Pediatric Food Allergy (FA) is recognized as a serious public health concern that affects approximately 4-8% of children, with symptoms affecting multiple organ systems, including skin, the respiratory tract, and the GI tract. Food-induced anaphylaxis, which is a rapid, potentially life-threatening reaction, can occur in more serious cases. Despite the substantial burden of disease management and associated negative quality of life effects, very few resources exist to promote effective strategies for managing FA. Moreover, most resources targeting this population emphasize information dissemination and education, either in-person or via the web, and typically focus on parents, with few resources designed for affected children. <p/>The central goal of Phases I & II of this proposed SBIR is to develop an engaging, interactive web- based intervention for school-aged children with FA that will increase knowledge, improve self-efficacy to manage the disease, and ultimately reduce risk of negative outcomes. Software-based interventions targeting children for various pediatric conditions have increased in availability and accessibility. Virtual Reality (VR) approaches offer distinct advantages over traditional interventions in providing virtual skills-based practice with interactive feedback and highly engaging formats of psychoeducation. <p/>This Phase I SBIR will build a user-friendly, interactive, and affordable web-based intervention, with a high potential fo broad dissemination, adaptation and commercialization across different disease conditions. The web-based intervention, which includes virtual experiential scenarios in a school cafeteria, will consist of three related technical components: (a) the VR software engine that serves as the architecture of the program, enabling the creation of interactive VR environments, individualized delivery of content, and collection and management of data, (b) the experiential scenarios that target knowledge and behavioral skills practice in social contexts, and (c) a token economy with rewards to be used in a virtual game, which will enhance motivation, engagement and usability of the intervention. Thirty-two children with IgE-mediated FA and their parents will participate ina 4-week intervention pilot, in which they will be prompted to use the system three times weekly. We will evaluate the feasibility, credibility, and acceptability of the treatment program via semi-structured interviews with parents and children, and digital questionnaire assessments throughout the software program. Preliminary clinical efficacy to increase knowledge and self-efficacy regarding FA decision-making and management will also be evaluated. <p/>This intervention will surpass existing approaches for child-focused software programs in interactivity, ease of use, and acceptance and promotion by health care professionals. If successful, we envision that the VR program will serve as a template for interactive VR interventions for children with other chronic conditions requiring self-management, such as asthma, diabetes, and celiac disease. The promise of commercial opportunity is significant in an era in which there is an increasingly widespread access to and everyday use of computers, smart phones, and tablet technologies.
PUBLIC HEALTH RELEVANCE: Pediatric Food Allergy (FA) represents a serious public health problem, with an estimated 4-8% of children affected, with dramatically increased prevalence over the past decade. There is no cure for FA; management of this condition requires consistent avoidance of the allergenic food and prompt treatment of symptoms upon ingestion. In this project titled "Web-Based Interactive Virtual Environments for Children with Food Allergies," we will create an engaging, interactive web-based intervention for school-aged children with FA to increase knowledge, improve self-efficacy to manage FA, and ultimately reduce risk of negative outcomes. We will leverage next generation technology methodologies inherent in current software for education, training, and entertainment to increase engagement and interactivity, which will facilitate broader adoption and use of the program. <p/>This project represents an exciting collaboration between thought leaders in the fields of FA, chronic disease management, clinical psychology, and modeling/simulation. If successful, this intervention will provide a clinically effective, web-delivered software program that is engaging, affordable, and widely available, with potential for adaptation to other childhood chronic conditions.