title: Relating Health Locus of Control to Health Care Use, Adherence, and Transition Readiness Among Youths With Chronic Conditions, North Carolina, 2015.
abstract: Health locus of control refers to the belief that health is in one's control (internal control) or is not in one's control (external control). Among adults, external locus of control is associated with negative health outcomes, whereas internal locus of control is associated with favorable outcomes. Few studies examined these associations among youths. The objective of our study was to determine how locus of control relates to health care use, medication adherence, missed school, and readiness for transition to adult medical care for youths with chronic conditions.
  
  
  
  Participants at a camp for youths aged 6 to 17 years with chronic health conditions completed a survey measuring locus of control, readiness for transition to adult care, and medication adherence. Their parents completed a separate part of the survey about health care use and missed school days in the past year.
  
  
  
  A total of 163 youths completed the survey (78.5% white; 52.1% female; mean age, 12.3 y). Internal locus of control (β = 0.196; P = .013) and external Doctor locus of control with doctors controlling disease (β = 0.181; P = .025) were positively associated with transition readiness. External control by chance or with others controlling disease was negatively associated with transition readiness (β = -0.248; P = .002) and positively associated with emergency department visits (β = 0.225; P = .004) and with number of hospital inpatient nights at hospital (β = 0.166; P = .04).
  
  
  
  Adolescents with external control of their health by chance or by other people are at increased risk for negative health outcomes and may fail to develop the self-management skills needed for successful transitioning to adult care. Future studies should examine effects of changes in locus of control on health outcomes among youths.
authors.affiliation: The University of North Carolina, Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Meaghan
authors.initials: M
authors.lastname: Nazareth
authors.affiliation: The University of North Carolina, Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Jordan
authors.initials: J
authors.lastname: Richards
authors.affiliation: The University of North Carolina, Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Karina
authors.initials: K
authors.lastname: Javalkar
authors.affiliation: Wake Forest University, Winston-Salem, North Carolina.
authors.forename: Cara
authors.initials: C
authors.lastname: Haberman
authors.affiliation: The University of North Carolina, Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhong
authors.affiliation: The University of North Carolina, Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Eniko
authors.initials: E
authors.lastname: Rak
authors.affiliation: The University of North Carolina, Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Nina
authors.initials: N
authors.lastname: Jain
authors.affiliation: The University of North Carolina, Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Maria
authors.initials: M
authors.lastname: Ferris
authors.affiliation: University of North Carolina, Department of Medicine, Division of Gastroenterology and Hepatology, 130 Mason Farm Rd, CB 7080, Chapel Hill, NC 27599. Email: tilburg@med.unc.edu.
authors.forename: Miranda A L
authors.initials: MA
authors.lastname: van Tilburg
mesh_terms: D000293:Adolescent; D002648:Child; D002908:Chronic Disease / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007389:Internal-External Control; D016014:Linear Models; D008297:Male; D055118:Medication Adherence; D009657:North Carolina / Q000453:epidemiology; D012648:Self Care; D011795:Surveys and Questionnaires; D060305:Transition to Adult Care