Differences in Familiarity with Oral Immunotherapy among Caregivers of White and Black Food-Allergic Children

Background Potential racial and ethnic disparities related to oral immunotherapy (OIT) have not been fully described among children with food allergy (FA). Objective To characterize the differences in attitudes towards, familiarity with, and utilization of OIT among non-Hispanic White (NHW), non-Hispanic Black (NHB) and Hispanic or Latino (H/L) caregivers of children with FA. Methods Surveys were administered to the caregivers of children enrolled in Food Allergy Outcomes Related to White and African American Racial Differences (FORWARD), a prospective, multisite cohort of children with FA. The distribution of responses by caregiver-reported race and ethnicity was described using an analysis of variance (ANOVA) for continuous outcomes and chi-squared tests for categorical outcomes. A logistic regression model was used to determine associations between familiarity with OIT as a treatment option and various other covariates. Results NHB and H/L respondents were more frequently not familiar with OIT compared to NHW responders (54.3% and 62.5% vs. 9.2%, p < 0.001). This finding remained true, even after adjusting for household income (OR: 0.1, 95% CI: 0.1, 0.4 for NHB participants and OR: 0.1, 95% CI: 0.0, 0.3 for H/L participants). NHB and H/L participants more frequently reported that they had never heard of OIT before the survey compared to NHW participants (76.7% and 50.0% vs. 26.7%, p < 0.001). None of the NHB and H/L respondents initiated OIT compared to 14.8% of NHW participants (p < 0.001). Conclusion In the FORWARD cohort, familiarity with OIT was lower among caregivers of minoritized racial and ethnic groups, even after adjusting for household income.