Parental Health Belief Scales

Abstract

The Parental Health Belief Scales (PHBS) is a psychological instrument designed to assess the underlying beliefs held by parents regarding the determinants of their child’s health and illness. This scale is crucial for understanding how parents perceive their own agency, the role of external authorities (such as physicians or government), and the influence of chance, luck, or supernatural forces on their child’s well-being. By quantifying these perceptions, the PHBS provides insight into the cognitive frameworks that drive parental health behavior and decision-making.

Keywords

Parental Health Beliefs, Locus of Control, Child Health, Health Behavior, Parenting, Pediatric Psychology, Health Education, Chance, Powerful Others

Authors

Barbara Tinsley, Ph.D. (Primary Contact/Developer), and colleagues.

Purpose

The primary purpose of the Parental Health Belief Scales is to measure the distinct dimensions of parental beliefs related to health outcomes in children. Specifically, the scale aims to delineate whether parents attribute their child’s health status primarily to their own actions (internal control), the actions of external experts (powerful others), or uncontrollable factors (chance, fate, or supernatural influences). Understanding these attributions is fundamental for tailoring effective health interventions and communication strategies aimed at improving preventative care and managing childhood illnesses.

The scale is utilized in pediatric and public health research to identify parental groups that may be resistant to health recommendations due to strong fatalistic beliefs or excessive reliance on external authorities. This diagnostic capability allows researchers and clinicians to predict engagement levels in complex health management tasks, such as managing chronic conditions or adhering to vaccination schedules.

Construct

The PHBS primarily measures the construct of Health Locus of Control as applied to the parental role. This construct posits that individuals differ in the degree to which they believe they have control over their own health, or in this case, their child’s health. The scale typically operationalizes this construct into several key dimensions:

• Internal Control: The belief that the parent’s own actions, vigilance, discipline, and teaching ability are the main determinants of the child’s health (e.g., “I can do many things to fight illness in my child.”).
• Powerful Others Control: The belief that health outcomes are controlled by influential external figures, such as doctors, nurses, dentists, or the government (e.g., “Only a doctor or a nurse keeps my child from getting sick.”).
• Chance/External/Fatalistic Control: The belief that health outcomes are determined by uncontrollable external factors, such as luck, fate, accidents, environment, or supernatural forces (e.g., “My child’s good health comes from being lucky,” or “Frequent sickness in children is a sign of being cursed by God or the devil.”).

Validity

Specific detailed validity statistics (e.g., content, criterion, and construct validity indices) are typically provided in the primary validation study for the PHBS. Given the structure of the items, strong construct validity is expected, demonstrating that the items load cleanly onto the hypothesized factors (Internal, Powerful Others, Chance). Evidence of concurrent validity would involve correlations between PHBS subscale scores and observed parental health-seeking behaviors, adherence to medical advice, and engagement in preventative activities.

The inclusion of items relating to cultural beliefs, such as the evil eye or divine blessing/curse, suggests a careful attempt to ensure cross-cultural relevance and content validity for diverse populations, particularly those where health beliefs incorporate supernatural or highly fatalistic components.

Reliability

Reliability of the PHBS is typically assessed using measures of internal consistency, such as Cronbach’s Alpha, for each subscale. High internal consistency is expected within the conceptually distinct subscales (Internal, Powerful Others, Chance). Test-retest reliability studies are also generally conducted to confirm the stability of parental health beliefs over time, suggesting that the scale provides consistent measures unless a significant life event intervenes.

Factor Analysis

Factor analysis of the Parental Health Belief Scales generally supports a multi-dimensional structure, consistent with the theoretical framework of Health Locus of Control. Exploratory or Confirmatory Factor Analysis (EFA/CFA) typically confirms the existence of at least three distinct, yet potentially correlated, factors: Internal Control, Powerful Others Control, and Chance/Fatalism. The analysis separates items reflecting personal responsibility (Internal) from those reflecting external dependence (Powerful Others) and those reflecting fate or luck (Chance).

Instrument

Test Type: Self-report questionnaire, Psychological assessment scale

Format: 30 items rated on a 5-point Likert scale.

Language Available: English (Original development language); other translations may exist based on research usage.

Population Group: Parents or primary caregivers of children.

Age Group: Adults (Parents/Caregivers).

Population Details: Applicable to diverse parental populations, particularly those whose health behaviors are studied in relation to their children’s well-being.

Test Methodology: Respondents rate each statement based on their level of agreement, ranging from 1 (Strongly agree) to 5 (Strongly disagree). Scoring involves reversing specific items and calculating subscale scores to reflect the strength of Internal, Powerful Others, and Chance beliefs.

Keywords

Parental Responsibility, Pediatric Care, Health Attribution, Fatalism, Preventative Medicine, Child Development, Health Psychology

Authors

Author ORCID Identifier: Not explicitly provided in source material.

Affiliation Email addresses: [email protected] (Barbara Tinsley, likely affiliated with Arizona State University – ASU)

Correspondence Address: Not explicitly provided in source material.

Permissions & Fee and Test Year

The scale is generally used for non-commercial academic research, though specific permissions should be sought from the primary author, Barbara Tinsley, via the provided email address.

Fee: Not specified; typically free for academic use but permission is required.

Test Year: The original validation study linked below suggests the scale was developed and published around 1999-2000, often cited in conjunction with research by Tinsley and Lauver.

The original PDF containing information about the scale and its development can be downloaded here: http://deepblue.lib.umich.edu/bitstream/handle/2027.42/62210/vazm_1.pdf;jsessionid=F8681CD1AB037236197869F8B4B172BC?sequence=1

Reference’s

Primary documentation and validation studies related to the Parental Health Belief Scales should be referenced for detailed statistical properties and scoring instructions. Key references often include work published by Tinsley, B. R., and Lauver, D. J. regarding child health locus of control.

Items of the Parental Health Belief Scales

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

Please rate each statement on a scale from 1 to 5 without thinking too deeply about it.

1=Strongly agree‚ 2‚ 3= No opinion ‚ 4‚ 5=Strongly disagree

1. My child’s good health comes from being lucky.
2. There is nothing that I can do to keep my child from getting sick.
3. Bad luck makes my child get sick.
4. I can only do what the doctor tells me to do for my child.
5. Getting sick just happens to children.
6. There is nothing I can do to make sure that my child has a healthy appearance.
7. Children who never get sick are just plain lucky.
8. It is my job as a father/ mother to keep my child from getting sick.
9. The government is responsible for the effects of quality of food on my child’shealth.
10. Only a doctor or a nurse keeps my child from getting sick.
11. I can make very few choices about my child’s health.
12. My child’s health can improve through self-discipline.
13. Accidents just happen to children.
14. I can do many things to fight illness in my child.
15. Only the dentist can take care of my child’s teeth.
16. I can teach my child many ways in which to protect their good health.
17. The government is responsible for the environmental effects on my child’s health.
18. Even the most healthy child can be affected by the evil eye or nazar of a jealousperson.
19. The only way I can make my child stay healthy is to do what other people tell meto do.
20. I take my child to the doctor right away if my child gets hurt.
21. It will be my child’s teachers’ job to keep my child from ha‎ving accidents atschool.
22. Children who never get sick are blessed by God.
23. I can make many choices about my child’s health.
24. If my child feels sick‚ I have to wait for other people to tell me what to do.
25. Whenever my child feels sick‚ I take my child to the doctor right away.
26. There is nothing I can do the make sure that my child has healthy teeth.
27. I can do many things to prevent my child from ha‎ving accidents
28. My child’s health can improve through prayer.
29. Frequent sickness in children is a sign of being cursed by God or the devil.
30. My child’s health is affected by living in a bad environment no matter what I do.