Introduction Food allergy affects up to 10% of Australian children, and living with food allergic children can be challenging for parents. This study explored parental perceptions and knowledge as they navigate a new reality of keeping their child safe. Methods Parents of children with food allergies completed an online food allergy survey in 2015. Questions explored health knowledge, skills, and attitudes (KSAs) as well as quality of life (QoL) through the inclusion of the Food Allergy Quality of Life — Parental Burden instrument (FAQL-PB). Notification of the survey included advertisements to more than 700 randomly selected Australia-wide preschools, 44 allergy specialists, and Allergy & Anaphylaxis Australia. Responses were tabulated and analysed. Results Of the 400 participants who logged on, 357 commenced the survey and 318 finished. Questionnaire analysis showed that 44.1% of parents (n = 135) hesitated to use an adrenaline auto-injector and may be influenced by a classification system where symptom severity is not universally understood. While 79% would sign up to a national Anaphylaxis Registry, intention to participate in clinical trials using vaccines was disclosed by only 56%. Allergen labelling and community acceptance continue to be the most challenging aspects of managing a food allergy, and 50% of parents reported that food allergy played a role in choosing a preschool or primary school. Overall, quality of life for participants was influenced more by gender (male) and age of the child than where they lived — capital city or regional location; however, regional participants were more frustrated over lack of appreciation relating to the seriousness of food allergy (p = 0.010). Conclusion Results highlight the need for educational strategies for both the food allergy community and public, particularly in regional areas, since there is a perceived lack of appreciation as to the seriousness of food allergy. Educational resources and relevant networks are required to support parents and caregivers in the management of children with food allergy.

Living with food allergy requires vigilance as patients and family members need to avoid allergenic food. However, mistakes can and do occur. To ensure patients and family members respond appropriately, medical professionals recognize the importance of classifying symptom severity as "mild, moderate, or severe." 1,2 However, when confronted with an adverse allergic reaction its application is mixed and this can lead to delays in the administration of adrenaline. 1,3,4 With international studies showing up to 60% of food allergy patients experiencing repeat adverse food-induced reactions in schools, restaurants, and at home, there is not only the need to recognize symptom severity, 5,6 but also improve health literacy so those who live with food allergy are empowered to make informed decisions. 7,8 This study, conducted from 2015 to 2017 over three phases, explored how four different stakeholders: Teenagers living with food allergy, parents of children with food allergy, general public, and allergy specialists classified food allergy symptoms. Phase 1 of the study engaged teenagers and parents of children living with food allergy. To maximize participation, recruitment was Australiawide, with advertisements mailed to over 700 randomly selected pre-schools as well as writing to 44 allergy specialists and the Australian patient support group, Allergy & Anaphylaxis Australia requesting promotion of the online survey.

Health-related knowledge, skills and attitudes that translate to behaviours are important foundations for healthy living. However, deficiencies in any one of these factors have the potential to impact quality of life. This study investigates how Australian children perceive and manage their food allergy as they transition through childhood onto adolescence. To measure this, children aged 12 years and under completed an online survey [under 8 years and 8–12 years] on knowledge, skills and attitudes. Although recruitment involved advertisements to over 700 Australian pre-schools, 44 allergy specialists and multiple representations to the patient support group, Allergy & Anaphylaxis Australia, completion relied on parental notification and/or guidance. Of the 139 participants recruited, 114 commenced the survey with 65 participants under 8 years (58%) and 49 between 8 and 12 years. Results showed participants recognised different ways to keep safe with children under 8 years ( N = 65) 100% cognisant of the need to check with ‘Mum/Dad’ or teachers if they could safely eat food as well as the importance of not swapping lunches, while there was a slight change in compliance for those aged 8–12 years as three (6.1%, n = 3/49) children did not see the necessity of asking an adult/teacher if a food item was safe to eat. Older children were also less likely to tell friends about their food allergy even if they thought they were having an allergic reaction, despite children under 8 years more likely to feel different to friends (38%, n = 24/64) compared to those aged 8–12 years (31%, n = 14/45). Although both groups disliked parents’ fussing, for children under 8 years, there was a strong association between this and ‘feeling different to friends'. Results from this study highlight the importance of normalising food allergy at home and in the community, so children are confident in telling others about their food allergy.

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