METHODS: We performed individual semi-structured interviews of general pediatricians in Northern California. Our interview guide discussed current practices regarding peanut introduction. Qualitative analysis started with open coding and was followed by secondary-level coding for important themes. Three researchers coded the data using Dedoose (Los Angeles, CA). We performed an iterative analysis to investigate subthemes and characterize specific topics to create a theoretical framework around peanut introduction in infants.
RESULTS: Eighty-five general pediatricians were approached and eighteen participated. Participants varied greatly in their awareness, understanding, and agreement with recent research and guidelines. Themes that emerged include “means of education” as pediatricians discussed learning modalities. “Specialist access” was a facilitator to knowledge and guideline uptake. “Testing beliefs” was another theme that emerged, as practitioners expressed concern about prick and serum testing in infants. Many pediatricians felt that addressing these areas would enable them to endorse early peanut introduction.
CONCLUSIONS: This is one of the first studies of general pediatrician uptake of early peanut introduction guidelines. Many are still unaware of or uncomfortable carrying out recent recommendations. There are opportunities to improve pediatrician uptake of guidelines to try to improve patient outcomes, including preventing development of peanut allergy.