Journal of Biostatistics and Epidemiology 2017. 3(1):20-28.

Confirmatory factor analysis of the Persian version of the multidimensional health locus of control scale - Form A
Teamur Aghamolaei, Farzan Madadizadeh, Amin Ghanbarnejad


Background & Aim: Health locus of control (HLC) is a construct that refers to how person’s beliefs influence on his/her health. The aim of this study was to assess the reliability and construct validity of multidimensional HLC (MHLC) scale in a representative Iranian samples.
Methods & Materials: This cross-sectional study was done among 881 subjects over 15 years old in Bandar Abbas, in the south of Iran through cluster sampling. Translated Persian version of MHLC questionnaire was administered to participants. Data were analyzed using confirmatory factor analysis (CFA) to compare three different models. Multiple groups CFA were conducted to examine the measurement equivalence across gender (390 men and 391 women) in EQS software. Reliability assessment was done by Cronbach’s α coefficient in SPSS v.16 software.
Results: Based on CFA, 18-item with three correlated factor had good fit (goodness-of-fit index = 0.92 and comparative fit index = 0.9). The results established full configural, metric, and scalar invariance across gender. Cronbach’s α for subscales was ranged from 0.65 to 0.74.
Conclusion: Eighteen items Persian version of MHLC scale in three oblique subscales was introduced as a valid and reliable tool for assessing HLC among the general population in Iran. Furthermore, it is derived that the MHLC was full invariant across gender.


Factor analysis; Validation study; Reliability

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Wallston KA, Wallston BS, DeVellis R. Development of the Multidimensional health locus of control (MHLC) sales. Health Educ Monogr 1978; 6(2): 160-70.

Strickland BR. Internal-external expectancies and health-related behaviors. J Consult Clin Psychol 1978; 46(6): 1192-211.

Rotter JB. Generalized expectancies for internal versus external control of reinforcement. Psychol Monogr 1966; 80(1): 1-28.

DeMello LR, Imms T, Psychological studies. Self-esteem, locus of control and coping styles and their relationship to school attitudes of adolescents. Psychological Studies 1999; 44(1-2): 24-34.

Gomez R. Locus of control and avoidant coping: Direct, interactional and mediational effects on maladjustment in adolescents. Pers Individ Dif 1998; 24(3): 325-34.

Luszczynska A, Schwarzer R. Multidimensional health locus of control: Comments on the construct and its measurement. J Health Psychol 2005; 10(5): 633-42.

Wallston KA. The validity of the multidimensional health locus of control scales. J Health Psychol 2005; 10(5): 623-31.

Wallston KA, Stein MJ, Smith CA. Form C of the MHLC scales: A condition-specific measure of locus of control. J Pers Assess 1994; 63(3): 534-53.

Roberts LJ, Ho R. Development of an Australian health locus of control scale. Pers Individ Dif 1996; 20(5): 629-39.

Malcarne VL, Fernandez S, Flores L. Factorial validity of the multidimensional health locus of control scales for three American ethnic groups. J Health Psychol 2005; 10(5): 657-67.

Athale N, Aldridge A, Malcarne VL, Nakaji M, Samady W, Robins SG. Validity of the multidimensional health locus of control scales in american sign language. J Health Psychol 2010; 15(7): 1064-74.

Lundgren S, Eurenius E, Olausson A, Opava CH. The swedish version of the multidimensional health locus of control scales, form C. Aspects of reliability and validity in patients with rheumatoid arthritis. Adv Physiother 2007; 9(1): 16-22.

Wrightson KJ, Wardle J. Cultural variation in health locus of control. Ethn Health 1997; 2(1-2): 13-20.

Moshki M, Ghofranipour F, Hajizadeh E, Azadfallah P. Validity and reliability of the multidimensional health locus of control scale for college students. BMC Public Health 2007; 7: 295.

De Las Cuevas C, Penate W, Betancort M, Cabrera C. What do psychiatric patients believe regarding where control over their illness lies? Validation of the multidimensional health locus of control scale in psychiatric outpatient care. J Nerv Ment Dis 2015; 203(2): 81-6. 16. Konkoly Thege B, Rafael B, Rohanszky M. Psychometric properties of the multidimensional health locus of control scale form C in a non-Western culture. PLoS One 2014; 9(9): e107108.

Pereira LS, Araujo LG, Sampaio RF, Haddad JP. Factorial analysis of the Multidimensional Health Locus of Control Scale-Form C for elderly. Rev Bras Fisioter 2011; 15(5): 363-70.

Afifi M. Health locus of control and depressive symptoms among adolescents in Alexandria, Egypt. East Mediterr Health J 2007; 13(5): 1043-52.

Kuwahara A, Nishino Y, Ohkubo T, Tsuji I, Hisamichi S, Hosokawa T. Reliability and validity of the multidimensional health locus of control Scale in Japan: Relationship with demographic factors and health-related behavior. Tohoku J Exp Med 2004; 203(1): 37-45.

Egan JT, Leonardson G, Best LG, Welty T, Calhoun D, Beals J. Multidimensional health locus of control in American Indians: The strong heart study. Ethn Dis 2009; 19(3): 338-44.

Aghamolaei T, Tavafian S, Ghanbarnejad A. Health locus of control and its relation with health-promoting behaviors among people over 15 in Bandar Abbas, Iran. J Health Adm 2014; 17(55): 7-16. [In Persian].

Astrom AN, Blay D. Multidimensional health locus of control scales: Applicability among Ghanaian adolescents. East Afr Med J 2002; 79(3): 128-33.

Cheung GW, Rensvold RB. Evaluating goodness-of-fit indexes for testing measurement invariance. Struct Equ Modeling 2002; 9(2): 233-55.

Drasgow F, Kanfer R. Equivalence of psychological measurement in heterogeneous populations. J Appl Psychol 1985; 70(4): 662-80. 25. Vandenberg RJ, Lance CE. A review and synthesis of the measurement invariance literature: Suggestions, practices, and recommendations for organizational research. Organ Res Methods 2000; 3(1): 4-70.

O'Looney BA, Barrett PT. A psychometric investigation of the multidimensional health locus of control questionnaire. Br J Clin Psychol 1983; 22 (Pt 3): 217-8.

Sura M. Selected findings of national population and housing census, 2011 [Online]. [cited 2011]; Available from: URL:

World Medical Association (WMA). WMA declaration of Helsinki-ethical principles for medical research involving human subjects [Online]. [cited 2014]; Available from: URL:

Brown TA. Confirmatory factor analysis for applied research. New York, NY: Guilford Publications; 2015.

Bazargan A, Sarmad Z, Hejazi E. Research methods in behavioral sciences. Tehran, Iran: Agah Publications; 1998. [In Persian].

Bentler PM. Comparative fit indexes in structural models. Psychol Bull 1990; 107(2): 238-46.

Bentler PM, Wu EJ. EQS 6.1 for windows; Users guideline. Encino, CA: Multivariate Software; 2005.

Kline RB. Principles and practice of structural equation modeling, third edition (methodology in the social sciences). New York, NY: Guilford Publications; 2015.

Stevens JP. Applied multivariate statistics for the social sciences. 5th ed. London, UK: Routledge; 2012.

Merkle EC, You D, Preacher KJ. Testing nonnested structural equation models. Psychol Methods 2016; 21(2): 151-63.

Bollen KA. Structural equations with latent variables. New York, NY: John Wiley & Sons; 2014.

Byrne BM, Shavelson RJ, Bengt M. Testing for the equivalence of factor covariance and mean structures: The issue of partial measurement invariance. Psychol Bull 1989; 105(3): 456-66.

Mardia KV. Measures of multivariate skewness and kurtosis with applications.

Biometrika 1970; 57(3): 519-30.

Satorra A, Bentler PM. A scaled difference chi-square test statistic for moment structure analysis. Psychometrika 2001; 66(4): 507-14.

Cooper D, Fraboni M. Toward a more valid and reliable health locus of control scale. J Clin Psychol 1988; 44(4): 536-40.

Otto C, Bischof G, Rumpf HJ, Meyer C, Hapke U, John U. Multiple dimensions of health locus of control in a representative population sample: Ordinal factor analysis and cross-validation of an existing three and a new four factor model. BMC Med Res Methodol 2011; 11: 114.

Hashemian M, Aminshokravi F, Hidarnia A, Lamyian M, Hassanpour K, Akaberi A, et al. Farsi version of the multidimensional health locus of control and God locus of health control scales: Validity and reliability study among Iranian women with a family history of breast cancer. J Pak Med Assoc 2014; 64(9): 1057-62.

Marshall GN, Collins BE, Crooks VC. A comparison of two multidimensional health locus of control instruments. J Pers Assess 1990; 54(1-2): 181-90.

Rodriguez-Rosero JE, Ferriani M, Dela Coleta MF. Multidimensional health locus of control scale - MHLC: Validation study. Rev Lat Am Enfermagem 2002; 10(2): 179-84.

Casey TA, Kingery PM, Bowden RG, Corbett BS. An investigation of the factor structure of the multidimensional health locus of control scales in a health promotion program. Educ Psychol Meas 1993; 53(2): 491-8.


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