Assessing Teachers' Confidence in Implementing Food Allergy Emergency Plans

154 Pages·2017·1.5 MB·English

Walden University
ScholarWorks
Walden Dissertations and Doctoral Studies
Walden Dissertations and Doctoral Studies
Collection
2017
Assessing Teachers' Confidence in Implementing
Food Allergy Emergency Plans
Keturah Elizabeth Hawkins
Walden University
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Walden University

College of Health Sciences

This is to certify that the doctoral dissertation by

Keturah-Elizabeth Harriett Hawkins

has been found to be complete and satisfactory in all respects,
and that any and all revisions required by
the review committee have been made.

Review Committee
Dr. Kai Stewart, Committee Chairperson, Public Health Faculty
Dr. JaMuir Robinson, Committee Member, Public Health Faculty
Dr. Cynthia Tworek, University Reviewer, Public Health Faculty

Chief Academic Officer
Eric Riedel, Ph.D.

Walden University
May 2017
Abstract
Assessing Teachers’ Confidence in Implementing Food Allergy Emergency Plans
by
Keturah-Elizabeth Harriett Hawkins

MS, University of St. Francis, 2003
BS, Governors State University, 2002

Dissertation Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Philosophy
Public Health

Walden University
May 2017
Abstract
Food allergies are an increasing health concern in the United States, affecting nearly 6
million children under the age of 18 years. Research has suggested that 18% of school-
age children will have their first allergic reactions at school. Life-threatening allergic
reactions experienced by children in the school setting are on the rise; however, little is
known about how schools implement policies and practices in response to this issue. The
purpose of this quantitative cross-sectional study was to narrow the knowledge gap by
examining teachers’ knowledge, ability, and confidence level caring for students with
food allergies. Bandura’s social cognitive theory, which holds that education and
experience influence confidence implementing tasks, served as the framework that
guided this research. The electronic survey was distributed to a convenience sample of
300 elementary school teachers; 93 respondents completed it. Eighty completed surveys
were used in the analysis. Multiple linear regression models were constructed to analyze
the relationships among confidence, education, and training related to food allergies.
Results showed that teachers who lacked knowledge of food allergies also lacked
confidence implementing food allergy plans. School personnel responsible for planning
or revising food allergy response protocols can use these findings. The potential for
positive social change includes identifying training opportunities, developing policies to
sustain food allergy knowledge, and building the capacity of all school staff to implement
life-saving measures when children are experiencing allergic reactions.
Assessing Teachers’ Confidence in Implementing Food Allergy Emergency Plans
by
Keturah-Elizabeth Harriett Hawkins

MS, University of St. Francis, 2003
BS, Governors State University, 2002

Dissertation Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Philosophy

Walden University
May 2017
Dedication
The work of this dissertation is specifically dedicated to my brother, Rodney
James Johnathan Hawkins, who succumbed on July 3, 2008, to anaphylactic shock
directly related to the ingestion of seafood (crabmeat) hidden in a meal. Rodney, you are
sadly missed, and through your experience, I hope that this study will help others to have
a safer and healthier future, and will open up future research to the hidden mystery and
prevention of food allergies. This also is a special dedication to all of the young victims
of food allergies.
Acknowledgments

First, I want to acknowledge my Lord/God, the head and leader of my mind, soul,
and spirit. He ordered and guided my steps through this endeavor and made everything
possible through trust and faith in Him. Thank you, my dear Lord/God, as I am greatly
appreciative and honored to know You. Next, I want to extend special thanks to my
dissertation chair, Dr. Kai Stewart, who was by my side through it all and who continued
to encourage me not to give up, saying, “You will get through this.” Thank you, Dr.
Stewart. You taught me a lot, and you truly had the patience of Job working with me. I
want to acknowledge and give special thanks to my five sisters, one brother, nieces, and
nephews for being there and cheering me on to the finish line. I made it! Thank you to
my church family and work colleagues, especially for helping to set up the participants,
reviewing my work, and encouraging me to set deadlines. I am extremely grateful to the
rest of my dissertation committee and my Walden family of friends whom I could depend
on to send encouraging e-mails that gave me the extra push needed to get through.
Finally, I extend a special thanks to my program chair, Dr. Nancy Rea, for listening.
Table of Contents
List of Tables ..................................................................................................................... vi
List of Figures ................................................................................................................... vii
Chapter 1: Introduction to the Study ................................................................................... 1
Introduction ................................................................................................................... 1
Background ................................................................................................................... 3
Food Allergies ......................................................................................................... 3
Anaphylaxis ............................................................................................................ 4
Food Allergy Emergency Plans .............................................................................. 5
Problem Statement ........................................................................................................ 6
Purpose of the Study ..................................................................................................... 8
Research Questions and Hypotheses ............................................................................ 9
Theoretical Framework ............................................................................................... 10
Nature of the Study ..................................................................................................... 14
Definitions of Terms ................................................................................................... 16
Assumptions ................................................................................................................ 18
Scope and Delimitations ............................................................................................. 19
Limitations .................................................................................................................. 20
Significance of Study .................................................................................................. 21
Contribution to Education ..................................................................................... 21
Implications for Social Change ............................................................................. 22
Summary ..................................................................................................................... 23

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Chapter 2: Literature Review ............................................................................................ 25
Introduction ................................................................................................................. 25
Literature Search Strategy ........................................................................................... 26
Theoretical Foundation ............................................................................................... 26
Literature Review Related to Key Variables and Concepts ........................................ 29
Understanding Food Allergy Emergency Plans .......................................................... 32
Children With Food Allergies ............................................................................... 32
Health Care Staff................................................................................................... 33
Nonhealth Staff Members’ Knowledge of Food Allergies ................................... 35
Parent-School Communication About Food Allergies ......................................... 36
Physical Education Staff ....................................................................................... 37
Allergens Elsewhere in the School ............................................................................. 39
The Environment .................................................................................................. 39
Cafeteria Preparation ............................................................................................ 40
Adequate Policies........................................................................................................ 41
Inadequate Food Allergy Policies ......................................................................... 41
ADA Section 504 Plan .......................................................................................... 42
State Department of Education Food Allergy Guidelines .......................................... 44
Efforts to Reduce Barriers .................................................................................... 44
Illinois State Guidelines ........................................................................................ 44
Georgia State Guidelines ...................................................................................... 45
Massachusetts State Guidelines ............................................................................ 46
Virginia State Guidelines ...................................................................................... 47
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North Carolina State Guidelines ........................................................................... 47
Global Concerns of Food Allergies at School ............................................................ 48
The United States .................................................................................................. 48
Outside the United States ...................................................................................... 50
Food Allergy Labeling Laws ................................................................................ 51
Limitations of Literature Reviewed ............................................................................ 52
Summary ..................................................................................................................... 53
Chapter 3: Methodology ................................................................................................... 54
Introduction ................................................................................................................. 54
Research Design and Rationale .................................................................................. 54
Research Questions and Hypotheses .................................................................... 54
Design ................................................................................................................... 55
Methodology ............................................................................................................... 57
Population ............................................................................................................. 57
Sampling and Sampling Procedures ..................................................................... 58
Sample Size Calculation and Justification ............................................................ 59
Recruitment ........................................................................................................... 60
Data Collection ........................................................................................................... 61
Instrumentation and Operationalization of Constructs ............................................... 63
Instrument ............................................................................................................. 63
Instrument Adaptation .......................................................................................... 66
Variables ............................................................................................................... 69
Data Analysis Plan ...................................................................................................... 71
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