Assessment 3: A Research Proposal For:

Why are food allergies and intolerances an important issue in Australia today? A Policy Review

Introduction

Itching of the mouth, difficulty of swallowing or breathing, presence of skin rash, vomiting, diarrhea, and abdominal pain, sounds terrifying? This are the signs and symptoms of food allergy and intolerance that can be potentially avoided if proper management and policies are implemented thoroughly. Food allergy happens when the human immune system reacts to a food protein. Some scientists state that food allergies are more common in the economically developed countries due to the lack of early exposure to dirt and germs. Besides, the modern society’s over-use of antibiotics and skin-care lotions that are manufactured with addition of peanut oil (one of the most common allergens) may cause the development of food allergies in a very early age (Jeffrey, 2012). Numerous possible explanations for the widespread food allergy are already ongoing, but additional detailed researches are required in this area (ASCIA_PCC_Food_ Allergy_2019).

Background Literature Review

Food allergy are becoming a common complain experienced by many people. It is a reaction of the immune system to food substances that are not harmful such as milk and peanuts, which results in the release of histamine that causes swelling, itchiness, or inflammation of body tissues. Australian studies found that 4% of children with age up to 4 years had food allergy while 11% of newly born up to 1 year have substantiated FA, though some food allergies overcome (Peters et al., 2017). amongst highly developed countries, Australia has the maximum anaphylaxis fatality rate (Mullins et al., 2016). In the most recent decade there is

1. times upsurge in hospital admissions due to anaphylaxis related to food (Allergies | Novalac, n.d.) .This research proposal will explore about Why are food allergies and intolerances an important issue in Australia today? A Policy Review.

Aims of the Research

1. What are the impacts in the daily lives to the individuals and family affected by this condition?
2. What are the programs implemented to address this concern, how is the public health sector dealing with the issues?
3. Provide an accurate and comprehensive Policy Review on the public health context regarding food allergy and intolerances in Australia.
4. To Identify the GAP’s in Food Allergy Policies.

Research Questions

1. What are the risk factors for food allergies in all population? (Age, Sex, Ethnicities, Comorbidities, Socio-economic strata) and how it is addressed in Health Policies in Victoria.
2. What changes have occurred in food preparation and consumption behavior in communities and what is their potential relationship to the increase in food allergies?
3. What are the economic and social impacts of food allergy based on current prevalence of both mild and severe reactions?

Research merit

In this study our research questions are directed towards to fulfill the literature gaps that we found in literature review including how health policies in Australia address the risk factors for food allergies in all population, regarding the changes that have occurred in food preparation and consumption behaviour in communities and their potential relationship to the increase in food allergies and what are the economic and social impacts of food allergy based on current prevalence of both mild and severe reactions. We could find out many important points that should be included in a future health policy in food allergy in Australia. The allergy policy needs to include the possible and practicable allergy preventive measures, requirements for staff training regarding anaphylaxis and managing of adrenaline injectors. Some policy implications are running in other countries which are not included in the Australian food allergy policies, for example in Allergy Guidance for Schools in UK, it is required to show the allergen ingredients information for all food businesses including school caterers under the Food Information Regulations 2014 (Allergy Guidance for schools, 2019)

Research design and methodology

This study is a policy review. Secondary data collected from national statistics, policy documents (acts, guidelines, directives), related papers and previous studies. Selected records identified through database searching (n=150) and additional records identified through other sources (n=6). The total records identified (n= 156) and duplicate records were removed (n=26). Screening of the records done through titles and abstracts (n=130) and excluded (n=103). Full-text articles assessed for eligibility (n=27) and some full-text articles were excluded with reasons (n=10). This study is going to conduct as a group work by four group members. Group member one will do the introduction and identification of aims and designing the research process. Data collection and data interpretation will be done by the group member two and group member three will be work on gathering research findings and data analysis. Conclusion and the recommended strategies approaching would be done by the group member four.

In Australia round 10% of infants, 4-8% of children develop allergies (Allergy, 2019) . The health needs of a community may change over time. Several preventable health problems are being faced by people globally but sometimes even allergies become life threatening. Allergies are the fastest growing chronic disease in Australia. The latest report of Allergy and Immune Diseases in Australia shows that 20% of Australian population develops allergies and according to a research in children disease genetically travels. If the parents have the history of eczema, asthma, hay fever or any kind of allergy then children are more prone to food allergies. Any delay in the diagnosis of the allergy could lead to premature deaths. The severity of food allergies in children of Australia is no rarer. The recent research by Murdoch Children’s Research Institute reported that most common food allergies in children of Australia are caused by cow’s milk, peanuts, and eggs and by some seafood. Australian Government has made progress to deal with this issue by providing a proper guideline to parents. According to ASCIA (Australian Society of Clinical Immunology and Allergy) parents should introduce such foods that are known to cause food allergies so that their children should be used to such foods and develop immunity to consume them (Barry, 2019).

The burden of allergies on Australian healthcare is quite high. Reduction in quality of life and the increased death rate is experienced because of allergies. Allergies bring an increased risk of low immune system and problematic respiratory system. If the children are not used to foods like soy, sesame, tree nuts and seafood within first 12 months of their age they would likely has more chance to develop allergic reactions against them (Allergy, 2019).Overall allergies has caused 19.6% of Australian population in trouble (Orman, 2010). According to WHO guidelines, Australia needs to prevent allergies and make it a priority to reduce the effect of chronic diseases. In this context, efforts directed to supporting parents who has history of food allergies and now they are worried about their kids for further chronic ailments. Management of allergy can help in improving the wellbeing of community members. In most cases, allergies can be prevented by regulating lifestyle. Allergy is called a wicked issue because sometimes people have to compromise their quality of life. Allergies can be prevented if this complexity is addressed with the remittance of health services. For this purpose, a population health approach is needed. Incorporation with ASCIA and by implementation of healthcare guidelines can help decreasing this issue. A systematic approach that can help in aligning the efforts with the changing healthcare needs should be applied. In the present research paper, preventive measures with allergies will be discussed using Lavarack’s ladder.

Lavarack’s ladder:

Lavarack’s ladder is a community-based interaction model that helps in measuring the readiness of a community toward a specific disease. The willingness of community members to react in response to a problem is checked and then identification of engagement, participation, empowerment, and action capacity is measured. The first step in any program of health care management is to check the participation of community members whose engagement is needed. The four components of Lavarack’s ladder will help create a community engagement program for food allergies. The first stage of the Lavarack’s ladder is information sharing with listening and communication. Allergies being a preventable health concern need to be understood in the community. The main causes of allergies amongst the Australian population are lifestyle, food, genetics, and lack of knowledge about food reactions. The community should be made aware of the reasons of the disease and potential relevant health threats. For this purpose it is important to equip the healthcare workforce including doctors, paramedical staff and community health works with the necessary information.

Implementation of the food allergy prevention program needs a healthcare professional’s involvement. Listening and communication can also be improved with the involvement of print and electronic media (Laverack, 2007).

Lavarack, (2007)

Secondly, a consultation can be done with parents who had family history of food allergies by healthcare practitioners with a referral program of intervention. There is a need to bring resources in place so practical measures can be taken. Healthcare workers can communicate with the larger society to improve their understanding of this health issue. These measures can make community members understand the absolute risk they can face by this preventable health condition. Along with this, improvement of participation of all stakeholders including community members, civic actors, healthcare teams, agencies, and community health centers can also help greatly. When participation is performed from all these stakeholders the outcomes of an initiative improve (leverak, 2007). The Australian government, department of health, food and industry consumer groups, WHO, and other government and private organizations are already working. These organizations can be brought at one platform to reduce the gaps present in the information system. Finally, the empowerment of new parents should be done by equipping them with appropriate guidelines to fight the issue of food allergies in infants and children. People who are involved in the system should express their opinions and concerns about this initiative. In addition to this, community clinics and healthcare centers can be involved to look into the gravity of the situation so suitable measures for prevention can be taken.

Liberato community capacity building

Liberato takes on the approach of community capacity building by assessing and finding general access within the community group with the help of analysis, assessment, defining, and taking action according to required health needs. A better distribution of resources can help in improving the capacity building of the community. Several tools are associated with community capacity building but here the study of Liberato (2004) will be used for conceptualization. The capacity building can be reinforced by focusing on nine domains of Liberato that include networking, linkage, community leadership, participation in decision making, development of pathway, communication resource mobilization, asset creation, learning, and skill development.

The first element of the Liberato capacity-building approach is problem assessment. Problems assessment is crucial for a successful plan because it helps in finding the most suitable solutions and actions for a community. In most of the committee, the main reason for food allergies in children is by sharing unhealthy food, low immunity toward natural proteins, a sedentary lifestyle, and late diagnosis of main issue. Moreover, children who were fed with improper allergic foods without following any guidelines develop risk of future food allergies (Liberato, 2004). Identification of such factors will help in appropriate problem assessment based on which a suitable plan can be devised. Afterward, the participation of community members, civic actors, and leaders are needed to identify the main causes of food allergies in children and defining practices to solve them. For instance, if in a community there is less ratio and encouragement of breastfeeding kids until 2 years of age then leaders and civic actors can promote breastfeeding kids until 2years or minimum 6months of age because it also helps in reducing allergic risks. In such a situation improving social networking to create awareness and participation of different groups can help in developing good lifestyle advice. Participants must work together to improve the chances of success of the prevention program of food allergies in children. Improved communication with resource mobilization will bring a targeted solution to food allergy issues within the community. Leadership is another important element. Networking cannot be made successful until there is effective leadership. A sense of direction and control is created with proper leadership where community members feel more connected (Liberato, 2004). These people will mobilize resources in the right direction. Here, the role of leadership can be adopted by doctors and community health workers. People can work in small groups with a community leader so problems can be identified and services to the most vulnerable population can be provided. Also, community organization is needed to make people aware of the health concerns they may face in association with a specific problem. This will help individuals to get motivated and take action. Under suitable leadership, organizations can be created for better participation of community members. In addition to this, institutes that are already working must also be involved. In Australia Australian government, the department of health is using a different approach to promote changes in lifestyle that can help fight food allergies in children. The involvement of such institutes can help in better organization of people toward a cause.

Educational approach:

The approach selected for food allergy prevention in children is the educational approach. This approach is directed to make people educated and informed about their healthcare choices so they can bring a change in their attitude. Behavioral change is necessary for the prevention of practices that lead to food allergies in children. There can be various socio-economic and environmental factors that can affect this change. However, evaluation of attitude, knowledge, and practice regularly can prove to be helpful to make this approach more effective (Fenton, 1999). The educational approach can be applied to improve inter-professional and personal learning attitudes. Frontline health care providers, community, and civic actors can help in changing behaviors. Improvement in the professional skills of new parents or people who are new to parenthood is needed so they can care for allergies and those kids who are at risk of increased food allergies. The training of these people can be identified and programs can be generated for inter-professional learning. The more useful content should be brought in place to improve the knowledge of community members. The program for education and training of healthcare professionals and community leaders can be named as ‘continued professional development’. It must include activities such as small and large group meetings, seminars, conferences, and presentations (Davis, 1999). Other interactive learning models can able be included such as small group discussions and individualized training with lectures and symposia. People who are trained with such programs should develop a network within the community that can help in the creation of a positive impact on competence and knowledge. Inter-professional training programs will involve healthcare professionals who will directly involve in improving practices of healthcare for better patient outcome. The report published by Healthy eating advisory service talks about such policies that would help to deal with food allergies in children. Combined educational formats can be used and the learning process is optimized. Information about educational activity is shared on various fronts. Healthcare professionals can train community leaders keeping in view the aim of the food allergy prevention program. In this regard, strong networking can help greatly.

Advantages and disadvantages of the program:

With the educational approach, and insight in professional skills is developed and challenges to a specific problem are identified. Frontline healthcare teams can equip them to bring effective care for those children who are at risk of getting food allergies. The design and content of the course can be arranged in a way that can help guide future aims regarding the care of children in case if there are history of allergic reaction in child’s family (Sanchez, 2018). Like all other approaches, the educational approach can have its disadvantages as well. For instance, lack of participation can result in potentially modifiable results. Limited representation from community members can also decline the outcomes of the program.

Furthermore, professional training in the field of food allergies in children, training is very limited so the chances of lack of availability of appropriate guidance course content and prevention methodologies can be challenging (Wallace, 2016).

Plan to communicate and disseminate the research

There are some principles of good research dissemination. The output of the research should be appropriately formatted. The audience might be from various levels, such as regional, local or national. For example, the current research report is about food allergies and intolerances for which the audience can be both regional and national as the issue is prevalent all throughout Australia. The use of language in the research should be accessible for all audience (Nihr, 2019). Identifying the target audience and engaging with them is very important. The audience should feel engaged and connected throughout the research. Communicating with the audience from the very beginning until the dissemination of findings is important. The audience should feel attracted to the output, and the output should be worth waiting as well. The research on the food allergies and intolerances is an important issue for the public for their health and well-being and therefore, the research is written in a very informative way that can attract the reader to read from the beginning to the end of the report. 

Dissemination is referred to as a process of communication through which the targeted audiences receive the findings of the research. It takes into account the involvement of the audiences, interaction with policies that are emerged for the target audiences (Rzheuskyi, 2018). For disseminating the findings on the research of food allergies and intolerances as an important issue in Australia, the research can be published in newspaper both digital and print as short article or can be published in health magazines. 

Unlike the uninterested audiences who will study the research, other audiences who will develop a deep interest will be the one who is the scholars and studying the particular topic along with others who have a common interest. Therefore, the research can be published in journal paper for a peer review or can be published from the university library and can be made open source for those interested to read papers on food allergies. The research should engage interested scholars. Representatives of central and state should make the policies and constituent speak on the interest policy should be heard. The public should reach the findings of the research through websites, conferences, and journals, social or traditional media. 

Conclusion of the complete report

From the above discussion, it is clear that food intolerance and food allergies have created significant health issues among Australians. It causes difficulty in breathing, swallowing, skin rash, diarrhoea, abdominal pain and vomiting. Reducing food allergy among children requires conducting food allergy preclusion program. A significant amount of research is needed in the area for developing an effective plan and raising awareness among parents and children for preventing food allergies. It needs the development and implementation of appropriate policies and programs for enhancing the delivery of quality products and services. Different perspectives and processes, which influence the changing care model, needs to be checked. It is important to offer effective educational and training programs to the community so that effective care can be given to the children. The frontline healthcare workers are encouraged to take part in the process of raising awareness and enriching knowledge of the communities and societies regarding food allergies among children. Effective plans can help in developing a proper diet for the children for supporting them in developing a healthy food habit and avoiding allergies. The focus should be given on the issue both in terms of present and future. The food allergy prevention program and education must be implemented in such a way that it brings only advantages to the community. Lack of active participation can reduce the effectiveness of the programs. Therefore, active participation of health care professionals and frontline healthcare workers is mandatory for increasing awareness of food allergies and preventing its occurrences among children.

GANTT chart describing the tasks and time-frames for the project

For Research proposal: 

For Research Report: