Food allergy anxiety in parents: what a BC study measured

Most parents of children with food allergies know the background hum of worry: reading every label, checking every party menu, wondering whether the teacher will know what to do. For some, that worry grows big enough to get in the way of daily life. Researchers at BC Children's Hospital are working out where that line is, with a questionnaire built for food allergy anxiety in parents. They presented new results at the Canadian Society of Allergy and Clinical Immunology (CSACI) meeting in Toronto in October 2026.

What is food allergy anxiety in parents?

Food allergy anxiety is worry centred on a child's allergy: fear of a reaction, avoiding situations because of it, and the toll that takes on the parent and the family. Some worry is useful. It keeps you reading labels and packing the epinephrine. The question clinicians try to answer is when it becomes moderate or severe, starting to limit the family's life or the child's independence.

How IMPAACT measures it

IMPAACT, the Impairment Measure for Parental Food Allergy-Associated Anxiety and Coping Tool, was developed at the University of British Columbia and BC Children's Hospital. It's a 28-question parent questionnaire, each question answered on a 1 to 7 scale, covering:

• worries about the child's food allergy
• emotional and physical distress, and its effect on the parent's life
• the child's coping
• avoidance because of the allergy
• the need for support, and how central the allergy is to family life

Until now, scores have been compared with norms from other parents, including norms collected before and during COVID-19. The tool's developers say those cut-offs hadn't yet been checked against clinicians' judgment, and that IMPAACT shouldn't be used on its own to diagnose food allergy anxiety.

What the 2026 study found

The new study asked a different question: where do clinicians draw the line? Parents seen in the BC Children's Hospital Allergy Clinic's Thriving Families Program filled in IMPAACT, and the program's physician, who didn't see their answers, rated each parent's anxiety on a standard clinical scale, the Clinical Global Impression Scale.

• Most parents in the study scored in the moderate-to-severe range: 24 parents, the large majority of those taking part.
• The score that separated mild from moderate-or-severe anxiety, as judged by the clinician, lined up more closely with the norms collected during COVID-19 than with the earlier ones, and sat lower than both.
• Whether a family was in food allergy immunotherapy made no difference to the clinician's ratings.

In plain terms, the point where ordinary worry becomes anxiety that deserves support may come at a lower score than the older norms suggested. The team says more work to validate the cut-offs is under way.

A self-check based on what IMPAACT asks

IMPAACT isn't a do-it-yourself test, but the areas it covers make a useful set of questions to ask yourself:

• Are we avoiding activities, outings or foods our allergist says are fine?
• Is the allergy at the centre of most family decisions?
• Is the worry affecting my own health or work?
• Is my child picking up on it, or losing independence they're ready for?

If several of those ring true, it's worth raising with someone.

Where to find support

• Your allergist. Tell them how you're coping, not just how your child is doing. A clear emergency plan, and practice with a trainer device, can make the unknowns smaller.
• BC Children's Hospital Thriving Families Program. For families seen at the BC Children's Hospital Allergy Clinic: virtual sessions using cognitive behavioural therapy (CBT) and dialectical behaviour therapy (DBT) skills, for parents, youth or whole families, covering stress around immunotherapy, allergy testing, epinephrine use, travel, school trips and life changes.
• Your family doctor, if worry is affecting your daily life.

Preparation that shrinks the unknowns

Part of the worry is about other people: will the adult with my child know what to do? You can't remove the allergy, but you can make that question smaller:

• A signed, current emergency plan in the bag, not only on the fridge.
• Two in-date doses of epinephrine, always together.
• Every caregiver briefed once, and something that reminds them later.

That last one is why we made the ResQBand Tap Card. Tapped with most phones, it shows the helper what to do and gives them a button to text you and your other emergency contacts who opted in, with the helper's location when their phone shares it. It can't make an allergy go away, but it can mean one less thing to wonder about. Our anaphylaxis emergency plan guide covers the rest.

About the study

Clinical Validation of the IMPAACT Cut-off Values for Moderate/Severe Food Allergy Anxiety was presented by Zerlyn Lee, Michael Golding, Kyle Burns, Jennifer Protudjer, Lianne Soller, Edmond Chan and Jennifer Tong of the University of British Columbia, BC Children's Hospital and the University of Manitoba, at the 81st CSACI Annual Scientific Meeting in Toronto, October 2026. It's a small, preliminary study.

This article is general information, not mental health advice. If worry is affecting your daily life, talk to your doctor. In an emergency, call 911.