Pre-med, nursing students show knowledge gaps pertaining to food allergy
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Food nutrition, nursing and pre-med students at a higher education institute reported inadequate training about food allergies, according to a letter published in Annals of Allergy, Asthma & Immunology.
Multidisciplinary health care professionals such as physicians, nurses and dietitians generally do not have adequate training in food allergy management despite often caring for these patients, Wan Shen, PhD, RDN, LD, assistant professor in the food and nutrition program, department of public and allied health, Bowling Green State University, and colleagues wrote in the letter.
To better assess the knowledge of students who intend to become these health care professionals, the researchers surveyed 32 food and nutrition majors, 28 nursing majors and 17 pre-med majors (87% women; 85.7% white; 90.9% aged 18-25 years; 61.9% sophomores or juniors) between Nov. 1 and 14, 2021, from a regional higher education institute in the Midwestern United States.
The assessment used the Chicago Food Allergy Research Surveys, which were designed for the public and for parents of children with food allergies. Knowledge domains in the surveys included definition and diagnosis, symptoms and severity, triggers and environmental risk, perceptions of susceptibility and prevalence, treatment, and policy issue.
Overall, 71.4% of these students had never been diagnosed with a food allergy, nor had they ever lived with someone with a food allergy. Also, 27.3% had received previous education or training about food allergies, including 37.5% of the food and nutrition, 25% of the nursing and 11.8% of the pre-med students.
Using the three-way analysis of variance F-test, researchers found that prior training (P < .05) and years in the program (P < .05) had significant main effects on food allergy knowledge, whereas life experience (P = .08) had a marginally significant main effect.
The average score for food allergy knowledge for all the participants was 67.2%, including 71.3% for the food and nutrition students, 62.7% for the nursing students and 67% for the pre-med students, with major showing a significant effect on these average scores using the three-way analysis of variance F-test (P < .05).
The weakest knowledge domain in the study was perceptions of susceptibility and prevalence, with less than 6% aware that more than 75% of children with milk allergies can outgrow their allergy, and less than 9% aware that teenagers are at higher risk for fatalities due to food allergy than children.
According to the researchers, these results are concerning because families that know their children could outgrow their allergies could experience reduced anxiety, whereas knowledge about risky behavior could help parents better protect their teenagers.
The researchers also asked participants to identify the top nine food allergens, including sesame seeds, with only 28.6% correctly identifying the eight top allergens. Half of these respondents who got the top eight allergens right also identified sesame as the newest addition to the list of top allergens.
When asked to respond “yes,” “no” or “I don’t know” to the statement, “Early introduction of allergenic foods to infants starting 4-6 months can prevent food allergies,” 46.4% of the nursing students, 81.2% of the food and nutrition students and 76.5% of the pre-med students correctly said that early introduction of allergenic food into infant diets could have benefits.
Participants further were asked to share their opinions about how food allergies were covered in their curriculum and how they preferred to learn about the topic.
Overall, 77.9% of the participants would support the addition of courses or training specific to food allergies into their curriculum. Preferred means for learning about food allergies in the future included the internet/email (42.9%), television (28.6%) and handouts/brochures (15.6%).
These findings should inform the design of modules about food allergy in undergraduate and continuing education courses, the researchers wrote, adding that standardized curricula and competency skillsets as well as hands-on experience are crucial in training.
Although food allergy training appeared inadequate, the researchers added, future research into such training should include larger and more geographically diverse samples, evaluation of respondent bias and assessment of participants’ previous work for stronger findings.
Perspective
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I commend the authors for working to identify opportunities for advanced education in food allergy among students in the food and nutrition, nursing and pre-medicine tracks. Considering the significant prevalence of food allergy among both children (8%) and adults (11%) in the U.S., it is imperative that these students receive adequate education and training before entering the health care field and begin treating families with food allergy.
As food allergy clinical guidelines have shifted over the past decade, we are hard at work trying to support and educate current clinicians to improve adherence to new guidance. If we can begin this process early on in students’ academic careers, the next generation of health care professionals will be much better equipped to provide comprehensive education and guidance while working with this population.
After reviewing the results from this paper, I am happy to see that most students would support adding more courses or training specific to food allergies in the curricula to enhance their education. I hope institutions begin to standardize modules in allergy/immunology across these majors in the future and look forward to the next steps to make this happen.
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