Health locus of control is defined as the set of beliefs a person has about his or her personal influence on health. This set of beliefs includes: internal locus of control (if the individual believes that personal actions or thoughts can affect their outcomes) and external locus of control (if the outcome is believed to be determined by powerful others, such as God, health professionals, or if chance is believed to control the outcome) [1, 2]. Empirical research suggests that health locus of control plays a significant role in determining people's health-related behaviours [3].
Individuals' health locus of control influences their own health-related behaviours, including health risk behaviour and adherence to recommended health care regimens [4, 5]. For example, adolescents with high internal control are more likely to abstain from risky behaviors such as smoking and drinking [6], and children suffering for asthma who perceive their ability to control their health more positively adhere to their recommended regimen [7]. Perrin and Shapiro [8] studied differences among children with and without a chronic physical illness, and especially among their parents; they found that learning occurs from experiences related to illness, resulting in an increased external orientation in locus of control beliefs. They concluded that health care professionals should be made aware of the tendency for young children, and for children with a chronic illness and their families, to rely heavily on providers, perhaps to the detriment of learning effective skills for independent health-related decision making.
Parents have an important role in the promotion of their children's health especially when their children are very young. It is therefore of interest to assess parental locus of control relative to children's health [9]. Parents are typically the primary agents in promoting their children's health, giving direct care, providing access to health services, modeling attitudes and behaviors that influence their children's well-being, and instilling a lifelong orientation in health behaviors and future morbidity [2, 10, 11]. In consequence, we studied locus of health control in parents of young children.
Taken together, this literature suggests that children's compliance with interventions may need to include components aimed at enhancing health locus of control both in parents and children themselves and that health locus of control can be considered a factor that promotes adherence to recommendations related to preventive medicine. Given the importance of locus of control in health-related situations, we asked how it should best be assessed.
The PHLOC is a major instrument used to evaluate adult and parent health locus of control. The goal of the present study is to verify the replicability and psychometric properties of the factor structure of the Parent Health Locus of Control (PHLOC) [2] in an Italian sample of mothers of newborn to 3-year-old children. Because of the significance of the PHLOC, validation studies in other cultures are requisite to verify the robustness of the instrument. More generally, assessment instruments in health research must be validated by investigators using different samples in different contexts.