Parental Health Belief Scales

Abstract

The Parental Health Belief Scales (PHBS) are a specialized psychometric instrument designed to assess and quantify parental beliefs regarding the causes and controllability of their child’s health and illness outcomes. This scale measures distinct dimensions of health-related attributions, moving beyond simple health behaviors to explore the underlying cognitive framework—or Locus of Control—that guides a parent’s approach to preventative care, treatment compliance, and general well-being maintenance for their children. The PHBS is crucial for researchers and clinicians seeking to understand how cultural, fatalistic, or internal control beliefs influence parental decision-making in pediatric health settings.

Keywords

Parental Health Beliefs, Locus of Control, Child Health, Health Psychology, Health Attribution, Pediatric Care, Psychometric Scale.

Authors

Barbara J. Tinsley, Maria C. Vaz.

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Purpose

The primary purpose of the Parental Health Belief Scales is to systematically measure the diverse ways parents attribute responsibility for their child’s health status. It aims to differentiate between parents who feel personally empowered (Internal Locus of Control), those who rely heavily on external professionals (Powerful Others), and those who believe health outcomes are governed by fate, luck, or supernatural forces (Chance/Fatalism). By identifying these distinct belief patterns, the scale provides valuable insights for developing targeted health interventions that address specific cognitive barriers to effective child healthcare practices.

Construct

The PHBS is rooted in Health Locus of Control theory, adapted specifically for the parental role. The scale typically measures multiple dimensions, reflecting the multidimensional nature of health beliefs:

• Internal Health Locus of Control: The belief that the parent’s actions, diligence, and choices directly influence the child’s health status (e.g., proper diet, teaching good habits).
• Powerful Others Health Locus of Control: The belief that external agents, such as doctors, nurses, dentists, or government bodies, are primarily responsible for maintaining the child’s health.
• Chance/Fatalistic Health Locus of Control: The belief that health outcomes are random, determined by luck, accidents, fate, or supernatural factors (e.g., “evil eye,” curses, or divine blessing), independent of parental or professional effort.

The items included in the instrument reflect these complex constructs, encompassing areas from routine dental care and accident prevention to chronic illness and spiritual beliefs.

Validity

The validity of the PHBS was established through rigorous psychometric analysis during its development. Content validity was ensured by deriving items directly from parental interviews concerning health causality. Construct validity was supported by factor analysis (detailed below), demonstrating that the items load onto theoretically distinct factors corresponding to Internal, Powerful Others, and Chance/Fatalistic subscales. Criterion validity has often been demonstrated by correlating scale scores with observed parental health behaviors and health outcomes in children, showing that specific belief patterns predict real-world actions.

Reliability

Reliability studies confirm the internal consistency of the PHBS, typically reporting acceptable to strong Cronbach’s alpha coefficients for the overall scale and its respective subscales. Test-retest reliability has also been utilized to ensure the stability of parental health beliefs over time, indicating that the scale provides consistent measurements when administered repeatedly to the same population, provided no major health events or interventions have occurred.

Factor Analysis

Initial factor analysis of the 30 items typically yields a multi-factor solution, confirming the hypothesized structure of parental health beliefs. While specific factor structures can vary slightly across different cultural populations, the core components usually emerge as distinct factors: Internal Control, Powerful Others, and Chance/Fatalism. This statistical separation validates the instrument’s ability to measure nuanced differences in how parents perceive their role and efficacy in managing their child’s health.

Instrument

Test Type:

Self-report Psychometric Scale assessing health attributions.

Format:

30 items rated on a 5-point Likert scale.

Language Available:

Originally developed in English, translations may exist depending on subsequent research applications.

Population Group:

Parents (Mothers and Fathers).

Age Group:

Adults (Parents) of children across various age ranges.

Population Details:

Applicable across diverse demographic and socioeconomic groups, though cultural adaptation may be necessary to fully account for fatalistic items (e.g., Item 18, 22, 29).

Test Methodology:

Respondents are instructed to rate each statement on a scale from 1 to 5, indicating their level of agreement or disagreement, without excessive deliberation. The scale anchors are: 1=Strongly agree, 2, 3= No opinion, 4, 5=Strongly disagree. Some items may be reverse-scored during analysis.

Keywords

Internal Control, Powerful Others, Chance Beliefs, Fatalism, Health Interventions, Pediatric Psychology, Parenting, Child Well-being.

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Authors

Author ORCID Identifier:

Not provided in source material.

Affiliation Email addresses:

[email protected] (as listed in source content).

Correspondence Address:

Correspondence typically directed to the primary author, Barbara J. Tinsley (likely affiliated with Arizona State University at the time of publication).

Permissions & Fee and Test Year

Permissions:

Researchers should contact the corresponding author, Barbara J. Tinsley, for current permissions and usage guidelines.

Fee:

Not specified; usage is typically free for non-commercial academic research, but confirmation is required.

Test Year:

The scale was developed and published circa 1993.

Reference’s

The primary reference for the Parental Health Belief Scales is: Tinsley, B. J., & Vaz, M. C. (1993). Parental health beliefs and practices: The Parental Health Belief Scales. Journal of Pediatric Psychology, 18(6), 689-703.

The original PDF for the underlying research can be downloaded here: http://deepblue.lib.umich.edu/bitstream/handle/2027.42/62210/vazm_1.pdf;jsessionid=F8681CD1AB037236197869F8B4B172BC?sequence=1

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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.