PROJECT SUMMARY This project proposes empirical research and a scholarly book on the medicalization and pharmaceuti- calization of food allergies. One out of every 13 US children has a food allergy, and nearly half of those children are allergic to multiple foods. Because food allergies can be life-threatening, a significant amount of biomedical research and development has been invested in finding effective therapies. These novel therapeutic options—including one recent FDA-approved drug, an array of clinical trials, and even un- regulated food-based treatments—have attracted considerable parental interest despite potentially sig- nificant risks. Indeed, preliminary research indicates that parents often have a higher tolerance for the risks of these medical treatments compared to the risks from food. I am currently completing an ethnographic study of peanut allergy clinical trials, and the proposed project will expand and continue this line of research for the scholarly book through three specific aims: (1) ex- plore the experiences and perceptions of parents of children with peanut or other food allergies who have not pursued clinical trials, (2) document how unregulated food allergy treatments are being offered through private practices, and (3) integrate empirical findings from Aims 1 & 2 with my current ethno- graphic work on food allergy clinical trial participation. For Aim 1, I will conduct 30 interviews with par- ents who are (a) practicing avoidance of their children's food allergens with no additional treatment, (b) treating their children's peanut allergy with the FDA-approved drug, or (c) treating their children's food allergies with unregulated therapies. For Aim 2, I will conduct 10 interviews with clinicians who offer unregulated food-based treatments for food allergies to analyze how they describe their practices, includ- ing any safety protocols they have in place. The book manuscript will be written as part of Aim 3, wherein I will use data from both projects to provide a comprehensive view of food allergy therapeutics. The proposed project is significant because it will provide rich information about how US families navi- gate food allergies as a part of everyday life as well as a condition that increasingly justifies risky thera- peutic interventions. This project is innovative because food allergy therapeutics have not been examined from a critical social science perspective, and there has been no empirical research comparing the per- spectives of parents who choose different medical pathways to manage their children's food allergies or comparing how stakeholders perceive potential differences between FDA-approved, investigational, and unregulated food allergy treatments. Food allergies are certainly a health threat, but this new era of food allergy therapeutics marks a transition in which the condition is being more intensely and problematically medicalized.

PROJECT NARRATIVE The proposed research is relevant to public health because children's food allergies are on the rise as are major efforts to develop safe and effective therapies to treat them. The book resulting from this research will critically examine how stakeholders, especially parents, clinicians, and researchers, perceive the risks and benefits of these treatments. Findings from the project could inform guidelines about how parents should be informed about the risks and benefits of FDA-approved, investigational, and unregulated treat- ment options for their children's food allergies.