asbhm - the role of habit in gluten free diet adherence - kothe and mullan 2014
DESCRIPTION
Differences in self-reported habit between individuals who do and do not strictly adhere to the gluten free diet Emily Kothe1 & Barbara Mullan2 1School of Psychology, Deakin University, Australia 2School of Psychology, Curtin University, Australia Abstract Introduction. Previous research has indicated that many individuals with coeliac disease fail to strictly adhere to the diet. The current study investigated differences in self-reported habit between individuals who do and do not adhere to the diet in order to better understand this phenomenon. Methods. Individuals with biopsy confirmed coeliac disease who reported that they did not voluntarily recruit gluten were recruited from the Coeliac Society of Victoria and Tasmania. Participants completed a validated self-report measure of gluten-free diet adherence (CDAT) and the self-report habit index (SRHI). Results. One hundred and thirty six individuals completed the study. Seventeen percent of individuals were not strictly adherent to the gluten free diet. Total score on the SRHI was a significant predictor of whether or not individuals were strictly adherent. Strictly adherent individuals were more likely to report that they followed the diet without thinking and did it without having to remember. The length of time the individual had been following the diet was also a predictor of strict adherence. Conclusions. Findings suggest that habit may be an important factor for determining whether or not individuals with coeliac disease are strictly adherent to the gluten free diet. The relationship between indicators of automaticity and strict adherence suggests that interventions to strengthen habit formation may be useful in this context. The relationship between length of time since diagnosis and strict adherence indicates that recently diagnosed individuals may require more support for following the diet.TRANSCRIPT
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.