Year 2016 / Volume 108 / Number 3
Original
Transcultural adaptation and validation of the Celiac Dietary Adherence Test. A simple questionnaire to measure adherence to a gluten-free diet

138-144

DOI: 10.17235/reed.2016.4033/2015

Ricardo Fueyo Díaz, Santiago Gascón Santos, Ángela Asensio Martínez, María Antonia Sánchez Calavera, Rosa Magallón Botaya,

Abstract
Background and aims: A gluten-free diet is to date the only treatment available to celiac disease sufferers. However, systematic reviews indicate that, depending on the method of evaluation used, only 42% to 91% of patients adhere to the diet strictly. Transculturally adapted tools that evaluate adherence beyond simple self-informed questions or invasive analyses are, therefore, of importance. The aim is to obtain a Spanish transcultural adaption and validation of Leffler’s Celiac Dietary Adherence Test. Methods: A two-stage observational transversal study: translation and back translation by four qualified translators followed by a validation stage in which the questionnaire was administered to 306 celiac disease patients aged between 12 and 72 years and resident in Aragon. Factorial structure, criteria validity and internal consistency were evaluated. Results: The Spanish version maintained the 7 items in a 3-factor structure. Reliability was very high in all the questions answered and the floor and ceiling effects were very low (4.3% and 1%, respectively). The Spearman correlation with the self-efficacy and life quality scales and the self-informed question were statistically significant (p < 0.01). According to the questionnaire criteria, adherence was 72.3%. Conclusion: The Spanish version of the Celiac Dietary Adherence Test shows appropriate psychometric properties and is, therefore, suitable for studying adherence to a gluten-free diet in clinical and research environments.
Share Button
New comment
Comments

09/03/2016 14:56:29
Cada vez más se diagnostican personas con Enfermedad celiaca, por lo que es necesario se adhieran a una dieta equilibrada


References
1. Ludvigsson JF, Leffler DA, Bai JC et al. The Oslo definitions for coeliac disease and related terms. Gut 2013;62:43-52.
2. Comino I, Real A, Moreno L et al. Is it the oat a toxic cereal for coeliac patients? Its depends on the variety. Ann Nutr Metab 2011;58:125-6.
3. Fasano A, Drago S, Thorpe M et al. Prevalence of Celiac disease in at-risk and not-at-risk groups in the United States: A large multicenter study. Arch Intern Med 2003;163:286-92.
4. Catassi C, Fabiani E, Iacono G et al. A prospective, double-blind, placebo-controlled trial to establish a safe gluten threshold for patients with celiac disease. Am J Clin Nutr 2007;85:160-6.
5. Cilleruelo ML, Roman-Riechmann E, Sanchez-Valverde F et al. Spanish national registry of celiac disease: incidence and clinical presentation. J Pediatr Gastroenterol Nutr 2014;59:522-6.
6. Riestra S, Fernández E, Rodrigo L et al. Prevalence of Coeliac disease in the general population of northern Spain. Strategies of serologic screening. Scand J Gastroenterol 2000;35:398-402.
7. Castaño L, Blarduni E, Ortiz L et al. Prospective population screening for celiac disease: high prevalence in the first 3 years of life. J Pediatr Gastroenterol Nutr 2004;39:80-4.
8. García Novo MD, Garfia C, Acuña Quirós MD et al. Prevalencia de la enfermedad celiaca en donantes de sangre de la Comunidad de Madrid. Rev Esp Enferm Dig 2007;99:337-42.
9. Mariné M, Farre C, Alsina M et al. The prevalence of coeliac disease is significantly higher in children compared with adults: Changing prevalence of coeliac disease in Catalonia. Aliment Pharmacol Ther 2011;33:477-86.
10. Polanco I. Libro blanco de la enfermedad celíaca. Madrid: ICM; 2008.
11. Hall NJ, Rubin G, Charnock A. Systematic review: adherence to a gluten-free diet in adult patients with coeliac disease. Aliment Pharmacol Ther 2009;30:315-30.
12. Leffler DA, Dennis M, Hyett B et al. Etiologies and Predictors of Diagnosis in Nonresponsive Celiac Disease. Clin Gastroenterol Hepatol 2007;5:445-50.
13. Casellas F, Rodrigo L, Molina-Infante J et al. Adaptación transcultural y validación del« Celiac Disease Quality of Life (CD-QOL) survey», un cuestionario específico de medida de la calidad de vida en pacientes con enfermedad celiaca. Rev Esp Enfermedades Dig 2013;105:585-93.
14. Casellas F, Rodrigo L, Vivancos JL et al. Factors that impact health-related quality of life in adults with celiac disease: A multicenter study. World J Gastroenterol 2008;14:46-52.
15. Morisky DE, Green LW, Levine DM. Concurrent and Predictive Validity of a Self-Reported Measure of Medication Adherence. Medical Care 1986;24:67-74.
16. Biagi F, Andrealli A, Bianchi PI et al. A gluten-free diet score to evaluate dietary compliance in patients with coeliac disease. Br J Nutr 2009;102:882-7.
17. Sainsbury K, Mullan B. Measuring beliefs about gluten free diet adherence in adult coeliac disease using the theory of planned behaviour. Appetite 2011;56:476-83.
18. Ajzen I. The theory of planned behaviour: Reactions and reflections. Psychol Health 2011;26:1113-27.
19. Leffler DA, Dennis M, Edwards George JB et al. A Simple Validated Gluten-Free Diet Adherence Survey for Adults With Celiac Disease. Clin Gastroenterol Hepatol 2009;7:530-6.
20. Kline RB. Principles and practice of structural equation modeling. New York [etc.] : Guilford Press, cop. 1998.; 1998.
21. Nunnally JC. Psychometric Theory. New Delhi: Tata McGraw-Hill; 2010.
22. Fueyo-Díaz R. Caracterización de la población celíaca en Aragón: aspectos psicosociales de la adherencia a la dieta sin gluten. [Tesis doctoral]. [Zaragoza]: Universidad de Zaragoza, Facultad de Medicina; 2015.
23. Baessler J, Schwarzer R. Evaluación de la autoeficacia: adaptación española de la Escala de Autoeficacia general. Ansiedad Estrés 1996; 2:1-8.
24. Dorn SD, Hernandez L, Minaya MT et al. The development and validation of a new coeliac disease quality of life survey (CD-QOL). Aliment Pharmacol Ther 2010; 31:666-75.
25. Ware JE Jr, Maruish ME, Turner-Bowker DM et al. User’s manual for the SF-12v2 Health Survey. 2nd Ed. Lincoln, Ri: Qualimetric Incorporated; 2009.
26. Leffler DA, Edwards George JB, Dennis M et al. A prospective comparative study of five measures of gluten-free diet adherence in adults with coeliac disease: Measures of gluten-free diet adherence. Aliment Pharmacol Ther 2007;26:1227-35.
27. Arranz E, Garrote JA. Enfermedad celíaca: introducción al conocimiento actual de la enfermedad celíaca. Majadahonda, Madrid: Ediciones Ergon; 2011.
28. Biagi F, Campanella J, Martucci S et al. A Milligram of Gluten a Day Keeps the Mucosal Recovery Away: A Case Report. Nutr Rev 2004; 62:360-3.
29. Collin P, Thorell L, Kaukinen K et al. The safe threshold for gluten contamination in gluten-free products. Can trace amounts be accepted in the treatment of coeliac disease? Aliment Pharmacol Ther 2004; 19:1277-83.
30. Hays RD, Anderson R, Revicki D. Psychometric Considerations in Evaluating Health-Related Quality of Life Measures. Quality of Life Research 1993; 2:441-9.
31. Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev 1977; 84:191-215.
32. Bandura A. Self Efficacy: The Exercise of Control. New York: Worth Publishers; 1997. 592 p.
Related articles

Letter

Liver disorders and celiac disease

DOI: 10.17235/reed.2023.9516/2023

Digestive Diseases Image

Calcified cavitating mesenteric lymph node syndrome: a rare complication of celiac disease

DOI: 10.17235/reed.2020.7494/2020

Letter

Balanced by iron. Hereditary hemochromatosis and celiac disease

DOI: 10.17235/reed.2020.7269/2020

Review

New celiac disease biomarkers

DOI: 10.17235/reed.2020.7217/2020

Editorial

Is celiac disease really associated with inflammatory bowel disease?

DOI: 10.17235/reed.2019.6779/2019

Original

Coping with celiac disease: how heavy is the burden for caregivers?

DOI: 10.17235/reed.2017.4518/2016

Letter to the Editor

Celiac disease and fibromyalgia: Is there an association?

DOI: 10.17235/reed.2015.3992/2015

Citation tools
Fueyo Díaz R, Gascón Santos S, Asensio Martínez Á, Sánchez Calavera M, Magallón Botaya R. Transcultural adaptation and validation of the Celiac Dietary Adherence Test. A simple questionnaire to measure adherence to a gluten-free diet. 4033/2015


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 489 visits.
This article has been downloaded 249 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 05/10/2015

Accepted: 29/12/2015

Online First: 18/02/2016

Published: 26/02/2016

Article revision time: 79 days

Article Online First time: 136 days

Article editing time: 144 days


Share
This article has been rated by 2 readers.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology