The management of children’s food allergy in childcare centres, preschools, and schools: a scoping review

Background: There are very few reviews on how children’s food allergy is managed across various educational settings, and none have considered psychological support in addition to child safety. This scoping review aimed to understand interventions to manage food allergy, addressing children’s safety and psychological support in childcare centres, preschools, and schools. Methods: Following the JBI methodology for scoping reviews and applying the PCC (population, concept, and context) mnemonic, a search was conducted via Medline (Ovid), Embase (Ovid), CINAHL (EBSCOhost), ERIC (ProQuest), PsychInfo (EBSCOhost), Scopus, and ProQuest Dissertations and Theses (ProQuest). Furthermore, two supplementary searches were conducted: first, backward citation tracking of all publications included in this review; and second, a search of seven peak allergy organisation websites, including Allergy & Anaphylaxis Australia and the World Allergy Organization. Findings: Eighteen publications were included from 6812 records retrieved from the databases. Most publications were from the United States of America (61%), representing food allergy management mainly in schools (39%), followed by preschools (22%), childcare centres (17%), and mixed settings (11%). All the interventions focused on child physical safety, largely neglecting psychosocial support for children or their families, and only four publications reported the use of control groups to test intervention benefits (22%). Furthermore, safety-focused interventions were centred on building educator or staff knowledge of food allergy and their skills, confidence, and self-efficacy to manage it (72%); these were found to be highly effective. Most interventions were aimed at adults, and none considered children. Interpretation: The findings suggest a need for more research on food allergy management involving child-focused, developmentally appropriate approaches, especially in childcare and preschool settings. There is also a need for research on psychological support, particularly that which involves control groups and encompasses different nations.