Date of Award

4-3-2018

Document Type

Dissertation

Copyright Status, No Creative Commons License

All Rights Reserved

Degree Name

Doctor of Philosophy (Ph.D.) Nursing

Department

Nursing

Abstract

Problem/Significance: Food allergy is a growing public health concern in the United States affecting nearly 15 million Americans. According to FAIR Health (Gelburd, 2017), diagnoses of anaphylactic food reactions increased by 377% nationwide from 2007 to 2016, with 66% among patients 18 years or younger, and 34% in those over 18 years old. Several tragic incidents and lawsuits have occurred on college campuses in recent years raising concerns over the safety of college students experiencing a food allergic emergency. Purpose: The purpose of this quantitative descriptive correlational study is to identify factors associated with college students’ willingness and readiness to act in a Food Allergic Emergency (FAE) in a campus community. Being able to identify individuals who are willing and ready to act in FAEs would provide a foundation to guide policies related to stock Epinephrine autoinjectors and anaphylaxis, as well as training and education of unlicensed individuals on college campuses. Currently, no data have been published on college students’ readiness or willingness to act in FAEs. This study will contribute to the food allergy body of knowledge and to the development of policy for college communities. Methods: The sample for this study was drawn from a population of undergraduate and graduate students 17 years old and older enrolled in the Spring of 2017 semester for one or more credits at a suburban private Catholic college near the metropolitan New York area. The survey tool for this study was comprised of a combination of existing, modified and newly created instruments that were assembled to capture respondents’ self-report of Readiness to Act and Willingness to Act in an FAE. IRB approvals were obtained for the pilot of the initial tool, and later, for the full study. Consents were provided to the participants prior to completion of the pilot and full study surveys. The full study commenced after validity and reliability of the measurement tool was established. An email with a link to a Google forms survey was emailed to all students using the all-students distribution list, with an anticipated response rate of 10%. Email addresses were not collected to maintain anonymity. Data from the survey were analyzed in SPSS version 24. Factor analysis, correlations, ANOVA, t-test and regression analysis were used to describe the findings. Results: Cronbach’s alphas were reported on final measurement instruments based on a larger sample size as compared to the pilot sample size. Exploratory factor analysis examined factor validity of the instrument through factor loading results, indicating a two components structure. All components (knowledge, familiarity, experience, training and confidence) measuring readiness to act in an FAE loaded close together and were highly correlated with each other and with readiness to act. Components (fear and bystander’s response) measuring willingness to act also loaded close together and were correlated with each other and with willingness to act. Additionally, several demographic characteristics including age, having children, and college major had statistically significant correlations with readiness to act. Statistically significant correlations were found between age, having one or more child/children, college major and willingness to act in an FAE. Multiple linear regression analysis was performed with five independent predictor variables, including age, health professions major, expressed desire to be trained, social desirability, and readiness to act as guided by the theoretical frameworks used in this study, indicating (R2 =.35) 35% of variability in willingness to act can be explained by these variables. Based on box and whiskers plots analysis by college major, students enrolled in nonhealth related majors expressed lower readiness to act, but higher willingness to act in an FAE. Conclusion/Implications: Students enrolled in health profession majors, those who are older and those with desire to be trained conveyed higher readiness to act and were more willing to act in an FAE. However, students in non-health related majors also expressed willingness to act, but reported lower level of readiness. Thus, establishing appropriate policies and training of willing individuals would be highly desirable to establish a pool of trained college students who can respond to an FAE in a college community. Data from this study may not be generalizable to all college campuses throughout the United States. Findings of this study may serve as a starting point for a larger population-based study as more lay people will have access to non-patientspecific Epinephrine auto-injectors and as the number of children and adults living with food allergies continues to spiral upwards.

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