Akbari Namvar Zahra, Mahdavi Reza, Shirmohammadi Masood, Nikniaz Zeinab
Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Int J Behav Med. 2021 Oct;28(5):583-590. doi: 10.1007/s12529-020-09949-7. Epub 2021 Jan 8.
Considering the importance of educational programs on compliance of patients with celiac disease with a gluten-free diet (GFD), we investigated the effect of a group-based education program on knowledge and adherence to a GFD in patients with celiac disease.
In the present controlled clinical trial, patients in the intervention group (n = 66) underwent a three-session group-based educational program, and patients in the control group (n = 64) received routine education in visits to the clinic. The primary outcomes were knowledge and adherence to a GFD. Participant knowledge was assessed by a validated author-designed questionnaire. Adherence rate was evaluated by the Persian version of celiac disease adherence test (CDAT) questionnaire. Results were analyzed based on intention-to-treat (ITT) analysis.
Results of the ANCOVA test showed that the mean score of knowledge about celiac disease and gluten in the intervention group was significantly higher compared with the control group immediately after intervention (p = 0.002) and 3 months post-intervention (p = 0.03). In terms of gluten-free food item selection, the intervention group achieved a significantly better score than the control group immediately after intervention (p < 0.001) as well as 3 months post-intervention (p < 0.001). Additionally, there was a significant difference in the CDAT score between the two groups 3 months post-intervention (p = 0.02).
Evidence suggests that group-based education was an effective intervention among patients with celiac disease to improve knowledge and adherence to a GFD. Trial registration IRCT code: IRCT20080904001197N21; registration date: 5/23/2019.
鉴于教育项目对乳糜泻患者遵循无麸质饮食（GFD）的重要性，我们调查了一项基于小组的教育项目对乳糜泻患者关于GFD的知识及依从性的影响。
在本对照临床试验中，干预组（n = 66）的患者接受了为期三节课的基于小组的教育项目，而对照组（n = 64）的患者在门诊就诊时接受常规教育。主要结局是关于GFD的知识和依从性。参与者的知识通过一份经过验证的作者设计问卷进行评估。依从率通过乳糜泻依从性测试（CDAT）问卷的波斯语版本进行评估。结果基于意向性分析（ITT）进行分析。
协方差分析（ANCOVA）测试结果显示，干预组关于乳糜泻和麸质的知识平均得分在干预后即刻（p = 0.002）及干预后3个月（p = 0.03）均显著高于对照组。在无麸质食品选择方面，干预组在干预后即刻（p < 0.001）以及干预后3个月（p < 0.001）的得分均显著高于对照组。此外，干预后3个月两组的CDAT得分存在显著差异（p = 0.02）。
有证据表明，基于小组的教育是对乳糜泻患者提高关于GFD的知识和依从性的有效干预措施。试验注册号：IRCT代码：IRCT20080904001197N21；注册日期：2019年5月23日。
