Effect of Nutrition Education Intervention Programme on Knowledge Attitude and Practices of Women Suffering from Celiac Disease

Abstract

Celiac disease is a chronic, immune-mediated disorder triggered by the ingestion of gluten, a protein found in wheat, barley, and rye. It primarily affects individuals genetically predisposed, with the HLA-DQ2 and HLA-DQ8 haplotypes being the strongest risk factors. Gluten exposure in these individuals results in an abnormal immune response that damages the small intestine, leading to malabsorption and systemic symptoms. Celiac disease is found in approximately 1% of the global populace and in India, it affects 1.5 lakh to 2.0 lakh people in the Delhi/NCR area. Effective health communication Interventions may lead to improvement of self-care and in disease parameters for celiac disease. The present study aimed to develop and conduct Nutrition Education Interventions to improve the nutritional, physical, social, and psychological well-being of women aged 18 to 39 years, affected by celiac disease. A total of 138 women participated and were chosen from the gastro/endocrinological clinics as well as hospitals situated in Delhi-NCR. Baseline tests were collected for assessing Anti-Tissue-Transglutaminase Antibodies, anthropometry, dietary patterns, and biochemical markers such as Hemoglobin (Hb) level, vitamin D, vitamin B12, and calcium. In the presence of other autoimmune diseases with celiac disease such as diabetes mellitus and thyroid disorder, HbA1c and TSH were assessed using standardized methods. A three-month Nutrition Education Intervention Program was developed and conducted to teach and improve their knowledge, Attitudes, and Practices about celiac disease management. Different modules, diet plans, and audio-visual tools as IEC materials were Validated by expert feedback, evidence-based practices, to educate, and to create awareness among the participants regarding disease management. A questionnaire was developed and validated, to assess the Knowledge, Attitude, and Practices of participants regarding their disease management. The effectiveness of this program was assessed by pre- to post-Knowledge, Attitude, Practices, and Nutritional status of participants. This study demonstrated the effectiveness of an Educational Intervention in improving knowledge, Attitudes, and Practices among women with celiac disease (CD). Post-intervention, the mean knowledge score significantly increased from 3.93±6.56 to 29.5±4.37, (plt0.001), Attitude scores from 20.6 ± 5.774 to 31.4 ± 2.452, (p lt 0.001) and Practice scores from 17.3± 7.194 to 29.9±3.380, (p lt 0.001). Nutritional intake also improved significantly, with an increase in energy from 1225±98 Kcal to 1580 ±65.1 Kcal (p lt 0.001), and protein 36.28 ± 3.5 to 51.2 ± 2.2 g, calcium 633.4± 54 mg to 984 ± 78mg (p lt 0.001). The study also found an increase in gluten-free diet (GFD) adherence from 89.9% to 95.6%, along with a reduction in gastrointestinal symptoms. However, physical activity levels showed only modest changes, indicating that additional lifestyle interventions were needed. newlineThis study demonstrates the profound impact of tailored interventions on the management of celiac disease, highlighting significant improvements in knowledge, attitudes, practices, and clinical outcomes. By focusing on education and support, the intervention addressed several critical challenges, including dietary adherence, symptom management, and lifestyle modifications. These findings highlight the importance of structured education in CD management. Future programs should incorporate digital tools and community-based strategies to enhance long-term adherence and improve overall well-being newline newline