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CRICOS Provider Code: 0113B
DIFFERENCES IN SELF-REPORTED HABIT BETWEEN INDIVIDUALS WHO DO AND DO NOT STRICTLY ADHERE TO THE GLUTEN FREE DIET
EMILY KOTHEBARBARA MULLAN
CRICOS Provider Code: 0113B
BACKGROUND• Coeliac disease is a multi-systems autoimmune disorder that
effects about 1% of the world’s population.
• The autoimmune response within coeliac disease is triggered by exposure to gluten; protein in wheat, rye and barley
CRICOS Provider Code: 0113B
BACKGROUND• Strict adherence to a gluten free diet is the only effective method
of managing coeliac disease
• However, many individuals with coeliac disease fail to strictly adhere to the gluten free diet.
• Recent research shows that the majority of non-adherence is accidental and that intention may be a relatively poor predictor of such non-adherence.
CRICOS Provider Code: 0113B
THE PRESENT STUDY• The aim of the present study was to investigate factors that
distinguish between individuals who and do not successfully adhere to the diet
• This research was primarily interested in identifying factors that account for non-adherence within individuals who report that they do not intentionally consume gluten.
• It was hypothesized that habit strength may be a predictor of accidental non-adherence and would distinguish between individuals who do and do not successfully adhere to the diet.
CRICOS Provider Code: 0113B
METHOD• Individuals with biopsy confirmed coeliac disease were recruited
from the Coeliac Society of Victoria and Tasmania.
• Participants completed a range of measures including:– Demographic and disease characteristics– A validated self-report measure of gluten-free diet adherence
(CDAT) – The self-report habit index (SRHI).
• Prior to analysis, data was screened to identify individuals who reported that they did not voluntarily consume gluten.
CRICOS Provider Code: 0113B
RESULTS• One-hundred and twenty five participants met criteria for the
study.
– Mean age = 48.13 years – Mean age at diagnosis = 42.13 years– Mean length of time following the diet = 7.78 years– Gender = 88% female
• Scores on the CDAT indicated that 83% of individuals were strictly adherent to the diet (mean CDAT scores = 10.76)
• Independent samples t-tests were used to compare habit scores between adherent and non-adherent individuals.
CRICOS Provider Code: 0113B
RESULTS• A logistic regression analysis was conducted to predict CDAT
adherence category (strictly adherent vs. not strictly adherent) using SHRI scores.
• A one unit increase in SRHI score increased the odds of being strictly adherent by 1.6 times (Nagelkerke R2 = .086, p=.007, OR=1.577).
• The automaticity sub-scale of the SHRI alone accounted for 6.2% of the variance in adherence levels (Nagelkerke R2 = .062, p=.021, OR=1.08)
CRICOS Provider Code: 0113B
RESULTS• We also attempted to identify which items within the SHRI could
distinguish between individuals in different adherence categories.
• Individuals who were strictly adherent to the diet were significantly more likely to report that following a strict gluten free diet is…– Something that makes me feel weird if I do not do it– I start doing before I realise I’m doing it– That should would require effort not to do it– That I have no need to think about doing– That is “typically me”– I have been doing a long time– I do frequently
CRICOS Provider Code: 0113B
CONCLUSIONS• Even among individuals who reported that they did not
intentionally consume gluten, only 83% of participants were strictly adherent to the gluten free diet.
• Results suggest that habit may be an important factor for determining whether or not individuals are strictly adherent to the gluten free diet.
• This study identified several indicators of automaticity that appeared to distinguish between individuals that were successful in adhering to the diet and those that were not.
CRICOS Provider Code: 0113B
CONCLUSIONS• Recent research suggests that motivational factors such as
intention may be limited in their ability to help understand accidental non-adherence to a gluten free diet. Habit may provide a better method of understanding this type of non-adherence.
• These findings would suggest that interventions may benefit from a focus on increasing habit in order to improve gluten free diet adherence.
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