Safer food allergy management for adolescents
Adolescents in the U.S. have the highest risk of experiencing food-allergy related adverse events. Our objective is to develop and test methods to encourage safer food allergy management among adolescents. This study aims to test the effectiveness of text message reminders on increasing carrying rates of epinephrine. Participants in the intervention groups will either receive text messages or a combination of text messages and modest financial incentives. We will measure carrying rates by asking participants to send pictures of their epinephrine auto-injectors at random times. Our primary hypothesis is that, compared to controls, adolescents who receive text message reminders plus modest financial incentives will more consistently carry their epinephrine.
Among the 15 million people with food allergies in the U.S., adolescents experience the highest risk of adverse events, including death from anaphylaxis. Visits to one pediatric emergency department for anaphylaxis doubled between 2001 and 2006, suggesting a rapidly escalating public health burden. Despite this critical concern, there are few evidence-based strategies to improve food allergy management in adolescents, who must sustain three core prevention strategies: diligent avoidance of allergenic foods, consistent carrying of potentially life-saving epinephrine auto-injectors, and prompt administration of epinephrine in the event of anaphylaxis. The objective of this proposal is to develop and test interventions to encourage safer food allergy management among adolescents. The primary outcome is consistency of epinephrine-carrying, measured using cell phone photographs at randomly-timed check-ins. This study will be among the first to longitudinally track normative food allergy management practices and one of the first to test behavior change strategies. This study is the necessary next step toward a definitive nationwide longitudinal study of food allergy management in adolescents. In a cohort multiple randomized controlled trial (n=130), the study will include two experiments to test the effectiveness of text message reminders and financial incentives, using various incentive designs that have proven effective in prior behavioral economics interventions to encourage weight loss and smoking cessation. Based on promising preliminary data, the central hypothesis is that, compared to controls, adolescents who receive text message reminders plus modest financial incentives will more consistently carry their epinephrine.
- Study Identifier: 827073