PC1250: Evaluating Knowledge and Implementation of the Aap-endorsed Early Peanut Introduction Guidelines in Florida

Purpose/Objectives: Prevalence of peanut allergy has tripled in western countries over the last two decades. Data from the 2015 LEAP trial showed that early introduction of peanut-based foods in high-risk infants reduces the development of peanut allergy. In 2019, the AAP endorsed the recommendation. Yet many practitioners remain unaware of the updated guidelines. We conducted a quality improvement (QI) project to evaluate the knowledge of the early peanut introduction guidelines and current practice behaviors among pediatric residents (PR) and practicing pediatricians (PP) in Florida from 2021 to 2022.

Design/Methods: All Florida pediatric residency programs were invited via email to participate. General pediatricians were recruited via an invitation through the Florida Chapter of the AAP News journal and through academic listservs. Participants’ baseline knowledge was evaluated utilizing a pre-survey questionnaire. They then either received educational enhancement via a lecture format (PR) or completed the AAP online module, “Peanut Allergy Prevention Through Early Introduction” (PP). Educational materials were also sent out in the form of a workroom poster and electronic health record smart-phrases to be utilized for well-child check appointments. One month later, the participants took the post-survey to assess retainment of knowledge, practice habits, and continued barriers.

Results: In the preliminary data, the pre-survey was completed by 78 participants (94% PR, 6% PP). Of those, 19 (24%; 25% PR vs 20% PP) provided correct answers on peanut introduction, 42 (54%; 53% PR vs 60% PP) on indication for allergist referral, and 16 (21%; 21% PR vs 20% PP) on appropriate peanut dosing at home. The most significant barriers to implementing the guidelines were being unaware the guidelines existed (35.9%) and forgetting at the visit (29.5%).

After the educational enhancement and receipt of supplemental materials, the post-survey demonstrated improvement in knowledge across all categories: peanut introduction by 43%, indication for allergist referral by 17%, and recommended dosing and frequency of peanut by 55%. The most significant barriers in adhering to the guidelines were forgetting (67%) and not having enough time (33%) during the visit.

Conclusion/Discussion: There is a significant knowledge gap on the AAP-endorsed early peanut introduction guidelines amongst pediatric providers in Florida. The methods of education enhancement demonstrated in the QI project can increase awareness. Continued efforts to strengthen practice of the guidelines is necessary to ultimately reduce the development of peanut allergy in the pediatric population.