Sharon To - Academia.edu (original) (raw)

Papers by Sharon To

Research paper thumbnail of Decreased food allergy-specific anxiety and increased general anxiety in parents of children with food allergies during the coronavirus disease 2019 pandemic

Annals of Allergy, Asthma & Immunology

Research paper thumbnail of Reducing parental anxiety during oral food challenges

Annals of Allergy, Asthma & Immunology, 2022

Research paper thumbnail of Author response for "Food‐allergy‐specific anxiety and distress in parents of children with food allergy: A systematic review

Research paper thumbnail of Delayed Unblinding of Double-Blind Placebo-Controlled Food Challenges in Anxious Patients Allows Exclusion of Both Immediate and Delayed Adverse Reactions to Food

The journal of allergy and clinical immunology. In practice, 2018

Research paper thumbnail of Chinese Adolescents’ Moral Reasoning of Rights Attitudes and Psychological Well-Being

ETHICS IN PROGRESS, 2017

This study examined rural and urban Chinese adolescents’ (aged 13–19 years, N = 395) attitudes to... more This study examined rural and urban Chinese adolescents’ (aged 13–19 years, N = 395) attitudes toward children’s self-determination and nurturance rights, and how these attitudes relate to various dimensions of socialization in their family and school environments, including perceptions of parental and teacher autonomy support and responsiveness and family and school democratic climate. Relations between these variables and psychological well-being also were examined. Perceived parent and teacher autonomy support and responsiveness and democratic climate differentially predicted attitudes toward each type of right and were positively correlated with adolescents’ psychological well-being. Our findings suggest that environments that are structured more democratically and that are responsive to children’s autonomy needs contribute to their psychological health and well-being in diverse cultural settings.

Research paper thumbnail of Parents of children with food allergy

Annals of Allergy, Asthma & Immunology, 2020

Abstract Background Parents experience a wide range of emotions, specifically stress and anxiety,... more Abstract Background Parents experience a wide range of emotions, specifically stress and anxiety, when their child receives a diagnosis of a food allergy. Managing this health condition and coping with emotions require professional and peer support. Currently, there is a lack of resources and a lack of awareness of the resources that are required to help assist parents in managing their child’s food allergy. Objective To describe parental experiences when caring for a child with food allergy and to review the resources parents need to manage living with a child with food allergy and more specifically how they would want these resources delivered. Methods A total of 7 semistructured focus groups were conducted in British Columbia, Canada. Parents were asked to describe their experiences with managing their child’s food allergy and identify helpful resources. Results A total of 40 parents (33 females) participated in the focus groups. Participant demographics were collected. The following 3 main themes emerged: (1) anxiety (an emotional roller coaster); (2) a transformational journey (the waiting game, loss of normalcy, strained relationships and mistrust, and financial challenges); and (3) the need for resources (day to day management, ages and stages, mental health supports, and “the dream”). Conclusion An in-person allied health care team is needed to provide an integrated, patient-centered approach for how families can live and manage food allergies. Credible information and resources, such as medically reviewed websites, support groups, and counseling services, with a goal of reducing child and parental anxiety, should be provided by health care professionals.

Research paper thumbnail of Proceedings of the Canadian society of allergy and clinical immunology annual scientific meeting 2015

Allergy, Asthma & Clinical Immunology, 2016

Background: Allergic rhinitis is a major risk factor for asthma development. Lower airway inflamm... more Background: Allergic rhinitis is a major risk factor for asthma development. Lower airway inflammation and remodeling have been observed in allergic rhinitis subjects without asthma. Tissue repair processes involve the production of extracellular matrix, in which fibroblasts play a major role. These cells originate from bone marrow progenitors called fibrocytes. The number of fibrocytes is increased in asthmatics following allergen exposure. In allergic rhinitis, allergen-induced inflammation has been widely observed, but studies on allergen-induced lower airway remodeling are still limited. The aim of this study is to determine the effect of seasonal allergen exposure on the profile of fibrocytes isolated from blood of allergic rhinitis subjects without asthma. Methods: Non asthmatic subjects with seasonal allergic rhinitis were recruited. At baseline (out of the pollen season), medical history, skin prick tests, spirometry, methacholine bronchoprovocation, blood sampling and sputum induction were performed. At the peak of rhinitis symptoms, the tests were repeated. Fibrocytes number and level of activation were determined in whole blood. Cells were stained for fibrocyte markers (CD34, CD45, CXCR4, collagen I) and analyzed by flow cytometry. Results: Thirty subjects (18F:12M) aged 28 ± 8 years were recruited. Among the 12 subjects that completed the study yet, there were 12.2 ± 7.9 % of fibrocytes at baseline, whereas there were 7.1 ± 3.6 % of fibrocytes during the pollen season. Mean fluorescence of CXCR4 was 1614 ± 646 (arbitrary units) at baseline and 1805 ± 770 during the pollen season. Conclusion: The observed decrease in fibrocytes during allergy season may indicate an active migration of these cells from the periphery to the airways. A change in the number and profile of fibrocytes during natural seasonal exposure in non-asthmatic rhinitic subjects may help direct further studies looking at future outcome of these patients to develop a predictor of asthma onset.

Research paper thumbnail of Development of IMPAACT (Impairment Measure for Parental Food Allergy-Associated Anxiety and Coping Tool), a validated tool to screen for food allergy-associated parental anxiety

Annals of Allergy, Asthma & Immunology, 2022

BACKGROUND Parents commonly experience anxiety due to their children's food allergies (FA). A... more BACKGROUND Parents commonly experience anxiety due to their children's food allergies (FA). Although FA-specific anxiety screening tools for adult and pediatric patients exist, a tool for parents with food-allergic children is lacking. OBJECTIVE This study aimed to develop and validate a tool that measures parental anxiety related to their child's FA. METHODS To construct the instrument, items were developed based on consultations with stakeholders and review of existing literature. The instrument was then pilot tested and items were modified based on relevance, importance, item-total correlations, and fit with the instrument's overall factor structure. The modified instrument was validated through assessing internal validity (reliability), convergent & discriminant validity, concurrent validity, and practical usefulness at two time points (pre-COVID and current). RESULTS The scale showed excellent reliability (Cronbach's α=.95). It had a four-factor structure which was replicated at the two time-points. The four subscales were moderately correlated (between r =.438 and .744). The scale showed excellent convergent and discriminatory validity, correlating moderately with STAI and GAD, and highly with FAQL-PB. It also showed excellent concurrent validity, differentiating amongst many external variables. Most importantly, it successfully differentiated parents in need of psychological support for problems related to their child's FA. CONCLUSION IMPAACT fills a gap in the existing literature by being the first screening tool to address parental anxiety associated with a child's FA. It has excellent internal and external validity, and is well-suited for use in both research and clinical settings to quickly determine which parents of children with FA are in need of further psychological support.

Research paper thumbnail of Culture, Autonomy and Rights

Research paper thumbnail of The Role of Democratic Family and School Environment in Urban and Rural Chinese Adolescents’ Attitudes about Children’s Rights and their Psychological Well-being

This study examined the significance of perceived parent and teacher support for autonomy and res... more This study examined the significance of perceived parent and teacher support for autonomy and responsiveness, along with perceptions of democratic social organization, in the development of conceptions of children's rights. Relations between these family and school environments and adolescents' psychological well-being were also examined and a contrast between urban and rural settings within mainland China was included. Current findings suggest that Chinese adolescents display patterns of children's rights attitudes similar to those found in Western settings. Different possible pathways of family and school environmental impact on children's rights attitudes are found and explored. Current findings support psychological models that propose that the promotion of autonomy and responsiveness is critical to adolescents' psychological well-being across cultures. Moreover, these findings provide strong evidence that features of democratic environments (e.g., mutual respect between parents and children, opportunities for children to express their opinions, shared decision making) are relevant to people in non-Western cultures.

Research paper thumbnail of Autonomy, Rights, and Parenting in Changing Chinese Cultural Contexts

Research paper thumbnail of The different pathways of "promoting" Children's Rights attitudes in the Family and School Environment: Findings from Urban and Rural China

This study examined the significance of perceived parent and teacher support for autonomy and res... more This study examined the significance of perceived parent and teacher support for autonomy and responsiveness, along with perceptions of democratic social organization, in the development of conceptions of children’s rights. Current findings suggest that Chinese adolescents display patterns of children’s rights attitudes similar to those found in Western settings. Older adolescents and those from urban settings exhibited higher levels of support for children’s rights. Different possible pathways of family and school environmental impact on children’s rights attitudes are found and explored. A subset of adolescents who endorsed extremely high levels of support for self-determination rights (freedoms to make choices over a wide range of areas) also reported low levels of parental autonomy support and responsiveness and psychological well-being. This finding may suggest a “reactive” developmental pathway in which some adolescents may claim extreme or developmentally inappropriate leve...

Research paper thumbnail of Does Democracy in the Family and School Promote Adolescents Psychological Well-Being

Our study included 395 Chinese adolescents from two research sites in urban and rural China, who ... more Our study included 395 Chinese adolescents from two research sites in urban and rural China, who are either in their Junior High (12-16 year-olds) and Senior High (15-19 year-olds). The results show that autonomy supportwas highly positively associated with all measures of psychological well-being. With respect to democratic climate, we also found that democratic climate was just as strongly related to psychological well-being. And as with autonomy support and responsiveness, democratic family climate was especially strongly related to psychological well-being. A developmental pattern was found, in which adolescents are more likely to endorse both nurturance rights and self-determination rights.

Research paper thumbnail of Food‐allergy‐specific anxiety and distress in parents of children with food allergy: A systematic review

Pediatric Allergy and Immunology

Research paper thumbnail of Development and Initial Validation of a Food Allergy Associated Parental Anxiety Screening Tool: IMPAACT

Journal of Allergy and Clinical Immunology

Research paper thumbnail of Current tools measuring anxiety in parents of food-allergic children are inadequate

Pediatric Allergy and Immunology

In the context of food allergy, excessive parental anxiety can be maladaptive and lead to unneces... more In the context of food allergy, excessive parental anxiety can be maladaptive and lead to unnecessary restriction of social activities. No validated tool exists to measure food allergy–associated anxiety (FAAA). This study sought to explore factors associated with parental FAAA, determine sensitivity and specificity of using generic state anxiety measure—State‐Trait Anxiety Inventory (STAI) versus FAAA, and determine whether validated tools for generalized anxiety or food allergy–specific quality of life (QoL) could be used as surrogates for FAAA.

Research paper thumbnail of Chinese Adolescents' Moral Reasoning of Rights Attitudes and Psychological Well-Being

Ethics in Progress, 2017

This study examined rural and urban Chinese adolescents’ (aged 13–19 years, N = 395) attitudes to... more This study examined rural and urban Chinese adolescents’ (aged 13–19 years, N = 395) attitudes toward children’s self-determination and nurturance rights, and how these attitudes relate to various dimensions of socialization in their family and school environments, including perceptions of parental and teacher autonomy support and responsiveness and family and school democratic climate. Relations between these variables and psychological well-being also were examined. Perceived parent and teacher autonomy support and responsiveness and democratic climate differentially predicted attitudes toward each type of right and were positively correlated with adolescents’ psychological well-being. Our findings suggest that environments that are structured more democratically and that are responsive to children’s autonomy needs contribute to their psychological health and well-being in diverse cultural settings.

Research paper thumbnail of Factors Associated with Increased Food Allergy-associated Anxiety in Parents of Food-allergic Children

Journal of Allergy and Clinical Immunology

RATIONALE: Parents of children with food allergy can experience anxiety and difficulty coping, wh... more RATIONALE: Parents of children with food allergy can experience anxiety and difficulty coping, which can affect the child's ability to cope with management. Predictors of parental anxiety are currently unknown. The goal of this study was to estimate the magnitude of food allergyassociated anxiety (FAAA) in Canadian parents and determine factors associated with high anxiety. METHODS: Food Allergy Canada, a not-for-profit organization supporting families with food allergies, emailed parent members in Fall 2017 inviting them to complete an online survey about their FAAA using a visual analogue scale, which measured FAAA on a scale of 0 (not anxious) to 100 (very anxious). Multiple linear regression was performed to determine demographic, clinical, and psychosocial factors associated with FAAA, and standardized coefficients were calculated. RESULTS: Of 1,244 parents who clicked on the survey, 548 completed it (44.1%). Mean FAAA was 71.2 (95% CI: 69.5, 73.0). Those with higher FAAA had a higher parental burden (beta50.51, p<0.001), higher perception of risk that their child would have a severe reaction (beta50.13, p50.001) or die (beta50.13, p50.001) if they were to accidentally ingest their food allergen, as well as lower tolerance of uncertainty (beta50.14, p<0.001). The overall model explained 52.8% of the variance (p<0.001). CONCLUSIONS: We identified psychosocial factors associated with parental anxiety, including risk perception, intolerance of uncertainty, and parental burden. Parental burden appeared to be most strongly associated with FAAA. This will help us develop a validated diagnostic tool, so that clinicians can more easily diagnose FAAA and provide support/resources to those who need it.

Research paper thumbnail of Distinguishing Parental Anxiety And Quality Of Life In Parents Of Food-allergic Children: Evidence From Factor Analyses

Journal of Allergy and Clinical Immunology

RATIONALE: While parental anxiety is commonly observed clinically in the food-allergic (FA) popul... more RATIONALE: While parental anxiety is commonly observed clinically in the food-allergic (FA) population, studies of FA patients and their parents have mainly focused on using broader measures (e.g., quality of life (QoL)) to capture this phenomenon. Moreover, measures of QoL have often been equated to measures of health anxiety. The current study sought to use factor analyses to determine whether parental anxiety and quality of life are distinct constructs. METHODS: Canadian parents of children with FA were invited to participate in an online survey through Food Allergy Canada about their generalized (state) anxiety using the State Trait Anxiety Inventory (STAI-S) and their QoL using the Food Allergy Quality of Life Parental Burden (FAQoL-PB) questionnaire. Factor analyses were used to evaluate the psychometric properties of STAI-S and its relation to FAQoL-PB. RESULTS: Factor analysis was first conducted separately for each measure-STAI-S yielded two factors (presence versus absence of anxiety) and the FAQoL-PB also yielded two factors (physical limitations on life versus emotional distress). Subsequently, factor analysis of all items (20 items from STAI-S and 17 items from FAQoL-PB) combined resulted in four factors that were orthogonal. These findings suggest that, although significantly correlated (r 50.54, p<0.001), parental anxiety and QoL are two distinct constructs. CONCLUSIONS: While it is very useful to understand the quality of life and parental burden as it relates to parenting children with FA, our findings demonstrate the importance of developing a separate measure for understanding food allergy-associated parental anxiety.

Research paper thumbnail of Predictors of Children's Rights Attitudes and Psychological Well-being Among Rural and Urban Mainland Chinese Adolescents

Social Development

This study examined rural and urban Chinese adolescents’ (13–19 years, N = 395) attitudes toward ... more This study examined rural and urban Chinese adolescents’ (13–19 years, N = 395) attitudes toward children's self-determination and nurturance rights, and how these attitudes relate to various dimensions of socialization in their family and school environments, including perceptions of parental and teacher autonomy support and responsiveness and family and school democratic climate. Relations between these variables and psychological well-being also were examined. Hierarchical regression analyses revealed that maternal responsiveness and teacher autonomy support predicted higher levels of endorsement of nurturance rights. Maternal autonomy support and tolerance of dissent at home predicted greater endorsement of self-determination rights. Democratic climate in the home predicted higher life-satisfaction and fewer depressive symptoms, even when parent and teacher autonomy support and responsiveness were controlled. Our findings suggest that environments that are structured more democratically and that are more responsive to children's autonomy needs are associated with higher levels of endorsement of children's rights and contribute to adolescents’ psychological health and well-being in a non-Western culture.

Research paper thumbnail of Decreased food allergy-specific anxiety and increased general anxiety in parents of children with food allergies during the coronavirus disease 2019 pandemic

Annals of Allergy, Asthma & Immunology

Research paper thumbnail of Reducing parental anxiety during oral food challenges

Annals of Allergy, Asthma & Immunology, 2022

Research paper thumbnail of Author response for "Food‐allergy‐specific anxiety and distress in parents of children with food allergy: A systematic review

Research paper thumbnail of Delayed Unblinding of Double-Blind Placebo-Controlled Food Challenges in Anxious Patients Allows Exclusion of Both Immediate and Delayed Adverse Reactions to Food

The journal of allergy and clinical immunology. In practice, 2018

Research paper thumbnail of Chinese Adolescents’ Moral Reasoning of Rights Attitudes and Psychological Well-Being

ETHICS IN PROGRESS, 2017

This study examined rural and urban Chinese adolescents’ (aged 13–19 years, N = 395) attitudes to... more This study examined rural and urban Chinese adolescents’ (aged 13–19 years, N = 395) attitudes toward children’s self-determination and nurturance rights, and how these attitudes relate to various dimensions of socialization in their family and school environments, including perceptions of parental and teacher autonomy support and responsiveness and family and school democratic climate. Relations between these variables and psychological well-being also were examined. Perceived parent and teacher autonomy support and responsiveness and democratic climate differentially predicted attitudes toward each type of right and were positively correlated with adolescents’ psychological well-being. Our findings suggest that environments that are structured more democratically and that are responsive to children’s autonomy needs contribute to their psychological health and well-being in diverse cultural settings.

Research paper thumbnail of Parents of children with food allergy

Annals of Allergy, Asthma & Immunology, 2020

Abstract Background Parents experience a wide range of emotions, specifically stress and anxiety,... more Abstract Background Parents experience a wide range of emotions, specifically stress and anxiety, when their child receives a diagnosis of a food allergy. Managing this health condition and coping with emotions require professional and peer support. Currently, there is a lack of resources and a lack of awareness of the resources that are required to help assist parents in managing their child’s food allergy. Objective To describe parental experiences when caring for a child with food allergy and to review the resources parents need to manage living with a child with food allergy and more specifically how they would want these resources delivered. Methods A total of 7 semistructured focus groups were conducted in British Columbia, Canada. Parents were asked to describe their experiences with managing their child’s food allergy and identify helpful resources. Results A total of 40 parents (33 females) participated in the focus groups. Participant demographics were collected. The following 3 main themes emerged: (1) anxiety (an emotional roller coaster); (2) a transformational journey (the waiting game, loss of normalcy, strained relationships and mistrust, and financial challenges); and (3) the need for resources (day to day management, ages and stages, mental health supports, and “the dream”). Conclusion An in-person allied health care team is needed to provide an integrated, patient-centered approach for how families can live and manage food allergies. Credible information and resources, such as medically reviewed websites, support groups, and counseling services, with a goal of reducing child and parental anxiety, should be provided by health care professionals.

Research paper thumbnail of Proceedings of the Canadian society of allergy and clinical immunology annual scientific meeting 2015

Allergy, Asthma & Clinical Immunology, 2016

Background: Allergic rhinitis is a major risk factor for asthma development. Lower airway inflamm... more Background: Allergic rhinitis is a major risk factor for asthma development. Lower airway inflammation and remodeling have been observed in allergic rhinitis subjects without asthma. Tissue repair processes involve the production of extracellular matrix, in which fibroblasts play a major role. These cells originate from bone marrow progenitors called fibrocytes. The number of fibrocytes is increased in asthmatics following allergen exposure. In allergic rhinitis, allergen-induced inflammation has been widely observed, but studies on allergen-induced lower airway remodeling are still limited. The aim of this study is to determine the effect of seasonal allergen exposure on the profile of fibrocytes isolated from blood of allergic rhinitis subjects without asthma. Methods: Non asthmatic subjects with seasonal allergic rhinitis were recruited. At baseline (out of the pollen season), medical history, skin prick tests, spirometry, methacholine bronchoprovocation, blood sampling and sputum induction were performed. At the peak of rhinitis symptoms, the tests were repeated. Fibrocytes number and level of activation were determined in whole blood. Cells were stained for fibrocyte markers (CD34, CD45, CXCR4, collagen I) and analyzed by flow cytometry. Results: Thirty subjects (18F:12M) aged 28 ± 8 years were recruited. Among the 12 subjects that completed the study yet, there were 12.2 ± 7.9 % of fibrocytes at baseline, whereas there were 7.1 ± 3.6 % of fibrocytes during the pollen season. Mean fluorescence of CXCR4 was 1614 ± 646 (arbitrary units) at baseline and 1805 ± 770 during the pollen season. Conclusion: The observed decrease in fibrocytes during allergy season may indicate an active migration of these cells from the periphery to the airways. A change in the number and profile of fibrocytes during natural seasonal exposure in non-asthmatic rhinitic subjects may help direct further studies looking at future outcome of these patients to develop a predictor of asthma onset.

Research paper thumbnail of Development of IMPAACT (Impairment Measure for Parental Food Allergy-Associated Anxiety and Coping Tool), a validated tool to screen for food allergy-associated parental anxiety

Annals of Allergy, Asthma & Immunology, 2022

BACKGROUND Parents commonly experience anxiety due to their children's food allergies (FA). A... more BACKGROUND Parents commonly experience anxiety due to their children's food allergies (FA). Although FA-specific anxiety screening tools for adult and pediatric patients exist, a tool for parents with food-allergic children is lacking. OBJECTIVE This study aimed to develop and validate a tool that measures parental anxiety related to their child's FA. METHODS To construct the instrument, items were developed based on consultations with stakeholders and review of existing literature. The instrument was then pilot tested and items were modified based on relevance, importance, item-total correlations, and fit with the instrument's overall factor structure. The modified instrument was validated through assessing internal validity (reliability), convergent & discriminant validity, concurrent validity, and practical usefulness at two time points (pre-COVID and current). RESULTS The scale showed excellent reliability (Cronbach's α=.95). It had a four-factor structure which was replicated at the two time-points. The four subscales were moderately correlated (between r =.438 and .744). The scale showed excellent convergent and discriminatory validity, correlating moderately with STAI and GAD, and highly with FAQL-PB. It also showed excellent concurrent validity, differentiating amongst many external variables. Most importantly, it successfully differentiated parents in need of psychological support for problems related to their child's FA. CONCLUSION IMPAACT fills a gap in the existing literature by being the first screening tool to address parental anxiety associated with a child's FA. It has excellent internal and external validity, and is well-suited for use in both research and clinical settings to quickly determine which parents of children with FA are in need of further psychological support.

Research paper thumbnail of Culture, Autonomy and Rights

Research paper thumbnail of The Role of Democratic Family and School Environment in Urban and Rural Chinese Adolescents’ Attitudes about Children’s Rights and their Psychological Well-being

This study examined the significance of perceived parent and teacher support for autonomy and res... more This study examined the significance of perceived parent and teacher support for autonomy and responsiveness, along with perceptions of democratic social organization, in the development of conceptions of children's rights. Relations between these family and school environments and adolescents' psychological well-being were also examined and a contrast between urban and rural settings within mainland China was included. Current findings suggest that Chinese adolescents display patterns of children's rights attitudes similar to those found in Western settings. Different possible pathways of family and school environmental impact on children's rights attitudes are found and explored. Current findings support psychological models that propose that the promotion of autonomy and responsiveness is critical to adolescents' psychological well-being across cultures. Moreover, these findings provide strong evidence that features of democratic environments (e.g., mutual respect between parents and children, opportunities for children to express their opinions, shared decision making) are relevant to people in non-Western cultures.

Research paper thumbnail of Autonomy, Rights, and Parenting in Changing Chinese Cultural Contexts

Research paper thumbnail of The different pathways of "promoting" Children's Rights attitudes in the Family and School Environment: Findings from Urban and Rural China

This study examined the significance of perceived parent and teacher support for autonomy and res... more This study examined the significance of perceived parent and teacher support for autonomy and responsiveness, along with perceptions of democratic social organization, in the development of conceptions of children’s rights. Current findings suggest that Chinese adolescents display patterns of children’s rights attitudes similar to those found in Western settings. Older adolescents and those from urban settings exhibited higher levels of support for children’s rights. Different possible pathways of family and school environmental impact on children’s rights attitudes are found and explored. A subset of adolescents who endorsed extremely high levels of support for self-determination rights (freedoms to make choices over a wide range of areas) also reported low levels of parental autonomy support and responsiveness and psychological well-being. This finding may suggest a “reactive” developmental pathway in which some adolescents may claim extreme or developmentally inappropriate leve...

Research paper thumbnail of Does Democracy in the Family and School Promote Adolescents Psychological Well-Being

Our study included 395 Chinese adolescents from two research sites in urban and rural China, who ... more Our study included 395 Chinese adolescents from two research sites in urban and rural China, who are either in their Junior High (12-16 year-olds) and Senior High (15-19 year-olds). The results show that autonomy supportwas highly positively associated with all measures of psychological well-being. With respect to democratic climate, we also found that democratic climate was just as strongly related to psychological well-being. And as with autonomy support and responsiveness, democratic family climate was especially strongly related to psychological well-being. A developmental pattern was found, in which adolescents are more likely to endorse both nurturance rights and self-determination rights.

Research paper thumbnail of Food‐allergy‐specific anxiety and distress in parents of children with food allergy: A systematic review

Pediatric Allergy and Immunology

Research paper thumbnail of Development and Initial Validation of a Food Allergy Associated Parental Anxiety Screening Tool: IMPAACT

Journal of Allergy and Clinical Immunology

Research paper thumbnail of Current tools measuring anxiety in parents of food-allergic children are inadequate

Pediatric Allergy and Immunology

In the context of food allergy, excessive parental anxiety can be maladaptive and lead to unneces... more In the context of food allergy, excessive parental anxiety can be maladaptive and lead to unnecessary restriction of social activities. No validated tool exists to measure food allergy–associated anxiety (FAAA). This study sought to explore factors associated with parental FAAA, determine sensitivity and specificity of using generic state anxiety measure—State‐Trait Anxiety Inventory (STAI) versus FAAA, and determine whether validated tools for generalized anxiety or food allergy–specific quality of life (QoL) could be used as surrogates for FAAA.

Research paper thumbnail of Chinese Adolescents' Moral Reasoning of Rights Attitudes and Psychological Well-Being

Ethics in Progress, 2017

This study examined rural and urban Chinese adolescents’ (aged 13–19 years, N = 395) attitudes to... more This study examined rural and urban Chinese adolescents’ (aged 13–19 years, N = 395) attitudes toward children’s self-determination and nurturance rights, and how these attitudes relate to various dimensions of socialization in their family and school environments, including perceptions of parental and teacher autonomy support and responsiveness and family and school democratic climate. Relations between these variables and psychological well-being also were examined. Perceived parent and teacher autonomy support and responsiveness and democratic climate differentially predicted attitudes toward each type of right and were positively correlated with adolescents’ psychological well-being. Our findings suggest that environments that are structured more democratically and that are responsive to children’s autonomy needs contribute to their psychological health and well-being in diverse cultural settings.

Research paper thumbnail of Factors Associated with Increased Food Allergy-associated Anxiety in Parents of Food-allergic Children

Journal of Allergy and Clinical Immunology

RATIONALE: Parents of children with food allergy can experience anxiety and difficulty coping, wh... more RATIONALE: Parents of children with food allergy can experience anxiety and difficulty coping, which can affect the child's ability to cope with management. Predictors of parental anxiety are currently unknown. The goal of this study was to estimate the magnitude of food allergyassociated anxiety (FAAA) in Canadian parents and determine factors associated with high anxiety. METHODS: Food Allergy Canada, a not-for-profit organization supporting families with food allergies, emailed parent members in Fall 2017 inviting them to complete an online survey about their FAAA using a visual analogue scale, which measured FAAA on a scale of 0 (not anxious) to 100 (very anxious). Multiple linear regression was performed to determine demographic, clinical, and psychosocial factors associated with FAAA, and standardized coefficients were calculated. RESULTS: Of 1,244 parents who clicked on the survey, 548 completed it (44.1%). Mean FAAA was 71.2 (95% CI: 69.5, 73.0). Those with higher FAAA had a higher parental burden (beta50.51, p<0.001), higher perception of risk that their child would have a severe reaction (beta50.13, p50.001) or die (beta50.13, p50.001) if they were to accidentally ingest their food allergen, as well as lower tolerance of uncertainty (beta50.14, p<0.001). The overall model explained 52.8% of the variance (p<0.001). CONCLUSIONS: We identified psychosocial factors associated with parental anxiety, including risk perception, intolerance of uncertainty, and parental burden. Parental burden appeared to be most strongly associated with FAAA. This will help us develop a validated diagnostic tool, so that clinicians can more easily diagnose FAAA and provide support/resources to those who need it.

Research paper thumbnail of Distinguishing Parental Anxiety And Quality Of Life In Parents Of Food-allergic Children: Evidence From Factor Analyses

Journal of Allergy and Clinical Immunology

RATIONALE: While parental anxiety is commonly observed clinically in the food-allergic (FA) popul... more RATIONALE: While parental anxiety is commonly observed clinically in the food-allergic (FA) population, studies of FA patients and their parents have mainly focused on using broader measures (e.g., quality of life (QoL)) to capture this phenomenon. Moreover, measures of QoL have often been equated to measures of health anxiety. The current study sought to use factor analyses to determine whether parental anxiety and quality of life are distinct constructs. METHODS: Canadian parents of children with FA were invited to participate in an online survey through Food Allergy Canada about their generalized (state) anxiety using the State Trait Anxiety Inventory (STAI-S) and their QoL using the Food Allergy Quality of Life Parental Burden (FAQoL-PB) questionnaire. Factor analyses were used to evaluate the psychometric properties of STAI-S and its relation to FAQoL-PB. RESULTS: Factor analysis was first conducted separately for each measure-STAI-S yielded two factors (presence versus absence of anxiety) and the FAQoL-PB also yielded two factors (physical limitations on life versus emotional distress). Subsequently, factor analysis of all items (20 items from STAI-S and 17 items from FAQoL-PB) combined resulted in four factors that were orthogonal. These findings suggest that, although significantly correlated (r 50.54, p<0.001), parental anxiety and QoL are two distinct constructs. CONCLUSIONS: While it is very useful to understand the quality of life and parental burden as it relates to parenting children with FA, our findings demonstrate the importance of developing a separate measure for understanding food allergy-associated parental anxiety.

Research paper thumbnail of Predictors of Children's Rights Attitudes and Psychological Well-being Among Rural and Urban Mainland Chinese Adolescents

Social Development

This study examined rural and urban Chinese adolescents’ (13–19 years, N = 395) attitudes toward ... more This study examined rural and urban Chinese adolescents’ (13–19 years, N = 395) attitudes toward children's self-determination and nurturance rights, and how these attitudes relate to various dimensions of socialization in their family and school environments, including perceptions of parental and teacher autonomy support and responsiveness and family and school democratic climate. Relations between these variables and psychological well-being also were examined. Hierarchical regression analyses revealed that maternal responsiveness and teacher autonomy support predicted higher levels of endorsement of nurturance rights. Maternal autonomy support and tolerance of dissent at home predicted greater endorsement of self-determination rights. Democratic climate in the home predicted higher life-satisfaction and fewer depressive symptoms, even when parent and teacher autonomy support and responsiveness were controlled. Our findings suggest that environments that are structured more democratically and that are more responsive to children's autonomy needs are associated with higher levels of endorsement of children's rights and contribute to adolescents’ psychological health and well-being in a non-Western culture.