Differences in Familiarity With Oral Immunotherapy Among Caregivers of White and Black Children With Food Allergy

To assess differences in attitudes toward, familiarity with, and use of oral immunotherapy (OIT) between ethnic minority groups in the United States.US non-Hispanic white (NHW), Black (NHB), and Hispanic or Latino (H/L) caregivers (C) of children with food allergy (FA).Survey data from the Food Allergy Related to White and African Racial Differences (FORWARD) cohort were used. Data included race, income, sex, and age, among other data points. Entries without the primary outcome (familiarity with OIT) or secondary outcome (income) were excluded. Continuous outcomes were analyzed by analysis of variance, categorical outcomes were assessed by χ2, and logistic regression was used for association for the above data categories with the primary and secondary outcomes.A total of 293 households were analyzed. NHB and H/L caregivers were significantly less familiar with OIT, even after controlling for income. None of NHB or H/L had initiated OIT vs 14.8% of NHW. Among those familiar with OIT, 71% felt confident they had enough information to make a decision. NHB and H/L caregivers who were aware of OIT were significantly less likely to be interested in pursuing it, indicating they wanted more information regarding the risks/benefits of OIT (62.1%), how it worked (60.5%), specific protocols (54%), and expected outcomes (50%). Households with incomes greater than $200 000 were more likely to be familiar with OIT than those with incomes less than $100 000.NHB and H/L caregivers were less likely to be familiar with OIT even after controlling for income and were less likely to have used OIT. Even members of those groups who were aware were less likely to pursue treatment, citing a desire for more information on OIT. There is also a significant income disparity among those using OIT.There is a clear gap in familiarity and use of OIT in racial and ethnic minorities. These data reinforce a known inequity in clinical allergy/immunology treatments and medicine broadly. The lack of OIT use among racial and ethnic minorities who were aware of it could indicate that more standardized resources that explain risks and benefits, mechanisms, and protocols of OIT could benefit patients and their caregivers. As a specialty, we should continue our pursuit of trust through patient-centered clinical conversations and user-friendly information.