External Health Locus Of Control Research Articles

Examining the educational experiences of Behvarzes from the insufficient participation of some people in preventive measures against the COVID-19 pandemic: a lesson for the future

BackgroundThis study aims to explore the experiences of Behvarzes regarding the reasons behind the insufficient participation of some individuals with the preventive protocols established during the COVID-19 pandemic.MethodsA qualitative study was conducted from July 2021 to December 2022 using the conventional content analysis method. Purposive sampling was employed to select 14 Behvarzes working in villages covered by Kashan University of Medical Sciences. Data were collected through semi-structured in-depth individual interviews and analyzed using conventional content analysis.ResultsThe study identified seven subcategories which were grouped into two main categories of reasons for inadequate compliance with health protocols by some individuals. These include: (1) Intentional non-compliance with preventive protocols, with the following subcategories: perceived obligation and adherence to social customs, denial of risk, belief in external health locus of control, and fear and distrust of prevention and treatment methods. (2) Unintentional non-compliance with preventive protocols, with the following subcategories: insufficient or contradictory information, negligence, and inevitability.ConclusionThe findings suggest that ensuring compliance with health guidelines is not a one-size-fits-all approach. providing empowerment and obstacle removal solutions to those forced to violate preventive protocols for various reasons are all critical components of successful interventions. Also, cultural familiarity can aid in the design of appropriate interventions to address these challenges.

Prehabilitation: The underutilised weapon for chronic pain management.

Prehabilitation encompasses preparatory clinical intervention(s) delivered during the period between diagnosis and treatment commencement. Despite widespread successful usage preoperatively, psychological prehabilitation is neglected in outpatient chronic pain management. Although pain management waitlists are associated with treatment attrition and psychological and physical decline, this time window is underutilised in preventing escalation. Waitlists present an under-explored opportunity to 'prehabilitate' patients waiting for treatment. This topical review aimed to: (1) examine the effectiveness of psychological prehabilitation for pain services; (2) evaluate the psychological and physical decline associated with waiting for pain management; (3) highlight key psychological prehabilitative targets for increasing treatment engagement; (4) promote pain management psychological prehabilitation within personalised pain medicine, building recommendations for future interventions. Studies regarding the impact of waitlists and prehabilitation for chronic pain were reviewed. Findings demonstrated that the psychological constructs of patient expectations, health locus of control, self-efficacy and pain catastrophizing dynamically influence attrition, treatment engagement and outcomes while waiting. These constructs are amenable to change, emphasising their potential utility within a targeted waitlist intervention. Prehabilitating chronic pain patients towards treatment engagement could circumvent cycles of failed treatment seeking, preventing psychological and physical decline, and reducing healthcare utilisation. Utilising the waitlist to identify psychosocial risk factors (external health locus of control, low self-efficacy and high pain catastrophizing) would identify who requires additional support to prevent increased risk of treatment failure, enhancing personalised care before prescribed treatment is accessed. This review cements the urgent need for pain services to engage proactively with prehabilitation innovation.

Exploring the Relationship between Cyberchondria, Intolerance of Uncertainty, External Health Locus of Control and Defensive Pessimism among Middle-aged Adults

Exploring the Relationship between Cyberchondria, Intolerance of Uncertainty, External Health Locus of Control and Defensive Pessimism among Middle-aged Adults

Social factors of health-related quality of life in older adults: a multivariable analysis

PurposeThe objective of the analysis was to examine the relationships between sociodemographic, socioeconomic, psychosocial, and behavioural factors and both physical and mental health-related quality of life (HRQOL) in older adults.MethodsThe analysis was based on recent cross-sectional data of 1687 community residents from a whole population postal survey of German adults aged 65 years and older (33% response rate, 52% female, mean age 76 years). HRQOL was assessed using the 36-Item Short Form Survey (SF-36v2). For a differentiated analysis, hierarchical multiple linear regressions were performed.ResultsAn internal health locus of control, physical activity, social support, and income were positively associated with physical HRQOL (Adj. R2 = 0.34; p < 0.001) and mental HRQOL (Adj. R2 = 0.18; p < 0.001), whereas an external health locus of control and age were negatively associated with both. Alcohol use and educational level were positively associated only with physical HRQOL, whilst female gender was negatively associated only with mental HRQOL.ConclusionSociodemographic, socioeconomic, psychosocial, and behavioural factors were associated with physical and mental HRQOL. These results highlight the importance of social factors in HRQOL and provide approaches for policy and practice to develop and implement tailored health interventions for older adults. Our findings may be transferable to municipalities in metropolitan areas of high-income European countries.Clinical trial registration: Not applicable.

Interactive Health Messages Work Better for Those Who Feel Less in Control: The Role of External Health Locus of Control and Risk Perception

Interactive websites, which provide greater user control over a site’s interface, are commonly employed in health communication campaigns to deliver risk information in more vivid and engaging ways. The present study explored whether interactive health websites could increase risk perception and encourage systematic processing (i.e. analytical review of persuasive arguments based on prior knowledge and experience) and information seeking and sharing intentions of anti-sugar consumption content. We further investigated whether the effect of interactivity could be moderated by individuals’ beliefs in the role of external factors such as sheer luck in determining their health outcomes. A between-subjects design experiment compared a high interactive website (n = 94) to a low interactive website (n = 73). Results showed that interactivity increased risk perception regarding sugar consumption, especially for the individuals who reported a higher level of external health locus of control. Risk perception was a positive predictor of systematic processing, as well as information seeking and sharing intentions. Theoretical and practical implications of this study are discussed.

A Survey of Breastfeeding Attitudes and Health Locus of Control in the Nigerian Population

ObjectivesBreastfeeding is important to infant health and survival in sub-Saharan Africa. To promote breastfeeding effectively, understanding of psychological factors associated with infant feeding choices is required. This study investigated breastfeeding attitudes and health locus of control (HLoC) in a Nigerian community sample.MethodsMen and women (N = 400) (71% female; mean age 34.2 years/ range 18–86 years) were recruited through community groups in Nigeria. Self-report survey by questionnaire measured breastfeeding attitudes using the Iowa Infant Feeding Attitude Scale (IIFAS) and health locus of control using the Multidimensional Health Locus of Control Scale (MHLoCs).Results MeanIIFAS scores (mean = 57.7; sd = 7.8) became less favourable with increasing age (p = 0.02). Men had higher IIFAS scores (mean = 58.6; sd = 7.6) than women (mean = 56.6; sd = 8.0) indicating more favourable attitudes toward breastfeeding (p = 0.02). Women scored higher than men on external chance HLoC (ECHLoC) (p = 0.003) and external powerful others HLoC (EPHLoC) (p = 0.02). Increasing age was associated with higher scores on ECHLoC (p < 0.01) and EPHLoC (p < 0.01). Multiple linear regression analysis was significant (p < 0.001) and explained 7.8% of variance in breastfeeding attitude. Lower IIFAS scores, reflecting more negative attitudes to breastfeeding, were associated with higher ECHLoC (p < 0.01) and EPOHLoC (p < 0.05). Higher IIFAS scores, reflecting more positive attitudes to breastfeeding, were associated with greater IHLoC (p < 0.01). Neither age nor gender were associated with IIFAS scores in the final model.ConclusionsThis implies a need to explore health locus of control when promoting positive attitudes to breastfeeding and supporting families in breastfeeding advocacy.

Health Locus of Control and Health Anxiety in Patients with COVID-19

IntroductionPerceived sense of control over one’s health contributes to determining health-related behaviors and an individual’s health status. Therefore, it may enhance vulnerability to health anxiety in response to COVID-19 and influence implementation of preventive strategies and adherence to them. Health anxiety may serve as one of the factors that increase the perception of COVID-19 as dangerous and life-threatening. We hypothesized that external health locus of control may demonstrate a connection with higher levels of health anxiety, whereas internal health locus of control may be considered a protective factor alongside some personality traits due to its role in determination of coping strategies.ObjectivesTo assess health locus of control (HLC) in patients with COVID-19 and evaluate its connection with the levels of health anxiety.MethodsThe study has involved 62 participants, average age is 23,4±8,2, with 36 of them being diagnosed with COVID-19 one or more times, average age is 24,5±8,9, whereas 26 of them were healthy, average age is 21,8±7,1. The following methods were used: Brief Illness Perception Questionnaire (modified for COVID-19), Perceived Stress Scale, the state scale from the State-Trait Anxiety Inventory, Short Health Anxiety Inventory, Illness- and Treatment-Related Locus of Control Scale, HEXACO-24 Personality Inventory, Self-Government Test.ResultsCOVID-19 patients differed from healthy participants by the following parameters: perceived danger of COVID-19 (31,53±9,51 vs 33,92±11,5; p&gt;0,05); perceived stress (28±8,68 vs 26,5±7,3; p&gt;0,05); state anxiety level (23,3±11,1 vs 25,1±12,5; p&gt;0,05); health anxiety (14,3±6,76 vs 13,8±5,7; p&gt;0,05); internal HLC (18,8±3,24 vs 17,8±4,67; p&gt;0,05); external HLC (5,97±1,89 vs 5,81±1,92; p&gt;0,05); extraversion (11,8±3,36 vs 13,10±3,71; p&gt;0,05).Correlation analysis has revealed mild positive correlations between health anxiety level and both external HLC (0,32; p&lt;0,05) and chance HLC (0,25; p&lt;0,05), mild negative correlation between health anxiety and internal HLC (-0,18; p&gt;0,05). Analysis of COVID-19 related variables found that health anxiety levels were positively correlated with perceived danger of coronavirus disease (0,37; p&lt;0,01), perceived stress (0,59; p&lt;0,001) in the whole sample. Negative correlation was observed between extraversion and health anxiety (-0,49; p&lt;0,05) in the group of COVID-19 patients.ConclusionsThe results obtained in our study demonstrate the connection of the higher levels of health anxiety in COVID-19 patients with more external orientation of HLC. The connection between extraversion and health anxiety is also observed. Our study indicates that participants diagnosed with COVID-19 one or more times tend to have higher health anxiety levels in comparison to healthy participants.Disclosure of InterestNone Declared

Role of health locus of control in preventing occupational decompression sickness among deep-sea fisherman divers

ABSTRACT Background Indigenous fisherman divers frequently experience decompression sickness (DCS). This study aimed to evaluate the associations between the level of knowledge of safe diving, beliefs in the health locus of control (HLC), and regular diving practices with DCS among the indigenous fisherman divers on Lipe island. The correlations among the level of beliefs in HLC, knowledge of safe diving and regular diving practices were evaluated also. Method We enrolled the fisherman divers on Lipe island and collected their demographics, health indices, levels of knowledge of safe diving, beliefs in external and internal HLC (EHLC and IHLC), and regular diving practices to evaluate the associations with the occurrence of DCS by logistic regression analysis. Pearson’s correlation was used to test the correlations among the level of beliefs in IHLC and EHLC, knowledge of safe diving, and regular diving practices. Results Fifty-eight male fisherman divers whose mean age was 40.39 (±10.61) (range 21–57) years were enrolled. Twenty-six (44.8%) participants had experienced DCS. Body mass index (BMI), alcohol consumption, diving depth, duration of time in the sea/dive, level of beliefs in HLC and regular diving practices were significantly associated with DCS (p < 0.05). Level of belief in IHLC had a significantly strong reverse correlation with that in EHLC and a moderate correlation with level of knowledge of safe diving and regular diving practices. By contrast, level of belief in EHLC had a significantly moderate reverse correlation with level of knowledge of safe diving and regular diving practices (p < 0.001). Conclusions Encouraging the fisherman divers’ belief in IHLC could be beneficial for their occupational safety.

Can Nutritional Status in Adults Be Influenced by Health Locus of Control?

The external health locus of control (HLC) is based on an assumption that obtained health results depend on the influences of external factors. As for the internal HLC-that is the effect of our own actions and capabilities. Little is known regarding how the HLC can influence body weight or the occurrence of visceral obesity. The study aimed to assess the relationship between the health locus of control and nutritional status in adults. The study included 744 adults (452 women, 292 men; 2.8% underweight, 43.8% normal weight, 29.7% overweight, and 23.7% obese). In addition to anthropometric measurement and socio-demographic data, the health locus of control, using the Multidimensional Health Locus of Control Scale (MHLC) by Wallston K, Wallston B, and DeVellis R, was assessed. The percentage of subjects with an internal HLC did not differ significantly between obese, overweight, and normal-weight groups. However, the percentage of subjects with an external HLC-dependent on the impact of others-was significantly higher in both men and women with obesity than in corresponding overweight and normal-weight groups (p < 0.01). Yet, the percentage of subjects with an external HLC subject to the impact of chance was significantly higher among overweight and obese women than in those of normal weight (p < 0.05) only. Women with overweight or obesity, with external health locus of control, experienced both the impact of others and of chance more often than women with normal weight. However, men with overweight and with obesity more often had external health locus of control influenced only by others.

Determinant Health Locus of Internal and External Health Locus of Control as a Predicator of Quality of Life in Type II Dm Patients In Tetunyung Village Takengon East 2021

Diabetes Mellitus (DM) is a metabolic disorder disease characterized by loss of carbohydrate tolerance. Problems with the quality of life of DM patients are quite complex problems. This will affect several aspects of life, DM conditions that are not managed properly in the long term will contribute to the occurrence of chronic complications. This will have an impact on the patient's quality of life. Decreased quality of life can affect the life expectancy of DM patients and can significantly affect the increase in mortality. This study aims to determine the determinants of internal health locus of control and external health locus of control as predictors of quality of life in type 2 diabetes patients in Tetunyung village, East Takengon in 2021. This study used a cross-sectional study design, the population in this study were Type-2 diabetes mellitus sufferers in Tetunyung Takengon Timur Village as many as 103 Type-2 DM sufferers. The sample in this study was selected by purposive sampling with the criteria of Type 2 DM sufferers with a total of 40 patients. Research instrument in the form of a questionnaire. Bivariate analysis using multiple linear regression. The results of the study found that what affects the quality of life in patients with type-2 diabetes mellitus is the internal locus of control as much as 66%. The results of calculations using the SPSS program with a p value of 0.000 (p &lt;0.05). The conclusion in this study is that there is a relationship between locus of control and quality of life where when individuals with good locus of control will produce a good quality of life.

Perception of COVID-19 threat, low self-efficacy, and external locus of control lead to psychological distress during the COVID-19 pandemic

ABSTRACT While it is well documented that the COVID-19 pandemic has had critical consequences for individuals’ mental health, few studies to date have investigated the influence of psychological factors on psychological distress in the context of COVID-19. This study explores the influences of self-efficacy, health locus of control, and COVID-19 threat perception on psychological distress (DASS-21). 180 adults completed an online set of standardised questionnaires. Results indicated that self-efficacy had a significant relationship with all three subscales of psychological distress. However, COVID-19 threat perception was significantly associated with stress. External health locus of control was significantly associated with depression by the chance externality subscale, and stress by the powerful others externality subscale. Additionally, external health locus of control was found to moderate the relationship between COVID-19 threat perception and depression.

Health locus of control and all-cause, cardiovascular, cancer and other cause mortality: A population-based prospective cohort study in southern Sweden

The aim was to investigate associations between health locus of control (HLC) and all-cause, cardiovascular (CVD), cancer and other cause mortality. A public health postal questionnaire was distributed in the autumn of 2008 to a stratified random sample of the 18–80 year old adult population in Scania in southernmost Sweden. The participation rate was 54.1%, and 25,517 participants were included in the present study. Baseline 2008 survey data was linked to cause of death register data to create a prospective cohort with 8.3-year follow-up. Associations between health locus of control and mortality were investigated in survival (Cox) regression models. Prevalence of internal HLC was 69.0% and external HLC 31.0% among women. Internal HLC was 67.6% and external HLC 32.4% among men. In the models with women and men combined, external HLC had significantly higher all-cause, CVD, cancer and other cause mortality even after adjustments for sociodemographic factors and chronic disease at baseline, but after the introduction of health-related behaviors, external HLC only displayed higher cancer mortality compared to internal HLC. External HLC displayed higher all-cause, cancer and other cause mortality for men in the final model adjusted for health-related behaviors, but not for women. Other pathways than health-related behaviors may exist for the association between external HLC and cancer mortality, particularly among men.

Multiple sclerosis: relationship between locus of control and quality of life in persons with low versus high disability

ABSTRACT Background: Health Locus of Control (HLOC) is the degree to which individuals believe that their health outcomes are controlled by ‘external’ factors – environmental forces, chance, fate, other people, or some higher power – or by ‘internal’ factors – their own behavior or action. Most of the literature on HLOC associates an Internal Health Locus of Control (IHLOC) to pro-health behaviors and better health outcomes. However, a few studies also suggest that in chronic illnesses, an External Health Locus of Control (EHLOC) could be beneficial with respect to pro-health behaviors and perceptions of Quality of Life (QoL), challenging assumptions about what leads to the most effective psychological coping in the face of difficult circumstances. Multiple sclerosis (MS) is a chronic immune condition of the central nervous system and the most frequent cause of non-traumatic disability in young adults, often despite treatment. Method: The primary goal of this non-experimental, cross-sectional, quantitative study of 89 individuals with MS was to explore the HLOC of individuals with MS, and to identify whether holding an EHLOC positively impacts the MS patients’ perceived QoL while taking into consideration their level of disability. Results: This research found that individuals with higher disability scores tended to hold more EHLOC beliefs, and that there was a significant correlation between QoL and holding EHLOC beliefs. Conclusion: This study was able to capture the importance of control beliefs in the QoL of individuals with MS with higher disability. The clinical implications of the findingare explored and areas for further research are suggested.

Facing the pandemic lockdown questionnaire - FPLQ: A brief tool to assess individual differences in front of pandemic experience

This paper presents the development and the initial validation of a self-report questionnaire (the Facing the Pandemic Lockdown Questionnaire - FPLQ) focused on the way in which people faced the impact of the lockdown related to the Coronavirus Disease 19. 504 adults (81.55% females; M age = 32.71 years, SD = 11.19) took part to the study. Exploratory and confirmatory factor analyses revealed a 15-item 4-factor structure, invariant for gender and age: two dimensions related to maladaptive processes (i.e., “Perception of low social connectedness and lack of routines” and “Health worry”) and two dimensions related to adaptive processes (i.e., “Positive re-thinking” and “Perception of online social connectedness”). Further, we investigated the associations between these dimensions and measures pertaining cognitive (i.e., internal and external health locus of control), emotional (i.e., positive and negative affect), and relational (i.e., attitude and behaviors toward civic engagement) processes, also testing the moderating role of gender and age. Finally, the potential usefulness of this new tool for both extant and future psychological research was highlighted.

The Use of E-Cigarettes among High School Students in Poland Is Associated with Health Locus of Control but Not with Health Literacy: A Cross-Sectional Study.

Since their introduction, the use of electronic cigarettes has increased considerably in the population and among adolescents. Determinants of smoking conventional cigarettes were thoroughly studied in various social groups. However, we know less about the predictors of the use of e-cigarettes in younger generations. The main aim of this study was the assessment of the factors associated with the use of electronic cigarettes among high school students. Specifically, the roles of health literacy (HL) and health locus of control (HLC) were addressed. The analysis was based on the data from a ‘pen-and-pencil’ survey performed in a large sample of 2223 high school students from southern Poland. The tools used in the survey encompassed 133 items, including a 47-item European Health Literacy Survey questionnaire, an 18-item Multidimensional Health Locus of Control Scale, and a set of questions asking about the health behaviors, and sociodemographic and economic characteristics of respondents. In the study sample, 47.5% of the respondents had used e-cigarettes in the past, and 18.6% had used them in the last month. HL was not significantly associated with dependent variables reflecting the use of e-cigarettes. Two types of external HLC were associated with using e-cigarettes in the past, and ‘Chance’ HLC (CHLC) was also associated with their use in the last month. Males, students of schools providing vocational training, and students declaring more Internet use during the week showed a higher likelihood of ever using e-cigarettes or using them in the last month. Students smoking conventional cigarettes were also more prone to use e-cigarettes. To sum up, it was an unexpected result that HL is not associated with the use of e-cigarettes. A greater likelihood of using e-cigarettes was positively associated with higher CHLC scores, as in the case of smoking traditional cigarettes.

Psychological determinants of the attitude towards vascular interventions in patients with lower limb ischaemia

BackgroundCritical lower limb ischaemia is associated with a 20% annual risk of amputation and death. It is necessary to activate pa-tients’ personal resources which comprise mental dispositions needed to effectively cope with the disease. The objective of the study was to evaluate the correlation between the attitude toward the vascular reconstruction and self-efficacy (SE), health locus of control (HLoC) and own life quality (QOL) assessment in patients with critical lower limb ischaemia.Participants and procedureThe study involved 64 patients with critical lower limb ischaemia (Rutherford 4 and 5), 26 women and 38 men. Four scales were applied during primary admission: the Generalized Self-Efficacy Scale; the Satisfaction with Life Scale; the Multidimensional Health Locus of Control Scale; and the visual scale revealing attitude to vascular reconstruction.ResultsThe attitude to the vascular reconstruction was positive (M = 8.50). The lowest grades were given by those hospitalised several times during follow-up (M = 8.30); women expressed low grades (M = 7.71). An overall positive correlation was found between the positive attitude to the surgery and self-efficacy (p = .012), internal HLoC (p = .041) and external locus (p = .026). In the patients who died within six months from baseline assessment, no correlations were found. In subjects with no readmission, a correlation was found between positive attitude to surgery and the external personal HLoC (p = .023). In patients with subsequent readmissions, a correlation was found between the originally positive attitude to the surgery and poor self-efficacy (p = .009).ConclusionsPatients with weak mental dispositions cannot cope with difficult situations and show a tendency to experience strong emotions, concentrating on their deficiencies, resulting in decreased motivation and feeble engagement in treatment. Poor mental disposition influences the final outcome of the vascular reconstruction.

The Role of Aging Anxiety, Ageism, and Health Locus of Control on Middle-Aged Adults Health Outcomes and Behaviors

Older adults with more ageist attitudes and aging anxiety and who endorse an external health locus of control (HLOC) have poorer mental and physical health and less engagement in healthy behaviors than those who report less ageist attitudes, aging anxiety, and endorse an internal HLOC. However, middle-aged adults have not been examined in this literature. Using Terror Management Theory as a framework, this study examined the relationship of middle-aged adults’ aging anxiety, ageist attitudes, and HLOC with health behaviors and mental and physical health outcomes. 391 middle-aged participants (40-55 years) completed measures of ageist attitudes, aging anxiety, HLOC (Internal, External, and Powerful Other), engagement in health behaviors, mental health, and physical health. The path analysis model demonstrated acceptable fit, χ2(2)=7.794, p=.02, CFI=.99, TLI=.92, RMSEA=.09). For health behaviors, eight of the 10 paths were significant; higher aging anxiety, higher ageist attitudes, and less endorsement of internal HLOC were related to less engagement in healthy behaviors. For mental health and physical health, five of the 10 paths were significant; in general, higher aging anxiety, higher ageist attitudes, and less endorsement of internal HLOC were related to poorer mental and physical health. This study demonstrated that middle-aged adults’ aging anxiety, ageist attitudes, and health locus of control are related to their health behaviors and mental and physical health. Furthermore, higher endorsement of specific forms of ageist attitudes and aging anxiety were related to worse reported mental and physical health and to less engagement in health behaviors. Implications of these findings will be discussed.

Nutritional Behaviors, Health Literacy, and Health Locus of Control of Secondary Schoolers in Southern Poland: A Cross-Sectional Study.

Nutritional behaviors remain an essential part of a healthy lifestyle. It seems obvious that unfavorable health behaviors adopted in adolescence are maintained late in adulthood and may have a profound effect on health status. The main aim of this study was to assess the association between nutritional behaviors and health literacy (HL), health locus of control (HLC), and socioeconomic variables in secondary school pupils from a voivodship (the main unit of territorial division) in southern Poland. The analysis was based on dataTable from a paper-and-pencil survey taken by 2223 pupils from schools selected as the result of cluster sampling. The survey questionnaire encompassed a set of five items asking about dietary patterns and the consumption of fruit and vegetables as well as fast food, a European Health Literacy Project Questionnaire consisting of 47 items, the Multidimensional Health Locus of Control (MHLC) scale, and items asking about sociodemographic and economic variables. Uni- and multivariate logistic regression models have been developed to assess the predictors of indicator nutrition behaviors. The adjusted models revealed that internal HLC was not significantly associated with any of analyzed nutritional behaviors. “Powerful other HLC” and “Chance HLC” (dimension of external HLC) were significant predictors of the selected dietary patterns. Furthermore, higher HL was associated with higher consumption of fruit and vegetables [odds ratio, 95% confidence interval (OR, 95% CI)]: 1.02 (1.01–1.04) and with lower consumption of fast food (OR, 95% CI, 0.98, 0.95–0.999). There was a significant relationship between gender, the size of the household, self-assessed economic situation, expenditures on mobile phones, and weekly duration of Internet use and selected nutrition behaviors. In conclusion, developed regression models confirmed a significant relationship between HL and the types of consumed food, but not with dieting patterns. Contrary to earlier studies, internal HLC was not associated with nutrition behaviors. In our study, boys showed more favorable nutritional behaviors than girls. More intense use of the Internet was associated with less beneficial nutritional behaviors. This study brings important results that should have an impact on health promotion interventions addressed to adolescents in southern Poland.

Perceptions of Tunisians on COVID-19 Vaccines: A Qualitative Study on a Sample of General Population

Background: Given that vaccine acceptance is the primary means to hopefully end this pandemic and given the deleterious consequences of vaccine hesitancy, understanding its determinants is critical. Aim: The aim of the study was to identify Tunisians' mental perceptions and attitudes towards COVID-19 vaccines. Methods: We conducted a qualitative study in the form of a focus group consisting of 11 people randomly selected from the general Tunisian population using a topic guide containing seven open-ended questions in Tunisian dialect covering the topic of COVID-19 vaccines. Results: Eleven people agreed to participate in the research session. The age of the participants ranged from 35 to 55 years with a mean of 42 ± 8.27. Their academic status varied from an elementary to a university education level. We found unanimous vaccine hesitancy in the group. Main themes reported were: Religious coping and external health locus of control, concerns about the safety and efficacy of the vaccines due to the short development time frame of current SARS- CoV-2 vaccines and the lack of ethnic diversity in vaccine studies, the distrust in the manufacturer with belief in a “western-plot” conspiracy. Conclusion: The perceptions and opinions of our focus group of Tunisian citizens about vaccination against COVID-19 consisted of unanimous vaccine hesitancy, with doubts about its safety and efficacy, religious coping and external health locus of control, and belief in conspiracy theory as the main themes. Public health authorities must implement multi-faceted and systematic interventions, including the involvement of mosques in the awareness campaign.

Association Between the Health Locus of Control and Medication Adherence: An Observational, Cross-Sectional Study in Primary Care.

Background: Medication non-adherence is an important healthcare issue and a common problem. Many predictors of non-adherence have been found in different settings and cohorts.Objective: Evaluate the impact of the health locus of control (HLC) on unintentional/intentional non-adherence in primary care.Methods: In this observational, cross-sectional study, 188 patients (mean age 63.3 ± 14.9 years) were recruited from three primary care practices in Jena, Germany, over 4 months. The study assessed demographic data, self-reported adherence (German Stendal adherence to medication score, SAMS), HLC, and depression.Results: According to the SAMS total score, 44 (27.5%) were fully adherent, 93 (58.1%) were moderately non-adherent, and 23 (14.4%) were clinically significantly non-adherent. The most common reasons for non-adherence were forgetting to take the medication or lacking knowledge about the prescribed medication. Multiple linear regression revealed that adherence was good in people with external HLC and poor in internal HLC. In particular, intentional non-adherence was positively associated with internal HLC and negatively with fatalistic external HLC. Depression had a negative influence on both intentional and unintentional non-adherence.Conclusion: HLC is an independent predictor of medication non-adherence and is a promising target for interventions that enhance adherence.