- Email: [email protected]
The Attitudes Toward and Beliefs About HIV Disclosure Among Perinatally-Infected HIV-Positive Youth and their Caregivers
AB98 Abstracts
385
SUNDAY
Need for Education About Sesame Allergy V. Krishna, MD, FAAAAI, S. KrishnaPhD, MBA; Asthma & Allergy Specialists, PC, Winchester, MA. RATIONALE: Sesame is increasingly being used in a variety of foods such as tahini, hummus, sesame crackers, cookies etc. Although parents have good awareness about peanuts, tree nuts and other major allergens, most parents are unaware of the allergic tendency of sesame. METHODS: The prevalence of IgE sensitivity to sesame food allergen was investigated in a suburban community practice in Boston. As part of medical history, parents were questioned about recognition of sesame as an allergen. Allergy testing was performed by scratch testing using commercial sesame extract. RESULTS: Less than one in 5 parents of children with sesame allergy were aware of the allergenic potential of sesame until their child skin-tested positive. Sesame is known to cause anaphylactic shock in addition to atopic dermatitis, urticaria/angioedema and gastrointestinal symptoms and often asymptomatic, although sensitized. The awareness of allergenic tendency to sesame in suburban population is under-recognized. Patients were generally more aware about peanuts, tree nuts, milk and other major allergens, but not sesame. We postulate that early sesame sensitization is likely due to lack of knowledge about the allergenicity of sesame, lack of labeling regulations, as well as the easier availability and increasing consumption of ethnic foods in the general population. CONCLUSIONS: The general awareness of sesame as an allergen is low in the suburban population. Education specific to sesame should be provided to primary-care-physicians, parents, day-care and school personnel. Sesame should be made easier to identify on food labels. The food industry should be subjected to stricter labeling guidelines on this emerging food allergen.
386
Asthma Education: Changing the Way We Communicate M. E. Cataletto; Winthrop University Hospital, Mineola, NY. RATIONALE: E-marketers have been tracking the way children communicate with each other and have responded by the way they engage them as internet users. They estimate that 82% teens, ages 12 - 17 and 43.5% of children ages 3 -11 will use the internet on a monthly basis in 2009. Predictors suggest that these numbers will continue to increase. The purpose of this study is to examine the impact of an online asthma education program. METHODS: The Girl Scout Asthma Awareness Patch Program: Helping Girls Breathe Easier went online October 2005 in order to improve outreach of the educational messages. Outreach was determined by the number of program downloads as well as the geographic distribution of respondents. Evaluations reflecting the responses of 2,131 participants between October 1, 2005 through July 1, 2009 were collected from the Zoomerang online survey tool and analyzed. This study was funded in part by AAAAI. RESULTS: There were 181,706 downloads of the program in English and 4,326 downloads of the Spanish language version. Ninety four percent of the downloads were from sites throughout the United States; 6% from foreign based sites. Over 21,500 girls were awarded the asthma awareness patch after completing the program. We received evaluation data from 2,131 participants who completed the asthma awareness patch program. Post-program knowledge outcome measures showed improvement in all core content areas. CONCLUSIONS: Stand alone online and tailored asthma education programs with opportunities for internet-based educational reinforcement are effective and sustainable methods to reach children and teens with asthma.
J ALLERGY CLIN IMMUNOL FEBRUARY 2010
387
The Attitudes Toward and Beliefs About HIV Disclosure Among Perinatally-Infected HIV-Positive Youth and their Caregivers L. M. Noroski1, G. Parcel2, Y. Fu2, C. Markham2; 1Texas Childrens Hospital, Houston, TX, 2University of Texas, Houston, TX. RATIONALE: HIV is more common than primary immunodeficiencies, without cure to date and is preventable. Perinatally-infected HIV-positive youth have survived unexpectedly into adulthood, have had unique HIV disclosure experiences and now face these issues in adulthood. Despite effective HIV therapies, no HIV prevention exists that has diminished HIV infections rates. At least 25% of the HIV-infected are unaware of their diagnosis. Hypothesis: attitudes and beliefs of HIV disclosure determine the likelihood of HIV disclosure behaviors. METHODS: Population: Perinatally-infected HIV-positive/disclosed youth (aged 13-24 years) of Allergy/Immunology at Texas Children’s Hospital and caregivers; Instrument: needs assessment theory-driven surveys. RESULTS: Of the eligible population, 26 participants (15 youth; 11 caregivers) completed The Care to Share HIV Disclosure surveys that were framed in the Theory of Reasoned Action/Theory of Planned Behavior (21-item, quantitative) and in the Transactional Model of Stress/Coping (1-item qualitative) to define the attitudes and beliefs (A/B) of HIV disclosure. A/B were classified as promoters (P) or inhibitors (I) of HIV disclosure. A/B - P (youth and caregivers)-HIV-knowledge; close family; caring people; when helping others; pre-puberty; (youth)-partner disclosure. A/B - I (youth and caregivers)-keeping HIV a secret; (youth)-close friends (caregivers)-partner notification; othersÕ opinions. (r50.63). CONCLUSIONS: HIV stigma was identified by youthsÕ belief in and caregiversÕ ambivalence to keeping HIV a secret from everyone. Yet youth and caregivers demonstrated perceived power for HIV disclosure when helping others and in settings of HIV-knowledge seeking and teaching. The revealed A/B serve as formative steps to unfolding effective HIV prevention planning and raise implications for immunologists in screening for HIV.
388
High Prevalence of Asthma and Obesity in Children from Pittsburgh's Inner-City D. P. Skoner1, J. Padden2, J. M. Koehrsen1, D. A. Gentile1; 1Allegheny General Hospital, Pittsburgh, PA, 2Duquesne University School of Pharmacy, Pittsburgh, PA. RATIONALE: Inner-city children are at risk for a variety of health problems including asthma and obesity. The objective of this study was to determine the prevalence of asthma and obesity in an inner-city pediatric population from Pittsburgh, PA. METHODS: Sixty-nine inner-city children enrolled in an after-school program at a local church participated in a health screen. The screen consisted of measurement of height, weight and lung function, and completion of a survey to evaluate asthma presence and control. RESULTS: Seventeen (24%) participants had a known diagnosis of asthma and 14 of those 17 (82%) had poorly controlled asthma. Twentyfive of the 52 (48%) participants without a diagnosis of asthma failed the asthma screen (FEV1 < 80% predicted). Fifty-one percent of the participants had a BMI in the normal range while 19% and 30% were overweight and obese, respectively. CONCLUSIONS: Both the prevalence of asthma and obesity in this population is alarming and cause for concern. More alarming is that over 80% of the known asthmatic participants had poor disease control. Additionally, the rate of screen failures for asthma is quite alarming in that it represents children with potential asthma that need further evaluation and possibly even treatment. Future efforts need to focus on community based interventions to improve health outcomes in this at-risk population.
385
SUNDAY
Need for Education About Sesame Allergy V. Krishna, MD, FAAAAI, S. KrishnaPhD, MBA; Asthma & Allergy Specialists, PC, Winchester, MA. RATIONALE: Sesame is increasingly being used in a variety of foods such as tahini, hummus, sesame crackers, cookies etc. Although parents have good awareness about peanuts, tree nuts and other major allergens, most parents are unaware of the allergic tendency of sesame. METHODS: The prevalence of IgE sensitivity to sesame food allergen was investigated in a suburban community practice in Boston. As part of medical history, parents were questioned about recognition of sesame as an allergen. Allergy testing was performed by scratch testing using commercial sesame extract. RESULTS: Less than one in 5 parents of children with sesame allergy were aware of the allergenic potential of sesame until their child skin-tested positive. Sesame is known to cause anaphylactic shock in addition to atopic dermatitis, urticaria/angioedema and gastrointestinal symptoms and often asymptomatic, although sensitized. The awareness of allergenic tendency to sesame in suburban population is under-recognized. Patients were generally more aware about peanuts, tree nuts, milk and other major allergens, but not sesame. We postulate that early sesame sensitization is likely due to lack of knowledge about the allergenicity of sesame, lack of labeling regulations, as well as the easier availability and increasing consumption of ethnic foods in the general population. CONCLUSIONS: The general awareness of sesame as an allergen is low in the suburban population. Education specific to sesame should be provided to primary-care-physicians, parents, day-care and school personnel. Sesame should be made easier to identify on food labels. The food industry should be subjected to stricter labeling guidelines on this emerging food allergen.
386
Asthma Education: Changing the Way We Communicate M. E. Cataletto; Winthrop University Hospital, Mineola, NY. RATIONALE: E-marketers have been tracking the way children communicate with each other and have responded by the way they engage them as internet users. They estimate that 82% teens, ages 12 - 17 and 43.5% of children ages 3 -11 will use the internet on a monthly basis in 2009. Predictors suggest that these numbers will continue to increase. The purpose of this study is to examine the impact of an online asthma education program. METHODS: The Girl Scout Asthma Awareness Patch Program: Helping Girls Breathe Easier went online October 2005 in order to improve outreach of the educational messages. Outreach was determined by the number of program downloads as well as the geographic distribution of respondents. Evaluations reflecting the responses of 2,131 participants between October 1, 2005 through July 1, 2009 were collected from the Zoomerang online survey tool and analyzed. This study was funded in part by AAAAI. RESULTS: There were 181,706 downloads of the program in English and 4,326 downloads of the Spanish language version. Ninety four percent of the downloads were from sites throughout the United States; 6% from foreign based sites. Over 21,500 girls were awarded the asthma awareness patch after completing the program. We received evaluation data from 2,131 participants who completed the asthma awareness patch program. Post-program knowledge outcome measures showed improvement in all core content areas. CONCLUSIONS: Stand alone online and tailored asthma education programs with opportunities for internet-based educational reinforcement are effective and sustainable methods to reach children and teens with asthma.
J ALLERGY CLIN IMMUNOL FEBRUARY 2010
387
The Attitudes Toward and Beliefs About HIV Disclosure Among Perinatally-Infected HIV-Positive Youth and their Caregivers L. M. Noroski1, G. Parcel2, Y. Fu2, C. Markham2; 1Texas Childrens Hospital, Houston, TX, 2University of Texas, Houston, TX. RATIONALE: HIV is more common than primary immunodeficiencies, without cure to date and is preventable. Perinatally-infected HIV-positive youth have survived unexpectedly into adulthood, have had unique HIV disclosure experiences and now face these issues in adulthood. Despite effective HIV therapies, no HIV prevention exists that has diminished HIV infections rates. At least 25% of the HIV-infected are unaware of their diagnosis. Hypothesis: attitudes and beliefs of HIV disclosure determine the likelihood of HIV disclosure behaviors. METHODS: Population: Perinatally-infected HIV-positive/disclosed youth (aged 13-24 years) of Allergy/Immunology at Texas Children’s Hospital and caregivers; Instrument: needs assessment theory-driven surveys. RESULTS: Of the eligible population, 26 participants (15 youth; 11 caregivers) completed The Care to Share HIV Disclosure surveys that were framed in the Theory of Reasoned Action/Theory of Planned Behavior (21-item, quantitative) and in the Transactional Model of Stress/Coping (1-item qualitative) to define the attitudes and beliefs (A/B) of HIV disclosure. A/B were classified as promoters (P) or inhibitors (I) of HIV disclosure. A/B - P (youth and caregivers)-HIV-knowledge; close family; caring people; when helping others; pre-puberty; (youth)-partner disclosure. A/B - I (youth and caregivers)-keeping HIV a secret; (youth)-close friends (caregivers)-partner notification; othersÕ opinions. (r50.63). CONCLUSIONS: HIV stigma was identified by youthsÕ belief in and caregiversÕ ambivalence to keeping HIV a secret from everyone. Yet youth and caregivers demonstrated perceived power for HIV disclosure when helping others and in settings of HIV-knowledge seeking and teaching. The revealed A/B serve as formative steps to unfolding effective HIV prevention planning and raise implications for immunologists in screening for HIV.
388
High Prevalence of Asthma and Obesity in Children from Pittsburgh's Inner-City D. P. Skoner1, J. Padden2, J. M. Koehrsen1, D. A. Gentile1; 1Allegheny General Hospital, Pittsburgh, PA, 2Duquesne University School of Pharmacy, Pittsburgh, PA. RATIONALE: Inner-city children are at risk for a variety of health problems including asthma and obesity. The objective of this study was to determine the prevalence of asthma and obesity in an inner-city pediatric population from Pittsburgh, PA. METHODS: Sixty-nine inner-city children enrolled in an after-school program at a local church participated in a health screen. The screen consisted of measurement of height, weight and lung function, and completion of a survey to evaluate asthma presence and control. RESULTS: Seventeen (24%) participants had a known diagnosis of asthma and 14 of those 17 (82%) had poorly controlled asthma. Twentyfive of the 52 (48%) participants without a diagnosis of asthma failed the asthma screen (FEV1 < 80% predicted). Fifty-one percent of the participants had a BMI in the normal range while 19% and 30% were overweight and obese, respectively. CONCLUSIONS: Both the prevalence of asthma and obesity in this population is alarming and cause for concern. More alarming is that over 80% of the known asthmatic participants had poor disease control. Additionally, the rate of screen failures for asthma is quite alarming in that it represents children with potential asthma that need further evaluation and possibly even treatment. Future efforts need to focus on community based interventions to improve health outcomes in this at-risk population.