Abstract
BACKGROUND: Food allergy (FA) is an immune-mediated reaction that can cause anything from minor symptoms such as skin rashes to severe, potentially fatal anaphylaxis. Little is known about FA knowledge and management among Palestinian university students, despite the abundance of studies on the condition in pediatric populations. To the best of the authors’ knowledge, this is one of the first studies to evaluate FA knowledge and attitudes, particularly among Palestinian university students, with the goal of identifying important gaps and investigating behavioral and sociodemographic factors that affect their understanding. METHODS: From September 2024 to May 2025, a cross-sectional, single-center study was conducted at An-Najah National University in Nablus, Palestine. A total of 424 students from a variety of academic fields were recruited via a convenience sampling technique, and the sample size was determined on the basis of feasibility and the population that was accessible. A questionnaire that was delivered by the interviewer and modified for cultural relevance was taken from the Chicago Food Allergy Research Survey. Demographic characteristics, FA knowledge (18 items), attitudes (9 Likert scale items), and relevant clinical history were all evaluated in four sections of the measure. Both descriptive and inferential statistical analyses were conducted, and a composite knowledge score was produced. RESULTS: Among the 424 participants (mean age 21 ± 2 years), 68.6% (n = 291) were female. The overall median knowledge score was 52.4% (IQR = 42.9–61.9%). The knowledge of female students was much greater than that of male students (p < 0.001). Additionally, the knowledge scores varied by field of study, with students in the Doctor of Pharmacy (median rank = 243.91) and Medicine (median rank = 240.68) programs demonstrating greater knowledge (p = 0.034). The knowledge scores were significantly higher for those who ate more meals outside the home (p = 0.007). Other variables, including marital status, income, residence, type of residence, and prior training, were not significantly associated with knowledge scores. CONCLUSIONS: University students demonstrated multiple knowledge gaps and positive attitudes toward food allergies. Targeted interventions are needed to address these knowledge gaps by adopting a peer-led approach for better outreach strengthened through collaboration with university-based public health institutions and student associations. These interventions should be complemented by institutional safety measures and management protocols implemented in universities. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-025-25637-1.