Background: Young people with coeliac disease (CD) often experience psychosocial difficulties that can impact quality of life (QoL), including increased levels of anxiety and depression compared to peers without CD and associated challenges of maintaining a gluten-free diet whilst socialising. However, there is currently no evidenced psychological support for this age group. Acceptance and Commitment Therapy (ACT) has been shown to be effective at improving QoL for other chronic conditions, but research in CD is limited. This study aimed to evaluate the preliminary efficacy of a self-help, ACT- based podcast intervention to support health-related QoL (HRQoL) in this population.
Methods: The study was a within-groups pre-post quantitative pilot intervention study. 36 participants, aged 16-24 years old with a diagnosis CD, completed self-report measures at baseline, post-intervention and four-week follow up. The candidate primary outcome was CD-specific quality of life (HRQoL); secondary outcomes were psychological wellbeing, gluten-free diet adherence and psychological inflexibility. Acceptability, appropriateness and feasibility were also assessed.
Results: Significant improvements in HRQoL were seen post-intervention and were maintained over time at one month, with a large effect (h2 =.32, 95% CI [.15, .47]). Psychological inflexibility was also moderately associated with improvements in HRQoL (r = -.49, 95% CI [-.72, -.15]). Gluten-free diet adherence remained stable over the study. The intervention was deemed appropriate, acceptable and feasible by participants who completed the study.
Conclusions: Findings offer preliminary indications of the efficacy an ACT-based podcast intervention for young people with CD for improving HRQoL and the feasibility of such. The results also highlight the possible utility of novel digital interventions such as podcasts for this age group.