Protocol development for a scale to assess self-efficacy in adherence to a gluten free diet: Self-Efficacy and Celiac Disease Scale

Authors

  • Ricardo Fueyo-Díaz Department of Medicine, Universidad de Zaragoza
  • Rosa Magallón-Botaya Institute of Health Research Aragón
  • María Antonia Sánchez-Calavera Department of Health Science, Universidad de Zaragoza
  • Angela Asensio-Martínez Department of Psychology and Sociology, Universidad de Zaragoza
  • Santiago Gascón-Santos Department of Psychology and Sociology, Universidad de Zaragoza

DOI:

https://doi.org/10.14306/renhyd.19.3.152

Keywords:

Celiac Disease, Self efficacy scale, Quality of Life, Adherence, Gluten-Free Diet

Abstract

Background: Celiac disease is a chronic autoimmune disorder consisting of a permanent intolerance for gluten, with a prevalence of 1%, for which the only treatment to date is to follow a strict gluten free diet for life. Lack of adherence to this treatment is related to severe health problems while compliance leads to normalization. Recently, self-efficacy has been associated with self-management behaviors in chronic disease and health status in many fields.

Aims: To construct and validate a self-administered scale to measure self-efficacy in adherence to gluten free diet in the different areas a patient with celiac disease must face everyday.

Material and Methods: For the validation phase, the research team aims to recruit 500 celiac individuals over 12 years of age from primary care services and patient associations. The scale will be designed to explore specific self efficacy to adhere to a gluten free diet in the following areas: purchases, eating out, eating at home with others, travelling and at work or school. An expert panel will be conducted to assure quality of the items and utility of the scale. The preliminary form will be tested in as many pilot studies as necessary. An exploratory factor analysis will be applied to study construct validity while concurrent validity will be measured with the correlation coefficient between the new instrument and the Baessler and Schwarzer General Self Efficacy Scale. The reliability of the instrument as well as that of each of the factors extracted from the prior analysis will be analyzed using Cronbach’s alpha internal consistency coefficient. Two weeks later, the scale will be administered to, at least, one third of the sample as a retest in the validation process and to allow for confirmatory factor analysis.

Results: This research will design, develop and validate a questionnaire for two types of measures: A score for Self-Efficacy for the management of celiac disease, and a score of self-efficacy for each of the identified key areas. This research will result in the first scale to assess specific self efficacy while following a strict gluten free diet and will allow further research in the role that this expectation may play in patient´s adherence to the unique treatment developed to date and it may be useful in both clinical and research settings. The new scale will be easy to apply and it is expected to have a higher predictive value than instruments assessing general self-efficacy.

Conclusions: This questionnaire will be the first of its kind to determine levels of self-efficacy for adherence to gluten free diet and will help to the design of self-management interventions for celiac patients.

Author Biographies

Ricardo Fueyo-Díaz, Department of Medicine, Universidad de Zaragoza

Department of Medicine

Rosa Magallón-Botaya, Institute of Health Research Aragón

Director of the Research Unit Primary Care

María Antonia Sánchez-Calavera, Department of Health Science, Universidad de Zaragoza

Department of Health Science

Angela Asensio-Martínez, Department of Psychology and Sociology, Universidad de Zaragoza

Department of Psychology and Sociology

Santiago Gascón-Santos, Department of Psychology and Sociology, Universidad de Zaragoza

Department of Psychology and Sociology

References

(1) Polanco I. Libro blanco de la enfermedad celíaca. Madrid: ICM; 2008.

(2) Leffler DA, Edwards–George J, Dennis M, Schuppan D, Cook F, Franko DL, et al. Factors that influence adherence to a gluten–free diet in adults with celiac disease. Dig Dis Sci. 2008; 53(6): 1573–81.

(3) Catassi C, Fabiani E, Iacono G, D'Agate C, Francavilla R, Biagi F, 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(1): 160–6.

(4) Farrell R, Kelly C. Diagnosis of celiac sprue. Am J Gastroenterol. 2001; 96(12): 3237–46.

(5) Gujral N. Celiac disease: Prevalence, diagnosis, pathogenesis and treatment. World J Gastroenterol. 2012; 18(42): 6036.

(6) Commission Regulation (EC) No 41/2009 of 20 January 2009 concerning the composition and labelling of foodstuffs suitable for people intolerant to gluten (OJ L 16, 21.1.2009, p. 3).

(7) Sverker A, Hensing G, Hallert C. 'Controlled by food'–lived experiences of coeliac disease. J Hum Nutr Diet. 2005; 18(3): 171–80.

(8) Bandura A. Self Efficacy: The Exercise of Control. New York: Worth Publishers; 1997. 592 p.

(9) Schwarzer R. Modeling Health Behavior Change: How to Predict and Modify the Adoption and Maintenance of Health Behaviors. Appl Psychol. 2008; 57(1): 1–29.

(10) Lorig K, Laurent DD, Plant K, Krishnan E, Ritter PL. The components of action planning and their associations with behavior and health outcomes. Chronic Illn. 2014; 10(1): 50.

(11) Schwarzer R, Luszczynska A, Ziegelmann JP, Scholz U, Lippke S. Social–cognitive predictors of physical exercise adherence: Three longitudinal studies in rehabilitation. Health Psychol. 2008; 27(1, Suppl): S54–63.

(12) Chiu C–Y, Lynch RT, Chan F, Berven NL. The Health Action Process Approach as a motivational model for physical activity self–management for people with multiple sclerosis: A path analysis. Rehabil Psychol. 2011; 56(3): 171–81.

(13) Hendricks PS, Delucchi KL, Hall SM. Mechanisms of change in extended cognitive behavioral treatment for tobacco dependence. Drug Alcohol Depend. 2010; 109(1–3): 114–9.

(14) Luszczynska A, Scholz U, Schwarzer R. The General Self– Efficacy Scale: Multicultural Validation Studies. J Psychol. 2005; 139(5): 439–57.

(15) Oei TPS, Hasking PA, Young RM. Drinking refusal self–efficacy questionnaire–revised (DRSEQ–R): a new factor structure with confirmatory factor analysis. Drug Alcohol Depend. 2005; 78(3): 297–307.

(16) Rigby SA, Domenech C, Thornton EW, Tedman S, Young CA. Development and validation of a self–efficacy measure for people with multiple sclerosis: the Multiple Sclerosis Self– efficacy Scale. Mult Scler. 2003; 9(1): 73–81.

(17) Urdan T, Pajares F. Self–Efficacy Beliefs of Adolescents. Greenwich, Conn: Information Age Publishing; 2006. 380 p.

(18) Schwarzer R, Jerusalem M. Generalized Self–Efficacy scale. In J. Weinman, S. Wright, & M. Johnston, Measures in health psychology: A user's portfolio. Causal and control beliefs (pp. 35–37). Windsor, England: NFER–NELSON. 1995.

(19) Baessler J, Schwarzer R. Evaluación de la autoeficacia: adaptación española de la Escala de Autoeficacia general. Ansiedad Estrés. 1996; 2(1): 1–8.

(20) Grau G. Metodología para la validación de cuestionarios. Medifam; 1995. 5(6) p.

(21) Streiner DL, Norman GR. Health Measurement Scales: A practical guide to their development and use. Edición: 4. Oxford ; New York: OUP Oxford; 2008. 452 p.

(22) Bandura A. Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, N.J: Prentice Hall; 1985. 617 p.

(23) Schwarzer R, Lippke S, Luszczynska A. Mechanisms of health behavior change in persons with chronic illness or disability: The Health Action Process Approach (HAPA). Rehabil Psychol. 2011; 56(3): 161–70.

(24) Bodenheimer T, Lorig K, Holman H, Grumbach K. Patient Self– management of Chronic Disease in Primary Care. JAMA J Am Med Assoc. 2002; 288(19): 2469.

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Published

2015-06-26

How to Cite

Fueyo-Díaz, R., Magallón-Botaya, R., Sánchez-Calavera, M. A., Asensio-Martínez, A., & Gascón-Santos, S. (2015). Protocol development for a scale to assess self-efficacy in adherence to a gluten free diet: Self-Efficacy and Celiac Disease Scale. Spanish Journal of Human Nutrition and Dietetics, 19(3), 160–166. https://doi.org/10.14306/renhyd.19.3.152