Figure and Table | A Two-week, Hands-on Educational Program for Primary Care Pediatricians Aimed at Equalization of Pediatric Allergy Practice across Institutions and Regions

Table 2. Participant Characteristics.

From: A Two-week, Hands-on Educational Program for Primary Care Pediatricians Aimed at Equalization of Pediatric Allergy Practice across Institutions and Regions

Age (years), median (interquartile range) (n = 64)		36 (32-40)
Male, (%) (n = 65)		33 (50.7)
Experience as a physician (years), median (interquartile range) (n = 65)		10 (8-14.5)
Workplace (district), No. (%) (n = 65)	Hokkaido	3 (4.6)
	Tohoku	7 (10.8)
	Chubu	6 (9.2)
	Kanto	31 (47.7)
	Kansai	9 (13.8)
	Chugoku and Shikoku	6 (9.2)
	Kyushu and Okinawa	2 (3.1)
	Overseas	1 (1.5)
Workplace (facility), No. (%) (n = 65)	Hospitals with ≥200 beds	46 (70.1)
	Hospitals with <200 beds	6 (9.2)
	Clinic	7 (10.8)
	No answer/parental leave	6 (9.2)
From the central base hospital of prefectures^† (n = 16)		9 (56.3)
Pediatric specialists, No. (%) (n = 65)		50 (76.9)
Allergy specialists, No. (%) (n = 65)		4 (6.2)
Number of patients undergoing OFC in participant’s facility per month, No. (%) (n =55^‡)	0^§	23 (41.8)
	1-9	19 (34.5)
	≥10	13 (23.6)
Number of patients undergoing SPT in participant’s facility per month, No. (%) (n = 55^‡)	0	29 (52.7)
	1-4	14 (25.4)
	≥5	10 (18.1)
	No answer	2 (3.6)
Knowing the “dual-allergen exposure hypothesis,” No. (%) (n = 45^‡)	Yes	35 (77.8)
	No	10 (22.2)

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Table 3. Evaluation of Knowledge and Skills.

From: A Two-week, Hands-on Educational Program for Primary Care Pediatricians Aimed at Equalization of Pediatric Allergy Practice across Institutions and Regions

Items related to knowledge and skills (third to seventh terms)		Mean achievement score (SD)		P value	Items related to knowledge and skills (eighth to ninth terms)		Mean achievement score (SD)		P value
		Pre-training	Post-training	P value			Pre-training	Post-training	P value
[Diagnosis and evaluation of food allergy]
1	Diagnosis of immediate allergic response	2.74 (0.64)	3.70 (0.46)	<0.001*	1	Diagnosis of immediate allergic response	2.81 (0.91)	3.44 (0.73)	0.010
2	Explanation of the differences in diagnostic methods for FA	2.36 (0.79)	3.59 (0.53)	<0.001*	2	Explanation of the differences in diagnostic methods for FA	2.69 (0.87)	3.56 (0.63)	0.002
3	Interpretation of SPT results	1.48 (0.80)	3.38 (0.64)	<0.001*	3	Interpretation of SPT results	2.13 (0.89)	3.44 (0.51)	0.001*
					4	Diagnosis based on allergen components	2.25 (0.86)	3.44 (0.51)	<0.001*
[Oral food challenge test]
4	Explanation and giving informed consent for OFC	2.39 (1.08)	3.70 (0.51)	<0.001*	5	Explanation and giving informed consent for OFC	2.38 (0.89)	3.13 (0.89)	0.031
5	Prescription and treatment instructions for OFC	2.09 (1.02)	3.60 (0.54)	<0.001*	6	Prescription and treatment instructions for OFC	2.00 (0.97)	2.94 (0.77)	0.003
6	Supervision of preparation by the medical staff for OFC	2.09 (1.04)	3.66 (0.52)	<0.001*	7	Supervision of preparation by the medical staff for OFC	2.38 (1.47)	3.38 (0.72)	0.005
7	Preparation of the test food and medical devices for OFC	1.66 (0.81)	3.60 (0.54)	<0.001*	8	Preparation of test food and medical devices for OFC	2.19 (1.05)	3.25 (0.77)	0.002
8	Conducting OFC for a patient	1.66 (0.81)	3.53 (0.55)	<0.001*	9	Conducting OFC for a patient	2.38 (1.09)	3.50 (0.73)	0.002
					10	Conducting double-blind food challenge tests	1.81 (0.91)	2.31 (0.87)	0.015
[Dietary guidance]
9	Listing notes in reintroducing foods for patients at low risk	2.40 (0.88)	3.49 (0.59)	<0.001*	11	Listing notes in reintroducing foods for patients at low risk	2.43 (0.89)	3.43 (0.63)	<0.001*
10	Listing notes for sensitized patients	2.15 (0.81)	3.45 (0.54)	<0.001*	12	Listing notes for sensitized patients	2.38 (0.89)	3.31 (0.60)	0.002
11	Guidance on partial introduction or reintroduction	1.87 (0.80)	3.12 (0.65)	<0.001*	13	Guidance on partial introduction or reintroduction	2.31 (0.87)	3.19 (0.91)	0.002
[Emergency treatment]
12	Immediate allergic response and emergency action	2.77 (0.79)	3.83 (0.38)	<0.001*	14	Immediate allergic response and emergency action	2.94 (0.77)	3.56 (0.63)	0.002
13	Explanation of the efficacy and dosage of AAI	2.68 (0.81)	3.78 (0.42)	<0.001*	15	Explanation of the efficacy and dosage of AAI	3.00 (0.73)	3.69 (0.60)	0.003
14	Rules to the prescription of AAI	2.32 (0.98)	3.54 (0.66)	<0.001*	16	Rules about the prescription of AAI	2.53 (0.99)	3.31 (0.87)	0.004
15	Usage instructions for AAI	2.68 (0.91)	3.81 (0.45)	<0.001*	17	Usage instructions for AAI	3.38 (0.72)	3.69 (0.60)	0.037
[Management of atopic dermatitis]
16	Description of the loss of skin barrier function, aggravating factors of AD	2.51 (0.80)	3.74 (0.44)	<0.001*	18	Diagnostic criteria of AD	2.56 (0.81)	3.56 (0.51)	0.003
17	Instructing techniques of skincare	2.44 (0.69)	3.79 (0.41)	<0.001*	19	Explanation of the loss of skin barrier function in AD	2.44 (0.81)	3.44 (0.51)	0.002
18	Explanation of the side effects of topical corticosteroids	2.77 (0.60)	3.81 (0.40)	<0.001*	20	Evaluation of the severity of AD	2.25 (0.86)	3.06 (0.57)	0.007
19	Avoiding side effects of topical corticosteroids	2.34 (0.70)	3.72 (0.45)	<0.001*	21	Instructing techniques of skincare	2.63 (0.81)	3.53 (0.64)	0.004
20	Idea of proactive treatment for AD	2.47 (0.95)	3.83 (0.38)	<0.001*	22	Avoiding side effects of topical corticosteroids	2.50 (0.82)	3.53 (0.52)	0.002
					23	Idea of proactive treatment for AD	2.63 (0.96)	3.60 (0.51)	0.005
					24	Exacerbation factors of atopic dermatitis	2.75 (0.68)	3.53 (0.52)	0.004
[Allergy prevention concept]
21	Knowledge of the theory “dual-allergen exposure hypothesis”	2.30 (0.93)	3.77 (0.43)	<0.001*	25	Knowledge of the theory “dual-allergen exposure hypothesis”	2.00 (0.89)	3.33 (0.49)	<0.001*
[Management of asthma]
					26	Diagnostic criteria of asthma	2.63 (0.72)	3.40 (0.51)	0.002
					27	Evaluation of the severity and control status of asthma	2.75 (0.68)	3.47 (0.52)	0.002
					28	Exacerbation factors of asthma	2.88 (0.62)	3.60 (0.50)	0.002
					29	Evaluation of pulmonary function	2.25 (1.00)	3.33 (0.62)	0.002
					30	Evaluation of fractional exhaled nitric oxide (FeNO)	2.06 (0.93)	2.93 (0.70)	0.002
					31	Conducting airway sensitivity tests	1.19 (0.40)	2.07 (0.70)	0.002
					32	Long-term management of asthma	2.63 (0.72)	3.40 (0.51)	0.006
					33	Guidance on the lifestyle and household environment for preventing asthma exacerbation	2.50 (0.89)	3.40 (0.74)	0.006
					34	Inhalation device	2.56 (1.03)	3.40 (0.63)	0.009
					35	Action plans for acute asthma exacerbation	2.94 (0.85)	3.60 (0.51)	0.005
[Allergic rhinitis]
					36	Sublingual immunotherapy	2.06 (1.12)	3.20 (0.68)	0.005
[Patient education]
22	Educational interventions for patients	2.11 (0.68)	3.43 (0.54)	<0.001*

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Table 4. Evaluation of Clinical Practice Behaviors.

From: A Two-week, Hands-on Educational Program for Primary Care Pediatricians Aimed at Equalization of Pediatric Allergy Practice across Institutions and Regions

	Items related to practice behaviors	Third to seventh terms			Eighth to ninth terms
		Yes/No			Yes/No
		Pre-training	Post-training	P value	Pre-training	Post-training	P value
1	Explanation based on correct test result interpretation for the diagnosis of FA	32/0	32/0	―	12/0	12/0	―
2	Explanation of the importance of immediate treatment of eczema with skincare and prescribed external medicine for patients under a food elimination protocol	24/8	31/1	0.105	12/0	12/0	―
3	Conducting skin tests or OFC for the reintroduction of foods for patients under a food elimination protocol without recent severe immediate reactions	6/26	22/10	<0.001*	4/8	10/2	0.281
4	Practical instructions on skincare and application of external medicine for patients with AD and FA	10/22	31/1	<0.001*	8/4	12/0	0.75
5	Quick interventions for the reintroduction of foods	14/18	26/6	0.001*	9/2	11/0	0.75
6	Confirmation of the improvement of atopic dermatitis after the intervention	6/26	25/7	<0.001*	4/7	8/3	1
7	Giving information on the action plan including AAI	18/14	26/6	0.023*	7/4	9/2	1
8	Explanation of the diagnosis and severity of atopic dermatitis based on diagnostic criteria and severity index				3/8	9/2	0.219
9	Provision of plans and guidance on treatment methods based on proactive remission maintenance therapy of AD				6/6	10/2	0.75
10	Evaluation of exacerbation factors and provision of guidance on lifestyle and household environment for AD				4/8	10/2	0.188
11	Application of self-monitoring tools or questionnaires to evaluate the severity and control status of asthma				3/9	6/6	1
12	Conducting pulmonary function tests, measurement of exhaled nitric oxide concentration, and airway hypersensitivity test to evaluate the severity and control status of asthma				3/8	8/3	0.375
13	Confirmation of the inhalation procedure after inhalation guidance				4/8	8/4	0.75
14	Consideration and application of sublingual immunotherapy for allergic rhinitis				3/8	7/4	0.75

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