Table 3 Qualitative themes, summary statement, codes and supporting quotations related to Theme 2: Food allergy-related knowledge, experience and supports shape teachers’ confidence

Theme description: This theme encompasses the variable confidence/perceived knowledge of teachers towards allergy management, particularly emergency management strategies. Teachers’ confidence is largely based on personal experience with allergy (direct or indirect) and by supports available from the school (i.e., other staff involvement), family involvement, communication and personal attitudes, beliefs and experiences related to food allergy.

Codes

Supporting Quotes

Family involvement

I always leaned on the parents with the kids with allergies and I always have them be my expert panel […] If I ever needed something I’d say, “Hey what’s your recommendation for this?”, “How do you think I should handle that?” (T17)

I think that’s what’s hard for [teachers without food allergy (experience)] is that you don’t have the support from someone who knows cause the parent isn’t always *sighs* available, and I think that when you have involved parents, it’s a little bit different. (T19)

So much of it is built on relationships, not just with your students. It’s with your community, your families, it’s with your co-teachers, your admin. You have to establish those relationships with so many people, for everything to work. (T10)

Teacher’s roles

If I can’t see anything that indicates that it’s made in a peanut-free facility, then unfortunately, I wouldn’t let that kid have it. If it was something that I think could be like a potential allergen, then I might send [treat] home with the student. I would have to use my judgement for the situation. (T11)

When you see barriers to food access, are you going to fall on the sword of food allergy and say “You can’t have this, or you can’t eat this”, or are you just going to put them in your office and [clean] the heck out of your office to make sure they’re okay and to make sure [student] got [allergenic food] out of their mouths? (T17)

Child’s evolution toward self-management

I think if students have allergies, very early on they should be able to know that, and identify that. So if I had to put a number on it, I’d say as early as kindergarten. (T9)

In Kindergarten, that’s also particularly, um, a bigger challenge, because we don’t have these kids prior to Kindergarten. So it’s kind of the first year we’re just starting to get to know them and their unique allergies. (T10)

The child [with food allergy] was also more capable and more independent than I think the parents realized, or gave the child credit for. (T14)

Teachers’ food allergy-related experience

Its one thing to know [feeling like you’re on the outside] on an intellectual level, but it’s another to walk that, and experience that. […] I’ve had a lot of food sensitivities for years, and I now myself have a food allergy. And even with having people around me with […] significant severe anaphylactic allergies, it wasn’t until I experienced it myself for the first time that I think I really, truly understood what [having food allergy] is like, and how difficult that can be. (T14)

There were no food allergies in my family or in my immediate family. So that was never part of our experience growing up. (T15)

Teachers’ food allergy-related attitudes and beliefs

I feel that it [food allergy] is a little daunting at the beginning of the year […] The beginning of the year is kind of the worst of it. Where it’s like OK, um you know maybe [parents] didn’t see the note, or just following up with parents, making sure that they’re aware [of food restrictions]. (T2)

I feel like it’s almost like innuendo, like it’s [food allergy] something that you should know but it’s not said explicitly. It’s implicit. (T16)

I recently did math shapes using marshmallows and toothpicks. And I have a kid with an egg allergy. Do marshmallows have eggs? And I’m like talking to some of the other teachers and going through the list of the ingredients. Things I’ve done in the past, involving food, giving [students with food allergy] that different sensory experience, and there’s things I’ve had to modify. And I choose to modify because you could easily say, well, just give the other kids [with allergy] something else. But, I think also having experienced [having food allergy] myself, I want to make sure that I’m being inclusive to the whole class but still trying to find ways to include those experiences. (T10)