Research Information System
Journal of Human Nutrition and Dietetics, vol.38, no.6, 2025 (SCI-Expanded, Scopus)
Purpose: Coeliac disease is a chronic autoimmune condition that significantly impairs health and quality of life if not managed through strict dietary adherence. Given that existing adherence assessment tools are primarily designed for adults, a child-focused, noninvasive scale is needed to accurately evaluate gluten-free diet compliance in the paediatric population. This study aimed to evaluate the Turkish psychometric properties of an adapted Gluten-Free Diet Adherence Survey originally designed for adults but modified for children aged 9–18 years with coeliac disease. Methods: A cross-sectional, methodological study was conducted with 211 children aged 9–18 years recruited from coeliac associations in Izmir and Istanbul. An expert panel simplified the language of the original adult survey, and a pilot study confirmed its readability and comprehension among children. The validation process employed exploratory and confirmatory factor analyses, internal consistency reliability assessments (Cronbach's α) and response bias evaluations. Results: Children (mean age 11.95 ± 2.87) achieved an average adherence score of 20 (range: 7–35), indicating moderate compliance with notable barriers to complete adherence. Furthermore, 45% of the participants maintained a gluten-free diet for 5–10 years, highlighting long-term sustainability. Factor loadings ranged from 0.40 to 0.75, and the scale demonstrated excellent model-data fit indices along with acceptable internal consistency (Cronbach's α = 0.797). Conclusion: The adapted Gluten-Free Diet Adherence Survey is a valid and reliable instrument for assessing dietary compliance in Turkish children with coeliac disease, underscoring the need for targeted interventions to enhance adherence and improve clinical outcomes.