RESULTS
The training programme was delivered to 18 primary schools; a total of
191 school personnel, that ranged from 3-25 attendees per school
(median=9, IQR=6). Participating schools originated from all six
districts in the county. 44% (8/18) of the schools were from the most
densely populated district. All schools were state-funded and there were
of small-to-medium size ranging from 29-428 pupils (median=128, SD±119).
29% (5/18) of the schools had pupils at risk of anaphylaxis and carried
an AAI; two of these schools (12%) reported that a Personalised Allergy
Action Plan (PAAP) was not available.
The response rate to the follow up survey was 78% (14/18). The schools’
characteristics (number of pupils registered, locality, socioeconomic
status or size) of non-respondents did not differ compared to the
respondents.
Fewer than half of the schools (39%, 7/18) reported confidence in
dealing with an allergic reaction at baseline survey. Following the
intervention, 86% (12/14) of schools stated they felt confident if
faced with such emergency (p=0.016).
The majority of schools (94%, 17/18) reported that they had both
procedures on identification of pupils with allergies on enrolment at
school, and reduction of risks and management of allergic reactions
(Table 3). Following training, all schools, 100% (14/14) reviewed their
practice regarding the identification of pupils with allergies on
admission and setting up a management plan. While only 45% (8/18) of
the respondents reported that they helped pupils to manage their
allergies (providing teaching material and practical skills) prior to
training, all but one (93%, 13/14) had arranged or considered
introducing such teaching sessions following the intervention (p=0.03).
Compared with 44% (8/18) of the schools who reported that they were
prepared to manage a severe allergic reaction in a child with no
previous history of allergy at baseline, 93% (13/14) reported so
following the intervention (p=0.016) (Table 4).
It is of note that 35% (5/14) of the respondents stated that they
introduced a standard management protocol for the first time following
the training and all schools updated or implemented a standard
management protocol (pre-training 78% vs post training 100%, p=0.25).
Arrangements for regular staff training were in place in the majority of
schools (78%, 14/18). However, 50% (9/18) of the schools reported not
offering in depth training for those who had frequent contact with
children with severe allergies. In 44% (8/18) of the schools there were
no arrangements in place to offer specialist training for those
responsible for the health of these children. Post-training, 93%
(13/14) of the schools reported that arrangements were made for regular
training of all staff (pre-training 78%, vs post-training 93%, p=0.63)
and 86% (12/14) offered in depth training (pre training 50% vs
post-training 86%, p=0.57). However, only 57% (8/14) offered
specialist training at follow-up (pre training 56%, vs post-training
57%, p=0.69).
More than one third of the schools, (39%, 7/18) reported that
preventative measures for accidental exposure to food allergens such as
a no food sharing policy were not in place prior to the training taking
place. Post training, all schools reported they had adopted such a
policy (pre-training 61% vs post- training 100%, p=0.03). 71% (10/14)
of schools put in place special supervision for high risk pupils during
meal times (pre training 56% (10/18), p=0.45). While 78% (14/18) of
the schools reported initially that they followed a nuts-free policy,
post intervention, only 57% (8/14) reported so (p=0.25) (Table 5).
Also, only one third of the schools, (33%,6/18) reported to have a ‘no
eating policy on transport to and from school’. Following the
intervention, the majority of the schools, (79%, 11/14) seemed to have
reviewed this policy (pre-training 33% vs post training 79%, p=0.07).
The majority of schools (83%, w15/18) expressed the need for national
guidelines on the management in school of children with severe allergies
at the baseline survey and all of them did so post training (100%
(14/14), p=0.63).
Similarly, post training 93% (11/18) schools either agreed or strongly
agreed with the generic provision of AAI to be kept at school
(pre-training 61% (11/18),
p=0.125).