APPEAL‐2: A pan‐European qualitative study to explore the burden of peanut‐allergic children, teenagers and their caregivers

Abstract

Background: Allergy to Peanuts ImPacting Emotions And Life (APPEAL-1) was a recent European multi-country questionnaire survey that highlighted the negative impacts of peanut allergy (PA) on quality of life. A follow-on qualitative study, APPEAL-2, further assessed the burden of PA and associated coping strategies through semistructured interviews. Objective: To gain qualitative insight on the strategies used to cope with and manage PA and the impact of these strategies on the quality of life of children, teenagers and caregivers.

Allergy to Peanuts imPacting Emotions And Life (APPEAL): the impact of peanut allergy on children, adolescents, adults and caregivers in France

“…The qualitative data collected in APPEAL-2 add detail to the findings of APPEAL-1, demonstrating wide variation in the levels of impact, and through the conceptual model, illustrating the range of coping strategies and moderators and their subsequent impact on different areas of participants' lives. As detailed in the primary APPEAL-2 paper, previous qualitative research in families of children with PA has noted similar PA-specific impacts as the current study, such as feeling excluded, the social challenges of eating in restaurants, and the lack of public awareness of PA [17]. Previous studies of PA and/or food allergy have also identified some of the same moderating factors as the caregiver conceptual model of APPEAL-2, such as the burden of meal preparation, ensuring the home is nut-free, and barriers to teenagers' transitions to independence [17].…”

“…As detailed in the primary APPEAL-2 paper, previous qualitative research in families of children with PA has noted similar PA-specific impacts as the current study, such as feeling excluded, the social challenges of eating in restaurants, and the lack of public awareness of PA [17]. Previous studies of PA and/or food allergy have also identified some of the same moderating factors as the caregiver conceptual model of APPEAL-2, such as the burden of meal preparation, ensuring the home is nut-free, and barriers to teenagers' transitions to independence [17]. The APPEAL-2 results provide further evidence that although some people with PA manage well with minimal HRQL impact; for some there is an unmet need for a treatment that reduces the impact of PA on their life.…”

“…For some there were negative impacts on relationships with their partner as they also had to avoid peanut; others reported being excluded from activities with friends because of their PA. A small number of participants (1 adult, 1 child and 3 caregivers) had experienced some bullying or teasing due to their PA; no adolescents reported any PA-related bullying. Of note, in the international APPEAL-2 study, bullying was reported by teenage participants with PA only after prompting, possibly owing to the sensitivity of the topic [17]. As was observed in the international cohort, among French participants a lower rate of bullying was observed in APPEAL-2 compared with APPEAL-1, possibly due to reluctance of participants to discuss bullying during in-person interviews or lack of direct child/adolescent reporting in APPEAL-1.…”

“…The APPEAL study was a two-stage, mixed methods (quantitative survey and qualitative interviews), crosssectional study of the psychosocial burden of PA, conducted in eight European countries (Germany, UK, France, Spain, Denmark, Ireland, Italy and the Netherlands) [15][16][17]. Details of the full APPEAL study have been previously reported [15][16][17]. This article reports the results from participants in France only.…”

Allergy to Peanuts imPacting Emotions And Life (APPEAL) study

“…Die Ergebnisse des Modells könnten außerdem zur Durchführung von Anaphylaxie-Schulungen bei Eltern von Betroffenen und erdnussallergischen Kindern, Jugendlichen und Erwachsenen hinzugezogen werden. Eine Subgruppenanalyse ergab, dass Teilnehmer mit Erdnussallergie und solche mit multiplen Lebensmittelallergien im konzeptionellen Modell über ähnliche Themen berichteten [6].…”