30 Minute Online Anaphylaxis Training Boosts School Staff Preparedness

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Bhanu Sharma, PhD

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An online course to teach school personnel how to prevent, recognize, and manage anaphylaxis can help improve anaphylaxis management, new research found.1

“Our data show that year to year, AllergyAware was completed on average in less than 30 min, and the time to completion remained consistent despite changes and/or updates to the learning module,” wrote investigators, led by Bhanu Sharma, PhD, from McMaster University in Canada.1 “We consider this a feasible time commitment, particularly given the post-course quiz and survey results, and adoption by many school boards.”

Food allergies have increased by 50% since the 1990s, according to the US Centers for Disease Control & Prevention (CDC).2 Approximately 33 million people in the US have a food allergy, and the most common ones among children include shellfish, milk, peanuts, tree nuts, egg, fin fish, wheat, soy, and sesame. Health insurance claims show the incidence of peanut allergy has tripled from 2001 to 2017 in 1-year-olds.3

Food allergies can have many negative impacts—reduced quality of life, food-related anxiety, social stigma, peer bullying, and the most serious one, anaphylaxis. About 40% of children with food allergies experience life-threatening anaphylaxis.4

With so many children with food allergies, it is important that adults in the room can recognize and promptly administer epinephrine. Yet, a study reported low use of epinephrine outside of the hospital (20.98%).5

Sabrina’s Law in Canada and the Food Allergy and Anaphylaxis Management Act in the United States ensure that anaphylaxis prevention and management strategies occur in schools.1 Strategies include training school personnel on recognizing the signs of anaphylaxis and how to respond in an emergency. Online learning can provide school personnel with up-to-date anaphylaxis management with easy access.

Investigators designed an online asynchronous course, AllergyAware, with expert-reviewed materials that adhered to consensus guidelines, specifically the Canadian Society of Allergy and Clinical Immunology’s “Anaphylaxis in Schools and Other Settings.” Modules followed best practices, using a combination of text, images, and videos. The AllergyAware team had 20 individuals—experts in anaphylaxis education and online learning, the target audience (school board members, teachers, and educational assistants), and allergy/immunology medical specialists.

Initial pilot testing (November 2009 to January 2010) showed school personnel had large gains in anaphylaxis knowledge and self-confidence after taking the course (P < .001).1 The testing, completed by school personnel in Alberta, Canada (n = 74), included a pre- and post-test with approximately 1 hour of anaphylaxis education. Primary outcomes included feasibility, user acceptance, and feedback or suggestions.

In 2015, investigators developed and published a website to help with enrollment and the delivery of the course modules. By 2022, there have been > 170,000 course completions, with more than a quarter of users completing the course several times. Most users completed the course in September, and on average, it took about 25 – 30 minutes to finish the modules.

After the course, many participants reported confidence with epinephrine auto-injectors and emergency management of anaphylaxis. More than 95% of participants would recommend the course to their peers. On average, users had a 9.05 score on the 10-item post-course quiz, with a pass rate of > 95%.1

The post-course quiz showed school personnel could consistently recognize anaphylaxis and when to administer epinephrine. The only areas that some school personnel still struggled with were ordering the steps of the epinephrine auto-injectors and distinguishing between a reaction to a particular protein vs food.

“Future research is needed to assess participants’ application of knowledge in real-world settings, including epinephrine auto-injector administration technique, long-term retention of key concepts, and impact on schools’ management of anaphylaxis,” investigators concluded.1

References

  1. Sharma B, Ayers S, Huang J, Gerdts J, Waserman S, Levinson AJ. Online food allergy and anaphylaxis education for school personnel is effective and scalable: experience with the allergyaware e-learning portal from 2015 to 2022. Allergy Asthma Clin Immunol. 2025;21(1):30. Published 2025 Jul 6. doi:10.1186/s13223-025-00977-0
  2. Food Allergy Facts and Statistics for the U.S. Food Allergy Research & Education. April 18, 2024. https://www.foodallergy.org/sites/default/files/2024-07/FARE%20Food%20Allergy%20Facts%20and%20Statistics_April2024.pdf
  3. J. Lieberman, J. Sublett, Y. Ali, T. Haselkorn, V. Damle, A. Chidambaram, K. Rosen, T. Mahr, Increased Incidence and Prevalence of Peanut Allergy in Children And Adolescents in The United States, Annals of Allergy, Asthma & Immunology, Volume 121, Issue 5, Supplement, 2018, https://doi.org/10.1016/j.anai.2018.09.039.
  4. Sicherer SH, Sampson HA. Food allergy: A review and update on epidemiology, pathogenesis, diagnosis, prevention, and management. J Allergy Clin Immunol. 2018;141(1):41-58. doi:10.1016/j.jaci.2017.11.003
  5. Miles LM, Ratnarajah K, Gabrielli S, et al. Community Use of Epinephrine for the Treatment of Anaphylaxis: A Review and Meta-Analysis. J Allergy Clin Immunol Pract. 2021;9(6):2321-2333. doi:10.1016/j.jaip.2021.01.038

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