{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T18:54:01Z","timestamp":1775069641521,"version":"3.50.1"},"reference-count":54,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There is limited knowledge of healthcare utilization and food allergy outcomes among non-primary English-speaking patients in the United States, despite language barriers potentially being a risk factor for less optimal health outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted of patients 0\u221218 years old with food allergy seen at our institution\u2019s allergy and immunology clinic between 1\/1\/2018-12\/31\/2021. Only patients with food allergy, defined as prior history of symptoms consistent with IgE-mediated reaction to food(s) and positive skin prick testing (wheal\u2009\u2265\u20093 mm) or food-specific IgE\u2009&gt;\u20090.35, were included. Demographics and clinical data were obtained from the electronic health record (EHR). Regression analyses examined the association between patient\/guardian-reported primary language and healthcare utilization, and whether COVID-19 pandemic modified these associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 1,418 patients with food allergy identified, 1,267 were primary English speakers and 151 were non-primary English speakers. Non-primary English-speaking patients had lower odds of EHR portal activation as compared to primary-English speakers (52.3% vs 81.8%, adjusted odds ratio\u2009=\u20090.43, 95% confidence interval (CI) 0.29\u20130.62). Regarding non-primary English-speakers, an increase in the probability of EHR portal activation (from 61.6% [95% CI 51.5% \u2212 71.8%] to 70.0% [95% CI 60.8%\u221278.7%]) and food-related emergency department visits (from 3.7% [95% CI \u22120.4%\u22127.9%] to 19.4% [95% CI 10.7%\u221228.0%]) from the pre-COVID-19 to COVID-19 period was noted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Disparities in rates of EHR portal activation and emergency department utilization which were differentially affected by the COVID-19 pandemic were identified among non-primary English-speaking patients in a cohort of pediatric patients with food allergy at a tertiary care referral center in the United States. This study highlights the need for greater understanding of language-based health disparities in food allergy and for more equitable EHR portal access among non-primary English-speaking patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0346248","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T17:42:02Z","timestamp":1775065322000},"page":"e0346248","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Language barriers in pediatric food allergy care: A single-center study on healthcare disparities"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6879-3196","authenticated-orcid":true,"given":"Katelyn 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