Living with Allergy During the Transition to Secondary School

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Supervisory team Dr Bere Mahoney, Professor Eleanor Bradley, Professor Alison Kington

Director of Studies Dr Bere Mahoney, Principal Lecturer in Psychology and Social Science Lead for the Three Counties Medical School, Living Well with Long-Term Conditions Research Group, School, University of Worcester

Supervisors

Professor Eleanor Bradley, Professor of Health Psychology, Living Well with Long- Term Conditions Research Group, School, University of Worcester

Professor Alison Kington, Professor in Psychology of Education for Institute of Education, Social Psychology of Education Research Group, University of Worcester

Research Group: Living Well with Long-Term Conditions Research Group

The PhD Opportunity Allergy, the immune system’s hypersensitive reaction to typically harmless substances, can be severe and lead to a potentially life-threatening reaction or anaphylaxis (Turner et al, 2019). Allergy prevalence is a global “major public health issue” (Sánchez-Borges et al, 2018, p.1), and one of the most common chronic conditions in Europe (Muraro, 2015).

The UK particularly faces an allergy crisis. UK allergy rates amongst adults and children are some of the highest in Europe (APPG, October 2021; Sigurdardottir et al, 2021). Allergy can develop across the lifespan but is common in childhood and can become lifelong (Chan et al, 2020; Waserman & Wason, 2001). Allergy prevalence is difficult to estimate, especially among children (Grabenhenrich et al, 2020). Nevertheless, estimates suggest proven and undiagnosed allergy prevalence among UK school age children is high (APPG, 2021), and 10% of primary school age with proven or undiagnosed allergic multimorbidity (Sigurdardottir et al, 2021).

For these children and their families, living with allergy has health, economic, and psychosocial costs (Grabenhenrich et al, 2020; Subramanain et al, 2021; Walker, 2007). Importantly, allergy’s adverse impact on children’s educational attainment and school experience is robust (e.g., Champaloux & Young, 2015; Fong et al, 2018; Newman et al, 2022; von Kobyletzki et al, 2017). Consequently, understanding factors influencing management of allergy in children is important (BSACI, nd).

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Adult carers (parents and schoolteachers) implement a young person’s allergy management action plan including strategies in the event of severe or potentially life- threatening anaphylactic reaction (NICE, 2020; 2018). Research on ways of avoiding and responding to allergy-related medical emergencies among young people focuses on two transition points (Kaplan, 2022; Sanagavarapu, 2017; 2016; 2012): the transition to school, and from adolescence to adulthood. Yet, UK research on children’s transitions from primary to secondary school is sparse (Newman, 2022) despite known psychosocial challenges this transition represents for children in general (Coffey, 2013).

We are looking for a PhD student to develop a qualitative or mixed methods study to enhance our understanding of the experiences of children living with proven and undiagnosed allergy before and after the transition from primary to secondary school. This multi-disciplinary, collaborative study will run across both UW, NHS, and school environments, offering an opportunity for the successful applicant to develop an applied, impactful research study which could inform policy and practice within schools and NHS Trusts.

References APPG (October, 2021) Meeting the challenges of the National Allergy Crisis A report from the All Party Parliamentary Group for Allergy and the National Allergy Strategy Group. https://www.bsaci.org/wp-content/uploads/2021/10/Meeting-the-challenges- of-the-national-allergy-crisis-2021.pdf BSACI (nd) Allergy Organisations join together to launch new guidelines to safeguard pupils with severe allergies while they are at school https://www.bsaci.org/allergy- organisations-join-together-to-launch-new-guidelines-to-safeguard-pupils-with- severe-allergies-while-they-are-at-school/ Champaloux, S. W., & Young, D. R. (2015). Childhood chronic health conditions and educational attainment: a social ecological approach. Journal of Adolescent Health, 56(1), 98-105. Chan, E. S., Dinakar, C., Gonzales-Reyes, E., Green, T. D., Gupta, R., Jones, D., ... & Greenhawt, M. (2020). Unmet needs of children with peanut allergy: aligning the risks and the evidence. Annals of Allergy, Asthma & Immunology, 124(5), 479-486. Coffey, A. (2013). Relationships: The key to successful transition from primary to secondary school? Improving Schools, 16, 261 Fong, A. T., Katelaris, C. H., & Wainstein, B. K. (2018). Bullying in Australian children and adolescents with food allergies. Pediatric allergy and immunology, 29(7), 740- 746. Grabenhenrich, L., Trendelenburg, V., Bellach, J., Yürek, S., Reich, A., Fiandor, A., ... & Beyer, K. (2020). Frequency of food allergy in school‐aged children in eight European countries—The EuroPrevall‐iFAAM birth cohort. Allergy, 75(9), 2294-2308. Kaplan, G., Mart, S., & Diken, İ. H. (2022). Transition to school process of children with disadvantages: A literature review. Journal of Childhood, Education & Society, 3(1), 28-47.

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Muraro, A. (2015). The European Academy of Allergy and Clinical Immunology (EAACI). Advocacy Manifesto. Tackling the Allergy Crisis in Europe-Concerted Policy Action Needed. EAACI—EU Liaison Office. Newman, K. L., Chater, A., & Knibb, R. C. (2022). Beliefs about food allergies in adolescents aged 11–19 years: A systematic review. Clinical and Translational Allergy, 12(4), e12142. NICE (2020) Anaphylaxis: assessment and referral after emergency treatment. www.nice.org.uk/guidance/cg134 NICE (2018) Food allergy in under 19s: assessment and diagnosis. www.nice.org.uk/guidance/cg116 Sanagavarapu, P. (2017). Young children’s knowledge of food allergy and transition to school. Cogent Education, 4(1), 1304617. Sanagavarapu, P., Said, M., Katelaris, C., & Wainstein, B. (2016). Transition to school anxiety for mothers of children with food allergy: Implications for educators. Australasian Journal of Early Childhood, 41(4), 115-122. Sanagavarapu, P. (2012). Don't forget to pack my EpiPen® please: What issues does food allergy present for children's starting school? Australasian Journal of Early Childhood, 37(2), 56-62. Sigurdardottir, S. T., Jonasson, K., Clausen, M., Lilja Bjornsdottir, K., Sigurdardottir, S. E., Roberts, G., ... & Keil, T. (2021). Prevalence and early‐life risk factors of school‐age allergic multimorbidity: The EuroPrevall‐iFAAM birth cohort. Allergy, 76(9), 2855-2865. Sánchez-Borges, M., Martin, B. L., Muraro, A. M., Wood, R. A., Agache, I. O., Ansotegui, I. J., ... & Rosenwasser, L. (2018). The importance of allergic disease in public health: an iCAALL statement. World Allergy Organization Journal, 11(1), 1-3. Subramanian, A., Adderley, N. J., Gkoutos, G. V., Gokhale, K. M., Nirantharakumar, K., & Krishna, M. T. (2021). Ethnicity-based differences in the incident risk of allergic diseases and autoimmune disorders: a UK-based retrospective cohort study of 4.4 million participants. Clin Exp Allergy, 51(1), 144-7. Turner, P. J., Worm, M., Ansotegui, I. J., El-Gamal, Y., Rivas, M. F., Fineman, S., Geller, M., Gonzalez-Estrada, A., Greenberger, P. A., Tanno, L. K., Borges, M. S., Senna, G., Sheikh, A., Thong, B. Y., Ebisawa, M., Cardona, V., & WAO Anaphylaxis Committee (2019). Time to revisit the definition and clinical criteria for anaphylaxis?. The World Allergy Organization journal, 12(10), 100066. https://doi.org/10.1016/j.waojou.2019.100066. van Rens, M., Haelermans, C., Groot, W., & Maassen van den Brink, H. (2018). Facilitating a successful transition to secondary school:(how) does it work? A systematic literature review. Adolescent Research Review, 3(1), 43-56. Walker, S., Khan-Wasti, S., Fletcher, M., Cullinan, P., Harris, J., & Sheikh, A. (2007). Seasonal allergic rhinitis is associated with a detrimental effect on examination performance in United Kingdom teenagers: case-control study. Journal of Allergy and Clinical Immunology, 120(2), 381-387. Waserman, S., & Watson, W. (2011). Food allergy. Allergy, Asthma & Clinical Immunology, 7(1), 1-7.

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Application Process To begin the application process please go to https://www.worc.ac.uk/research/research-degrees/applying-for-a-phd/.

The Interview All successful applicants will be offered an interview with the proposed Supervisory Team. You will be contacted by a member of the Doctoral School Team to find a suitable date. Interviews can be conducted in person or over Microsoft Teams.

Funding your PhD For information about Doctoral Loans please visit: https://www.worc.ac.uk/study/fees- and-finance/doctoral-loans.aspx

During your PhD you can access the Research Conference Support Scheme to support the costs of presenting your research at an external conference.

Research at the University of Worcester Research is central to the University’s mission to make a difference in everything that we do. We are committed to delivering excellent research which extends the boundaries of human knowledge but which also improves people’s lives by enabling better health outcomes, improving food security, developing environmentally sustainable solutions for crop production and socially sustainable solutions to our ageing population, enhancing public knowledge and understanding of the past and present. The University hence focuses its research around five high-level challenges facing society, locally, nationally and globally: • Human Health and Wellbeing • Sustainable Futures • Digital Innovation • Culture, Identity and Social Exclusion • Professional Education The success of our research is reflected in our continuous improvement in external research assessment processes. In the most recent Research Excellence Framework, REF 2021, the University saw a near 50% increase in the scale of its research and 12% increase in quality, building on its performance in REF 2014 when it was the UK’s most improved university in terms of Research Power, a combination of scale and quality.

Research Degrees at Worcester Our research students are central to our overall mission for research. They are working at the cutting edge of their disciplines and driving forward the quality of our research whilst enriching our research culture. We are looking to increase our research student numbers as a strategic imperative.

Our commitment to our students is reflected in the results of the Postgraduate Research Experience Survey 2023 in which we ranked 3rd for overall research student satisfaction nationally. Key to our success in his area is the Doctoral School, a focal point for all our research students.

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It provides: • day-to-day support for our students, both administrative and practical, through our dedicated team • a Research Student Study Space with both PCs and laptop docking station • a comprehensive Researcher Development Programme for students and their

supervisors

• a programme of student-led conferences and seminars

Living Well with Long-Term Conditions Research Group Approximately 15 million people in England, representing 1 in 4 adults, have one or more long-term conditions (LTCs). A LTC is an illness that cannot be cured but may be controlled with medicines or other treatments. People living with LTCs face considerable challenges around the management of their long-term physical and mental health.

The ‘Living Well with Long-Term Conditions’ Research Group aims to facilitate the development and implementation of high-quality research and knowledge exchange, targeted at helping people with long-term conditions and their families to live well.

Widening Participation As part of its mission statement the University is committed to widening participation for its higher degrees. Although most candidates will have an undergraduate and/or a Masters degree, the University is happy to accept applications from candidates with relevant professional qualifications and work related experience.

Research areas