Pediatric Food Allergy (FA) is recognized as a serious public health concern that affects approximately 4-8 percent of children, with symptoms affecting multiple organ systems, including skin, the respiratory tract, and the GI tract. Food-induced anaphylaxis, which is a rapid, potentially life-threatening reaction, can occur in more serious cases. Despite the substantial burden of disease management and associated negative quality of life effects, very few resources exist to promote effective strategies for managing FA. Moreover, most resources targeting this population emphasize information dissemination and education, either in-person or via the web, and typically focus on parents, with few resources designed for affected children. The central goal of Phases I and II of this SBIR/STTR is to develop an engaging, interactive game-based intervention for school-aged children with FA that will increase knowledge, improve self-efficacy to manage the disease, and ultimately reduce risk of negative outcomes. Software-based interventions targeting children for various pediatric conditions have increased in availability and accessibility. Interactive, game-based approaches available on multiple platforms (computer, mobile devices) offer distinct advantages over traditional interventions in providing highly engaging formats of psychoeducation and skills-based practice. This Phase II application builds on the highly promising prototype of the Friends, Family, and Food App (F3A-App), produced through the successful and synergistic collaboration of our Phase I team. The F3A- App consists of four related parts: (a) an interactive, game-based application that is the core of the program, (b) the experiential scenarios in interactive environments (e.g., school cafeteria vignette) that target knowledge and behavioral skills practice in social contexts, (c) two engaging multi-level games to build skills i food avoidance (Label Learning: Like it or Lose it!) and symptom assessment (Reaction Action!), and (d) a multi- tiered reward system that uses token economy-based reinforcement to enhance motivation and engagement (SeaLife Spectacular). Feasibility and efficacy testing of our initial prototype indicated the F3A-App was very well-received by parents and children with FA, facilitated child knowledge acquisition, and increased FA self- efficacy in key areas of FA management. Qualitative reports indicated the F3A-App also enhanced communication between parents and children regarding FA management. In this Phase II project, we propose to produce a fully-developed version of the F3A-App, including added content and enhanced features, to pilot the new version in a small sample (n = 40), and to evaluate the final product in a randomized clinical trial (n=100). This intervention will surpass existing approaches for child-focused software programs in interactivity, ease of use, acceptance by parents, and promotion by health care professionals. We envision that the F3A-App will serve as a template for interactive game-based interventions for children with other chronic conditions requiring self-management, such as asthma, diabetes, and celiac disease. The promise of commercial opportunity is significant in an era in which there is an increasingly widespread access to and everyday use of computers, smart phones, and tablet technologies.

Public Health Relevance

Pediatric Food Allergy (FA) represents a serious public health problem, with an estimated 4-8 percent of children affected, with dramatically increased prevalence over the past decade. Currently, there is no cure for FA;management of this condition requires consistent avoidance of the allergenic food and prompt treatment of symptoms upon ingestion. In this project titled Friends, Family, and Food: Interactive Virtual Environments for Children with Food Allergies, we will build on a promising prototype created in a successful Phase I project to further develop and evaluate our engaging, interactive game-based intervention for school-aged children with FA, the F3A-App. We will leverage next generation technology methodologies inherent in current software for education, training, and entertainment to increase engagement and interactivity, which will facilitate broader adoption and use of the program. This project represents an exciting collaboration between thought leaders in the fields of FA, chronic disease management, clinical psychology, and modeling/simulation. The final version of this program, to be developed in this Phase II project, has great potential to be a clinically effective, interactive, game-based intervention that is engaging, affordable, and widely available, with potential for adaptation to other childhood chronic conditions.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Small Business Technology Transfer (STTR) Grants - Phase II (R42)
Project #
Application #
Study Section
Special Emphasis Panel (ZRG1-RPHB-C (10))
Program Officer
Mann Koepke, Kathy M
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Virtually Better, Inc.
United States
Zip Code