The Context of Food Allergy Management for Latino Children: Identifying Drivers of Health Disparities - PROJECT SUMMARY/ABSTRACT Pediatric food allergy (FA) is estimated to affect ~8% of children in the United States (US), with evidence of increased prevalence. Pediatric FAs disproportionately affect children of color. Latino children have increasing prevalence relative to other demographic groups, and higher rates of anaphylaxis and Emergency Department (ED) use relative to Non-Latino White children. To date, limited research has evaluated facilitators and barriers to FA management specific to Latino families. The proposed mixed-methods study will identify multi-level facilitators and barriers to FA management among Latino families to guide future intervention efforts. We will focus on community engagement and integrate community input throughout the project. In Aim 1 we will use geographic information systems (GIS) to evaluate the contextual and environmental factors associated with FA management among Latino children aged 0-12 in Greater Providence, RI. We will examine spatial patterning (Aim 1a) of FA-related ED use for Latino children to identify “hot spots” and differences within and across communities. We will develop preliminary Community Assessment Profiles (CAPs; Aim 1b), community-specific overview documents incorporating multi-method data (visual maps, quantitative data) that will provide rich detail about the retail food environment, specialist access and practice patterns, school policies, and FA-related ED use. In Aim 2 we will use qualitative methods to identify barriers to FA management related to food access, specialty care, and home and school management for Latino families. We will conduct focus groups with Latino caregivers of children with FA to probe areas such as food avoidance and purchasing habits consistent with cultural traditions, health system and epinephrine access, and perceptions of school safety. We will also conduct key informant interviews with physicians, school nurses, policy makers and community leaders to probe barriers and facilitators to FA management. In Aim 3 we will review and interpret data from Aims 1 and 2 in collaboration with our FA Community Advisory Board (FA-CAB) to inform future intervention development to promote guidelines-based FA management for Latino children in communities, health care settings, and schools (Aim 3a). We will co-create and implement a Dissemination Plan (Aim 3b) with our FA-CAB to share findings with community partners to foster engagement in intervention development and policy change to promote health equity for Latino children with FA.
