Preventing Peanut Allergy in Young Children: Identifying Barriers to Protocol Engagement and Adherence

预防幼儿花生过敏：识别协议参与和遵守的障碍

• 批准号: 10641769
• 负责人: Grace Cushman
• 金额: $ 7.18万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-12 至 2024-07-11
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10641769
• 关键词: Accounting; Adherence; Adopted; Adoption; Affect; Allergy to peanuts; Attention; Attitude; Behavior; Behavioral; Caliber; Caregivers; Characteristics; Child; Child Development; Childhood; Chronic Disease; Classification; Clinical; Consumption; Data; Development; Disease Management; Effectiveness; Environment; Family; Family history of; Fellowship; Financial Hardship; Food Hypersensitivity; Future; Goals; Guidelines; Health Personnel; Hospitals; Human; Infant; Infant Care; Infant Food; Ingestion; Intervention; Interview; Knowledge; Learning; Measures; Medical; Methods; Modeling; National Institute of Allergy and Infectious Disease; National Research Service Awards; Outcome; Parents; Pattern; Patterns of Care; Personal Satisfaction; Prevalence; Prevention; Prevention Guidelines; Prevention approach; Process; Proteins; Protocols documentation; Provider; Psychiatry; Psychosocial Factor; Public Health; Qualitative Research; Recommendation; Reporting; Research; Research Personnel; Rhode Island; Risk; Risk Factors; Social Environment; Structure; Surveys; Training; Training Activity; Typology; United States; Universities; Well in self; career; clinical care; contextual factors; design; family support; feeding; food insecurity; high risk; improved; interest; medical schools; novel strategies; post-doctoral training; prevent; response; risk perception; social factors; sociodemographic factors; therapy design; willingness

PROJECT SUMMARY/ABSTRACT This F32 National Research Service Award will support the applicant’s long-term career goal of becoming an independent investigator examining effective approaches to disease management in pediatric chronic illness. Consistent with this goal, the proposed study will focus on extending the applicant’s research to the examination of families’ barriers to initiating and adhering to NIAID guidelines to prevent the development of peanut allergy (PA). PA is the most commonly reported food allergy (FA), tends to develop early in childhood, and is rarely outgrown. PA poses serious medical risks, accounting for the majority of fatal anaphylactic responses. In 2015, the Learning Early about Peanut Allergy (LEAP) trial demonstrated the effectiveness and feasibility of preventing the onset of PA in infants at risk of developing PA; infants regularly ingesting peanut protein were less likely to develop a PA than those avoiding peanuts. Consistent infant consumption of peanuts has proven challenging, however, as early introduction studies report non-adherence ranging from 25-65%. Limited information is known about what factors impact families’ knowledge of guidelines for early introduction of peanut protein, willingness to initiate early introduction, and ability to initiate early introduction of peanuts, all of which are essential components of successful PA prevention. The aims of the study are to (1a) develop a typology of patterns of caregiver knowledge of, willingness to initiate, and means to initiate early introduction of peanuts for caregivers of young children at risk of PA; (1b) examine predictors of patterns of characteristics related to initiation of peanut early introduction; (2a) identify factors associated with initiation and adherence to early introduction of peanuts among families recommended PA prevention; (2b) identify contextual barriers and facilitators to early introduction initiation and adherence through in-depth qualitative interviews; and (3) integrate quantitative and qualitative outcomes to develop an understanding of factors impeding and facilitating initiation and adherence to early introduction of peanuts. The long-term goal of the proposed research is to design interventions to increase families’ abilities to follow through on treatment recommendations within FA protocols and improve long-term outcomes of children at risk of developing PA. A highly structured training plan will allow the applicant to conduct the proposed research and receive individualized training to facilitate her development as an independent researcher. Through the training activities provided by this fellowship, the applicant will (1) enhance her knowledge of the medical aspects of FA, (2) develop expertise in qualitative and mixed-methods approaches, (3) establish proficiency in classification modeling, and (4) advance her professional development. The applicant’s interests and training goals are an excellent fit for the Department of Psychiatry and Human Behavior at Brown University’s Alpert Medical School and Rhode Island Hospital, given the strength of the research environment, caliber of postdoctoral training, and availability of research and clinical care within FA.

项目摘要/摘要 该F32国家研究服务奖将支持申请人的长期职业目标 独立研究者研究小儿慢性病中疾病管理的有效方法。 与这个目标一致，拟议的研究将重点将申请人的研究扩展到 检查家庭启动和遵守NIAID指南的障碍，以防止发展 花生过敏（PA）。 PA是最常见的食物过敏（FA），往往在儿童早期发展， 而且很少长大。 PA将严重的医疗风险定位，占致命过敏反应的大部分 回答。在2015年，关于花生过敏（LEAP）试验的早期学习证明了有效性和 防止患有PA的风险的婴儿发作的可行性；婴儿定期摄取花生 蛋白质与避免花生的蛋白质的可能性较小。一致的婴儿食用花生 然而，随着早期简介研究报告的不遵守情况的挑战已被证明是25-65％。 有限的信息已知有关哪些因素会影响家庭对早期介绍准则的了解 花生蛋白，愿意提早引入的意愿以及早期引入花生的能力 其中是成功预防PA的重要组成部分。该研究的目的是（1a）发展 护理人员知识的模式类型，愿意发起的意愿以及提前引入的手段 面向PA风险的幼儿照顾者的花生； （1B）检查特征模式的预测指标 与花生的早期介绍有关； （2a）确定与启动和遵守相关的因素 在家庭中早期引入花生建议预防PA； （2b）确定上下文障碍和 通过深入的定性访谈的促进者提出早期引入启动和遵守； （3） 综合定量和定性结果，以发展对阻碍和促进因素的理解 开始和遵守早期花生的引入。拟议研究的长期目标是 设计干预措施以提高家庭的能力遵循FA中的治疗建议 方案并改善有发展PA风险的儿童的长期结局。 高度结构化的培训计划将使申请人能够进行拟议的研究并接受 个性化的培训，以促进她作为独立研究人员的发展。通过培训 该奖学金提供的活动，申请人将（1）增强她对医疗方面的了解 FA，（2）开发定性和混合方法方法的专业知识，（3） 分类建模，以及（4）提高她的专业发展。申请人的利益和培训 目标非常适合布朗大学Alpert的精神病学和人类行为系 鉴于研究环境的力量，医学院和罗德岛医院的能力 博士后培训以及FA内的研究和临床护理的可用性。