pre-ED medication use in these patients than race and ethnicity. Future research is needed to further explore barriers to pre-hospital medication use for anaphylaxis.
Natural History of Food Allergy Study
SOAAR has enrolled a cohort of U.S. families with at least 1 food allergic child to determine predictors of severity and the development of tolerance as well as progression of atopic disease. The study also measures quality of life, health care utilization, patient empowerment, and the type and severity of certain comorbid chronic conditions.
School Food Allergy Policy Survey
SOAAR is reviewing current school-based food allergy policies in public and private schools, including policies specific to the classroom, cafeteria, and extracurricular activities. Survey participants answered questions about policy necessity/effectiveness and barriers. By understanding what food allergy policies work best, SOAAR will be able to issue evidence-based recommendations for improving food safety for all children in school.
Spotlight on Campus Allergies
In 2016, SOAAR began working with graduate students from Northwestern University's Engineering Design Innovation group to develop the Spotlight on Campus Allergies program to address the specific issues that students with life-threatening food allergies face on college campuses.
Spotlight helps high school students transition to college by instilling confidence in their ability to manage their allergies and be proactive in educating others about their allergies. The program raises awareness of food allergies on college campuses through the implementation of five essential services: Compass, Cares, Captivates, Connect and Confidence.
- Spotlight on Campus Allergies
- Northwestern University Design School news article, "Helping students with food allergies transition to college"
- Northwestern University McCormick School of Engineering news article, "Hope for Food-Allergic Students Transitioning to College"
- Kids with Food Allergies Blog: College Students With Food Allergies Find Big Challenges in Staying Safe
Pediatrician Adherence to Peanut Guidelines
In early 2017, the National Institute of Allergy and Infectious Diseases released new guidelines for the introduction of peanut products to infants at risk of developing peanut allergies, the Addendum Guidelines for the Prevention of Peanut Allergy in the United States Summary for Parents and Caregivers
SOAAR is studying how to support pediatrician adherence to these new guidelines. Successful implementation of the guidelines is expected to decrease the incidence of peanut allergy in children nationwide.
- Addendum Guidelines for the Prevention of Peanut Allergy in the United States Summary: For Clinicians, Parents and Caregivers
- "Peanuts and Your Baby: How to Introduce the Two", featuring Ruchi Gupta, MD, MPH
- WTTW Prevent Peanut Allergies: Give Kids Peanuts
- NPR: New Guidelines Tell Parents When To Introduce Babies to Peanut Products
Economics of Food Industry Allergen Management Practices
SOAAR conducted a survey of food production industry representatives to determine the main areas of cost associated with industry food allergen management practices. Recalls due to food allergen cross-contact, cleaning procedures, equipment and facility design, and employee training were ranked as the highest expenses related to allergen management.
This study may lead to future projects examining the economics of food allergen management and methods to refine allergen handling protocols in the food production industry.
- Gupta RS, Taylor SL, Baumert JL, Kao LM, Schuster E, Smith B. Economic factors impacting food allergy management: Perspectives from the food industry. The Journal of Food Protection. 2017; In press.
Food allergy management Outcomes Related to White and African American Racial Differences (FORWARD), Recipient of NIH R01 grant funding
SOAAR recently received a major NIH grant to examine disparities in the ways that food allergy develops, affects, and is managed by African American and White children throughout the U.S. through the use of a prospective, longitudinal design. SOAAR will determine differences in food allergy clinical and psychosocial outcomes, the ways and mechanisms through which their allergies manifest themselves, as well as their management practices. A total of 1,000 families will be recruited.
Update: The Northwestern coordinating site is on track to recruit at least 400 families by September 2017. A total of 600 new families with children ages 0-12 will be recruited from allergy clinics in four academic medical centers located in three cities (Chicago, IL; Cincinnati, OH; Washington, DC).
Outcomes will be measured at baseline and at every four months for two years. Clinical medical record data, survey data, and biological samples will be obtained from participants.
This study will help determine true prevalence, severity, and distribution of childhood food allergy in India and identify modifiable causal determinants of food allergy.
SOAAR also hopes to better understand how and why food allergy arises by examining the differences in early dietary and environmental exposures between India and the U.S.
Peer to Peer Food Allergy Videos (K-12)
SOAAR created peer-to-peer food allergy educational videos for elementary, middle, and high school students using format and content preference data collected through surveys and interviews with children, adolescents, and parents. The videos were then filmed and produced in collaboration with a wide variety of food allergy stakeholders. Each video was then evaluated to determine its effectiveness in changing student food allergy knowledge, beliefs and attitudes.
Results: The videos increased knowledge and understanding of food allergies. Results will be published in late 2017/early 2018.
- Peer-to-Peer Food Allergy Videos
Epinephrine Auto-Injector (EAI) Access and Carrying Practices Study
While evidence suggests that many individuals with food allergy do not carry EAIs, little is known about the factors influencing these food allergy management behaviors. As such, the primary objective of this study is to learn more about current EAI carrying practices among food-allergic children, adolescents and adults. These findings will help identify barriers to engaging in physician recommended management practices and guide future work in to improving patient adherence.
Intervention to Reduce Early Allergy in Children (iREACH)
Recently, the Learning Early About Peanut (LEAP) study showed that giving kids peanut early in life is likely to reduce their risk for developing peanut allergy. In light of the substantial peanut allergy (PA) risk reductions identified by the LEAP study, promoting provider adherence to the new Prevention of Peanut Allergy (PPA) Guidelines may prevent PA and associated morbidity. As a result, SOAAR is planning to implement and evaluate an electronic health record (EHR)-integrated CDS tool, iREACH, within a large, diverse network of primary care pediatricians. The iREACH tool will support pediatricians through:
- Identification of infants at high PA risk--based on presence of severe eczema and/or egg allergy;
- Peanut specific (s)IgE testing or allergist referral of children at high PA risk;
- Interpretation of peanut (s)IgE test results, if applicable; and
- Counseling parents of non- peanut-allergic children on how to introduce dietary peanut.
This study will provide valuable data on the effectiveness of the iREACH CDS tool in improving clinical processes and outcomes consistent with the PPA guidelines. The results of this study will also provide important insights into whether and how the PPA guidelines are currently being implemented by pediatricians, parents and allergists and the role that each currently plays in introducing peanut products to infants.