Study title: Improving Racial Diversity in our Food Allergy Programs

Program: Structural Racism, Social Injustice and Health Disparities in Maternal and Child Health Pilot Awards

Research summary: Recent epidemiological research indicates that food allergy is a condition that disproportionately impacts low-income, racial/ethnic minority patients, many of whom reside in households at elevated risk of food insecurity. Up to 70 percent of the patients seen at the Sean N. Parker Center for Allergy and Asthma Research at Stanford are allergic to more than one of the top 8 allergenic foods, including milk, eggs, wheat, soybeans, peanuts, tree nuts, fish, and shellfish. Sharon Chinthrajah, MD, Clinical Associate Professor of Pulmonary, Allergy and Critical Care Medicine, is partnering with Food Equality Initiative (FEI) to evaluate a program that offers families who are food-insecure and have food allergies a subscription to allergy-safe, nutritious foods in conjunction with one-on-one nutrition coaching. Dr. Chinthrajah and her team – including Chris Warren, PhD, postdoctoral fellow at the Sean N. Parker Center – will work with FEI to increase engagement in the program with mothers and their children from underrepresented racial/ethnic backgrounds. They will simultaneously evaluate the feasibility, acceptability, and preliminary efficacy of this “food-as-medicine” model.

Q: What progress have you made to date?
A: To date, we have established a new research partnership with the FEI. Based out of Kansas City, MO, FEI is a community-based organization working to improve health and end hunger in individuals diagnosed with food allergies, and they recently launched an online platform to partner with others across the nation doing similar work. We are also collaborating with local clinics and have developed a comprehensive set of assessment instruments, which are currently being evaluated by the Stanford Institutional Review Board (IRB). To coordinate our efforts with FEI and other sites around the country, we plan to share our electronic questionnaires in REDCap and comprehensive IRB protocol. We are also building partnerships with numerous organizations around the Bay Area, with whom we will collaborate to recruit patients immediately upon gaining IRB approval—including multiple federally qualified health centers and non-for-profit clinics as well as programs within Stanford. We’re not multi-centered, but in essence we are, and we can have greater power in our pilot study.

Q: How will this award impact your broader research goals related to healthcare disparities?
A: On a recent call, we convened with our partners at the FEI and two other major US academic medical centers. We are planning to develop a larger proposal to evaluate the effectiveness of our “food-as-medicine” intervention via a multi-site randomized controlled trial. The goal for this follow-up trial will be to provide evidence of sufficient rigor to inform payers of the cost-effectiveness of covering this monthly supplemental allergen-free food assistance for low-income, racial/ethnic minority families who are disproportionately burdened by food allergy management. 

Another goal of this MCHRI project is to increase the diversity in our clinical research trials here at Stanford. The Sean N. Parker Center manages mostly food allergy-based clinical trials. We traditionally serve or have Caucasian, Asian, mixed-race research participants. We have a very low Hispanic or Black representation in our research trials that we conduct. This is another way to reach out and try and make sure that all populations are represented so that we can understand the efficacy of interventions across all races.

The project is currently in progress. This story is a complimentary piece to a larger article. To read the article, click here.

BY LAURA HEDLI

Laura Hedli is a writer for the Division of Neonatal and Developmental Medicine in the Department of Pediatrics and contributes stories to the Stanford Maternal and Child Health Research Institute.