Revista Española de Nutrición Humana y Dietética (Jun 2015)
Protocol development for a scale to assess self-efficacy in adherence to a gluten free diet: Self-Efficacy and Celiac Disease Scale
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.
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