Children’s Health Locus of Control Scale

Abstract

The Children’s Health Locus of Control Scale (CHLOC) is a specialized psychometrics instrument designed to assess how children perceive the causes of their health and illness. Specifically, it measures the degree to which a child believes that their health outcomes are controlled by internal factors (their own actions), powerful external figures (like parents or doctors), or chance/fate. The scale utilizes a simple dichotomous response format (YES/NO) across 20 items to capture the child’s perspective on health Locus of Control beliefs. The CHLOC provides valuable insights into the cognitive frameworks children use to understand responsibility for their well-being.

Keywords

Health Locus of Control, CHLOC, Pediatric Health, Health Beliefs, Internal Control, Powerful Others, Chance, Health Psychology, Self-efficacy

Authors

Guy S. Parcel

Purpose

The primary purpose of the CHLOC scale is to quantify the dimensions of Locus of Control specifically related to health behaviors and outcomes in children. Understanding a child’s perceived control over their health is crucial in predicting engagement in positive health practices, adherence to medical regimens, and responsiveness to health education programs. The instrument aims to differentiate between children who feel personally responsible for their health and those who attribute health outcomes primarily to external forces.

This instrument serves as a valuable tool for researchers and clinicians in Health Psychology to evaluate interventions aimed at empowering children to take greater personal responsibility for their well-being. By identifying children who exhibit high external control (Powerful Others or Chance), targeted educational strategies can be implemented to foster a stronger sense of internal control and promote preventative health behaviors.

Construct

The CHLOC scale operationalizes the psychological construct of Health Locus of Control (HLOC) for pediatric populations. It measures perceived control over health status along three distinct, theoretically derived dimensions, consistent with generalized Locus of Control theory:

• Internal Health Locus of Control (I): This subscale measures the extent to which a child believes that good or bad health is a direct result of their own actions, choices, and efforts (e.g., brushing teeth, eating healthy food, getting rest).
• Powerful Others Health Locus of Control (P): This subscale assesses the belief that health outcomes are predominantly determined by influential external agents, such as doctors, nurses, parents, or teachers. The child believes these figures hold the power to prevent or cure illness.
• Chance Health Locus of Control (C): This subscale captures fatalistic beliefs, measuring the conviction that health and illness are random, unpredictable events governed by luck, fate, or uncontrollable external forces, making personal actions irrelevant.

Validity

Initial studies establishing the CHLOC reported satisfactory evidence of construct validity. This was primarily demonstrated through correlations between the subscales and other established measures of generalized Locus of Control and children’s health behaviors. For instance, children scoring high on the Internal subscale often demonstrated greater knowledge of health facts and reported engaging in more preventative health behaviors compared to those scoring high on the Chance subscale.

Content validity was ensured by deriving the 20 items directly from common health situations and concepts accessible and relevant to the target age group. Discriminant validity has also been explored, confirming that the three subscales—Internal, Powerful Others, and Chance—are distinct psychological dimensions, measuring unique aspects of health attribution rather than a single unified construct.

Reliability

The reliability of the Children’s Health Locus of Control Scale is typically assessed using measures of Internal Consistency (e.g., Cronbach’s alpha) and test-retest stability. Studies have consistently demonstrated acceptable to good Internal Consistency across the three subscales, though the Chance subscale sometimes exhibits slightly lower reliability compared to the Internal and Powerful Others subscales in certain samples.

Test-retest reliability, measured over periods ranging from several weeks to a few months, has generally supported the stability of the children’s health control beliefs, indicating that the scale provides consistent measurement over time, suggesting that health locus of control is a relatively stable personality trait within this developmental period.

Factor Analysis

Exploratory and confirmatory Factor Analysis conducted on the CHLOC items generally supports the theoretical three-factor structure proposed by the author. The results typically confirm the distinct grouping of items into the Internal, Powerful Others, and Chance dimensions, validating the multidimensional nature of the construct.

The factor structure confirms that the scale effectively separates self-efficacy beliefs (Internal) from reliance on external authorities (Powerful Others) and fatalistic attributions (Chance). This statistical validation is critical for ensuring that the interpretation of subscale scores accurately reflects the underlying psychological dimensions of health attribution in pediatric populations.

Instrument

Test Type: Self-report questionnaire, Psychological Inventory

Format: 20 items requiring dichotomous forced-choice responses (YES/NO).

Language Available: English (Original). Translations into other languages (e.g., Spanish, Chinese) have been developed and validated in subsequent research.

Population Group: School-aged children.

Age Group: Typically utilized with children aged 8 to 12 years old (corresponding roughly to Grades 3 through 6), as items require basic reading comprehension and abstract understanding of causality.

Population Details: Originally standardized on non-clinical school populations, but widely applied in pediatric clinical settings, particularly for children managing chronic illnesses or participating in health intervention trials.

Test Methodology: The scale is usually administered in a group setting (classroom) or individually. Participants are instructed to choose the answer (YES or NO) that best reflects their personal belief about the statement, emphasizing that there are no right or wrong answers. Scoring involves assigning points to responses corresponding to the three underlying factors (Internal, Powerful Others, Chance).

Keywords

Pediatric assessment, health education, self-efficacy, attribution theory, preventable disease, psychological screening, health behaviors, Internal Locus of Control, Powerful Others Locus of Control, Chance Locus of Control

Authors

Author ORCID Identifier: Information not publicly available.

Affiliation Email addresses: [email protected]

Correspondence Address: Information not publicly available. (Guy S. Parcel, Ph.D., was historically affiliated with the UT Health Science Center at Houston.)

Permissions & Fee and Test Year

The Children’s Health Locus of Control Scale was developed and copyrighted by Guy S. Parcel, Ph.D., in 1977. All rights are reserved. Researchers and practitioners seeking to utilize the scale should direct permission requests to the copyright holder via the provided email address to ensure compliance with usage terms. While the scale is often made available for non-commercial academic research, formal permission is necessary.

Reference’s

Key foundational references for the Children’s Health Locus of Control Scale include:

• Parcel, G. S., & Meyer, M. P. (1978). The development of an instrument to measure children’s health Locus of Control. Health Education Monographs, 6(2), 149-159.
• Wallston, K. A., Wallston, B. S., & DeVellis, R. (1978). Development of the Multidimensional Health Locus of Control (MHLC) scales. Health Education Monographs, 6(2), 160-170. (Provides crucial theoretical context for HLOC measurement.)
• Parcel, G. S. (1977). Children’s Health Locus of Control Scale. All Rights Reserved. (Original copyright notice.)

Items of the Children’s Health Locus of Control Scale

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

We would like to learn about different ways children look at their health. Here are some statements about health or illness (sickness). Some of them you will think are true and so you will circle the YES. Some you will think are not true and so you will circle the NO. Even if it is very hard to decide‚ be sure to circle YES or NO for every statement. Never circle both YES and NO for one statement. There are no right or wrong answers. Be sure to answer the way you really feel and not the way other people might feel.

PRACTICE:

Try the statements below.

Children can get sick.

If you think this is true‚ circle……………………………………… YES

If you think this is not true‚ circle…………………………………NO

Children never get sick.

If you think this is true‚ circle………………………………………. YES

If you think this is not true‚ circle………………………………… NO

Try one more statement for practice.

When I am not sick‚ I am healthy……………………………

NOW DO THE REST OF THE STATEMENTS THE SAME WAY YOU PRACTICED.