249 - Pediatric Clinicians’ Knowledge of Infant Peanut Introduction Guidelines Following iREACH Training Modules

Poster Number: 249
Publication Number: 249.418

Ruchi S. Gupta, Northwestern University The Feinberg School of Medicine; Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Jialing Jiang, Northwestern University The Feinberg School of Medicine, Chicago, IL, United States; Anahita Iyer, Northwestern University The Feinberg School of Medicine, Chicago, IL, United States; Haley Hultquist, Northwestern University The Feinberg School of Medicine, Chicago, IL, United States; Richard D. Cohn, Independent Consultant, Chapel Hill, NC, United States; Khalid Ibrahim, Northwestern University The Feinberg School of Medicine, Chicago, IL, United States; Sirisha Yeddula, Northwestern University The Feinberg School of Medicine, Naperville, IL, United States; Tegan M. Morcott, Northwestern University The Feinberg School of Medicine, Chicago, IL, United States; Lucy A. Bilaver, Northwestern University The Feinberg School of Medicine, Chicago, IL, United States

Background: The 2017 NIAID Addendum Guidelines for the Prevention of Peanut Allergy recommend early introduction of food containing peanuts to infants. Barriers to implementing the guidelines include insufficient knowledge.

Objective: This study aims to measure the effectiveness of a training video to improve pediatric clinicians’ knowledge of the guidelines.

Design/Methods: A training video was developed for the Intervention to Reduce Early (Peanut) Allergy in Children (iREACH). iREACH seeks to increase pediatric clinicians’ knowledge of the guidelines and lower the incidence of peanut allergy. Pediatric clinicians (n=185) from 16 practice sites in Illinois participated in this training and survey. The video summarized the guidelines, a clinical decision support tool, and classifications of eczema. Pediatric clinicians completed a multiple-choice survey consisting of seven clinical scenarios designed to assess guideline knowledge before and after the training. Before the training, pediatric clinicians were also surveyed on their awareness and implementation of guidelines. Differences in the percentage of pediatric clinicians who answered items correctly in the pre- vs. post-training survey were assessed via McNemar’s test.

Results: Overall, 100% of pediatric clinicians completed the surveys and training. Before training, 89% of pediatric clinicians were aware of the guidelines and 78% reported partial or full implementation of the guidelines. 
In assessing knowledge of the guidelines prior to training, 85% of pediatric clinicians correctly identified recommendations for infants at low risk of developing peanut allergy (no eczema and food allergy), 70% correctly identified recommendations for infants at moderate risk (mild-to-moderate eczema), and 82% correctly identified recommendations for infants at high-risk (severe eczema and/or egg allergy). Additionally, the percent of correct responses to four scenarios related to the assessment of eczema and guideline recommendations ranged from 46% (when to introduce peanut-containing foods to an infant at moderate risk) to 80% (identifying severe eczema).
After training, the percent of correct responses increased significantly for all scenarios (p < 0.001). Knowledge on when to introduce peanut to an infant at moderate risk and what to recommend for an infant at high risk increased the most after the training (p < 0.001).Conclusion(s): The iREACH training video improved pediatric clinicians’ knowledge of peanut introduction guidelines. Future efforts exploring knowledge retention following use of the training video is necessary.