title: Experiencing a first food allergic reaction: a survey of parent and caregiver perspectives.
abstract: BACKGROUND
  Insufficient knowledge of food allergy and anaphylaxis has been identified by caregivers as an important barrier to coping, and a potential cause of fear and anxiety, particularly for those with children newly diagnosed with food allergy. The purpose of the study was to better understand the experiences of caregivers of children with a first allergic reaction to food, and to identify any deficiencies in the information received at diagnosis.
  
  
  METHODS
  A mixed-methods study consisting of an online survey administered to the Anaphylaxis Canada online registry (a patient support group database of approximately 10,000 members), and a follow-up qualitative interview with a subset of survey participants. Analysis consisted of frequency analysis (quantitative and qualitative data) and descriptive statistics to calculate proportions and means with standard deviations. Qualitative analyses were guided by the constant comparative method of grounded theory methodology.
  
  
  RESULTS
  Of 293 survey respondents, 208 were eligible to complete the survey (first allergic reaction to food within 12 months of the study), and 184 respondents consented. Identified gaps included education about food allergy, anaphylaxis management, for example, how to use epinephrine auto- injectors, and coping strategies for fear and anxiety. The qualitative follow-up study supported these findings, yielding 3 major themes: 1) lack of provision of information following the episode on the recognition and management of food allergy related allergic reactions, 2) prolonged wait times for an allergist, and 3) significant family anxiety.
  
  
  CONCLUSIONS
  The online survey highlighted multiple deficiencies at diagnosis, findings which were supported by the follow up qualitative study. Results will inform the development of educational strategies for patients newly diagnosed with food allergy.
authors.affiliation: Division of Clinical Immunology and Allergy, Department of Medicine, McMaster University, HSC Room 3 V49, 1280 Main Street West, Hamilton, ON, L8S 4 K1, Canada.
authors.forename: Zainab B
authors.initials: ZB
authors.lastname: Abdurrahman
authors.affiliation: St. Michael's Hospital Li Ka Shing Knowledge Institute, University of Toronto, Toronto, ON, Canada.
authors.forename: Monika
authors.initials: M
authors.lastname: Kastner
authors.affiliation: Department of Health Science, UWO, London, ON, Canada.
authors.forename: Cory
authors.initials: C
authors.lastname: Wurman
authors.affiliation: Anaphylaxis Canada, Toronto, ON, Canada.
authors.forename: Laurie
authors.initials: L
authors.lastname: Harada
authors.affiliation: Anaphylaxis Canada, Kamloops, BC, Canada.
authors.forename: Laura
authors.initials: L
authors.lastname: Bantock
authors.affiliation: Anaphylaxis Canada, Toronto, ON, Canada.
authors.forename: Heather
authors.initials: H
authors.lastname: Cruickshank
authors.affiliation: Division of Clinical Immunology and Allergy, Department of Medicine, McMaster University, HSC Room 3 V49, 1280 Main Street West, Hamilton, ON, L8S 4 K1, Canada.
authors.forename: Susan
authors.initials: S
authors.lastname: Waserman
keywords: Anaphylaxis; Food allergy; Qualitative methods