Development and Validation of the Coping with Food Allergy Scales (CoFAS) for Children and Young People and Parents.

Abstract

Managing food allergy (FA) entails complex lifestyle changes and development of specific coping strategies. How we cope with long-term conditions is associated with clinical and psychological outcomes and so it is important that adaptive strategies are promoted. To develop and establish the reliability and validity of new coping with FA scales (Coping with Food Allergy Scales [CoFAS]) for children and young people (CYP) aged 8 to 16 years (CoFAS-C) and for parents (CoFAS-P). The CoFAS were developed following interviews with 32 CYP aged 8 to 16 years and 8 parents, a systematic review of literature, and consultation with FA experts. Reliability and validity analysis was conducted on 151 CYP aged 8 to 16 years who completed the CoFAS-C and 390 caregivers who completed the CoFAS-P. Participants also completed validation measures of generic coping, anxiety and depression, quality of life, and self-efficacy. Exploratory factor analysis resulted in 4 subscales for the CoFAS-C (Avoidance and Minimisation, Positive Beliefs, Self-Management, and Social Support) and 3 subscales for the CoFAS-P (Avoidance and Minimisation, Planning and Preparation, and Dealing with Emotions). All had good to excellent internal reliability (Cronbach α values = 0.74-0.84) and low to medium correlations with validation measures. The CoFAS are reliable and valid scales to identify coping strategies used for FA management by CYP and parents. Planning and preparation appear to be the most adaptive strategies, with avoidance and minimization the least, but managing emotions is also important to promote. Knowledge of the types of coping strategies used by patients could direct clinical care.