title: The food hypersensitivity family impact (FLIP) questionnaire - development and first results.
abstract: BACKGROUND
  Elimination of the offending food(s) is the usual treatment when a child suffers from food hypersensitivity. This treatment can impair everyday life in families with affected children. Instruments to assess these impairments generated from families attending primary care and in comparison to families with children without food hypersensitivity are scarce. The aim of this study is to develop and test a method to assess food hypersensitivity's impact on everyday life on affected families.
  
  
  METHODS
  The Food hypersensitivity famiLy ImPact (FLIP) questionnaire was developed and validated on parents of children (0.5-7 years) with cow's milk protein hypersensitivity, exclusively or in combination with other food hypersensitivity, together with the Swedish Parental Stress Questionnaire (SPSQ) and in comparison to parents with children without food hypersensitivity.
  
  
  RESULTS
  The validation of FLIP on 94 families indicated excellent internal consistency (Cronbach α 0.9) and good reproducibility (ICC 0.71). The FLIP showed moderate correlation with the SPSQ (r = 0.48) and proved capable of discriminating families by disease burden. Affected families experienced higher stress on their daily lives (p = 0.02) and higher impact on nutrition concerns (p < 0.0001) compared to families with children without food hypersensitivity.
  
  
  CONCLUSIONS
  The FLIP is a reliable, valid and sensitive instrument and could be valuable both clinically and in research. The results confirm recommendations of the need for continuous and updated dietary treatment and support for the families with young children with food hypersensitivity.
authors.affiliation: Pediatric clinics, Primary Care, Region Västra Götaland, Sweden. andrea.mikkelsen@vgregion.se
authors.forename: Andrea
authors.initials: A
authors.lastname: Mikkelsen
authors.forename: Magnus P
authors.initials: MP
authors.lastname: Borres
authors.forename: Cecilia
authors.initials: C
authors.lastname: Björkelund
authors.forename: Lauren
authors.initials: L
authors.lastname: Lissner
authors.forename: Lena
authors.initials: L
authors.lastname: Oxelmark
mesh_terms: D000818:Animals; D002417:Cattle; D002648:Child; D002675:Child, Preschool; D003710:Demography / Q000706:statistics & numerical data; D005190:Family; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008892:Milk / Q000276:immunology; D016269:Milk Hypersensitivity / Q000453:epidemiology*; D011320:Primary Health Care; D011788:Quality of Life; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013315:Stress, Psychological / Q000453:epidemiology*; D011795:Surveys and Questionnaires / Q000592:standards*; D013548:Sweden
keywords: children; elimination diet; food hypersensitivity; impact on family