FORWARD-COVID 19 Supplement

项目摘要/摘要 背景：食物过敏(FA)是一种潜在威胁生命的疾病，估计影响8%的 美国的儿童。尽管黑人和白人儿童在患病率和死亡率方面的差异 其他特应性疾病如哮喘和湿疹的严重程度已经被很好地描述了，但对此知之甚少。 FA中的这种差异。有限的现有文献表明，黑人儿童的临床症状可能更差 结果，包括与FA相关的致命过敏反应和与FA相关的急诊科就诊率， 比他们的白人同龄人。表型和内型的差异，包括敏感率和协同 黑人和白人儿童之间的病态开始受到检验。关于FA的种族差异的数据 管理实践并不完整；初步数据显示，黑人家庭在以下方面的支出明显减少 无过敏原的食物和FA药物比白人家庭更好。照顾有足总经验的儿童的家庭 严重的心理社会结果障碍，包括与FA相关的生活质量(FAQOL)；然而，这些 数据主要来自白人私人保险家庭，人们对这些家庭的心理社会后果知之甚少。 黑人家庭。最近的两篇综述得出的结论是，现有的检查FA种族差异的研究太过 在方法上受到限制，无法得出明确的结论，主要是因为依赖FA诊断的自我报告 和横截面设计。 具体目标和方法：我们的目标是前瞻性地研究800名黑人和白人儿童(0- 12年)，以便：1)确定黑人和白人之间临床FA结果的变异性 患者通过季度在线评估、年度诊所访问和两年内的病历审查； 2)使用特定的方法检测患有FA的黑人和白人儿童的表型和内型差异 实验室标本采集技术和分析；3)辨别黑人和白人的区别 儿童在FA管理实践中的家长报告(例如，避免过敏原和携带肾上腺素)； 4)确定黑人和白人儿童在心理社会FA相关结果上的差异 (例如，与FA相关的生活质量、欺凌、焦虑和担忧)。 假设和预期结果：我们假设，与白人儿童相比，黑人儿童将： 有较高的食物过敏反应发生率和FA相关的医疗利用；展示独特的FA 表型和内型；对FA管理知识较少，对预防性措施的坚持较少 行为；获得药物和无过敏原食物的机会有限；以及报告更好的生活质量。 对其他研究的意义和影响：确认和进一步表征差异 黑人和白人儿童之间的FA将提供制定临床指南所需的数据， 优化治疗，建立满足黑人和白人儿童需求的卫生政策。

PROJECT SUMMARY/ABSTRACT Background: Food allergy (FA) is a potentially life-threatening condition that affects an estimated 8% of children in the United States. Although differences between Black and White children in the prevalence and severity of other atopic conditions such as asthma and eczema have been well described, little is known about such differences in FA. The limited existing literature indicates that Black children may have worse clinical outcomes, including rates of FA-related fatal anaphylaxis and FA-related emergency department (ED) visits, than their White peers. Phenotypic and endotypic differences, including rates of sensitization and co- morbidities, between Black and White children are beginning to be examined. Data on racial differences in FA management practices are incomplete; preliminary data suggest that Black families spend significantly less on allergen-free foods and FA medications than do White families. Families caring for children with FA experience significant impairments in psychosocial outcomes, including FA-related quality of life (FAQoL); however, these data come primarily from White, privately insured families, and little is known about psychosocial outcomes in Black families. Two recent reviews concluded that existing studies examining racial disparities in FA are far too methodologically limited to draw definitive conclusions, primarily due to reliance on self-report of FA diagnosis and cross-sectional designs. Specific Aims and Methods: Our goal is to prospectively study a cohort of 800 Black and White children (0- 12 years) with FA in order to: 1) Determine variability in clinical FA outcomes between Black and White patients via quarterly online assessments, annual clinic visits, and medical chart review over a two-year period; 2) Examine phenotypic and endotypic differences between Black and White children with FA using specific laboratory specimen collection techniques and assays; 3) Identify differences between Black and White children in FA management practices by parent report (e.g. allergen avoidance and epinephrine carriage); and 4) Determine differences between Black and White children in psychosocial FA-related outcomes (e.g., FA-related quality of life, bullying, anxiety, and worry) via the above survey methods. Hypotheses and Expected Results: We hypothesize that compared to White children, Black children will: have higher rates of food-allergic reactions and FA-related healthcare utilization; demonstrate unique FA phenotypes and endotypes; have less knowledge of FA management and less adherence to preventative behaviors; have limited access to medications and allergen-free foods; and report better quality of life. Significance and Effects on Other Research: Confirming and further characterizing differences between Black and White children with FA will provide the data required to develop clinical guidelines, optimize treatment, and build health policies that meet the needs of both Black and White children.