Preliminary psychometric analyses and clinical performance of a caregiver self-efficacy scale for food allergy self-management

Background Food allergy health-related quality of life has been defined, but self-efficacy is poorly described. Objective To examine the preliminary reliability, validity, and clinical performance of a novel food allergy self-efficacy index. Methods An 8-item Food Allergy Self-Efficacy Questionnaire (FASEQ) was adapted for food allergy–related themes and coadministered with the Food Allergy Quality of Life Parental Burden (FAQL-PB) index to caregivers self-reporting a food allergic child (group A) and those with children followed up at a food allergy referral center clinic (group B). FASEQ split-half reliability, 2-week recall, factor analysis, and construct and discriminative validity were assessed. Multiple linear regression was used to explore predictive associations between the FAQL-PB and the FASEQ. Results Among 2,308 caregivers, the mean FASEQ score was 2.69 (95% CI, 2.66–2.73) and was lower (better) among group A (mean FASEQ score, 2.52; 95% CI, 2.49–2.56) vs group B (mean FASEQ score, 3.75; 95% CI, 3.66–3.84; P <.001). The FASEQ Cronbach α was 0.87, and the 2-week intraclass correlation coefficient (ICC) was 0.75. Total and 6 of 8 individual FASEQ domain scores were significantly lower among caregivers with children having anaphylaxis or epinephrine use vs none and peanut or tree nut allergy vs milk or egg allergy, demonstrating good discriminative validity. Total FASEQ score was associated with FAQL-PB score (ICC, 0.13; 95% CI, 0.06–0.19; P <.001), with 6 of 8 FASEQ individual domains significantly associated (ICC range, −0.17 to 0.3; P <.01 for all). Factor analysis revealed 2 domains (medical care and social functioning) with construct validity. Conclusion We present preliminary evidence the FASEQ is a valid tool to assess caregiver food allergy self-efficacy. Self-efficacy is a distinct but related concept that captures aspects of self-management that are an important companion to health-related quality of life.