An Institutional Ethnography Inquiry into the Management of Anaphylaxis for Adolescents at-risk in Ontario Schools

Abstract

In Ontario, Sabrina’s Law mandates that all school boards have anaphylaxis policies in place to protect at-risk students. Despite this law research has shown that within schools, the management of anaphylactic allergies is still challenging and at-risk students report feelings of anxiety and risk of an allergic reaction. The purpose of this study is to explore how the everyday experiences of adolescents at risk of anaphylaxis is mediated and shaped by exterior forces (e.g. Sabrina’s Law and school board policies) and secondarily to map how these forces shape and affect the everyday experiences of managing their allergies. The study employed Institutional Ethnography, a methodology that begins in the everyday experience of a particular standpoint (at risk adolescents) and then moves outwards to examine the social organization of anaphylaxis management in school settings. Data were collected through in-depth interviews with at-risk students and key informants, as well as through document analysis. Writing and mapping were used as analytical techniques to make visible the social organization of anaphylaxis management within school systems. Through this, the movement of institutional processes from their formation in the translocal and in the text, through their implementation in the local environment, to their effect on the everyday experience was explicated. Within this movement from the translocal down to the local, parts of the text are lost, unclear, or not implemented. Overall, translocal forces (Sabrina’s Law and the School Board Anaphylaxis Policy) affected the student experience by shaping the environment students moved through. Students and families were separated from the institutional processes occurring around anaphylaxis management and unaware of the work done within the schools. Within student safety as it pertains to anaphylaxis management, there is a focus on an allergic reaction and the emergency response, removing the social and emotional needs of anaphylactic students. Anaphylaxis management has been split into two concepts, Emergency Preparedness and Anaphylaxis Prevention, with Emergency Preparedness measures overshadowing preventative measures within the institutional processes. The results of this study support a need to incorporate Anaphylaxis Prevention back into the institutional processes, acknowledging the life experience of anaphylactic allergies, instead of focusing solely on the reaction.