Assessing Parental Anxiety in Pediatric Food Allergy: Development of the Worry About Food Allergy Questionnaire
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Assessing Parental Anxiety in Pediatric Food Allergy: Development of the Worry About Food Allergy Questionnaire Stefanie Poehacker1 · Alix McLaughlin1 · Tori Humiston1 · Catherine Peterson1
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Food allergies (FAs) in children are increasingly common, and strict allergen avoidance and safety concerns place parents at risk for anxiety (Lau et al. in Pediatr Allergy Immunol 25:236–242, 2014). Assessing parental anxiety with generic instruments may not capture the unique experience of parents managing children’s FAs. This study developed and preliminarily validated the 13-item Worry About Food Allergy (WAFA) questionnaire, a measure of FA-specific parental anxiety, in an online sample of 265 parents aged 22–66 (M = 40.25) of children with FAs. The WAFA showed good internal reliability (Cronbach’s α = .89) and moderate convergent validity with other anxiety measures, indicating support for a reliable measure of a discrete, specific construct. Exploratory factor analysis indicated a single factor structure. Criterion validity was established through significant, small, positive correlations with relevant allergy variables. A coherent single factor measure, the WAFA, shows promise as a screening tool for parental anxiety in pediatric practice and FA management. Keywords Parental anxiety · Pediatric food allergy · Assessment · Measure development Recent prevalence rates for pediatric food allergy (FA) are estimated to be approximately 9% (Gupta et al., 2017), with 38.7% of children having a history of severe reactions (Gupta et al., 2011). Food allergy reactions can be life-threatening: In the US, every three minutes someone is sent to the emergency room due to a food allergy reaction (Clark, Espinola, Rudders, Banerji, & Camargo, 2011). The current management strategy for childhood food allergy is strict avoidance of the allergen, monitoring for cross contamination, carrying an epinephrine auto-injector, and yearly visits to the child’s physician (Longo, Berti, Burks, Krauss, & Barbi, 2013). Although there is increasing focus on development of novel therapies such as allergen immunotherapy, which involves repeated exposure to increasing doses of the antigen (Burks, Laubach, & Jones, 2008), a recent analysis indicated risk for adverse reactions (Nurmatov et al., 2017), and long-term effects remain uncertain. As such, current practice in FA management generally remains focused on strict avoidance and preparation for a reaction.
* Stefanie Poehacker [email protected] 1
Department of Psychology, Eastern Michigan University, 352E Science Complex, Ypsilanti, MI 48197, USA
While mortality in children with FA is relatively low, the burden on the child and the family system can be significant due to the high level of vigilance required for avoiding a food allergen and preparing for a potential reaction (Cummings, Knibb, King, & Lucas, 2010; King, Knibb, & Hourihane, 2009). Children with FA report greater separation anxiety than healthy siblings (K
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