Development of a food allergy education resource for primary care physicians.

BACKGROUND: Food allergy is estimated to affect 3-4% of adults in the US, but there are limited educational resources for primary care physicians. The goal of this study was to develop and pilot a food allergy educational resource based upon a needs survey of non-allergist healthcare providers. METHODS: A survey was undertaken to identify educational needs and preferences for providers, with a focus on physicians caring for adults and teenagers, including emergency medicine providers. The results of the survey were used to develop a teaching program that was subsequently piloted on primary care and emergency medicine physicians. Knowledge base tests and satisfaction surveys were administered to determine the effectiveness of the educational program. RESULTS: Eighty-two physicians (response rate, 65%) completed the needs assessment survey. Areas of deficiency and educational needs identified included: identification of potentially life-threatening food allergies, food allergy diagnosis, and education of patients about treatment (food avoidance and epinephrine use). Small group, on-site training was the most requested mode of education. A slide set and narrative were developed to address the identified needs. Twenty-six separately enrolled participants were administered the teaching set. Pre-post knowledge base scores increased from a mean of 38% correct to 64% correct (p < 0.001). Ability to correctly demonstrate the use of epinephrine self injectors increased significantly. Nearly all participants (>95%) indicated that the teaching module increased their comfort with recognition and management of food allergy. CONCLUSION: Our pilot food allergy program, developed based upon needs assessments, showed strong participant satisfaction and educational value.

Risky eating behaviors of young adults-implications for food safety education.

Young adults engage in risky eating behaviors like eating raw/undercooked foods of animal origin that put them at increased risk for foodborne disease. This cross-sectional survey assessed the self-reported risky eating behaviors of young adults enrolled in higher education as a part of a large-scale survey administered over 10 months. Participants (N=4,343) completed a risky eating questionnaire by indicating which of the foods listed they consumed (the list included a random sequence of foods that are considered safe or risky to eat). Each risky food consumed earned one point, with the risky eating score calculated by summing points earned (range 0 to 27). Higher scores indicated more risky eating behaviors. Food safety knowledge and self-efficacy and stage of change for safe food handling were also assessed. Mean risky eating score (5.1+/-3.6) indicated that young adults consumed risky foods. Male respondents and whites consumed more risky foods compared with female respondents and nonwhites, respectively. As stage of change (movement to higher stages) and self-efficacy increased, risky eating score decreased; those who believed food poisoning was a personal threat tended to eat fewer risky foods. Regression models indicated that the strongest predictor of risky eating was self-efficacy score followed by stage of change. These variables, together with sex and race, explained about 10% of the variance in risky eating score. Although food safety knowledge correlated weakly with risky eating score, it did not significantly predict it. Efforts to improve current food-handling behaviors and self-efficacy through education are important to reduce prevalence of risky eating behaviors within this population.

Calcium intake of Asian, Hispanic and white youth.

OBJECTIVE: To examine calcium intake and food sources among Asian, white and Hispanic youth, in order to develop and target interventions to improve calcium intake. METHODS: Cross-sectional survey with two 24-hour dietary recalls one week apart. Calcium intake was evaluated in 167 male and female adolescents of Asian, Hispanic and white ethnicity, ages 10-18 years, from six states. Main outcome measures were mean daily calcium intake (mg/day). STATISTICAL ANALYSES PERFORMED: t tests, Chi-square and analysis of variance for differences by age, ethnicity and gender, multiple regression of factors influencing calcium intake. RESULTS: Overall median calcium intake was 938 mg/day with 868 mg/day for Asians, 1180 mg/day for whites and 896 mg/day for Hispanics. Daily milk intake was the primary predictor of calcium intake with Asian ethnicity and female gender each showing a negative association to calcium intake in multiple regression models. CONCLUSIONS: Milk intake was the primary factor positively influencing calcium intake, while Asian ethnicity and female gender negatively influenced calcium intake. Thus, interventions to improve calcium intake should focus on improving milk intake of Asians and females.

Perspectives on intake of calcium-rich foods among Asian, Hispanic, and white preadolescent and adolescent females.

OBJECTIVE: Declining calcium intake among adolescents warrants attention. Our objective was to identify influences on adolescents' consumption of calcium-rich foods. DESIGN: Focus groups were conducted with girls representing 2 age groups (11 to 12 or 16 to 17 years) and 3 macroethnic groups (Asian, Hispanic, or white). SETTING: Public schools in 10 states. PARTICIPANTS: A convenience sample (n = 200) was recruited through schools. VARIABLES MEASURED: Focus groups (n = 35) were audiotaped and transcribed. Influences relative to consumption of milk or other calcium-rich foods were identified. ANALYSIS: Comments were coded as motivators or barriers within each focus group. Content analysis procedures were used to compare ethnic and age groups. RESULTS: A barrier to milk consumption that was more common among older girls and Asian groups was the limited expectation within families for drinking milk. Many controlled their own beverage choices, and milk, even if liked, was only one option. Milk was positively associated with strength and bone health, but these attributes were viewed as being more important for boys than girls. Milk was associated with breakfast, school lunches, cereal, and desserts. White girls had the most positive reactions to milk and Hispanic girls the most negative. All groups were positive toward pizza, ice cream, and cheese. CONCLUSIONS AND IMPLICATIONS: To improve calcium intake among teens, interventions should include a family component, stress the benefits of milk for girls, and focus on breakfast.