Hope for Food-Allergic Students Transitioning to College

Food-allergic students face challenges in the transition to college that reach far beyond the food served in dining halls, according to research from Northwestern University.

Tasked to address the issue, students in an innovative master-level design course led by engineering and medical instructors at Northwestern produced a website, http://allergyspotlight.com, and an accompanying video with recommendations for how colleges can better prepare for and support food-allergic students.

The toolkit suggests that colleges address the following five components of a college student's life to help ease the transition: preparing for college, during orientation, joining a club sports team, attending an event and facilitating an emergency response. Making “Epi Boxes,” or epinephrine auto-injector sites, more prominent near food service also is among the recommendations.

In addition to her partnership on this course, Dr. Ruchi Gupta, associate professor of pediatrics and director of the Food Allergy Outcomes Research Program at Northwestern University Feinberg School of Medicine, also conducted research in her lab. She will be presenting those findings today, Nov. 11, at the American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting in San Francisco, California.

“Even though food allergy has become a disease of public health importance, most college campuses are in the beginning stages of creating systems, structures, and policies that provide comprehensive support, safeguard against accidental ingestions, systematically train key stakeholders in emergency preparedness protocols and make students more aware of allergic reactions and management,” said Gupta, who also is a pediatrician at Ann & Robert H. Lurie Children's Hospital of Chicago and whose 10-year-old daughter has food allergies. “Moving forward, I think interdisciplinary collaborations like ours – between medicine and design – will allow us to design a system in partnership with key stakeholders that ensures accountability, and ultimately, the health of students with food allergies.”

She partnered with Liz Gerber, associate professor of design, and Amy O’Keefe, associate director for the Engineering Design and Innovation Program at Northwestern’s McCormick School of Engineering, to instruct the master-level class.

Gerber and O’Keefe have been teaching this course for years to further the idea that, like physical products, services and experiences also need to be intentionally designed. Each quarter they partner with a different client to explore service design opportunities through the lens of Human-Centered Design. Past projects have included designing a laundry service, launched by P&G as TideSpin, and designing new ways for low-income patients to access electronic medical records.

For last spring’s course, in which Gupta was involved, the students interviewed key stakeholders at Northwestern, such as cafeteria employees, athletic directors, coaches and senior-level administrators, about food allergy preparations at the University.

“For food-allergic students, going to college and dealing with these challenges is similar to the challenges a student in a wheelchair would have dealt with before ramps were required to make buildings accessible,” said O’Keefe, who, like Gupta, has a young daughter with food allergies. “It’s not just the dining hall; you need to navigate all these other areas of life on campus, and those accessible services need to be built by collaboration between a lot of different departments.”

These accessible services can include helping employees learn to think of food allergies as a disability and helping dining hall cooks realize that using certain ingredients in a salad can be a matter of life and death for students.

As part of the course, students simulated a dining hall experience to test the reaction of 10 randomly chosen Northwestern undergraduates when faced with a student who experienced an allergic reaction. Jonathan Crow, a McCormick engineering design and innovation masters student involved in the course, faked an allergic reaction to a cookie, and within minutes an undergraduate student administered an epi-pen injection on Crow.

“When someone is experiencing anaphylaxis and they forget in the moment how to use their own Epi-pen or maybe they’ve left it at home, it’s vital that some type of easy-to-use epinephrine is readily available to them,” said Crow, who also suffers from mild food allergies. “We’re talking about going into severe shock within minutes, which is why we recommended installing Epi Boxes in expected locations to help automatically communicate to first responders. On a college campus, there are no parents around to hold your Epi-pen for you.”

For the third consecutive year, Northwestern Athletics this fall announced that three non-conference football games at Ryan Field and a total of 32 events at Welsh-Ryan Arena would be peanut and tree-nut aware in 2016, calling it “the most extensive allergy-aware program in sports.”

This course will be offered again this winter and will again focus on designing for inclusion, O’Keefe said.

The next phase of Gupta’s research is testing and honing in on usable materials for each of these key problem areas that the students and her lab discovered. She hopes to be able to provide it to college campuses within a year.

“That’s my goal,” Gupta said.