Food Allergy Management: Training Innovations. Kevin Sauer, PhD, RDN, LD
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1 Food Allergy Management: Training Innovations Kevin Sauer, PhD, RDN, LD
2 AFFILIATION OR FINANCIAL DISCLOSURE Kevin Sauer, PhD, RDN, LD Associate Professor: Kansas State University Researcher: Center of Excellence for Food Safety Research in Child Nutrition Programs
3 AFFILIATION OR FINANCIAL DISCLOSURE The Center has been funded, in part, with Federal funds from the U.S. Department of Agriculture. The contents of this presentation do not necessarily reflect the views or policies of the U.S. Department of Agriculture nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government or the Center.
4 Center of Excellence Kevin Roberts, PhD Center Director Associate Professor Carol Shanklin, RD Dean of the Graduate School Paola Paez, PhD Research Associate Professor Kerri Cole Project Coordinator Graduate Research Assistants Michelle Alcorn, MS Tracee Watkins, MBA
5 Session Objectives Objective 1: gain knowledge about current food allergy management practices in schools Objective 2: learn about useful training strategies, including a recently developed behavior-based video to capture employee attention for facilitating best food allergy management practices Objective 3: understand how to inform and influence stakeholders throughout the school environment about the importance of food allergies
6 Overview Food allergy - a potentially serious immune response to eating or otherwise coming into contact with certain foods or food additives. A food allergy occurs when the immune system: 1) identifies a food protein as dangerous and creates antibodies against it; 2) tries to protect the body against the danger by releasing substances, such as histamine, into our blood when that food is eaten.
7 Overview The reaction to a food allergy can mild to life-threatening. Some of the symptoms or signs that might occur include: A tingling sensation in the mouth Swelling of the tongue and throat Difficulty breathing Itchy skin/hives Drop in blood pressure Loss of consciousness These complications can sometimes lead to death
8 Overview Eight (8) foods cause ninety (90) percent of the food allergic reactions in the United States: Milk Peanuts Tree Nuts Eggs Wheat Fish Soy Shellfish
9 Overview Increased presence of students with food allergy; 18% increase (children under 18) Better/more diagnosing? Hygiene Hypothesis? Teens are the highest risk group for fatal allergic reactions Emergencies are inevitable Proactive approach rather than reactive
10 Overview The only known prevention is food avoidance Anaphylaxis is a serious possible life-threatening allergic reaction Rapid onset If not treated, can lead to death in a matter of minutes Not all food allergic reactions result in anaphylaxis Epinephrine by injection is the treatment for a serious reaction Administration is key a delay can be deadly
11 Broad Discussion Multi-faceted issue in schools 25% of children Many diverse stakeholders Guidance USDA: Accommodating Children with Special Dietary Needs in the School Nutrition Programs Guidance for School Food Service Staff. CDC: Food Allergies in Schools ICN: several great resources
12 Broad Discussion What nation-wide interviews tell us Relationships are important Loyalty Social media School Nutrition Directors Training Dealing with multiple allergies Expertise Am I the best? Communication External, internal, with parents Recalls, allergen-based
13 2014 Study Current Findings Determine current practices and challenges for managing food allergies in schools, specifically those challenges: during key points of food production with food vendors and with recall communication, with USDA foods, and with personnel training Determine the incidence, nature of, and response to food allergic reactions Survey of national directors (n = 5,592)
14 Current Findings Frequency of Schools Providing Meals to Students with Allergies to the Top Eight Food Allergens (N=390) Yes No Unsure Peanuts 375 (96.9) 10 (2.6) 2 (0.5) Milk 363 (96.0) 10 (2.6) 5 (1.3) Tree nuts 298 (88.7) 27 (8.0) 11 (3.3) Wheat 297 (87.4) 36 (10.6) 7 (2.1) Eggs 274 (80.6) 52 (15.3) 14 (4.1) Soy 206 (72.8) 56 (19.8) 21 (7.4) Fish 198 (66.7) 78 (26.3) 21 (7.1) Shellfish 174 (62.6) 77 (27.7) 27 (9.7) Other 94 (72.3) 22 (16.9) 14 (10.8)
15 Current Findings Frequency of Students Accommodated per Food Allergen (N=301) Number (%) >200 Peanuts 2 (7.0) 137 (45.5) 71 (23.6) 37 (12.3) 24 (8.0) 9 (3.0) 8 (2.7) 13 (4.3) Milk 1 (0.3) 159 (54.5) 65 (22.3) 36 (12.3) 17 (5.8) 4 (1.4) 3 (1.0) 7 (2.4) Tree nuts 3 (1.3) 127 (54.3) 44 (18.8) 27 (11.5) 13 (5.6) 9 (3.8) 6 (2.6) 5 (2.1) Wheat (63.9) 45 (19.3) 24 (10.3) 12 (5.2) 2 (0.9) 1 (0.4) - Eggs (74.0) 29 (13.5) 13 (6.0) 11 (5.1) 2 (0.9) 1 (0.5) - Soy 3 (1.8) 124 (74.3) 24 (14.4) 8 (4.8) 7 (4.2) 1 (0.6) - - Fish 2 (1.4) 108 (73.5) 22 (15.0) 10 (6.8) 2 (1.4) - 3 (0.6) - Shellfish 3 (2.3) 100 (75.2) 16 (12.0) 9 (6.8) 2 (1.5) - 3 (2.3) -
16 Current Findings School Personnel Allowed to Administer Epinephrine (N=480) Number (%) Yes No School Nurse 307 (64.0) 173 (36.0) School Administrator 155 (32.3) 325 (67.7) Teachers 146 (30.4) 334 (69.6) School Nutrition Employees 81 (16.9) 399 (83.1) Other 92 (19.2) 388 (80.8)
17 Current Findings Personnel Responsible for Maintaining Food Allergy Documentation (N=293) Number (%) Registered Nurse 169 (57.7) District Nutrition Director 48 (16.4) Other 31 (10.6) School Nutrition Manager 25 (8.5) Registered Dietitian 20 (6.8)
18 More Perspective Foodborne Illness 1 in 6 Food Allergy 1 in 13 children 48 million 15 million 128,000 hospitalizations 3,000 deaths annually CDC 200,000 ER visits 300,000 care visits 63 to 99 deaths annually CDC, FARE
19 More Perspective Food Safety Plan and Master Plan Food Allergy Plan Food Safety Food Allergy
20 More Perspective Foodborne Illness Prevention Time Temperature Sourcing Training Cross-contamination Handwashing HACCP Food Allergic Reaction Prevention Time? Temperature? Sourcing? Training Cross-contact Handwashing HACCP? Hazard Analysis
21 Achieving Food Safety Traditional Approach-- Command and Control Regulation Standard setting Enforcement Food Safety Culture Behavior-based food safety management system Integrates food science and behavioral science
22 What is Culture? What does culture mean within an organization? Characteristics of culture Shared knowledge, beliefs, values, attitudes, meanings A way of life Patterns of behavior Learned behavior of a group of people Transmitted from generation to generation
23 What is your district s culture? Our school district has a rigorous food safety policy that covers all food served in schools. Q: Does our school district has a rigorous food allergy policy? Are the district superintendent, teachers, and others committed to food allergies?
24 What is your district s culture? Does the school nutrition program have a behavior-based food allergy management program? Are food allergies a core consideration when making decisions about menus, procurement, service, and staffing? Do facilities and equipment support food allergy management?
25 What is your district s culture? Do foodservice managers in our schools value food allergies and serve as good role models? Do parents and others view our schools as providing safe food for students?
26 Known Strategies Talk to parents and include them Identify the student Do students know HOW to watch and notify others? Learn to recognize the symptoms for foods that commonly cause allergic reactions Read and monitor ingredient labels for all foods Create a separate storage space for allergy-free foods
27 Known Strategies Prepare the kitchen, avoid cross-contact Designate one or two people to be responsible, BUT TRAIN EVERYONE Communicate with the serving line staff Communicate with the school nurse and classroom staff Encourage thorough hand washing - throughout
28 Training Strategies Guidance USDA: Accommodating Children with Special Dietary Needs in the School Nutrition Programs Guidance for School Food Service Staff. CDC: Food Allergies in Schools ICN: several resources
29 Training Strategies Behavior change Knowledge + Attitudes Barriers = Behavior Change
30 Training Strategies Behavior change through stories Persuasive Emotion and conflict Stimulate cognitive curiosity Motivate employees to probe further Develop mental solutions
31
32 NEW Caitlin Remembered
33 PROFESSIONAL STANDARDS CODE This session provides one (1) CEU Presentation Key Area: 1 - Nutrition Professional Standards Code: 1160
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