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Food Allergy Education and Management in Early Learning and Childcare Centres: A Scoping Review on Current Practices
Mae Jhelene L Santos1,2, Kaitlyn A Merrill2,3, Moshe Ben-Shoshan4
1Department of Food and Human Nutritional Sciences, Faculty of Agriculture, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
Insights
Early learning centres lack consistent food allergy management. Staff have variable knowledge and limited training on epinephrine auto-injector use, highlighting the need for standardized emergency plans and annual education.
Area of Science:
- Pediatric Allergy and Immunology
- Childcare Health and Safety
- Public Health Policy
Background:
- Anaphylaxis is a serious concern in early learning and childcare centres (ELCC).
- Existing food allergy (FA) management practices in ELCC are inconsistent across jurisdictions.
- There is a lack of synthesized knowledge on FA management and practices within ELCC settings.
Purpose of the Study:
- To conduct a scoping review of food allergy management in ELCC.
- To identify perceived gaps and barriers in FA management within ELCC.
- To synthesize current knowledge on FA management practices in ELCC settings.
Main Methods:
- A PRISMA-ScR-guided literature search was performed across multiple databases (OVID-MedLine, Scopus, PsycInfo).
- Searches included North American, European, and Australian articles published in English and French.
- Two independent reviewers screened 2010 titles/abstracts and 77 full-text articles, with a third reviewer for disagreements and French articles. Ten articles specifically related to ELCC were included.
Main Results:
- ELCC staff demonstrate variable knowledge, comprehension, experience, and practices regarding FA management.
- Staff possess limited training and experience in administering epinephrine auto-injectors (EAI).
- Emergency Anaphylaxis Plans (EAP) were documented in four studies; educational interventions improved FA knowledge and confidence, with participants desiring annual training.
Conclusions:
- ELCC staff administer EAI in emergencies, but training consistency is lacking.
- Effective FA management requires robust communication and care planning between ELCC staff and parents.
- Annual education, readily available EAI, and established EAPs are essential for managing FA emergencies in ELCC.
Abstract:
Anaphylaxis has occurred in preschools/schools yet there are no consistent food allergy (FA) management practices in early learning and childcare centres (ELCC) across jurisdictions. Presently, there are no reviews that have synthesized FA-related knowledge and management practices within ELCC. We aimed to perform a scoping review of FA management in ELCC, and report on perceived gaps or barriers. A PRISMA-ScR-guided search was conducted for North American, European and Australian articles in English/French in the OVID-MedLine, Scopus, and PsycInfo databases. Two independent reviewers screened the titles/abstracts of 2010 articles and full-text screened 77 articles; 15 of which were specifically related to ELCC. If the two reviewers could not agree to the relevance of a given study, a third reviewer provided guidance. This third reviewer also screened French articles. Thematic and descriptive reports of the studies were presented. We reported solely on pre-Coronavirus Disease pandemic ELCC studies. We included ten articles in this review, which provide evidence that ELCC staff have variable baseline knowledge, comprehension, experience, and practices in place to manage FA. ELCC staff also have limited FA-related training and experience regarding administration of epinephrine auto-injectors (EAI). Emergency Anaphylaxis Plans (EAP) were described in four studies. One study reported the parental influence on the site's food purchasing and FA management. Three studies provided educational interventions, which demonstrated increased and sustained FA-related knowledge and confidence post-intervention. Participants deemed the training beneficial and desired annual training and more FA resources to be available. Across jurisdictions, ELCC staff have provided care and administered EAI in emergencies, but training remained variable. Communication and care planning amongst ELCC staff, and parents, is crucial. Annual education, available EAI and EAPs are tools necessary for effectively managing emergencies.
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