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A Randomized Controlled Trial of an Online Intervention to Improve Gluten-Free Diet Adherence in Celiac Disease

Sainsbury, Kirby BA/BEd, DCP (candidate)1; Mullan, Barbara PhD2; Sharpe, Louise PhD1

American Journal of Gastroenterology: May 2013 - Volume 108 - Issue 5 - p 811–817
doi: 10.1038/ajg.2013.47
Colon/Small Bowel

OBJECTIVES: To test the effectiveness of an interactive online intervention to improve gluten free diet adherence in adults with celiac disease.

METHODS: A Randomized controlled trial was conducted. A total of 189 adults with biopsy-confirmed celiac disease were recruited and randomized to receive the intervention (n=101) or to a waitlist control condition (n=88). Post-intervention data was available for 70 intervention and 64 waitlist participants. Three month follow-up data was obtained for 46/50 completers from the intervention group. The primary outcome measure was gluten-free diet adherence. Secondary outcomes were gluten-free diet knowledge, quality of life and psychological symptoms.

RESULTS: Results were based on intention-to-treat analyses. The intervention group evidenced significantly improved gluten-free diet adherence, and gluten-free diet knowledge following the treatment period relative to the waitlist control group. The change in knowledge did not contribute to the change in adherence. These improvements were maintained at 3-month’ follow-up.

CONCLUSIONS: The online program was effective in improving adherence and represents a promising resource for individuals with celiac disease who are struggling to achieve or maintain adequate gluten free diet adherence.

1 Clinical Psychology Unit, The University of Sydney, Sydney, New South Wales, Australia

2 School of Psychology, The University of Sydney, Sydney, New South Wales, Australia

Correspondence: Barbara Mullan, PhD, School of Psychology, The University of Sydney, Sydney, New South Wales 2006, Australia. E-mail: or

SUPPLEMENTARY MATERIAL accompanies this paper at

Received 4 December 2012; accepted 29 January 2013

published online 5 March 2013

© The American College of Gastroenterology 2013. All Rights Reserved.
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