Evaluating an online self-help intervention for parents of children with food allergies.

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.

Interventions for caregivers of children with food allergy: A systematic review.

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.