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The Effect of Group-Based Education on Knowledge and Adherence to a Gluten-Free Diet in Patients with Celiac Disease: Randomized Controlled Clinical Trial

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Abstract

Background

Considering the importance of educational programs on compliance of patients with celiac disease with a gluten-free diet (GFD), we investigated the effect of a group-based education program on knowledge and adherence to a GFD in patients with celiac disease.

Method

In the present controlled clinical trial, patients in the intervention group (n = 66) underwent a three-session group-based educational program, and patients in the control group (n = 64) received routine education in visits to the clinic. The primary outcomes were knowledge and adherence to a GFD. Participant knowledge was assessed by a validated author-designed questionnaire. Adherence rate was evaluated by the Persian version of celiac disease adherence test (CDAT) questionnaire. Results were analyzed based on intention-to-treat (ITT) analysis.

Results

Results of the ANCOVA test showed that the mean score of knowledge about celiac disease and gluten in the intervention group was significantly higher compared with the control group immediately after intervention (p = 0.002) and 3 months post-intervention (p = 0.03). In terms of gluten-free food item selection, the intervention group achieved a significantly better score than the control group immediately after intervention (p < 0.001) as well as 3 months post-intervention (p < 0.001). Additionally, there was a significant difference in the CDAT score between the two groups 3 months post-intervention (p = 0.02).

Conclusion

Evidence suggests that group-based education was an effective intervention among patients with celiac disease to improve knowledge and adherence to a GFD.

Trial registration IRCT code: IRCT20080904001197N21; registration date: 5/23/2019

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Acknowledgments

We thank the East Azerbaijan patients with celiac disease who participated in the study. The results of the present study are derived from the Zahra Akbari Namvar MSc thesis in gastroenterology.

Funding

This study was funded by the Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Author information

Authors and Affiliations

  1. Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran

    Zahra Akbari Namvar

  2. Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

    Reza Mahdavi

  3. Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

    Masood Shirmohammadi & Zeinab Nikniaz

Authors
  1. Zahra Akbari Namvar
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  2. Reza Mahdavi
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  3. Masood Shirmohammadi
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  4. Zeinab Nikniaz
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Contributions

ZN and RM were responsible for the conception and design of the study. MSh and ZAN were responsible for data acquisition. ZAN and ZN were responsible for data analysis. ZN, RM, ZAN, and MSh were responsible for data interpretation. ZAN and ZN drafted the manuscript; all other authors revised and commented on the draft. All authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Zeinab Nikniaz.

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The authors declare that they have no competing interests.

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Akbari Namvar, Z., Mahdavi, R., Shirmohammadi, M. et al. The Effect of Group-Based Education on Knowledge and Adherence to a Gluten-Free Diet in Patients with Celiac Disease: Randomized Controlled Clinical Trial. Int.J. Behav. Med. 28, 583–590 (2021). https://doi.org/10.1007/s12529-020-09949-7

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