Food Allergies School Guidelines and Education Presented by: Christanne Harrison and Karen McGrail

Food Allergies School Guidelines and Education Presented by: Christanne Harrison and Karen McGrail

Disclosures Christanne Harrison, MPH, RD Consultant The John C. Stalker Institute for Food and Nutrition The Institute of Child Nutrition Karen McGrail, MEd, RDN, LDN None

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Learning Outcomes Participants will recognize key areas of focus for revising state allergy guidelines. Participants will identify key methods to create and deliver consistent training to school staff. Participants will identify three ways to apply information to their own work with food allergies in schools.

Background Parents Department of Education led Advisory Group Managing Life Threatening Food Allergies in Schools

Poll How many states provide Life-Threatening Food Allergy Guidance for Schools? 5-10 11-15 16-20 21-25 Most recent editions ranged from 2007-2014.

Reasons to Update Guidance

Food Allergen Labeling and Consumer Protection Act of 2004 First phase became effective January 1, 2006. Requires all products to declare the presence of major food allergens, Milk, Soy, Egg, Tree Nuts, Peanuts, Wheat, Fish and Shellfish, in plain language on the label: Using the word Contains followed by the name of the major food allergen (milk, wheat, or eggs for example); or Using a parenthetical statement in the list of ingredients, e.g., albumin (egg) Major food allergens will be declared in flavorings, colorings and spice blends

Technology POS School websites Communication

CDC Guidance Inclusion of Early Education Care Education for Staff Terminology (i.e. Allergy Management and Prevention Plan)

Laws and Regulations Massachusetts Allergy Awareness Act Massachusetts Department of Health, School Health Services Regulations USDA Related Guidance Medical professional Disability

MA School Nursing Data Number of epinephrine administrations reported in schools increased from 133 in 2004 to 225 in 2010 23 percent of epinephrine administrations involved individuals who did not have a previously recognized or reported allergy

Guidelines Across the United States Inclusions of EEC Inclusions of Labeling/Food Handling 7% 21% 93% 79% Yes No Yes No

Key Updates for Guidelines

Revision Committee Department of Elementary and Secondary Education Department of Public Health The John C. Stalker Institute of Food and Nutrition School Nutrition Programs Early Education and Care Pediatric Allergist

Life-Threatening Allergic Triggers Food Latex Insect venom Medication Exercise Cold

Previously Undiagnosed Be ready to respond to severe allergic reactions in children with no history of anaphylaxis School doctor or nurse should stock their emergency medical kits with epinephrine auto-injectors

Education and Training Needs School All staff, including in-depth for staff with frequent contact Contracted employees Parents and students Volunteers and substitutes After-School Summer Feeding

Early Education and Care Programs Challenges Less nurse availability Fewer opportunities for training State regulations undergoing revisions High variation in programs and staff education

Label Reading and Cross-Contact

Terminology Consistent terminology for plans Allergy management and prevention plan Medical emergency response plan Individual health care plan Anaphylaxis emergency care plan Cross-contamination vs cross-contact

http://www.johnstalkerinstitute.org/r/mng-allergies.pdf

Practice Applications Strengthen connection between the school nurse and school nutrition program Create Allergy Management and Prevention Plans for school nutrition Provide much needed training and education to school staff, parents, and school community

School Nutrition Staff: Food Allergy Knowledge Strengths Seriousness of food allergies Symptoms of food allergies Foods are labeled for allergens Identifying students with food allergies Avoiding cross-contact Sharing information about allergens

School Nutrition Staff: Food Allergy Knowledge Weaknesses Difference between allergies and intolerance Practices on consistent label reading/keeping labels Specific details about how foods are labeled School Allergy and Prevention Plan/Emergency plan

The John C. Stalker Institute of Food and Nutrition (JSI) is a partnership between the Office for Food and Nutrition Programs at the Massachusetts Department of Elementary and Secondary Education and Framingham State University

Updated January 2016 to align with Massachusetts Managing Life-Threatening Allergies in Schools Guidelines

Food Allergy Training Totals FY16 # WTG/ # Participants FY15 # WTG/ # Participants FY14 # WTG/ # Participants Food Allergies Workshop-To-Go (WTG) 15 / 339 (16% total workshops) 16 / 425 (22% total workshops) 14 / 311 (23% total workshops) Food Allergies Online 10 / 115 9 / 98 9 / 125 Total 25 / 454 25 / 523 23 / 436

Development Interactive 2-hour workshop Face-to-face and online Adult learning theory Professional presentation of content Q & A, scenarios and learning activities Content aligns with Massachusetts Managing Life-Threatening Allergies in Schools Guidelines Evaluation Learning Objectives Instructional Qualities

Learning Objectives

Mode of Delivery Workshop-To-Go Face-to-face K-12 schools

Mode of Delivery Online 2-hour course available 24/7 over 2 week sessions Certificate 4-week online course for school professionals 15 hours Continuing Education Units for SN and RDNs 22.5 PDPs for Teachers

Instructors Cadre of instructors JSI contractors Experts in school nutrition, special diets and workshop presentation RDNs with Masters degree or SNS credential

Participant Evaluation

Resources Center for Disease Control and Prevention, Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Education Programs http://www.cdc.gov/healthyyouth/foodallergies/pdf/13_2 43135_a_food_allergy_web_508.pdf Massachusetts Department of Secondary and Elementary Education, Managing Life-Threatening Allergies in Schools http://www.johnstalkerinstitute.org/r/mng-allergies.pdf The John Stalker Institute of Food and Nutrition http://www.johnstalkerinstitute.org/

Questions Thank you!