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Which foods should a child with food allergy avoid? The role of parental knowledge in food avoidance appraisals

ABSTRACT This study explored factors that influence the accuracy of caregivers’ appraisals of the foods their children with food allergy should avoid. Seventy-two caregivers of children with food allergy completed measures of caregiver educational attainment, food allergy knowledge, food allergy worry, and a questionnaire assessing whether or not their child should avoid specific foods (the Foods to Avoid Test). Unnecessary avoidance was indicated when a caregiver reported their child should avoid a food item, even though that item was safe for their child based on their food allergy (i.e., false positive). Lack of appropriate avoidance was represented by caregivers reporting a food did not need to be avoided when it should be avoided based on the child’s food allergy (i.e., false negative). Caregivers with lower educational attainment and less food allergy knowledge and whose children were more recently diagnosed had more false-negative appraisal errors. In contrast, false-positive appraisal errors were most strongly related to parental worry about food allergy. The findings suggest that screening for food allergy general knowledge and food avoidance appraisals may help identify gaps in caregivers’ knowledge and ultimately prevent accidental exposures and/or unnecessary avoidance.