Understanding health care professionals’ barriers and facilitators to supporting the management of food allergy in British South Asian adults: Qualitative results from the FAIR Study

Background: The burden of food allergy (FA) is greater among South Asian (SA) individuals in high-income countries. Objective: We sought to investigate facilitators/barriers for health care professionals (HCPs) in FA management in SA patients. Methods: HCPs involved in the management of SA adults with FA were recruited for online, semistructured interviews. Interviews were analyzed using thematic analysis. Results: Interviews were conducted with 30 HCPs (46% White, 34% Indian, 7% Pakistani, 10% Sri Lankan, 3% ethnicity not disclosed). Allergists, immunologists, and general practitioners (77%); nurses (13%); dietitians (7%); and 1 pharmacist (3%) were interviewed. Three major themes were generated: (1) cultural and social influences on health—patient reliance on traditional medicine, scepticism toward conventional therapies, and strong family influence in decision making; (2) patient characteristics and behavior—presence of unique allergens in SA diets adding complexity to diagnosis and management; (3) health care communication and support—language barriers, interpreter limitations, and cultural misunderstandings hindering care. Younger patients were regarded as more proactive, whereas older patients relied on family members for translation and decision making. HCPs highlighted a need for multidisciplinary teams, culturally tailored dietary guidance, and training in cultural competency. They felt constrained by limited consultation times and long waiting times. Conclusion: A multipronged and multidisciplinary strategic approach is needed to address inequalities in FA management among SA patients targeting some key areas including development of culturally tailored multimodality resources for patients and their families, education and training for HCPs in SA cuisine/allergens and cultural competency, and adaptive changes in the health service framework.