The multidimensional health locus of control scales: Testing the factorial structure in sample of African American medical patients

Objective: A fifth subscale was recently added to the widely used multidimensional health locus of control (MHLC) measure, and little is known about the factor structure of the MHLC with the new scale among African Americans from disadvantaged backgrounds. Also, few studies have examined differences in Health Locus of Control (HLOC) beliefs across medical patients from similar demographic backgrounds. Methods: We asked participants to complete a survey about HLOC beliefs and extracted biological markers from their medical charts. Participants were drawn from patients of internal medicine and infectious disease clinics at a charity hospital in Baton Rouge, Louisiana. In total, we surveyed 186 African American patients who were diagnosed with HIV/AIDS or type 2 diabetes. Results: Confirmatory factor analysis could not confirm a 5-factor structure; however, a new 3-factor structure was produced that includes 1) internal health beliefs, 2) external health beliefs, and 3) God health beliefs. Patients with HIV/AIDS reported more external and God HLOC beliefs than did patients with type 2 diabetes. Conclusions: The factor structures that emerged from previous research may not be appropriate to use when conducting research with individuals from a low SES who are also from an ethnic/racial minority background. Our findings suggest a new 3-factor structure for the MHLC. Future research should examine whether patients with HIV/AIDS may benefit from interventions that target external beliefs to improve health behavior.