Beliefs and understanding of food allergy in children and adolescents aged 11-16 years in the United Kingdom

Abstract

Children and adolescents with food allergy (FA) face significant challenges in managing their condition. Adolescents are at the highest risk of FA reactions and have the highest frequency of fatal reactions. However, previous research about FA beliefs is limited. Furthermore, though previous research suggests the importance of peers, there are no previous studies that explore adolescent peers’ beliefs about FA. This thesis comprises of four studies to explore beliefs about FA in adolescents aged 11-16 years in the United Kingdom. An inductive mixed methods pragmatic approach was adopted for flexibility, with each study informing development of the next in this exploratory research. First, a systematic review of beliefs about FA in adolescents aged 11-19 years was conducted to identify previous research and gaps in knowledge. This informed development of two qualitative semi-structured interview studies in adolescents aged 11-16 years; one for adolescents with FA and one for adolescents with no clinical history of FA. The systematic review and both qualitative studies were analysed with thematic analysis (Braun & Clarke, 2008). From these findings, two scales were developed: The Adolescent Food Allergy Beliefs scale (AFAB) and the Adolescent Food Allergy Beliefs scale: Peers without food allergy (AFAB-P). Both preliminary scales demonstrate good reliability and validity. Recommendations for future research include further understanding of peer beliefs, especially where interventions include peer-education. Further understanding of the psychological impact of different FA diagnoses should be explored. The preliminary AFAB and AFAB-P, with further validation, may be useful in clinical and educational settings to identify and address beliefs to reduce risk-taking behaviour and peer stigma, and decrease the rate of reactions in this age range.