Food Allergy Management and Outcomes Related to Racial/Ethnic Differences from Infancy through Adolescence: The FORWARD Study

食物过敏管理和与从婴儿期到青春期的种族/民族差异相关的结果：FORWARD 研究

• 批准号: 10446840
• 负责人: Ruchi S Gupta
• 金额: $ 94.5万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-05-11 至 2027-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10446840
• 关键词: Address; Adolescence; Affect; Age; Allergens; Anaphylaxis; Asthma; Black race; Caregivers; Child; Child Care; Childhood; Clinical; Clinical Data; Clinical assessments; Collection; Communities; Data; Data Reporting; Development; Diagnosis; Disease Management; Eating Behavior; Eczema; Emergency department visit; Enrollment; Ensure; Environment; Epinephrine; Ethnic Origin; Family; Food; Food Hypersensitivity; Geography; Goals; Guidelines; Health Knowledge Attitudes Practice; Health Policy; Heterogeneity; Hispanic; Home; Immune Tolerance; Impairment; Knowledge; Knowledge Management; Latinx; Latinx population; Life; Linguistics; Literature; Longitudinal cohort; Methodology; Methods; Mexican; Mexican Americans; National Institute of Allergy and Infectious Disease; Not Hispanic or Latino; Outcome; Parents; Participant; Patient Outcomes Assessments; Patient Self-Report; Patients; Pharmaceutical Preparations; Phenotype; Practice Management; Prevalence; Prevention; Prospective Studies; Public Health; Puerto Rican; Quality of life; Race; Reaction; Reporting; Research; Sample Size; Sampling; Self Management; Serum; Severities; Site; Subgroup; Surveys; Symptoms; Testing; United States; Variant; clinical development; cohort; comorbidity; cost; data resource; design; ethnic difference; ethnic disparity; experience; fecal microbiome; follow-up; infancy; middle childhood; novel; nutrition; peer; precision medicine; prospective; psychosocial; racial and ethnic; racial difference; racial disparity; recruit; sample collection; skin microbiome; sociodemographic factors; socioeconomics; treatment optimization

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, White, and Latinx 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. 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. There is limited data on these outcomes among the Latinx population of children food allergy. 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 1,450 Black, White, and Latinx children with FA in order to: 1) Determine the clinical and sociodemographic factors associated with differences in the development of clinical immune tolerance and the development of new food allergies; 2) Determine differences in FA management and outcomes during pivotal developmental periods (i.e. middle childhood; adolescence) by expanding assessment of patient-reported outcomes to include dyadic assessment of the following caregiver-reported and patient self-reported constructs: Psychosocial Outcomes and Disease Management (e.g. epinephrine carriage and allergen exposure) and Eating behaviors and nutrition environments (e.g. in the home and community). 3) Identify phenotypic and endotypic differences in FA by applying state-of-the-art precision medicine approaches for multidimensional phenotyping and endotyping of FA patients. Hypotheses and Expected Results: We hypothesize that compared to White children, Black children are less likely to develop clinical immune tolerance to foods and more likely to develop new-onset food allergy during the study period. We also hypothesize that concordance between patient- and caregiver-report data will decrease as children age and eating behaviors and nutrition environment will differ by child race/ethnicity. Additionally, we hypothesize that White, Black, Mexican-American and Puerto-Rican children have unique FA phenotypes (e.g., specific allergens, symptoms, reaction severity) as well as unique FA endotypes (e.g., hyper-eosinophilic FA) Significance and Effects on Other Research: Confirming and further characterizing differences between Black, White, and Latinx children with FA will provide the data required to develop clinical guidelines,optimize treatment, and build health policies that meet the needs of Black, White, and Latinx children.

项目总结/文摘