Development and Validation of the Coping with Food Allergy Scales (CoFAS) for Children and Young People and Parents

Rebecca Knibb; Suzanna E. M. Purser; Jennifer Hammond; Kate Ambridge

doi:10.1016/j.jaip.2026.02.034

Development and Validation of the Coping with Food Allergy Scales (CoFAS) for Children and Young People and Parents

Rebecca Knibb
, Suzanna E. M. Purser
, Jennifer Hammond
, Kate Ambridge

Research output: Contribution to journal › Article › peer-review

2 Citations (SciVal)

3 Downloads (Pure)

Abstract

Background:
Managing food allergy (FA) entails complex lifestyle changes and development of specific coping strategies. How we cope with long-term conditions is associated with clinical and psychological outcomes and so it is important that adaptive strategies are promoted.

Objective:
To develop and establish the reliability and validity of new coping with FA scales (CoFAS) for children and young people (CYP) aged 8-16 and for parents.

Methods:
The CoFAS were developed following interviews with 32 CYP aged 8-16 years and 8 parents, a systematic review of literature and consultation with FA experts. Reliability and validity analysis was conducted on 151 CYP aged 8-16 who completed the CoFAS-C and 390 caregivers who completed the CoFAS-P. Participants also completed validation measures of generic coping, anxiety and depression, quality of life and self-efficacy.

Results:
Exploratory factor analysis resulted in four sub-scales for the CoFAS-C (Avoidance and Minimisation, Positive Beliefs, Self-Management and Social Support) and three sub-scales for the CoFAS-P (Avoidance and Minimisation, Planning and Preparation and Dealing with Emotions). All had good to excellent internal reliability (Cronbach alphas = 0.74 to 0.84). and low to medium correlations with validation measures.

Conclusion:
The CoFAS are reliable and valid scales to identify coping strategies used for FA management by CYP and parents. Planning and preparation appear to be the most adaptive strategies, with avoidance and minimisation the least, but managing emotions is also important to promote. Knowledge of the types of coping strategies used by patients could direct clinical care.

Original language	English
Pages (from-to)	1165-1174.e9
Journal	Journal of Allergy and Clinical Immunology: In Practice
Volume	14
Issue number	5
Early online date	9 Mar 2026
DOIs	https://doi.org/10.1016/j.jaip.2026.02.034
Publication status	Published - 1 May 2026

Bibliographical note

Copyright © 2026 Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/).

Funding

This study was part funded by a PhD studentship from Allergy UK. Conflicts of interest: R. C. Knibb reports research funding from the National Institute for Health Research, Aimmune, National Peanut Board, Novartis, and the Food Standards Agency; honoraria from Nutricia, Viatris, Stallergenes Greer, and DBV Technologies; and being Chair of the British Society for Allergy and Clinical Immunology Psychology Special Interest Group. The rest of the authors have no relevant conflicts of interest.

Funders
National Peanut Board
Allergy UK
National Institute for Health and Care Research
Food Standards Agency
British Society for Allergy and Clinical Immunology Psychology Special Interest Group
Novartis

Keywords

Food allergy
allergy
caregivers
coping
children
adolescents
paediatrics
scale
scale development
health psychology

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10.1016/j.jaip.2026.02.034Licence: CC BY 4.0

R Knibb et al_Development and Validation of the Coping with Food Allergy Scales_CoFAS_for Children and Young People and Parents
Copyright © 2026 Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/).
Final published version, 1.95 MBLicence: CC BY 4.0

Cite this

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title = "Development and Validation of the Coping with Food Allergy Scales (CoFAS) for Children and Young People and Parents",

abstract = "Background: Managing food allergy (FA) entails complex lifestyle changes and development of specific coping strategies. How we cope with long-term conditions is associated with clinical and psychological outcomes and so it is important that adaptive strategies are promoted. Objective: To develop and establish the reliability and validity of new coping with FA scales (CoFAS) for children and young people (CYP) aged 8-16 and for parents. Methods: The CoFAS were developed following interviews with 32 CYP aged 8-16 years and 8 parents, a systematic review of literature and consultation with FA experts. Reliability and validity analysis was conducted on 151 CYP aged 8-16 who completed the CoFAS-C and 390 caregivers who completed the CoFAS-P. Participants also completed validation measures of generic coping, anxiety and depression, quality of life and self-efficacy. Results: Exploratory factor analysis resulted in four sub-scales for the CoFAS-C (Avoidance and Minimisation, Positive Beliefs, Self-Management and Social Support) and three sub-scales for the CoFAS-P (Avoidance and Minimisation, Planning and Preparation and Dealing with Emotions). All had good to excellent internal reliability (Cronbach alphas = 0.74 to 0.84). and low to medium correlations with validation measures. Conclusion: The CoFAS are reliable and valid scales to identify coping strategies used for FA management by CYP and parents. Planning and preparation appear to be the most adaptive strategies, with avoidance and minimisation the least, but managing emotions is also important to promote. Knowledge of the types of coping strategies used by patients could direct clinical care.",

keywords = "Food allergy, allergy, caregivers, coping, children, adolescents, paediatrics, scale, scale development, health psychology",

author = "Rebecca Knibb and Purser, \{Suzanna E. M.\} and Jennifer Hammond and Kate Ambridge",

note = "Copyright {\textcopyright} 2026 Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma \& Immunology. This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/).",

year = "2026",

month = may,

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doi = "10.1016/j.jaip.2026.02.034",

language = "English",

volume = "14",

pages = "1165--1174.e9",

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T1 - Development and Validation of the Coping with Food Allergy Scales (CoFAS) for Children and Young People and Parents

AU - Knibb, Rebecca

AU - Purser, Suzanna E. M.

AU - Hammond, Jennifer

AU - Ambridge, Kate

N1 - Copyright © 2026 Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/).

PY - 2026/5/1

Y1 - 2026/5/1

N2 - Background: Managing food allergy (FA) entails complex lifestyle changes and development of specific coping strategies. How we cope with long-term conditions is associated with clinical and psychological outcomes and so it is important that adaptive strategies are promoted. Objective: To develop and establish the reliability and validity of new coping with FA scales (CoFAS) for children and young people (CYP) aged 8-16 and for parents. Methods: The CoFAS were developed following interviews with 32 CYP aged 8-16 years and 8 parents, a systematic review of literature and consultation with FA experts. Reliability and validity analysis was conducted on 151 CYP aged 8-16 who completed the CoFAS-C and 390 caregivers who completed the CoFAS-P. Participants also completed validation measures of generic coping, anxiety and depression, quality of life and self-efficacy. Results: Exploratory factor analysis resulted in four sub-scales for the CoFAS-C (Avoidance and Minimisation, Positive Beliefs, Self-Management and Social Support) and three sub-scales for the CoFAS-P (Avoidance and Minimisation, Planning and Preparation and Dealing with Emotions). All had good to excellent internal reliability (Cronbach alphas = 0.74 to 0.84). and low to medium correlations with validation measures. Conclusion: The CoFAS are reliable and valid scales to identify coping strategies used for FA management by CYP and parents. Planning and preparation appear to be the most adaptive strategies, with avoidance and minimisation the least, but managing emotions is also important to promote. Knowledge of the types of coping strategies used by patients could direct clinical care.

AB - Background: Managing food allergy (FA) entails complex lifestyle changes and development of specific coping strategies. How we cope with long-term conditions is associated with clinical and psychological outcomes and so it is important that adaptive strategies are promoted. Objective: To develop and establish the reliability and validity of new coping with FA scales (CoFAS) for children and young people (CYP) aged 8-16 and for parents. Methods: The CoFAS were developed following interviews with 32 CYP aged 8-16 years and 8 parents, a systematic review of literature and consultation with FA experts. Reliability and validity analysis was conducted on 151 CYP aged 8-16 who completed the CoFAS-C and 390 caregivers who completed the CoFAS-P. Participants also completed validation measures of generic coping, anxiety and depression, quality of life and self-efficacy. Results: Exploratory factor analysis resulted in four sub-scales for the CoFAS-C (Avoidance and Minimisation, Positive Beliefs, Self-Management and Social Support) and three sub-scales for the CoFAS-P (Avoidance and Minimisation, Planning and Preparation and Dealing with Emotions). All had good to excellent internal reliability (Cronbach alphas = 0.74 to 0.84). and low to medium correlations with validation measures. Conclusion: The CoFAS are reliable and valid scales to identify coping strategies used for FA management by CYP and parents. Planning and preparation appear to be the most adaptive strategies, with avoidance and minimisation the least, but managing emotions is also important to promote. Knowledge of the types of coping strategies used by patients could direct clinical care.

KW - Food allergy

KW - allergy

KW - caregivers

KW - coping

KW - children

KW - adolescents

KW - paediatrics

KW - scale

KW - scale development

KW - health psychology

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U2 - 10.1016/j.jaip.2026.02.034

DO - 10.1016/j.jaip.2026.02.034

M3 - Article

SN - 2213-2201

VL - 14

SP - 1165-1174.e9

JO - Journal of Allergy and Clinical Immunology: In Practice

JF - Journal of Allergy and Clinical Immunology: In Practice

IS - 5

ER -

Development and Validation of the Coping with Food Allergy Scales (CoFAS) for Children and Young People and Parents

Abstract

Bibliographical note

Funding

Keywords

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