Grant: CIHR Fellowship

Celiac disease is an autoimmune dysfunction that requires strict adherence to a gluten-free (GF) diet in order to prevent detrimental health outcomes including bloating, diarrhea, constipation, and increased risk of intestinal cancers and osteoporosis. Following a strict GF diet is difficult given that gluten is added as a preservative or binding agent to many foods. Findings from a recent review suggest that as few as 42% of people with celiac disease report strict adherence to a GF diet. As such, poor adherence to a GF diet is an emerging health concern for people with celiac disease. Currently there is limited existing literature on evidence-based strategies to improve this dismal adherence to a GF diet. The goal of this research program is to develop and implement an evidence-based online intervention to improve adherence to a strict GF diet and quality of life among adults with celiac disease. The intervention material will teach people self-regulation and self-compassion skills. Self-regulation is considered a crucial skill necessary for successful adherence to a medical regimen (such as following a GF diet) among people with chronic disease. Self-compassion improves the ability to cope with chronic disease and is associated with greater quality of life. Study 1 will involve development, pilot testing and refinement of a 6-week online intervention to improve adherence to a GF diet and quality of life. Findings from focus groups with 16 individuals with celiac disease will be used to revise and refine the intervention material. In Study 2, 200 individuals with celiac disease will be randomized to an intervention or an attention control condition. It is expected that compared to the control condition, after completing the intervention, participants will report greater adherence to a GF diet and quality of life. Findings from this work will be used to inform evidence-based guidelines for the treatment and long-term care of people living with celiac disease.