Turkish Psychometric Properties of the Gluten-Free Diet Adherence Survey for Children With Coeliac Disease

Area of Science:

• Pediatric gastroenterology
• Autoimmune diseases
• Dietary adherence research

Background:

• Coeliac disease requires strict gluten-free diets, significantly impacting children's quality of life.
• Existing adherence tools are adult-focused, necessitating a child-specific assessment.
• Accurate evaluation of paediatric gluten-free diet compliance is crucial for effective management.

Purpose of the Study:

• To evaluate the Turkish psychometric properties of an adapted Gluten-Free Diet Adherence Survey.
• To modify an adult-designed survey for children aged 9-18 years with coeliac disease.
• To establish a reliable and valid tool for assessing gluten-free diet adherence in Turkish paediatric coeliac patients.

Main Methods:

• A cross-sectional methodological study involved 211 children (aged 9-18) from coeliac associations in Izmir and Istanbul.
• An expert panel simplified the original adult survey language, with pilot testing for comprehension.
• Validation included exploratory/confirmatory factor analyses, Cronbach's alpha for internal consistency, and response bias evaluation.

Main Results:

• Children achieved a mean adherence score of 20 (range 7-35), indicating moderate compliance and identifying adherence barriers.
• 45% of participants had adhered to a gluten-free diet for 5-10 years, demonstrating long-term sustainability.
• The adapted survey showed acceptable internal consistency (Cronbach's α = 0.797) and excellent model-data fit.

Conclusions:

• The adapted Gluten-Free Diet Adherence Survey is a valid and reliable instrument for Turkish children with coeliac disease.
• The survey aids in assessing dietary compliance and identifying areas for intervention.
• Findings support the need for targeted interventions to enhance adherence and improve clinical outcomes in paediatric coeliac disease.