{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T06:13:28Z","timestamp":1788243208377,"version":"build-2803163510"},"reference-count":21,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:p>Food allergies are a significant public health concern in the United States. Fatality from food-induced anaphylaxis is associated with delayed administration of epinephrine. Utah children were at increased risk for school-related anaphylaxis due to a lack of school nurses, adequately trained staff, and a standardized approach to food allergy emergency management. In collaboration with the Utah School Nurses Association, the Utah Food Allergy Network, and the Utah Department of Health &amp; Human Services, among other contributors, we aimed to accomplish the following goals: (1) develop and implement a web-based curriculum to train school staff to recognize and respond to anaphylaxis in school settings; (2) educate school officials on existing legal protections for layperson first responders; and (3) facilitate acquisition of unassigned epinephrine for use in schools through existing charitable pharmaceutical programs. From 2012 to 2023, our training program was completed 5759 times by individuals representing 421 Utah schools. The course was most frequently completed by teachers (n\u2009=\u20093006, 52.2%), office staff (n\u2009=\u20091480, 25.7%), and principals (n\u2009=\u2009276, 4.8%). Since 2015, we have maintained an average year-to-year retention rate of greater than 68%. We observed a 245% increase in the number of schools with unassigned epinephrine. Due to this intervention, many Utah schools now prepare employees to administer epinephrine in the case of anaphylactic emergencies. Although school nurses play a significant role, their coverage is inadequate to meet the needs of all students at risk for anaphylaxis. Training volunteers to recognize and respond to anaphylaxis in school settings is needed to reduce delays in treatment and improve outcomes.<\/jats:p>","DOI":"10.1542\/peds.2025-073978","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:02:46Z","timestamp":1776211366000},"source":"Crossref","is-referenced-by-count":0,"title":["A Collaborative Initiative to Improve Anaphylaxis Management in Utah Schools"],"prefix":"10.1542","volume":"157","author":[{"given":"Bryan S.","family":"Witt","sequence":"first","affiliation":[{"name":"1Mayo Clinic Alix School of Medicine, Scottsdale, Arizona"},{"name":"2Division of Allergy and Immunology, Phoenix Children\u2019s Hospital, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin L.","family":"Wright","sequence":"additional","affiliation":[{"name":"2Division of Allergy and Immunology, Phoenix Children\u2019s Hospital, Phoenix, Arizona"},{"name":"3Division of Allergy, Asthma, and Clinical Immunology, Department of Medicine, Mayo Clinic Arizona, Scottsdale, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"issue":"6","key":"2026090101165623200_r1","doi-asserted-by":"crossref","first-page":"e20181235","DOI":"10.1542\/peds.2018-1235","article-title":"The public health impact of parent-reported childhood food allergies in the United States","volume":"142","author":"Gupta","year":"2018","journal-title":"Pediatrics."},{"issue":"10","key":"2026090101165623200_r2","first-page":"1","article-title":"Food allergy among U.S. children: trends in prevalence and hospitalizations","author":"Branum","year":"2008","journal-title":"NCHS Data Brief."},{"issue":"7","key":"2026090101165623200_r3","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1001\/archpedi.155.7.790","article-title":"Food-allergic reactions in schools and preschools","volume":"155","author":"Nowak-Wegrzyn","year":"2001","journal-title":"Arch Pediatr Adolesc Med."},{"issue":"4","key":"2026090101165623200_r4","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1067\/mpd.2001.111821","article-title":"The US Peanut and Tree Nut Allergy Registry: characteristics of reactions in schools and day care","volume":"138","author":"Sicherer","year":"2001","journal-title":"J Pediatr."},{"issue":"3","key":"2026090101165623200_r5","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1089\/ped.2016.0675","article-title":"Anaphylaxis in schools: results of the EPIPEN4SCHOOLS survey combined analysis","volume":"29","author":"White","year":"2016","journal-title":"Pediatr Allergy Immunol Pulmonol."},{"issue":"46 suppl","key":"2026090101165623200_r6","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1111\/j.1398-9995.1998.tb04982.x","article-title":"Fatal food-induced anaphylaxis","volume":"53","author":"Sampson","year":"1998","journal-title":"Allergy."},{"issue":"2","key":"2026090101165623200_r7","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.anai.2017.06.001","article-title":"Factors associated with epinephrine administration for anaphylaxis in children before arrival to the emergency department","volume":"119","author":"Robinson","year":"2017","journal-title":"Ann Allergy Asthma Immunol."},{"issue":"6","key":"2026090101165623200_r8","doi-asserted-by":"crossref","first-page":"2321","DOI":"10.1016\/j.jaip.2021.01.038","article-title":"Community use of epinephrine for the treatment of anaphylaxis: a review and meta-analysis","volume":"9","author":"Miles","year":"2021","journal-title":"J Allergy Clin Immunol Pract."},{"key":"2026090101165623200_r9","author":"Emergency Injection for Anaphylactic Reaction, HB 176 (Utah 1998)"},{"key":"2026090101165623200_r10","author":"Amendments to Emergency Injection for Anaphylactic Reaction Act, HB 101 (Utah 2008)","year":"2008"},{"key":"2026090101165623200_r11","author":"Epinephrine Auto-Injector Use Expansion, SB 147 (Utah 2015)"},{"issue":"5","key":"2026090101165623200_r12","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1177\/10598405241253565","article-title":"Public school nurses in the United States: National School Nurse Workforce Study 2.0","volume":"40","author":"Willgerodt","year":"2024","journal-title":"J Sch Nurs."},{"key":"2026090101165623200_r13","volume-title":"Nursing Services in Utah Public Schools 2021\u20132022, Annual Report","year":"2025"},{"key":"2026090101165623200_r14","article-title":"University of Utah Health","author":"Wright","year":"2012"},{"key":"2026090101165623200_r15","article-title":"Bioridge Pharma","author":"EpiPen 4 Schools","year":"2025"},{"issue":"2","key":"2026090101165623200_r16","doi-asserted-by":"crossref","first-page":"AB25","DOI":"10.1016\/j.jaci.2013.12.114","article-title":"Availability and utilization of epinephrine in utah schools for the management of anaphylaxis","volume":"133","author":"Wright","year":"2014","journal-title":"J Allergy Clin Immunol."},{"issue":"1","key":"2026090101165623200_r17","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1177\/1942602X10391969","article-title":"NASN position statement: caseload assignments","volume":"26","author":"Durant","year":"2011","journal-title":"NASN Sch Nurse."},{"issue":"1","key":"2026090101165623200_r18","doi-asserted-by":"crossref","first-page":"e25","DOI":"10.1542\/peds.2011-1762","article-title":"Allergic reactions to foods in preschool-aged children in a prospective observational food allergy study","volume":"130","author":"Fleischer","year":"2012","journal-title":"Pediatrics."},{"issue":"5","key":"2026090101165623200_r19","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1111\/josh.12620","article-title":"Barriers to the administration of epinephrine in schools","volume":"88","author":"Hogue","year":"2018","journal-title":"J Sch Health."},{"key":"2026090101165623200_r20","article-title":"Presented at: AAP National Conference & Exhibition","author":"O\u2019Keefe","year":"2024"},{"issue":"4","key":"2026090101165623200_r21","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1016\/j.anai.2018.06.010","article-title":"Epinephrine auto-injector carriage and use practices among US children, adolescents, and adults","volume":"121","author":"Warren","year":"2018","journal-title":"Ann Allergy Asthma Immunol."}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2025-073978\/1926219\/pediatrics.2025073978.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2025-073978\/1926219\/pediatrics.2025073978.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T05:17:05Z","timestamp":1788239825000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/157\/5\/e2025073978\/207212\/A-Collaborative-Initiative-to-Improve-Anaphylaxis"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,15]]},"references-count":21,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,4,15]]},"published-print":{"date-parts":[[2026,5,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2025-073978","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,15]]},"article-number":"e2025073978"}}