Risk-taking and coping strategies of adolescents and young adults with food allergy

BACKGROUND: Fatal food-allergic reactions are most common among adolescents and young adults. OBJECTIVE: To gain insight toward devising interventions, we queried risk-taking behaviors and coping strategies of persons age 13 to 21 years with food allergy. METHODS: We used an Internet-based anonymous questionnaire devised on the basis of data from focus groups. RESULTS: Participants (174 subjects; 49% male; mean age, 16 years) reported the following: 75% had peanut allergy, 75% had 2 or more food allergies, and 87% had been prescribed self-injectable epinephrine. Regarding risk taking, 61% reported that they "always" carry self-injectable epinephrine, but frequencies varied according to activities: traveling (94%), restaurants (81%), friends' homes (67%), school dance (61%), wearing tight clothes (53%), and sports (43%). Fifty-four percent indicated purposefully ingesting a potentially unsafe food. Willingness to eat a food labeled "may contain" an allergen was reported by 42%. Twenty-nine participants were designated at high risk because they did not always carry epinephrine and ate foods that "may contain" allergens. The high-risk group, compared with the rest of the participants (P < .05), felt less "concern" about and "different" because of their allergy and had more recent reactions. The high-risk group was not distinguishable (P = not significant) by age, sex, or number or severity of reactions. Participants variably (60%) tell their friends about their allergy, but 68% believe education of their friends would make living with food allergy easier. CONCLUSIONS: A significant number of teens with food allergy admit to risk taking that varies by social circumstances and perceived risks. The results imply that education of teenagers and, importantly, those around them during social activities might reduce risk taking and its consequences. CLINICAL IMPLICATIONS: Our survey of adolescents and young adults with food allergy revealed risk-taking behaviors that vary by social circumstances and perceived risks, indicating that education of teenagers and their peers might reduce risk taking and its consequences.