Prediction of adherence to a gluten-free diet using protection motivation theory among adults with coeliac disease.
BACKGROUND
Coeliac disease is a chronic autoimmune disease that requires strict adherence to a gluten-free diet. However, strict adherence to a gluten-free diet is difficult, with findings from a recent review suggesting that up to 42% of individuals with coeliac disease do not eat a strict gluten-free diet.


METHODS
The present study aimed to examine psychosocial predictors of adherence (purposeful and accidental) to a gluten-free diet among adults with coeliac disease over a 1-month period. In this longitudinal study, 212 North American adults with coeliac disease completed online questionnaires at two time points, baseline and 1 month later.


RESULTS
The results revealed that intentions partially mediated the effects of symptom severity, self-regulatory efficacy, planning and knowledge on purposeful gluten consumption. Intentions did not mediate the effects of severity, response cost, self-regulatory efficacy, planning and knowledge for accidental gluten consumption but, interestingly, self-regulatory efficacy directly predicted fewer accidental incidents of gluten-consumption.


CONCLUSIONS
These findings delineate the differential psychological processes in understanding accidental and purposeful gluten consumption among adults with coeliac disease and emphasise the importance of bolstering self-regulatory efficacy beliefs to prevent accidental and purposeful consumption of gluten.
School of Health and Exercise Sciences, The University of British Columbia at Okanagan, Kelowna, BC, Canada.
A J
AJ
Dowd
School of Health and Exercise Sciences, The University of British Columbia at Okanagan, Kelowna, BC, Canada.
M E
ME
Jung
Department of Education and Counselling Psychology, The University of British Columbia, Vancouver, BC, Canada.
M Y
MY
Chen
School of Kinesiology, The University of British Columbia, Vancouver, BC, Canada.
M R
MR
Beauchamp
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001519:Behavior; D002170:Canada; D002446:Celiac Disease / Q000178:diet therapy*; D055050:Diet, Gluten-Free / Q000523:psychology*; D005983:Glutens / Q000008:administration & dosage; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D008137:Longitudinal Studies; D008875:Middle Aged; D009042:Motivation; D010349:Patient Compliance / Q000523:psychology*; D020377:Self Efficacy; D011795:Surveys and Questionnaires
D005983:Glutens
adherence behaviour; coeliac disease; gluten-free diet; psychosocial