Friends, Family, and Food: Interactive Virtual Environments for Children with Food Allergies

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DESCRIPTION (provided by applicant): Pediatric Food Allergy (FA) is recognized as a serious public health concern that affects approximately 4-8 percent of children, with symptoms affecting multiple organ systems, including skin, the respiratory tract, and the GI tract. Food-induced anaphylaxis, which is a rapid, potentially life-threatening reaction, can occur in more serious cases. Despite the substantial burden of disease management and associated negative quality of life effects, very few resources exist to promote effective strategies for managing FA. Moreover, most resources targeting this population emphasize information dissemination and education, either in-person or via the web, and typically focus on parents, with few resources designed for affected children. The central goal of Phases I and II of this SBIR/STTR is to develop an engaging, interactive game-based intervention for school-aged children with FA that will increase knowledge, improve self-efficacy to manage the disease, and ultimately reduce risk of negative outcomes. Software-based interventions targeting children for various pediatric conditions have increased in availability and accessibility. Interactive, game-based approaches available on multiple platforms (computer, mobile devices) offer distinct advantages over traditional interventions in providing highly engaging formats of psychoeducation and skills-based practice. This Phase II application builds on the highly promising prototype of the Friends, Family, and Food App (F3A-App), produced through the successful and synergistic collaboration of our Phase I team. The F3A- App consists of four related parts: (a) an interactive, game-based application that is the core of the program, (b) the experiential scenarios in interactive environments (e.g., school cafeteria vignette) that target knowledge and behavioral skills practice in social contexts, (c) two engaging multi-level games to build skills i food avoidance (Label Learning: Like it or Lose it!) and symptom assessment (Reaction Action!), and (d) a multi- tiered reward system that uses token economy-based reinforcement to enhance motivation and engagement (SeaLife Spectacular). Feasibility and efficacy testing of our initial prototype indicated the F3A-App was very well-received by parents and children with FA, facilitated child knowledge acquisition, and increased FA self- efficacy in key areas of FA management. Qualitative reports indicated the F3A-App also enhanced communication between parents and children regarding FA management. In this Phase II project, we propose to produce a fully-developed version of the F3A-App, including added content and enhanced features, to pilot the new version in a small sample (n = 40), and to evaluate the final product in a randomized clinical trial (n=100). This intervention will surpass existing approaches for child-focused software programs in interactivity, ease of use, acceptance by parents, and promotion by health care professionals. We envision that the F3A-App will serve as a template for interactive game-based interventions for children with other chronic conditions requiring self-management, such as asthma, diabetes, and celiac disease. The promise of commercial opportunity is significant in an era in which there is an increasingly widespread access to and everyday use of computers, smart phones, and tablet technologies.