{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T21:32:46Z","timestamp":1783200766009,"version":"3.54.6"},"reference-count":68,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T00:00:00Z","timestamp":1745280000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: Coeliac disease, a chronic and lifelong health condition, is one of the most common autoimmune diseases. However, it is also one of the most under-recognised conditions, and emotionally and cognitively appropriate materials are especially lacking for young children and their families who are coping with this disease. Effective health communication is essential for educating and supporting children living with coeliac disease as well as their families and communities. Picture books can serve as useful and accessible educational and health promotion tools, promoting adaptive coping strategies for dealing with a potentially traumatic condition. Methods: This study aimed to fill a critical gap in the literature by examining a range of picture books (n = 9) aimed at children three to eight years of age diagnosed with coeliac disease. Reflective thematic and structural narrative analyses were applied to explore strategies and themes used in these books and how they align with the current literature on developing coping through children\u2019s narratives. Results: Four themes were developed and measured against an existing model of coping narratives to find a more specific model that recognises the specific concerns of coeliac disease. The four themes found were Information Provision; Promotion of CD Management; Anxiety and Hypervigilance Reduction, with two subthemes of Validating Feelings and Reducing Concerns; and Community and Connection. Conclusions: The findings have likely implications for the following applications: incorporation into clinician training (as a therapeutic and health promotion intervention), support within schools, authors of similar books for children coping with chronic illness, and coping approaches for individuals\/families to promote health literacy\/support regarding living with coeliac disease.<\/jats:p>","DOI":"10.3390\/children12050530","type":"journal-article","created":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T03:50:57Z","timestamp":1745293857000},"page":"530","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Strategies of Picture Books as a Mode of Health Communication for Young Children with Coeliac Disease"],"prefix":"10.3390","volume":"12","author":[{"given":"Lydia","family":"McKeon","sequence":"first","affiliation":[{"name":"School of Psychology and Wellbeing, Centre for Health Research, University of Southern Queensland, Toowoomba, QLD 4350, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7694-5615","authenticated-orcid":false,"given":"Jessica","family":"Gildersleeve","sequence":"additional","affiliation":[{"name":"School of Humanities and Communication, Centre for Health Research, University of Southern Queensland, Toowoomba, QLD 4350, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy B.","family":"Mullens","sequence":"additional","affiliation":[{"name":"School of Psychology and Wellbeing, Centre for Health Research, University of Southern Queensland, Toowoomba, QLD 4350, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1080\/14616734.2019.1589064","article-title":"On what is read, shared, and felt: Parent-child conversation about stories","volume":"22","author":"Thompson","year":"2020","journal-title":"Attach. Hum. Dev."},{"key":"ref_2","unstructured":"Shonkoff, J.P., and Phillips, D.A. (2000). From Neurons to Neighborhoods: The Science of Early Childhood Development, National Academy Press."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1111\/j.1750-8606.2012.00246.x","article-title":"Hot and cool executive function in childhood and adolescence: Development and plasticity","volume":"6","author":"Zelazo","year":"2012","journal-title":"Child Dev. Perspect."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Schoppmann, J., Severin, F., Schneider, S., and Seehagen, S. (2023). The effect of picture book reading on young children\u2019s use of an emotion regulation strategy. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0289403"},{"key":"ref_5","unstructured":"Children\u2019s Health Queensland (2024, July 01). Coeliac Disease, Available online: https:\/\/www.childrens.health.qld.gov.au\/health-a-to-z\/coeliac-disease."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2556","DOI":"10.1016\/j.mayocp.2019.02.019","article-title":"Celiac disease","volume":"94","author":"Oxentenko","year":"2019","journal-title":"Mayo Clin. Proc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"23247096211053702","DOI":"10.1177\/23247096211053702","article-title":"The progression of celiac disease, diagnostic modalities, and treatment options","volume":"9","author":"Tarar","year":"2021","journal-title":"J. Investig. Med. High Impact Case Rep."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"53","DOI":"10.5409\/wjcp.v10.i4.53","article-title":"Celiac disease in children: A review of the literature","volume":"10","author":"Sahin","year":"2021","journal-title":"World J. Clin. Pediatr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.jpeds.2017.01.043","article-title":"Celiac disease is associated with childhood psychiatric disorders: A population-based study","volume":"184","author":"Butwicka","year":"2017","journal-title":"J. Pediatr."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Dochat, C., Afari, N., Satherley, R.-M., Coburn, S., and McBeth, J.F. (2024). Celiac disease symptom profiles and their relationship to gluten-free diet adherence, mental health, and quality of life. BMC Gastroenterol., 24.","DOI":"10.1186\/s12876-023-03101-x"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1097\/SGA.0000000000000365","article-title":"Current evidence in the diagnosis and treatment of children with celiac disease","volume":"42","author":"Gallegos","year":"2019","journal-title":"Gastroenterol. Nurs."},{"key":"ref_12","unstructured":"Coeliac Australia (2024, July 01). Coeliac Disease. Available online: https:\/\/coeliac.org.au\/learn\/coeliac-disease\/."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"75","DOI":"10.4103\/ijmr.ijmr_1102_21","article-title":"Clinical spectrum and changing presentation of celiac disease in Indian children","volume":"158","author":"Lal","year":"2023","journal-title":"Indian J. Med. Res."},{"key":"ref_14","first-page":"e139456","article-title":"Quality of Life and Psychological Problems in Children with and without Celiac Disease","volume":"15","author":"Yaztappeh","year":"2023","journal-title":"J. Compr. Pediatr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e20183933","DOI":"10.1542\/peds.2018-3933","article-title":"Celiac disease autoimmunity and emotional and behavioral problems in childhood","volume":"144","author":"Wahab","year":"2019","journal-title":"Pediatrics"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Pinto-Sanchez, M.I., Blom, J.-J., Gibson, P.R., and Armstrong, D. (2024). Nutrition assessment and management in celiac disease. Gastroenterology, 167.","DOI":"10.1053\/j.gastro.2024.02.049"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/s43058-022-00282-6","article-title":"A framework to guide storytelling as a knowledge translation intervention for health-promoting behaviour change","volume":"3","author":"Brooks","year":"2022","journal-title":"Implement. Sci. Commun."},{"key":"ref_18","first-page":"829","article-title":"The Power of Stories","volume":"70","author":"Kulish","year":"2022","journal-title":"JAPA"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Gregory, E.M., and Rutledge, P. (2016). Everything is story: Telling stories and positive psychology. Exploring Positive Psychology: The Science of Happiness and Well-Being, ABC-Clio Praeger.","DOI":"10.5040\/9798400649127"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1819635","DOI":"10.1080\/17482631.2020.1819635","article-title":"Finding ways to carry on: Stories of vulnerability in chronic illness","volume":"15","author":"Synnes","year":"2020","journal-title":"Int. J. Qual. Stud. Health Well-Being"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2592","DOI":"10.1177\/1359105320922304","article-title":"Examining core self-management skills among adolescents with celiac disease","volume":"26","author":"Meyer","year":"2020","journal-title":"J. Health Psychol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e25","DOI":"10.2105\/AJPH.2014.302041","article-title":"Self-Management: A comprehensive approach to management of chronic conditions","volume":"104","author":"Grady","year":"2014","journal-title":"Am. J. Public Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s11892-014-0520-2","article-title":"Young Children with Type 1 Diabetes: Challenges, research, and future directions","volume":"14","author":"Streisand","year":"2014","journal-title":"Curr. Diab. Rep."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1007\/s11892-022-01465-0","article-title":"Young children with Type 1 Diabetes: Recent advances in behavioral research","volume":"22","author":"Monaghan","year":"2022","journal-title":"Curr. Diabetes Rep."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Catarino, M., Charepe, Z., and Festas, C. (2021). Promotion of self-management of chronic disease in children and teenagers: Scoping review. Healthcare, 9.","DOI":"10.3390\/healthcare9121642"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1177\/2050640614562599","article-title":"Support for patients with celiac disease: A literature review","volume":"3","author":"Ludvigsson","year":"2015","journal-title":"United Eur. Gastroenterol. J."},{"key":"ref_27","first-page":"7006220010p1\u20137006220010p8","article-title":"Children with celiac disease: Health-related quality of life and leisure participation","volume":"70","author":"Meyer","year":"2016","journal-title":"AJOT Off. Publ. Am. Occup. Ther. Assoc."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"102","DOI":"10.3390\/diseases3020102","article-title":"The perceived social burden in celiac disease","volume":"3","author":"Ciacci","year":"2015","journal-title":"Diseases"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1055\/s-0040-1722218","article-title":"Factors affecting compliance to a gluten-free diet in pediatric populations with celiac disease","volume":"11","author":"Antunes","year":"2021","journal-title":"J. Child Sci."},{"key":"ref_30","first-page":"248402","article-title":"Predictors of compliance to gluten-free diet in children with celiac disease","volume":"2014","author":"Garg","year":"2014","journal-title":"Int. Sch. Res. Notices"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Sady, M.D., Coburn, S.S., Kramer, Z., Streisand, R., and Kahn, I. (2023). Associations between executive functioning and adherence in pediatric celiac disease. Child. Health Care, 1\u201315.","DOI":"10.1080\/02739615.2023.2259291"},{"key":"ref_32","unstructured":"Bandura, A. (1977). Social Learning Theory, Prentice-Hall."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1007\/s10880-019-09673-9","article-title":"Psychological needs and services in a pediatric multidisciplinary celiac disease clinic","volume":"27","author":"Coburn","year":"2019","journal-title":"J. Clin. Psychol. Med. Settings"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Andrews, B., Krishnamoorthy, G., Dallinger, V.C., and Maybery, D. (2024). The role of caregivers in promoting connectedness in youth with mental health concerns. Children, 11.","DOI":"10.3390\/children11121469"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Mazzola, A.M., Zammarchi, I., Valerii, M.C., Spisni, E., Saracino, I.M., Lanzarotto, F., Ricci, C., Mazzola, A.M., Zammarchi, I., and Valerii, M.C. (2024). Gluten-free diet and other celiac disease therapies: Current understanding and emerging strategies. Nutrients, 16.","DOI":"10.3390\/nu16071006"},{"key":"ref_36","first-page":"367","article-title":"Coping after cancer: Risk perceptions, worry, and health behaviors among colorectal cancer survivors","volume":"13","author":"Mullens","year":"2004","journal-title":"Psycho-Oncol. J. Psychol. Soc. Behav. Dimens. Cancer"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1016\/j.gtc.2022.07.003","article-title":"Psychological considerations for food intolerances","volume":"51","author":"Coburn","year":"2022","journal-title":"Gastroenterol. Clin."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"38","DOI":"10.4236\/health.2020.121004","article-title":"Coping process in children with food allergies developing during early childhood","volume":"12","author":"Suzuki","year":"2020","journal-title":"Health"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1177\/1359105320965664","article-title":"Coping self-efficacy influences health information avoidance","volume":"27","author":"Hua","year":"2022","journal-title":"J. Health Psychol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1177\/0165025408098024","article-title":"Preschool children\u2019s views on emotion regulation: Functional associations and implications for social-emotional adjustment","volume":"33","author":"Dennis","year":"2009","journal-title":"Int. J. Behav. Dev."},{"key":"ref_41","first-page":"585","article-title":"Literature as a therapeutic instrument in the health-disease process during childhood","volume":"17","author":"Velez","year":"2018","journal-title":"Glob. Nurs."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1080\/00228958.2010.10516558","article-title":"Bibliotherapy: Helping children cope with life\u2019s challenges","volume":"47","author":"Rozalski","year":"2010","journal-title":"Kappa Delta Pi Rec."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e88","DOI":"10.1016\/j.pedn.2022.12.012","article-title":"Grief in children\u2019s story books. A systematic integrative review","volume":"69","author":"Melero","year":"2023","journal-title":"J. Pediatr. Nurs."},{"key":"ref_44","first-page":"569","article-title":"The use of story boxes as an adjuvant strategy to cope with hospitalization of children and adolescents with cancer","volume":"22","author":"Pfeifer","year":"2014","journal-title":"Cad. Ter. Ocup. UFSCar"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"7703205120","DOI":"10.5014\/ajot.2023.050086","article-title":"Stories to take the edge off pain during immunization for preschoolers: A randomized controlled trial","volume":"77","author":"Sarah","year":"2023","journal-title":"Am. J. Occup. Ther."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e09454","DOI":"10.1016\/j.heliyon.2022.e09454","article-title":"Coping with COVID: Pandemic narratives for Australian children","volume":"8","author":"Gildersleeve","year":"2022","journal-title":"Heliyon"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1111\/jpm.13008","article-title":"The impact of storytelling on building resilience in children: A systematic review","volume":"31","author":"Ramamurthy","year":"2023","journal-title":"J. Psychiatr. Ment. Health Nurs."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Nauman, H., Dobson, O., Taddio, A., Birnie, K.A., and McMurtry, C.M. (2023). Picturing bravery: A rapid review of needle procedures depicted in children\u2019s picture books. Children, 10.","DOI":"10.3390\/children10071097"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1016\/j.jneb.2016.06.005","article-title":"Qualitative analysis of dietary behaviors in picture book fiction for 4- to 8-year-olds","volume":"48","author":"Matvienko","year":"2016","journal-title":"J. Nutr. Educ. Behav."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"13","DOI":"10.15171\/hpp.2020.05","article-title":"Children\u2019s literature to promote students\u2019 global development and wellbeing","volume":"10","author":"Pulimeno","year":"2020","journal-title":"Health Promot. Perspect."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1111\/bjhp.12599","article-title":"\u201cI sort of never felt like I should be worried about it or that I could be worried about it\u2019\u201d an interpretative phenomenological analysis of perceived barriers to disclosure by young people with coeliac disease","volume":"27","author":"Wheeler","year":"2022","journal-title":"Br. J. Health Psychol."},{"key":"ref_52","unstructured":"Braun, V., and Clarke, V. (2021). Thematic Analysis: A Practical Guide to Understanding and Doing, SAGE."},{"key":"ref_53","first-page":"248482","article-title":"Differentiation between celiac disease, nonceliac gluten sensitivity, and their overlapping with Crohn\u2019s disease: A case series","volume":"2013","author":"Vojdani","year":"2013","journal-title":"Case Rep. Immunol."},{"key":"ref_54","unstructured":"Bullock, C. (2022). Sophie Doesn\u2019t Eat Gluten: A Book About Coeliac Disease, Independently Published."},{"key":"ref_55","unstructured":"Marie, V. (2017). I Have Coeliac Disease: Autumn\u2019s Story, CreateSpace Independent Publishing Platform."},{"key":"ref_56","unstructured":"Botziou, C. (2019). Celia\u2019s Coeliac Story, Independently Published."},{"key":"ref_57","unstructured":"Quarless-Carew, J. (2023). Little Jak the Silly Yak Has Silly-Yak Disease, Independently Published."},{"key":"ref_58","unstructured":"Quarless-Carew, J. (2023). Little Jak the Silly Yak: The Apple Pie Quest, Independently Published."},{"key":"ref_59","unstructured":"Quarless-Carew, J. (2023). Little Jak the Silly Yak at Tara\u2019s Birthday Bash, Independently Published."},{"key":"ref_60","unstructured":"Mac, S. (2023). It\u2019s Great to Be Gluten Free: How Hayden Found Her New Favourite Foods, Wolfebaun Press."},{"key":"ref_61","unstructured":"Anderson, K. (2020). Gluten Tootin\u2019, PEG Books."},{"key":"ref_62","unstructured":"Mangano, A.R. (2021). Silly-Yak, InHouse Publishing."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"James, W. (2023). Structural Narrative Analysis. Springer Texts in Education, Springer International Publishing.","DOI":"10.1007\/978-3-031-04394-9_70"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1080\/2159676X.2019.1628806","article-title":"Reflecting on reflexive thematic analysis","volume":"11","author":"Braun","year":"2019","journal-title":"Qual. Res. Sport Exerc. Health"},{"key":"ref_65","first-page":"86","article-title":"A study of using reward and punishment in the education of school-aged children: Based on behaviorism theory operant conditioning","volume":"10","author":"Chen","year":"2023","journal-title":"J. Educ. Humanit. Soc. Sci."},{"key":"ref_66","unstructured":"Morgan, C.H. (2022). Superhero media and risk-taking: Is superhero play a risk factor for unintentional injury in preschool-aged children?. All ETDs UAB, 174, Available online: https:\/\/digitalcommons.library.uab.edu\/etd-collection\/174."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Pedoto, D., Troncone, R., Massitti, M., Greco, L., and Auricchio, R. (2020). Adherence to gluten-free diet in coeliac paediatric patients assessed through a questionnaire positively influences growth and quality of life. Nutrients, 12.","DOI":"10.3390\/nu12123802"},{"key":"ref_68","first-page":"191","article-title":"The child\u2019s understanding of promotional communication","volume":"2","author":"Young","year":"2000","journal-title":"Young Consum."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/5\/530\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:19:08Z","timestamp":1760030348000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/5\/530"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,22]]},"references-count":68,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["children12050530"],"URL":"https:\/\/doi.org\/10.3390\/children12050530","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,22]]}}}