PDF(Pubmed)
Abstract：
Responding to international research showing that early introduction of common food allergens can reduce the chance of developing allergies, in 2016 the Australasian Society of Clinical Immunology and Allergy (ASCIA) revised allergen introduction guidelines, recommending earlier introduction of allergens to infants in their first year. Australia has high food allergy rates, and limited understanding of adherence to allergen introduction guidelines, especially in rural areas. This project explored rural parent adherence to ASCIA guidelines.
This was a mixed method cross sectional study using an online survey including multiple-choice and qualitative short answer responses. The sample were 336 women from two rural health districts in New South Wales. All were aged 18 or over, and either pregnant or had delivered a baby since July 2018. Descriptive statistics were used to measure behavioural alignment with the recommended guidelines, thematic analysis was used to analyse attitudes and explanations.
In 84.3% of children, feeding adhered to all four guidelines studied, including no elimination of allergens during pregnancy (98%), age of introduction of solids (97.7%), continuation of breast milk/cow\'s milk formula during introduction of solids (95%), and age of introduction of allergens (92.9%). Adherence was not significantly correlated with the education (X2 = 17.9, P = .056), prior history of allergy [neither mother (X2 = 0.945,P = .623) nor previous children (X2 = 0.401,P = .818)], or primary care received during pregnancy. More than 90% of participants agreed or strongly agreed that the guidelines are realistic, trustworthy, and important for the health of their child. However, thematic analysis revealed that parents\' perceptions of a child\'s individual progress, and medical conditions or other circumstances, such as challenges with breastfeeding, will often take precedence over adherence to specific guideline recommendations.
High rates of adherence with ASCIA guidelines found here are comparable with findings from metropolitan studies and encouraging for future population health. Participant comments on the guidelines imply to rural policymakers that there are multiple influences on parent decisions about infant feeding, often including parents\' own intuition and experiences. Further studies to improve understanding of the role of information, carers, and other influences on parent decision-making concerning feeding attitudes and behaviours will be necessary to optimise adherence in rural areas.
This was a mixed method cross sectional study using an online survey including multiple-choice and qualitative short answer responses. The sample were 336 women from two rural health districts in New South Wales. All were aged 18 or over, and either pregnant or had delivered a baby since July 2018. Descriptive statistics were used to measure behavioural alignment with the recommended guidelines, thematic analysis was used to analyse attitudes and explanations.
In 84.3% of children, feeding adhered to all four guidelines studied, including no elimination of allergens during pregnancy (98%), age of introduction of solids (97.7%), continuation of breast milk/cow\'s milk formula during introduction of solids (95%), and age of introduction of allergens (92.9%). Adherence was not significantly correlated with the education (X2 = 17.9, P = .056), prior history of allergy [neither mother (X2 = 0.945,P = .623) nor previous children (X2 = 0.401,P = .818)], or primary care received during pregnancy. More than 90% of participants agreed or strongly agreed that the guidelines are realistic, trustworthy, and important for the health of their child. However, thematic analysis revealed that parents\' perceptions of a child\'s individual progress, and medical conditions or other circumstances, such as challenges with breastfeeding, will often take precedence over adherence to specific guideline recommendations.
High rates of adherence with ASCIA guidelines found here are comparable with findings from metropolitan studies and encouraging for future population health. Participant comments on the guidelines imply to rural policymakers that there are multiple influences on parent decisions about infant feeding, often including parents\' own intuition and experiences. Further studies to improve understanding of the role of information, carers, and other influences on parent decision-making concerning feeding attitudes and behaviours will be necessary to optimise adherence in rural areas.
摘要：
背景：针对国际研究表明，早期引入常见食物过敏原可以减少发生过敏的机会，2016年，澳大利亚临床免疫学和过敏协会（ASCIA）修订了过敏原介绍指南，建议在婴儿第一年早期引入过敏原。澳大利亚的食物过敏率很高，对遵守过敏原引入指南的理解有限，尤其是在农村地区。该项目探讨了农村父母对ASCIA指南的遵守情况。
方法：这是一项混合方法的横断面研究，使用在线调查，包括多项选择和定性的简短回答。样本是来自新南威尔士州两个农村卫生区的336名妇女。都是18岁或以上,自2018年7月以来怀孕或分娩。描述性统计数据用于衡量行为与推荐指南的一致性，主题分析用于分析态度和解释。
结果：在84.3%的儿童中，喂养遵守了所有研究的四项指导方针，包括在怀孕期间不消除过敏原（98％），固体引入年龄（97.7%），在引入固体期间继续母乳/牛奶配方(95%)，和引入过敏原的年龄（92.9％）。依从性与受教育程度无显著相关(X2=17.9,P=.056),既往过敏史[母亲（X2=0.945，P=.623）和既往儿童（X2=0.401，P=.818）]，或怀孕期间接受的初级保健。超过90％的参与者同意或强烈同意准则是现实的，值得信赖,对孩子的健康很重要。然而,主题分析显示，父母对孩子个人进步的看法，以及医疗状况或其他情况，例如母乳喂养的挑战，通常优先于遵守特定的指南建议。
结论：此处发现的ASCIA指南的高依从率与大城市研究的结果相当，对未来的人群健康也是令人鼓舞的。参与者对指南的评论意味着农村决策者对父母关于婴儿喂养的决定有多种影响，通常包括父母自己的直觉和经验。进一步研究，以提高对信息作用的理解，看护者,以及其他有关喂养态度和行为的父母决策的影响将是必要的，以优化农村地区的依从性。
方法：这是一项混合方法的横断面研究，使用在线调查，包括多项选择和定性的简短回答。样本是来自新南威尔士州两个农村卫生区的336名妇女。都是18岁或以上,自2018年7月以来怀孕或分娩。描述性统计数据用于衡量行为与推荐指南的一致性，主题分析用于分析态度和解释。
结果：在84.3%的儿童中，喂养遵守了所有研究的四项指导方针，包括在怀孕期间不消除过敏原（98％），固体引入年龄（97.7%），在引入固体期间继续母乳/牛奶配方(95%)，和引入过敏原的年龄（92.9％）。依从性与受教育程度无显著相关(X2=17.9,P=.056),既往过敏史[母亲（X2=0.945，P=.623）和既往儿童（X2=0.401，P=.818）]，或怀孕期间接受的初级保健。超过90％的参与者同意或强烈同意准则是现实的，值得信赖,对孩子的健康很重要。然而,主题分析显示，父母对孩子个人进步的看法，以及医疗状况或其他情况，例如母乳喂养的挑战，通常优先于遵守特定的指南建议。
结论：此处发现的ASCIA指南的高依从率与大城市研究的结果相当，对未来的人群健康也是令人鼓舞的。参与者对指南的评论意味着农村决策者对父母关于婴儿喂养的决定有多种影响，通常包括父母自己的直觉和经验。进一步研究，以提高对信息作用的理解，看护者,以及其他有关喂养态度和行为的父母决策的影响将是必要的，以优化农村地区的依从性。
