Background
Studies have identified that food allergy (FA) in children is related to poorer caregiver quality of life (QoL). However, it is unclear which interventions are most effective at improving ...outcomes for caregivers of children with FA. This review aimed to identify and determine the efficacy, acceptability and quality of interventions for caregivers of children with FA.
Methods
A systematic search of four databases was conducted to identify studies evaluating any intervention that targeted well‐being and support of caregivers of children with FA. Studies were not excluded based on design and were rated for quality using the Mixed Methods Appraisal Tool (MMAT) and the Cochrane risk of bias tool for randomized controlled trials (RCTs).
Results
Fifteen studies met the inclusion criteria: eight studies used a pre‐test/post‐test design, four studies used a post‐test design, two studies used an RCT design, and one study used a case‐control design. Seven studies were educational interventions, five were psychological interventions, and three involved peer/professional support. All interventions had high participant acceptability; some evidence for cognitive behavioural interventions in supporting mothers was observed. Educational interventions tended to be associated with improvements in FA knowledge. With the exception of three studies, most studies were assessed as poor or moderate in terms of quality.
Conclusion
There is a paucity of high‐quality research evaluating interventions to improve outcomes in parents of children with FA. Limited evidence suggests that cognitive behavioural interventions could benefit some mothers, but this has not been tested in other populations. Future research should use methodologically sound designs with validated outcome measures.
Background
Parents of children with food allergies (CwFA) experience reduced quality of life (QoL) and may have reduced access to in‐person interventions in the COVID‐19 pandemic. This trial ...developed and evaluated an online, self‐help, information provision website, aimed at improving QoL in parents of CwFA.
Methods
In a single‐blinded, randomised controlled trial (RCT), participants were randomised to either receive access to the website or a waiting‐list control. At baseline, post‐intervention (week 4) and follow‐up (week 8), measures of parental food allergy‐related QoL, depression, anxiety, stress, intolerance of uncertainty (IU) and self‐efficacy were obtained.
Results
A total of 205 participants were randomised; 97% were females, 91% white and 78% educated ≥ degree level, with a mean age of 38.95 years (SD = 6.89). 44.9% (n = 92) were retained at follow‐up. The arms did not significantly differ on any outcome at any time point. For a sub‐group of participants above the clinical cut‐off for depression at baseline, the intervention may have improved QoL. Participants reported the website content as useful and accessible, but accessed it infrequently. In baseline data, IU and self‐efficacy were significantly associated with QoL.
Conclusion
While the COVID‐19 pandemic has encouraged greater provision of online interventions, our RCT suggests this particular website is not suitable for this population in general, although future research could examine its efficacy for depressed parents of CwFA, to increase confidence that the sub‐group finding was not a Type 1 error. The baseline data suggest IU and self‐efficacy remain potential proximal targets for intervention.
Caring for a child with a food allergy can be burdensome and negatively affect parental quality of life. The mechanisms for improving quality of life in parents of food-allergic children are not yet ...understood, but recent studies have suggested that information provision can enhance self-efficacy, and in turn quality of life. The present study developed an online self-help website that aimed to improve quality of life and psychological wellbeing in parents of children with food allergy. The website was developed in consultation with parents and allergy specialists. Parents of children with food allergy (N=205) participated in a randomised controlled trial, comparing the website intervention with a waitlist control. No significant differences were found between the website intervention group and the control group between baseline and post-intervention (4 weeks) on any outcome (quality of life, depression, anxiety or stress) or in any potential mediator (self-efficacy and intolerance of uncertainty). Analysis of adherence data identified low engagement with the website, suggesting that the intervention may not have been best suited to the participating parents. Feedback recommended that the intervention would be better targeted at parents of newly diagnosed children. Study limitations are discussed.
PDF
