O2057: The Muslim Pediatric Fasting Study: The Culmination of a Multi-phase Longitudinal Study

Background: Muslims abstain from all water, food, and medications from dawn to dusk for the duration of the of the holy month of Ramadan. Currently, the existing medical literature focuses on health outcomes among Muslim adults who fast, with little attention to pediatric patients. This abstract is a compilation of the Muslim Pediatric Fasting Study, a 4-part survey-based study that has been ongoing since 2017. The purpose of this multi-phase study is to assess current fasting practices among pediatric patients, and the knowledge and clinical practice of their physicians to inform a medical education intervention.

Methods: Phase 1 (P1) was a community-based survey assessing pediatric fasting practices; it was administered to Muslim parents/guardians of children between the ages of 7 and 18. Phase 2 (P2) was a survey that assessed the knowledge and clinical practice of residents, fellows or attendings in Michigan. Phase 3 (P3) was a mixed method study that included a retrospective chart review of pediatric patients with diabetes at the Children’s Hospital of Michigan Endocrinology Clinic and a survey for their parents/guardians. The results of the 3 previous studies culminated in Phase 4 (P4): a medical education intervention conducted at pediatric residencies and medical schools in Michigan, which included a post intervention survey. All surveys were conducted using Qualtrics software.

Results: Overall, 63% (522/827) of parents surveyed reported that their child’s physician was unaware that their child/ren fasted during Ramadan (P1). In addition, 75% (613/820) of parents indicated that their child’s physician did not offer them any medical advice regarding fasting (P1). In contrast, about 52% (141/273) of physicians indicated that they had at least a moderate amount of exposure to Muslim pediatric patients in their clinical practice (P2). Although most physicians, about 61% (167/273), rated their understanding of fasting as minimal to none (P2). Regarding pediatric patients with diabetes, about 27% (14/52) fasted during Ramadan, with a majority of them 79% (11/14) fasting 15 or more days during the month (P3). The medical education intervention (P4) was shown to be efficacious with participants indicating improved ability in providing anticipatory guidance to parents regarding fasting.

Conclusion: This multi-phase study is the first of its kind in assessing current knowledge and clinical practice regarding Muslim pediatric fasting in a comprehensive manner. A structured medical intervention has shown promise in helping to elucidate the beliefs surrounding pediatric Muslim fasting and informing physician recommendations.