title: Food Allergy-Related Risk-Taking and Management Behaviors Among Adolescents and Young Adults.
abstract: BACKGROUND
  Food allergy (FA) affects 8% of children and adolescents in the United States. Nearly 40% of those affected have experienced severe reactions. Fatal food-induced anaphylaxis is most common among adolescents and young adults (AYA); however, FA-related risk behaviors persist in this population and factors associated with these behaviors remain unclear.
  
  
  OBJECTIVE
  To characterize FA-related risk-taking and self-management behaviors of AYA with FA.
  
  
  METHODS
  A cross-sectional survey was administered to 200 AYA with FA. Latent class analysis was used to identify distinct behavioral risk classes and predictors of risk class membership.
  
  
  RESULTS
  Two distinct FA behavioral risk classes were identified, representing less (N = 120) and more (N = 80) risky subpopulations. After adjusting for age, sex, and anaphylaxis history, odds of more risky class membership were significantly reduced for AYA with peanut allergy (odds ratio [OR], 0.27; 95% CI, 0.11-0.65), supportive female friends (OR, 0.27; 95% CI, 0.07-0.99), overprotective mothers (OR, 0.42; 95% CI, 0.18-0.97), teachers who are aware of their FA (OR, 0.39; 95% CI, 0.17-0.91), a history of being bullied (OR, 0.22; 95% CI, 0.09-0.51), and an established 504 education plan (OR, 0.35; 95% CI, 0.15-0.81). AYA also reported numerous positive outcomes of their FA, such as greater responsibility, empathy, and improved diet, which was significantly associated with reduced odds of risky class membership (OR, 0.38; 95% CI, 0.18-0.80).
  
  
  CONCLUSIONS
  Among AYA, increased FA-related risk-taking was associated with clinical, demographic, and social factors, including peanut allergy, greater age, as well as absence of social support and specific school FA policies. These associations may be used to inform future interventions designed to address FA-related risk and management behaviors.
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Ill.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Warren
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Ill.
authors.forename: Ashley A
authors.initials: AA
authors.lastname: Dyer
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Ill; Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill.
authors.forename: Alana K
authors.initials: AK
authors.lastname: Otto
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Ill; Edward J. Hines Jr VA Hospital, Center for Management of Complex Chronic Care, Hines, Ill.
authors.forename: Bridget M
authors.initials: BM
authors.lastname: Smith
authors.affiliation: Creekwood Associates, St Charles, Ill.
authors.forename: Kristen
authors.initials: K
authors.lastname: Kauke
authors.affiliation: Children's Mercy Hospital, Kansas City, Mo.
authors.forename: Chitra
authors.initials: C
authors.lastname: Dinakar
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Ill; Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill. Electronic address: r-gupta@northwestern.edu.
authors.forename: Ruchi S
authors.initials: RS
authors.lastname: Gupta
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D000328:Adult; D000367:Age Factors; D000707:Anaphylaxis / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D005512:Food Hypersensitivity / Q000523:psychology*; D006801:Humans; D008297:Male; D012309:Risk-Taking; D012944:Social Support; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult
keywords: Adolescents and young adults (AYA); Food allergy; Latent class analysis (LCA); Risk-taking behaviors; Self-management; Social support