title: The importance of internal health beliefs for employees' participation in health promotion programs.
abstract: OBJECTIVE
  To investigate associations between employees' health locus of control (HLOC) and self-perceived health, health behaviors, and participation in health promotion programs (HPPs) and the mediating effect of self-perceived health and health behaviors on the relation between HLOC and participation.
  
  
  METHODS
  Between 2010 and 2012, a six-month longitudinal study was conducted among 691 Dutch employees. Using questionnaires, information was collected on health behaviors, self-perceived health, HLOC, and intention to participate at baseline. Actual participation was assessed at follow-up. Logistic regression analyses were used to study associations between HLOC and self-perceived health, health behaviors, and participation, and to examine whether associations between HLOC and participation were mediated by self-perceived health and health behaviors.
  
  
  RESULTS
  Higher internal HLOC was associated with sufficient physical activity (moderate: OR:1.04, 95%CI:1.00-1.08; vigorous: OR:1.05, 95%CI:1.01-1.10) and fruit and vegetable intake (OR:1.05, 95%CI:1.01-1.09), a good self-perceived health (OR:1.20, 95%CI:1.11-1.30), a positive intention towards participation (OR:1.05, 95%CI:1.00-1.09), and actual participation (OR:1.06, 95%CI:1.00-1.13). Self-perceived health or health behaviors did not mediate associations between HLOC and participation.
  
  
  CONCLUSIONS
  Employees with a higher internal HLOC behaved healthier and were more likely to participate in HPPs, irrespectively of their health. Increasing internal HLOC seems a promising avenue for improving employees' health and participation in HPPs.
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
authors.forename: Anne
authors.initials: A
authors.lastname: Rongen
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands. Electronic address: s.robroek@erasmusmc.nl.
authors.forename: Suzan J W
authors.initials: SJ
authors.lastname: Robroek
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
authors.forename: Alex
authors.initials: A
authors.lastname: Burdorf
mesh_terms: D000328:Adult; D001294:Attitude to Health; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D007389:Internal-External Control; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010358:Patient Participation / Q000523:psychology*; D012649:Self Concept; D011795:Surveys and Questionnaires; D017132:Workplace
keywords: Health locus of control; Health promotion; Lifestyle; Longitudinal design; Mediation analysis; Workplace