*Review* **Food Allergy Education and Management in Schools: A Scoping Review on Current Practices and Gaps**

**Mae Jhelene L. Santos 1,2, Kaitlyn A. Merrill 2,3, Jennifer D. Gerdts <sup>4</sup> , Moshe Ben-Shoshan <sup>5</sup> and Jennifer L. P. Protudjer 1,2,6,7,8,\***


**Abstract:** Currently, no synthesis of in-school policies, practices and teachers and school staff's food allergy-related knowledge exists. We aimed to conduct a scoping review on in-school food allergy management, and perceived gaps or barriers in these systems. We conducted a PRISMA-ScR-guided search for eligible English or French language articles from North America, Europe, or Australia published in OVID-MedLine, Scopus, and PsycINFO databases. Two reviewers screened 2010 articles' titles/abstracts, with 77 full-text screened. Reviewers differed by language. Results were reported descriptively and thematically. We included 12 studies. Among teachers and school staff, food allergy experiences, training, and knowledge varied widely. Food allergy experience was reported in 10/12 studies (83.4%); 20.0–88.0% had received previous training (4/10 studies; 40.0%) and 43.0–72.2% never had training (2/10 studies; 20.0%). In-school policies including epinephrine auto-injector (EAI) and emergency anaphylaxis plans (EAP) were described in 5/12 studies (41.7%). Educational interventions (8/12 studies; 66.7%) increased participants' knowledge, attitudes, beliefs, and confidence to manage food allergy and anaphylaxis vs. baseline. Teachers and school staff have more food allergy-related experiences than training and knowledge to manage emergencies. Mandatory, standardized training including EAI use and evaluation, and the provision of available EAI and EAPs may increase school staff emergency preparedness.

**Keywords:** anaphylaxis; epinephrine; food allergy; schools; scoping review; teachers
