A brief psychological intervention for mothers of children with food allergy can change risk perception and reduce anxiety: Outcomes of a randomized controlled trial

• Published in: Clinical and experimental allergy Vol. 47; no. 10; pp. 1309 - 1317
• Main Authors: Boyle, R. J., Umasunthar, T., Smith, J. G., Hanna, H., Procktor, A., Phillips, K., Pinto, C., Gore, C., Cox, H. E., Warner, J. O., Vickers, B., Hodes, M.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-10-2017
• Subjects: Adult; Anaphylaxis; Anxiety; Anxiety - epidemiology; Anxiety - therapy; Child; Child, Preschool; Children; Cognitive ability; cognitive behavioural therapy; Cognitive Therapy; Comorbidity; Computer simulation; Cortisol; Female; Food allergies; food allergy; Food Hypersensitivity - epidemiology; Humans; Infant; London - epidemiology; Male; Medical personnel; Mothers - psychology; Perception; Randomization; Risk; Risk communication; Risk Factors; Risk perception; Risk reduction; Stress (physiology); Stress response; Stress, Psychological; anxiety; stress response; food allergy; cognitive behavioural therapy; risk perception
• ISSN: 0954-7894; 1365-2222
• DOI: 10.1111/cea.12981

Summary
Background
Mothers of children with food allergy have increased anxiety, which may be influenced by healthcare professionals’ communication of risk.
Objective
To evaluate a brief psychological intervention for reducing anxiety in mothers of children with food allergy.
Methods
Two hundred mothers of children with food allergy were recruited from allergy clinics. A computer‐generated randomization list was used to allocate participants to a single‐session cognitive behavioural therapy intervention including a risk communication module, or standard care. Anxiety and risk perception were assessed at 6 weeks and 1 year. Primary outcome was state anxiety at 6 weeks. Secondary outcomes included state anxiety at 1 year, risk perception at 6 weeks and 1 year, and salivary cortisol response to a simulated anaphylaxis scenario at 1 year.
Results
We found no significant difference in the primary outcome state anxiety at 6 weeks, with mean 31.9 (SD 10.2) intervention, 34.0 (10.2) control; mean difference 2.1 (95% CI −0.9, 5.0; P=.17). There was significantly reduced state anxiety at 6 weeks in the intervention group, in the subgroup of participants with moderate/high anxiety at enrolment (103/200, 52%), with mean 33.0 (SD 9.3) intervention, 37.8 (SD 10.0) control; mean difference 4.8 (95% CI 0.9, 8.7; P=.016; Cohen's d effect size 0.50). The psychological intervention also reduced risk perception and salivary cortisol response (P=.032; effect size 0.36).
Conclusion
We found evidence that a brief psychological intervention which incorporates accurate risk information may impact on anxiety, risk perception and physiological stress response in mothers of children with food allergy.