title: Transitioning to Independence: Late Adolescents Access to Food and Health Care and Self-Management of Food Allergies
Creators: name: Laheri, Zainab
Publisher: name: University of Central Lancashire
Year: 2024

description: The period of transition from late adolescence to adulthood is a pivotal life stage characterised by increasing autonomy, risk-taking and many developmental changes. This can lead to poorer food choices, which will directly impact dietary intake. The presence of a food allergy will significantly impact both food choice and dietary intake due to the implementation of avoidance diets and the reduced access to safe, allergen-free food. The management of food allergies during the life stage of late adolescence necessitates adequate support. Despite this, access to sufficient support is a challenge for this group. At present, little research exists exploring the food choice, food access, dietary intake and healthcare access of late adolescents with food allergies. To understand the factors which influence food choice and therefore dietary intake and to understand the challenges and opportunities faced by late adolescents with food allergies when accessing food and healthcare is crucial. This can enable the development of tailored interventions which contribute to a more robust support system, consequently optimising the overall health and quality of life in this group. Therefore, the overall aim of this research was to investigate the current food choice, food access, healthcare access and dietary intake in late adolescents with food allergies in North West England. 

This research consisted of five stages - the first three addressing the current food choice, food access and healthcare access of late adolescents with food allergies; the fourth stage explored their dietary intake while in the fifth stage, possible interventions were discussed and suggested with a diverse group of participants (food-allergic patients, parents/carers and healthcare professionals) to improve the current food and healthcare access of late adolescents with food allergies. 

A mixed methods approach was used for this research. Through quantitative questionnaires, geographical mapping and qualitative focus groups, the current food choice, food access and healthcare access of late adolescents with food allergies was explored. In each case, a comparative analysis between late adolescents with and without food allergies was also conducted. Main results highlighted no differences between groups in relation to food choice. Challenges in accessing allergen-free foods were also identified. Similarly, late adolescents with food allergies struggled in accessing sufficient healthcare, in particular nutritional and psychological support were challenging. Through diet diaries the current dietary intake of late adolescents with food allergies was also explored. Dietary intake was found to be broadly similar in both late adolescents with and without food allergies. Diet quality was considered to be poor in all participants, with increased intakes of saturated fat, refined carbohydrates, sugar and salt and an inability to meet the recommended fibre intake. A novel approach of this research was the collaboration between food-allergic patients, parents and healthcare professionals in recommending potential interventions based on the findings of each stage of this research. 

The results of this PhD research have important implications for further research. Late adolescents with food allergies desire to be like their peers and balancing this with the realities of managing food allergies is a challenge. The need to create an environment that promotes inclusivity while at university and supports the needs of late adolescents with food allergies is crucial. Additionally, access to quality health care that considers the unique needs during the transition from adolescence to adulthood is an imperative aspect of management. Collaboration is key – educational institutions, healthcare providers, policymakers and food-allergic patients themselves must work together to ensure a holistic and supportive approach in the management of food allergies.