Provider Education of Avoidant Restrictive Food Intake Disorder in Pediatric Primary Care

Abstract

Purpose. The purpose of this DNP project was to use an educational presentation to increase provider awareness of pediatric Avoidant/Restrictive Food Intake Disorder (ARFID) with an emphasis on food allergy. Background. In 2013, ARFID was added as an eating disorder in the DSM-V. Due to its recent designation as a diagnosis, education and awareness on the diagnosis is limited. Children with ARFID are extremely selective in their diet for various reasons, and most often is seen in children with comorbidities such as autism spectrum disorder (ASD), obsessive-compulsive disorder (OCD), and food allergy. ARFID is often underdiagnosed, and if unrecognized, can lead to severe complications. Current data, while limited, shows a lack of understanding of this diagnosis by pediatric providers. Education of primary care providers can be beneficial in early recognition of ARFID in a child demonstrating restrictive eating. Methods. This quality improvement project utilized a quantitative pretest and posttest design. Pediatric primary care providers at MHC Healthcare in Tucson, Arizona completed a 10-item pretest, listened to a 15-minute presentation on the clinical symptoms and current management of ARFID, and then completed a 10-item posttest. After the implementation period, a statistical analysis was completed to understand how provider knowledge was impacted. Results. The implementation and data collection period lasted one day. The final analysis included a total of three (3) providers who completed the pretest and posttest within the data collection period. The final analysis demonstrated a statistically significant increase in provider knowledge of ARFID after the educational presentation (p = 0.039), with an average pretest score of 4.667/10, and average posttest score of 9/10. The pretest average demonstrated an overall low understanding of ARFID in pediatric providers, while the posttest average showed improvement in knowledge after the educational presentation. Conclusion. This study supports a low understanding and awareness of ARFID among pediatric primary care providers. An educational presentation is beneficial in improving knowledge within a primary care practice. Further studies with larger sample sizes and follow-up questionnaires are indicated to demonstrate the sustainability of the knowledge. Overall, the continued education of pediatric providers on ARFID is indicated to support positive patient outcomes.