Turkish Psychometric Properties of the Gluten-Free Diet Adherence Survey for Children With Coeliac Disease.

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.