Tonghuan Hua

Date of Award


Degree Type

Thesis - ECU Access Only

Degree Name

Master of Public Health


School of Medical and Health Sciences

First Advisor

Professor Amanda Devine

Second Advisor

Ros Sambell

Third Advisor

Dr Ruth Wallace

Fourth Advisor

Sandra Vale


Background: Childhood food allergies (FA) are increasing in Australia. Although death from anaphylaxis caused by FA is rare, food-induced anaphylaxis could be fatal. It is unclear if staff in Early Childhood Education and Care (ECEC) are well prepared to manage food-induced anaphylaxis. This cross-sectional study utilised an online survey to assess the preparedness of ECEC staff nationally to manage FA.

Method: A survey addressing training, knowledge, skills and staff confidence to manage FA and anaphylaxis was emailed to 5956 ECEC centres nationally (excluding WA). Four hundred and ninety-four surveys were completed. Demographics were used to determine differences between State/Territory and socioeconomic status of the centres. Data was analysed using descriptive statistics and Chi-squared Test.

Results: A high proportion (76.7%) of ECEC services had children with a medically confirmed FA. A small percent (9.5%) of ECEC services did not require staff to undertake anaphylaxis training, which was non-compliant with current legislation. Staff confidence in FA and anaphylaxis management was high regardless of whether they had undertaken training, which indicated perception of confidence is not reflective of staff skill set to manage FA and anaphylaxis within services. Most (93.9%) ECEC services had a FA policy requiring Action Plans be provided. Over one third (37%) ECEC services stored adrenaline autoinjectors (AAI) in a locked location (not recommended). Approximately half (51.4%) of ECEC services reported having an AAI training device. NSW and Queensland had a significantly lower proportion of services with AAI training devices than Victoria (p-value < 0.001). Victoria reported the highest level of anaphylaxis management training (p-value < 0.05). Victorian services were also significantly less likely to store their AAI devices in a locked location compared to NSW and QLD (p-value < 0.001). There was no significant difference in staff training, knowledge, skills and confidence based on socio-economic status (p-value > 0.05).

Conclusion: ECEC staff self-reported a high level of training, knowledge, skills and confidence in FA and anaphylaxis management. However, this study revealed gaps in staff knowledge and skills, especially in how to correctly store and administer an AAI device. This study also identified a lack of awareness about the online FA and anaphylaxis training currently available. Better promotion of existing approved online training resources would increase the engagement of ECEC staff in anaphylaxis training


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