Ep. 288: Inside FAMP-IT: A New Resource for Families and Clinicians

Imagine having a trusted roadmap for navigating food allergies during the infant and toddler years—whether you're a parent, caregiver, or healthcare professional. A newly launched platform from Mass General Brigham for Children may be changing the way families and clinicians access food allergy information. We're joined by the project lead behind FAMP-IT (Food Allergy Management and Prevention for Infants and Toddlers), Dr. Michael Pistiner, to explore this exciting new resource and why it could be a gamechanger for our community. 

Resources to keep you in the know:

• FAMP-IT - For Families
• FAMP-IT - for Clinicians 
• FAMP-IT Office Hours - for Clinicians with Dr. Pistiner

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Thanks for listening! FAACT invites you to discover more exciting food allergy resources at FoodAllergyAwareness.org!

Transcript

Caroline: Welcome to FAACT's Roundtable, a podcast dedicated to navigating life with food allergies across the lifespan. Presented in a welcoming format with interviews and open discussions,

each episode will explore a specific topic, leaving you with the facts to know or use.

Information presented via this podcast is educational and not intended to provide individual medical advice.

Please consult with your personal board certified allergist or healthcare providers for advice specific to your situation.

Hi everyone. I'm Caroline Moassessi and I am your host for the FAACT Roundtable podcast. I am a food allergy parent advocate and the founder of the Grateful Foodie Blog. And I am FAACT's Vice President of community relations.

Before we start our conversation today,

I just want to take a moment to say thank you to the National Peanut Board for being a kind sponsor of FAACT's roundtable podcast.

Imagine having a trusted roadmap for navigating food allergies during the infant and toddler years. Whether you're a parent, caregiver or a healthcare professional,

a newly launched platform from Mass General Brigham for Children may be changing the way families and clinicians access food allergy information.

Today we're joined by the project lead behind FAMP-IT, Dr. Michael Pistener, to explore the exciting new resource and why it could be a game changer for our community.

Welcome back to FAACT's Roundtable podcast. Dr. Pistiner, you are just a crowd favorite and this is a really exciting project.

So I am just doubly excited to talk about this today. So welcome.

Dr. Pisitiner: Thanks for having me again.

Caroline: You're very welcome. You are just a favorite and our conversations just go so well and I love that we share such important information to everybody and you deliver it in a way that we can understand it and we can take off and run with it.

So we're just going to jump right into this.

So our purpose today is to talk about Fampit and it feels like it's a real game changer for both families and healthcare providers.

So before we even dive into it, if you can give our listeners just a high level overview of these two platforms and listeners, there are two different websites and we're going to dig through this.

If you could just walk us through each platform in each side of it, very high level. And then let's dig in really deep to it. But I just want listeners to get a feel for what we're talking about.

Dr. Pisitiner: All right, so the FAMPIT stands for food allergy management for the infant and the toddler. And so this is a resource that is ultimately turned into a platform.

And so what we're trying to do is get everyone on the same page.

So we're trying to get families,

clinicians,

family medicine, pediatricians, allergists,

dermatologists,

you name it,

registered dietitians, WIC,

everyone having the same information.

But as you can see, these are different audiences.

So we try to take the same important information for preventing and managing food allergy in infants and toddlers and tweak it just subtly for each group to be able to then get together and have the same understanding and to be able to fill some of the gaps that we currently have.

And so FAMP-IT was meant to help fill some of these access gaps.

By the time a family gets to an allergist, prevention is done.

And now it might be too late.

And so that four to six months of life for an infant is critical for early introduction and even before for that for prevention of food allergy.

But again,

if a child already has an allergy problem and winds up in the allergy office,

then we missed prevention.

And so in order to actually make change and prevent food allergy, we have to be getting to families early, early, early.

And so who's going to do that?

Folks in pediatrics and folks in family medicine.

And so we have created,

initially we started creating our resources and tools for the clinician and we have electronic medical record support for the clinicians. We have after visit summaries, so upon discharge they can give education for the families.

Then we have family facing resources in English and Spanish. So this way the clinicians will be able to share this with their patients. But then we also have direct information for families if they find us on the Internet or especially if it's going to be in their after visit summaries from their,

well, child visits.

Now what we're also realizing is that primary care is busy.

They're talking about vaccines, firearms, trampolines, car seats. Are they going to have time to go through all of this?

This is where then filling the gaps with different resources,

video resources for the families,

this is where it all kind of comes together.

Additionally, we realized that, wait, primary care and allergy, by the time it gets to all of these folks, it might even be too late. So now collaborating with WIC and newborn hospitalists in newborn nursery is actually really important because there's some prevention stuff that comes even before food touches the baby's lips.

Caroline: This is just so exciting. I spent a lot of time myself on each platform, which I intended on spending a little time and just getting a good overview, but it was so rich and deep.

I honestly spent probably close to an hour because there was so much rich information.

And that really showed me that after exploring the platform that there was tremendous amount of thought and expertise and heart that went into it.

And so I'm just so excited that you were trying to fill those gaps. But can you also talk to us a little bit just about the journey of creating it and developing it?

Because you had to have had an extensive team.

Dr. Pisitiner: I've been fortunate to work with an amazing team.

And so the FAMFIT team has been actually evolving over the years.

This is our seventh year now,

and initially it was designed to support the primary care clinicians.

And now we have collaborated with many to be able to reach a much more broad audience.

We have had within our own team, we've had many volunteers. But then we have had the luck of being able to bring on some Sandra Rosenbluth, who is a digital health communications specialist, who has helped us specifically tailor our resources for our audiences and be thinking about health literacy.

And it's really taken us to the next level.

We've had program coordinators that have been with us for a long time, Samantha Yap.

And then we recently have a new hire who is specifically coming on with a big focus on this project,

Penny. And then we have so many people who have kind of been on our team and then transitioned out to medical schools or residency programs or fellowships.

We also have partnered with Allergy Asthma Network and they helped us create the family facing website and they helped us technically build it and they helped us with some of the core build.

And so they kind of taught us how to fish and now we're fishing. And we also have collaborated with multiple allergy experts to help us with content.

We have collaborated with registered dietitians,

we have collaborated with RNs, NPs, PAs, you name it. And the whole point is that we're trying to work with everyone who is giving us the insight.

One of the things that I always do that we're trying to do here is surround ourselves with people smarter than us and then this way we all can get a lot done.

And so this has really been a team effort. And so thank you to everyone who's been involved,

especially collaborations with wic,

with Massachusetts wic, with National WIC association,

with newborn hospitalists and folks in the newborn nursery. We've been able to really think about reaching people right where they need it and use the expertise with all the people who are right there in the weeds.

Caroline: It makes a difference and it shows. So, you know, let's just go right in and let's talk about the Famfit family website.

So the patient facing website. So if you can just walk us through some highlights, there's, I mean we could probably talk for hours on that website. But just give us things that our listeners can learn about and learn how to use the website really effectively.

Dr. Pisitiner: So the family facing website, FAMPITfamily.org is meant to be one stop shopping for anyone who wants to prevent or take care of an allergic issue in an infant or a toddler.

And so on this we have a section for early introduction. So this would be appropriate for anybody who's expecting to have a baby soon,

who has a young baby or has a baby who's just about to start eating.

We also have an area for food allergy management. If somebody is suspicious that their kid has a food allergy, this is for them to check it out.

If somebody has an IGE mediated food allergy, the kind of allergy that you think of when you can have quick signs or symptoms in more than one system that somebody gives them epinephrine for,

this is for them, but then also the kind that has delayed reactions that might be isolated to the gut.

F pies proctocolitis. This is also the place to come for there now we also recently added a section on eczema. Now what we're doing with all of these and all of our content, not only in the family facing, but also the clinician facing, is we're building it based on the most up to date guidance and recommendations.

And so for the eczema section, for example, that's based on the relatively new practice parameters for the management of eczema coming from the allergy societies, but we also based it on new guidance coming from the American Academy of Pediatrics.

And so that's kind of the theme with all of our content is that wherever up to date recommendations and guidance is available,

we try to translate it into whatever method we need to communicate it to the audience that's looking.

So we change this stuff for the families, we change this stuff for WIC staff,

for newborn hospital staff,

for primary care clinicians, for allergists.

We try to meet them where they are looking for the content that they want and need for the roles that they're playing.

The family facing site is entirely available in Spanish, which we're very excited about. And on it we house a set of videos that we created in collaboration with National WIC association.

And in about a week or two we're going to have the Spanish version of those videos available as well,

we have handouts, we have the site itself and so we're trying to make it very digestible in whatever method someone wants to learn.

Caroline: Well, I really like too that you have a section in there like under early introduction and you have step by step instructions.

And I like that it seems that you really put some thought into breaking everything down into these little digestible bites.

Dr. Pisitiner: We are still working on being able to be succinct,

give the necessary information and then figure out how to give people the opportunity to then go down, as you said, the rabbit hole.

And so this is one of the things that we didn't want to overwhelm and we want to give just enough.

But then we, at the same time, if people want more, we want to be able to offer that. We're going to keep trying to be better at reaching all of our audiences, but that's ultimately the goal.

Caroline: Also, when I was looking at your food allergy management section, which is really excellent if someone has a toddler but then they have an older child,

is the website still viable, useful?

Dr. Pisitiner: Yeah, absolutely. And we specifically were trying to put it in the language and to put people in the shoes of infant and toddler management because it can be a little trickier because the infants and the toddlers for the most part are nonverbal and they can't tell us what they're feeling.

And then there's also going to be more putting hands or objects in the mouth. There's going to be different things to be thinking about when it comes to cross contact.

And then there's going to be difference in medication.

And so where the infants and the toddlers may be lighter than the older kids and there might be some approvals for different medication.

We see this especially in the eczema section where there's going to be some stuff that the kids are too young for. But if somebody was checking it out and they had a kid who was older,

then the very same pillars of food allergy management,

prevention and emergency preparedness could still be and should be applied to the bigger kid. But then in thinking about which medications are available then when the child is over age 3, then I'd say doing a deeper search because we did need to limit our content a bit until under 36 months.

Caroline: Well, it's very in depth. I liked how you had label reading in there and cross contact and so it was just very thorough.

So now going hand in hand, can you share some of the highlights from the clinician side and the FAMPA website that are for the healthcare professionals all

Dr. Pisitiner: right, so as I was mentioning, a little bit of a gap currently is a gap of time.

So we have the issue of the time that it might take for a kid to get in the hands of an allergist. So there might be a long wait in between primary care and making it to an allergist.

But then there's also the time issue of the short amount of time that most people have with their families with education.

And so what we're trying to do is get salient,

important information in the hands of primary care to be able to confidently pass it along to families and to help them with some of their decision making.

So on this site we have electronic medical record tools that primary care clinicians or any clinician actually can copy and then download into their electronic medical record and then use it again and again.

And so the way we're intending people to use this site is come to the site where we have the most up to date guidance, where we take these practice parameters and we take these recommendations from the American Academy of Pediatrics and we try to distill them into something that is applicable to the primary care setting and what the primary care clinician can think about when they are seeing these families in the well,

child visits or an urgent visit or even like handling phone triage. We are hoping that the teams are going to educate their own teams within their clinic setting and then be able to then educate the families that they take care of.

So now that we have the family facing site, it's really exciting because now we have the tools that the clinicians can pass along so they don't have to do the hard work that our team has done to get these after visit summary, to get these patient educational materials in the hands of the families.

So then the family facing materials now are going to be in handouts that the primary care team can use. These are like color PDFs, but not everybody has a printer.

So then they would be able to then use the after visit summary dot phrases to put in their after visit summaries that they could print out or they can include in their discharge summaries.

So we're trying to be thinking about some of the limitations of time that a team is going to have with education.

We are then realizing that the primary care teams,

they are going to need to collaborate and work with their allergy providers or their dermatology providers. And so what we're also offering then is office hours where my team will meet with anybody who wants to sign up to work together to roll out some of the FAMFIT materials to their communities.

And so if there is an allerg team who wants to invite their primary care referring providers, they can all sign up for office hours. And then we're going to work with the allergy team and the primary care providers to pick and choose the resources from the FAMPIT clinician site and the FAMPIT family site to make their visits smoother and quicker and easier.

And we may even in certain cases, tailor things to help facilitate some of these rollouts.

Caroline: Wow. So basically what you're saying, clinician can sign up for that office hour and then have the information curated for their practice, their situation, their patients.

Dr. Pisitiner: Yeah. So we right now we're actively doing this office hours project and we're hoping that we're going to extend it and do it next year as well.

And until we fill up, my team and I will join folks when they sign up for one of these office hours for like a 60 minute to 90 minute session.

And then these teams can invite the providers and clinicians that they want to bring on. So for example, if an allergy just in, let's say Texas, wants to bring on their entire staff because they want to improve their own management of infants and toddlers, then they can sign up and bring them on.

If an allergist in, let's say Minnesota wants to invite 45 of their referring primary care providers, then they can sign up. They could do the 90 minute, they bring them on and we all geek out together.

And then I don't know what's happening there as far as what their access looks like, as far as what their allergist team wants to do.

So then when we're all together,

we're able to then talk about what the approach and what the flow might look like, because it's going to be very different,

rural Maine to Minnesota to Boston.

And so the point of these office hours is to be able to then take this general material and individualize it right into the area based on the resource. You know, some places,

like the Boston area, we have a lot of allergy providers,

but then there's going to be places in rural US where there might be 80 miles until the closest allergy team. And so the teams are going to need to do things a little differently based on how available an oral food challenge might be or how available an allergy team might be to do skin testing.

Primary care may need to do a lot on their own. And there's so much that can be done for prevention and needs to be done.

So we're hoping that we're going to give confidence to primary care to be able to do the things they need to do to keep the kids in good shape until they get in the hands of a board certified allergy team.

Caroline: This is so groundbreaking. I don't think we've ever had this available to us before. I think this is a first time, right?

Dr. Pisitiner: We are having fun doing new things and trying to like serve these unmet needs and these gaps. And this has been a really wonderful experience and a nice way to meet a lot of people who are like minded.

Caroline: So here's a very selfish question for not only myself and Nevada, which has a lot of rural areas. I mean basically you've got two big cities, Reno and Vegas and everything in between and for our listeners.

So as we're listening to this and we're learning about these amazing resources for our physicians, what's the best way for us to get the word out to our allergists, our doctors, or even just our community healthcare workers in those rural areas to know that this is a available to them?

So what can we do as patients tool?

Dr. Pisitiner: To the list of people I'd also add then wic.

So the WIC offices, especially for the rural areas,

we're also offering office hours for state, local, regional WIC offices to help them roll it out too. And so this would be where as families let the folks who you work with know about this.

And so as you are looking at the material from a family perspective and if you find it useful,

then let your primary care team, let your allergy team, let your local WIC office know about this stuff. And if they like it and they may then use it for the other people that they take care of and serve.

So we're going from both ends.

Caroline: I love that. I mean, because honestly, I mean children are past pediatrician age. But you know, I'd go to the pediatrician and I'd tell them about new things and food allergies that I would learn or whatever.

And he absolutely loved it. And so this seems like again one of these opportunities where you can let going to wic,

letting our primary care physicians know that this is available. Do you have a flyer or anything like this or do we just give them the website?

Dr. Pisitiner: So we have the website but now one of the things that we've also then been working on is we have a cute poster that has a QR code and this can actually be hung in the offices of WIC offices or primary care teams that goes to the family facing site.

We also have a special poster that's made for the newborn nursery where we're not yet really talking about adding foods yet because the babies are so young.

And we have a specific video for those first couple of months for prevention. And so so far that's the way we're spreading the word and we just keep on trying to come up with new and better ways to share.

And so I would be very open to anyone who has ideas to get the word out there.

Thank you FAACT for helping us spread the word because this is very exciting and it's so fun to be able to share this with everyone through you guys.

Caroline: We're delighted to help get the word out and to talk to you. So before we say goodbye today, is there anything else that you want our listeners to hear from you?

Dr. Pisitiner: It was an honor to join you.

It's so good to be back. I look forward to many more and thank you for helping us try to decrease the burden of food allergies on our entire community.

So thanks for having me. Thanks for having us.

Caroline: Well, thank you. We appreciate, as you know, endlessly, the work you do and your team and I do look forward to speaking to you again on this podcast. So thank you so much.

Dr. Pisitiner: See you soon.

Caroline: Before we say goodbye today, I just want to take one more moment to say thank you to the National Peanut Board for being a kind sponsor of FAACT's roundtable podcast.

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