Failure to comply with prescribed regimens is a major reason for the failure of treatment programs. This study investigated factors which are related to compliance with prescribed diet revision therapy for food allergies in school-aged children. Forty-five children, aged 6 to 12 years, who were under a physician's care for food allergies, formed the sample. The Health Belief Model was used as the basis for a questionnaire devised to measure these factors. The development of the Diet Revision Therapy Parent Questionnaire involved a pilot test and revisions; the resulting instrument consists of 38 items organized into 4 subtests, of which one 7-item subtest is to be considered optional. The 38-item DRTPQ has a full scale internal consistency reliability of .87, and a composite reliability of .61 for the four subscales. The canonical correlation between 3 types of subjective ratings of compliance and the 4 subtests is .80, with 64% shared variance between these sets of variables. A discriminant function of 3 subtests of the DRTPQ proved capable of discriminating diet therapy dropouts from continuing subjects with 88.9% accuracy. These three subtests measured: 1. Parent and family life factors, such as the amount of perceived interference in normal routines, 2. Child's attitudes to the treatment and his/her normal behavior with respect to cooperation with parental demands, and 3. Belief in the benefits to be derived from the treatment. A fourth category of items measured perceived severity of the condition and perceived susceptibility to illness but proved not to predict compliance in this sample, although it may be useful in clinical practice. Suggestions for interventions to aid compliance are outlined. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

Thesis (MSc Consumer Sc)--Stellenbosch University, 2002. / ENGLISH ABSTRACT: Food allergies in children are a growing problem and have various effects on these children, their households, the community and the economy. No medication or cure is currently available to consumers suffering from food-allergies. Medical teams are aware of the patients' need for support, but information is lacking and understanding of their basic needs and problems neglected. Two qualitative research methods, namely the focus group technique and case studies were used to investigate the emotional and physical environment of children allergic to wheat, soy, cow's milk and egg respectively. Five focus group meetings were conducted with the caregivers of food-allergic children. Two during the pilot study and three in the main study. A total of twenty three participants attended the three meetings of the main study. A meeting schedule was developed and the meetings carefully moderated. After the data had been obtained from the focus group meetings, there was a need for more in-depth information and understanding. Seven of the participants of the focus groups were identified, through developed criteria, to be further investigated as case studies. Five units of investigation were identified for the case studies. It was the (i) caregiver, (ii) allergic child, (iii) other children, (iv) "non-caregiver parent" and (v) household. Some of the matters that were investigated in both the focus groups and case studies were health consciousness, menu planning, recipe needs and use, reading of food labels, hidden allergens and the social and emotional effects of having and being a food-allergic child. A great need for better support and educational programs to assist these households were identified. Very few of the households were health conscious, while they all experienced problems with menu planning, identifying hidden allergens and suffered from social and or emotional problems. Very few participants made use of recipes or identified a need for allergen-free recipes. After having gained insight in the daily lives of these households, four - virtually identical, two-week menu cycles were developed to suit the life style requirements and restrictions of these children. The same recipes were used, but allergens omitted, replacements made and the recipes adapted as necessary. Product scouting was done for hidden allergens in selected popular convenience foods, especially those from the lowest level of the USDA Food Guide Pyramid. Hidden allergens appeared to be a problem when food is prepared and bought for the food allergic child. It should be taken into account that despite the information stated on the food label undeclared allergens might still be present in food. The two-week menu cycle for the child allergic to cow's milk was then quantitatively evaluated for nutritional adequacy by FoodFinder ™ 2 - a software program, for children aged between seven and ten years. All the macronutrients and micronutrients identified by the National Survey in 1999 as insufficient «67% of the RDA) among South African children aged between one and nine years, were evaluated as well as those mentioned in the WHO Dietary and Health Goals. All the nutrients were sufficient, except for calcium and Vitamin D. Supplementation is advised. The sensory acceptability of the menu-items in the two-week menu cycles were not evaluated. A vast number of issues pertaining to the food-allergic child require further research. A great need exists for the development of educational programs to support the households with food-allergic children. The identification of hidden allergens and the development of reliable sensory testing models for food-allergic children are all areas that should urgently be researched further. / AFRIKAANSE OPSOMMING: Voedsel-allergieë by kinders is 'n groeiende probleem met 'n verskeidenheid effekte op dié kinders, hulle huishoudings, die gemeenskap en die ekonomie. Tans is geen medikasie of kuur teen voedsel-allergieë beskikbaar nie. Mediese spanne is bewus van die behoefte aan sorg en leiding wat deur dié spesifieke groep verbruikers benodig word, maar inligting oor hulle behoeftes en probleme is ontoereikend. Twee kwalitatiewe navorsingsmetodes, naamlik die fokusgroeptegniek en gevallestudies, is gebruik om die emosionele en fisiese omgewing van kinders allergies vir onderskeidelik grane, soja, melk en eiers te ondersoek. Tydens 'n voorloperstudie is twee fokusgroepvergaderings gehou. Vir die hoofstudie is drie fokusgroepvergaderings met versorgers van kinders met 'n voedsel-allergie gehou met 'n totaal van drie en twintig deelnemers. 'n Vergaderingskedule is ontwikkel en die vergaderings is sorgvuldig gemodereer. Nadat die data van die fokusgroepe ingesamel is, was daar behoefte aan meer in diepte inligting en begrip. Aan die hand van ontwikkelde kriteria is sewe van die deelnemers aan die fokus groepe as gevallestudies geselekteer. Vyf eenhede van ondersoek is geïdentifiseer vir die gevallestudies. Dit is: (i) die allergiese kind, (ii) versorger, (iii) ander kinders, (iv) die "nie-versorgende" ouer en (v) die huishouding. Sommige van die aspekte wat in beide die fokusgroepe en gevallestudies ondersoek is, was gesondheidsbewustheid, spyskaartbeplanning, die gebruik en behoefte aan resepte, lees van voedseletikette, verskuilde allergene en die sosiale en emosionele effek van 'n voedsel-allergie op die kind sowel as die ouers. 'n Groot behoefte aan beter ondersteuning en opvoedkundige programme, om hierdie huishoudings te help, is geïdentifiseer. Baie min van die huishoudings was werkilk gesondheidsbewus, terwyl hulle almal probleme met spyskaartbeplanning, identifisering van verborge allergene en sosioemosionele probleme ondervind het. Weinig van die deelnemers het gebruik gemaak van resepte of het 'n behoefte aan allergeen-vrye resepte ondervind. Nadat insig in die daaglikse lewenstyl van hierdie huishouding verkry is, is vier amper-identiese twee-weekse siklusspyskaarte ontwikkel wat die lewenstyl en behoeftes van hierdie huishoudings aanspreek. Dieselfde resepte was gebruik vir al vier twee-weeksiklusspyskaarte, met die verskil dat verskillende allergene vervang is, na gelang van die allergie verskillende behoefte. Marknavorsing is gedoen op alledaagse produkte en is hoofsaaklik gefokus op die produkte wat die basis van die voedselpiramide uitmaak. Daar is bevind dat verskeulde allergene voorkom in produkte waar dit nie verwag word nie, en soms selfs nie op die voedseletikette verklaar word nie. Die twee-weeksiklusspyskaart van die melk-allergiese kind is kwantitatief ge-evalueer vir toereikendheid van die dieet vir kinders tussen die ouderdomme sewe tot tien jaar op die Foodfinder TM 2 - sagteware program. Die makro- en mikronutriente wat volgens 'n nasionale opname in 1999 as problematiese «67% van die RDA) vir kinders in die ouderdomsgroep een tot nege, uitgewys is, is geneem en die voedingstowwe is ook teen die Werêld Gesondheidsorganisasie (WHO) se dieetdoelwitte getoets. AI die nutriënte was voldoende volgens die analise, behalwe kalsium en Vitamen D. Supplementasie word aanbeveel vir dié twee nutriënte. Die sensoriese aanvaarbaarheid van die spyskaartitems in die siklusspyskaart is nie getoets nie. Verskeie aspekte wat vorendag gekom het, benodig verdere navorsing. 'n Groot behoefte aan die ontwikkeling van opvoedkundige programme, wat die huishoudings met voedsel-allergiese kinders ondersteun, bestaan. Die identifikasie van verskuilde allergene en die ontwikkeling van 'n beproefte sensoriese toetsmodel vir voedsel-allergiese kinders is potensiële gebiede wat dringend verder nagevors behoort te word.