Knowledge, Attitudes and Comfort of Childcare Providers in the Care of Children with Food Allergies
Sunday, March 4, 2018
South Hall A2 (Convention Center)
Kara J. Wada, MD, Amanda Mazzaferri, Rebecca Scherzer, MD FAAAAI, David R. Stukus, MD FAAAAI
RATIONALE: Approximately 4-8% of children have food allergies(FA). Finding childcare providers proficient in FA management can be stressful for parents of food allergic children. There are limited data evaluating FA knowledge and comfort among childcare providers.

METHODS: An anonymous electronic survey with knowledge and comfort questions surrounding FA management was distributed via emailed web-link to a convenience sample of 144 childcare providers in the central Ohio area. Comfort level was assessed on a Likert scale 1-5.

RESULTS: Thirty-six childcare providers (25%) responded: 45% had >10 years experience, 68.6% held a bachelor's or higher degree, 91.4% reported prior care of a child with FA, and 62.9% reported prior FA education. None reported using epinephrine on a client; 8.6% used it on a friend/family member. Comfort level in deciding how(3.4) or when(3.2) to administer epinephrine was moderate. Despite feeling very comfortable(4.4) with safe meal preparation, baked goods (waffle 53.3%, cake 62.5%) and pudding(75%) were recognized as a source of potential milk exposure less often than milk(100%), yogurt(100%) or butter(82.3%). Skin rash(100%), swelling(100%), difficulty breathing(100%), vomiting(97.1%), passing out(91.2%) and runny nose(64.7%) were identified as signs of FA reaction; 61.8% correctly recognized the need for administering epinephrine for rash/vomiting after allergen ingestion. There were no significant differences in answers for knowledge or comfort based questions between those with prior FA training compared to those without(p>0.05).

CONCLUSIONS: Although child care providers demonstrate moderate levels of FA knowledge and comfort in management, several gaps were demonstrated. Despite prior training, comfort level with decision making in emergency situations was not high.