Impact of a nationwide web-based training program on food allergy knowledge and perceived competences management in...

Background. Food allergy (FA) is a growing public health concern among school-aged children. Schools are high-risk settings for accidental exposures and anaphylaxis, yet staff frequently report insufficient preparedness to manage such emergencies. Educational programs are essential to improve knowledge, confidence, and preventive practices. This study aimed to develop and evaluate a nationwide web-based FA training program for school professionals, aimed at improving knowledge and perceived competence in FA management. Methods. A quasi-experimental interventional study was conducted among 639 Portuguese school professionals, of whom 477 completed FA questionnaires. Participants were in pre-test (n = 172), post-test (n=100), and pre-post groups (n = 205). The intervention was an online program based on guidelines from the European Academy of Allergy and Clinical Immunology, Portuguese education and health authorities, and a national FA manual. FA knowledge was assessed with a 26-item validated questionnaire covering general concepts, allergen avoidance, and school practices. Perceptions of competence were gauged using Likert scales. Statistical analysis used General Linear Model repeated measures. Results. Knowledge scores increased significantly from baseline (62.1%) to post-intervention (79.6%) (p < 0.001). The most significant gains were observed in anaphylaxis management (+35.6%), bullying awareness (+42.4%), and prevention of accidental exposures. Perceived competence in allergen identification, label reading, and exposure prevention also improved significantly (p < 0.001). Conclusions. This nationwide web-based program substantially enhanced school staff's FA knowledge and perceived competence, addressing critical gaps in emergency preparedness. Its scalability supports integration into national and international school health policies to improve safety and inclusion for children with FA.