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Resources to Integrate CDC Voluntary Guidelines for Managing Food Allergies into Practice Zanie Leroy, MD, MPH Medical Officer, CDC Robin Wallin, DNP, RN, CPNP, NCSN Director of Health Services, Parkway Schools American School Health Association Conference October 16, 2015 National Center for Chronic Disease Prevention and Health Promotion Division of Population Health School Health Branch Objectives Describe the Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Education Programs. Understand how the Knowledge to Action Framework was used to create specific CDC food allergy research translation materials to reach key target audiences. Evaluate the audience specific food allergy resources for use in the school setting 2 Background 4% of students are affected by food allergies, and the incidence is increasing 1,2 1 in 5 students with food allergies will have a reaction while at school 3,4 25% of severe food allergy reactions at school happen to students with no previous known food allergy 3,4 3 1

Priority Recommendations for Schools 1. Ensure the daily management of food allergies in individual children. 2. Prepare for food allergy emergencies. 3. Provide professional development on food allergies for staff members. 4. Educate children and family members about food allergies. 5. Create and maintain a healthy and safe educational environments. http://www.cdc.gov/healthyschools/foodallergies/index.htm 4 Guidelines Contents Section 1- Food Allergy Management in Schools and Early Care and Education Programs Section 2 - Actions for School Boards and District Staff Section 3 - Actions for School Administrators and Staff Section 4 - Actions for Early Care and Education Administrators and Staff Section 5 - Federal Laws and Regulations Section 6 - Food Allergy Resources 5 Actions for School Administrators Lead school s planning for managing food allergies. Oversee the daily management of food allergies for students. Prepare schools to be ready to respond to food allergy emergencies: Ensure that responding to food allergy emergencies is a part of each school s emergency plan. Set up an easy-to-use communication system for staff who may need to respond to food allergy reactions and emergencies. 6 2

Actions for Entire School Team Get trained and know how to respond to food allergy emergencies! If anaphylaxis is suspected, act! Plan! 7 Actions for School Teachers and Paraeducators Help manage food allergies at school. Help prevent food allergy emergencies! Create and maintain a healthy, safe and inclusive classroom! Create and maintain healthy, safe and inclusive eating environments! Carefully plan field trips! 8 School Nutrition Professionals Help prevent food allergy reactions in the cafeteria. Develop and follow procedures for handling food allergens in the cafeteria 9 3

School Mental Health Professionals Help with the daily management of students with food allergies. Support a healthy and safe school environment for students with food allergies. 10 School Transportation Staff Help prevent food allergy emergencies. Support healthy and safe transportation. Take immediate action if a severe food allergy reaction is suspected. 11 Translation Project Goals To develop research translation tools and resources for key stakeholders, to support greater dissemination of the Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Educational Programs. To inform technical assistance provided to CDC funded partners about food allergy management in schools. 12 4

Translation Methods and Process Environmental Scan Stakeholder Engagement School Nurse Focus Group Discussion with School and Stakeholder Contacts Stakeholder and Content Expert Review 13 School superintendents School administrators Priority Target Audiences Teachers and paraeducators School nutrition professionals School mental health professionals School transportation staff School nurses 14 NCCDPHP Knowledge to Action Framework for Public Health* * Source: Wilson KM, et al., on behalf of the National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) Work Group on Translation. An organizing framework for translation in public health: the Knowledge to Action Framework. Prev Chronic Dis 2011;8(2) http://www.cdc.gov/pcd/issues/2011/mar/10_0012.htm Accessed 9/24/2015. 15 5

Translation Methods and Process Environmental Scan Stakeholder Engagement School Nurse Focus Group Discussion and collaboration with School and Stakeholder Contacts Stakeholder and Content Expert Review 16 17 A DEEPER DIVE 18 6

CDC Food Allergy Toolkit for Schools 6 audience-specific tip sheets 6 audience-specific customizable PowerPoint presentations 7 audience-specific podcasts Select Resources list for schools 19 School Audiences Administrators Superintendents Nutrition Professionals Teachers and Para-educators Mental Health Professionals Transportation Staff School Nurses 20 21 7

FARE Webinar http://www.foodallergy.org/cdc/toolkit 22 POWERPOINT PRESENTATIONS http://www.cdc.gov/healthyschools/foodallergies/toolkit.htm 23 Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Education Programs 24 8

Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Education Programs 25 Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Education Programs 26 Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Education Programs 27 9

Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Education Programs 28 Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Education Programs 29 AUDIENCE SPECIFIC TIP SHEETS 30 10

Audience Specific Tip Sheets http://www.cdc.gov/healthyschools/foodallergies/toolkit.htm 31 AUDIENCE SPECIFIC PODCASTS 32 Podcasts Mental Health Professionals http://www.cdc.gov/healthyschools/foodallergies/toolkit.htm 33 11

Podcasts School Nurses The leadership role of school nurses in the management of food allergies in schools http://www.cdc.gov/healthyschools/foodallergies/toolkit.htm 34 Reflections and Lessons Learned 35 http://www.cdc.gov/healthyschools/foodallergies/pdf/resources_508_tagged.pdf 36 12

References 1 Branum AM, Lukacs SL. Food allergy among U.S. children: trends in prevalence and hospitalizations. NCHS Data Brief. 2008;10:1-8. 2 Liu AH, Jaramillo R, Sicherer SH, et al. National prevalence and risk factors for food allergy and relationship to asthma: results from the National Health and Nutrition Examination Survey 2005-2006. J Allergy Clin Immunol. 2010;126(4):798-806.e13. 3 Nowak-Wegrzyn A, Conover-Walker MK, Wood RA. Food-allergic reactions in schools and preschools. Arch Pediatr Adolesc Med. 2001;155(7):790-795. 4 McIntyre CL, Sheetz AH, Carroll CR, Young MC. Administration of epinephrine for life-threatening allergic reactions in school settings. Pediatrics. 2005;116(5):1134-1140. 5 Sicherer SH, Furlong TJ, DeSimone J, Sampson HA. The US Peanut and Tree Nut Allergy Registry: characteristics of reactions in schools and day care. J Pediatr. 2001;138(4):560-565. 6 Lieberman J, Weiss C, Furlong TJ, Sicherer SH. Bullying among pediatric patients with food allergy. J Allergy Clinical Immunol. 2010;105:267-271. 7 Cummings AJ, Knibb RC, King RM, Lucas JS: The psychosocial impact of food allergy and food hypersensitivity in children, adolescents and their families: a review. Allergy. 2010;65:933-945. Sofaer, S., Talis, N., Edmunds, M., Papa, K. (August 2013). Navigating the Translation and Dissemination of PHSSR Findings: A Decision Guide for Researchers. Academy Health. Retrieved from http://www.academyhealth.org/files/tdguidephsr.pdf 37 Where can you find more information? Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Education Programs www.cdc.gov/healthyyouth/foodallergies/ Allergyhome.org resources for schools http://www.allergyhome.org/schools/ Food Allergy Resource and Education (FARE) http://www.foodallergy.org/resources/schools Michigan State University Extension, Alternatives to Using Food as a Reward. http://www.michigan.gov/documents/mde/foodrewards_290201_7.pdf National Association of School Nurse (NASN), Food Allergy and Anaphylaxis Tool Kit. http://www.nasn.org/toolsresources/foodallergyandanaphylaxis NEA Health Information Network. Food Allergy Book: What School Employees Need to Know. http://www.neahin.org/educator-resources/foodallergybook.html 38 Where can you find the guidelines and K2A Framework? Centers for Disease Control and Prevention. (2013). Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Education Programs. Washington, DC: US Department of Health and Human Services. http://www.cdc.gov/healthyyouth/foodallergies/pdf/13_243135_a_food_allergy_web_ 508.pdf Wilson, K.M, Brady, TJ, Lesesne, C,on behalf of the NCCDPHP Work Group on Translation. (2011). An organizing framework for translation in public health: the Knowledge to Action Framework. Preventing Chronic Disease, 8(2):A46. http://www.cdc.gov/pcd/issues/2011/mar/10_0012.htm Wilson, K. M., & Fridinger, F. (2008). Focusing on public health: a different look at translating research to practice. Journal of Women's Health, 17(2), 173-179. 39 13

QUESTIONS? Zanie Leroy - zleroy@cdc.gov Robin Wallin - rwallin@pkwy.k12.mo.us 40 For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA 30333 Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348 E-mail: cdcinfo@cdc.gov Web: http://www.cdc.gov The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. National Center for Chronic Disease Prevention and Health Promotion Division of Population Health School Health Branch 41 14