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

Background: Parents commonly experience anxiety owing to their children's food allergies (FAs). Although FA -specific anxiety screening tools for adult and pediatric patients exist, a tool for parents with children with food allergy is lacking.Objective: 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 instru-ment was validated through assessing internal validity (reliability), convergent and discriminant validity, con-current validity, and practical usefulness at 2 time points (precoronavirus disease 2019 and current). Results: The scale showed excellent reliability (Cronbach's a = 0.95). It had a 4-factor structure that was replicated at the 2 time points. The 4 subscales were moderately correlated (between r = 0.438 and 0.744). The scale showed excellent convergent and discriminatory validity, correlating moderately with State Trait Anxiety Inventory and Generalized Anxiety Disorder, and highly with Food Allergy Quality of Life-Parental Burden. It also showed excellent concurrent validity, differentiating among many external variables. Most importantly, it successfully differentiated parents in need of psychological support for problems related to their child's FA.Conclusion: The Impairment Measure for Parental Food Allergy-associated Anxiety and Coping Tool fills a gap in the existing literature as a validated screening tool for parental anxiety associated with a child's FA, employing a multi-factor structure addressing multiple dimensions of anxiety and its functional impacts. It has excellent internal and external validity and is well-suited for use in both research and clinical settings to quickly deter-mine which parents of children with FA are in need of further psychological support.(c) 2022 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.