Parent perspectives on guided self-care approaches to ensure timely access to therapy in infants with food allergy.

Abstract

Background: Early allergen immunotherapy (AIT), including oral immunotherapy (OIT), is increasingly recognized as a disease-modifying intervention for infants with Immunoglobulin E (IgE)-mediated food allergy. However, limited access to allergy specialists and long wait times often prevent timely initiation during the critical early-life window. Guided self-care models could offer alternative care pathways, yet parents' perspectives on such approaches remain poorly understood.

Objective: To explore parents' perceptions of the acceptability, feasibility, and conditions required for guided self-care approaches to to early-life food allergen immunotherapy in infants, drawing on parental experiences managing food allergy in their children in their early years.

Methods: A qualitative study was conducted using semi-structured videoconference interviews (Zoom) with 11 parents of children with food allergies in Québec, Canada, between June and August 2024. Participants were recruited through purposive sampling to capture a range of experiences. Interviews were conducted in French, transcribed verbatim, and analyzed using thematic analysis to identify key themes and constructs in French, translated into English for publication. Rigor was enhanced through independent coding by two analysts, iterative interim analyses, and team discussions to resolve discrepancies.

Results: The mean age of the index child at food allergy diagnosis was 0.8 years (range 0.2-2); four participants were still parents of infants at the time of interview. Three major themes emerged: (1) acceptability of self-care driven by barriers to timely access to AIT and the perceived benefits of early intervention; (2) parental confidence in self-management shaped by experience, preparedness, and education; and (3) the necessity of professional support and clear protocols. Participants expressed strong motivation to initiate early treatment to avoid missing a critical therapeutic window, even in the absence of direct allergist supervision. However, guided self-care was consistently viewed as requiring diagnostic validation, structured protocols, and access to trained healthcare professionals for support, particularly at treatment initiation.

Conclusion: Parents of children with food allergy are receptive to guided self-care approaches for early infant AIT when timely access to specialists is limited. Developing low-risk AIT modalities, standardized protocols, and training for non-allergist healthcare professionals may facilitate earlier intervention and improve outcomes for infants with food allergy.