Journal of the National Medical Association · 2026
Predicting locus of control for health in adults with sickle cell disease via mental health visits.
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Sollers John J, Lopez Ashley S Membreno, Edwards Christopher L, Norris Jenny L, Mattassini Luca, Malibongwe Mkosi, Green Cara, Wood Mary, Barker Camela S, Sartor James, Johnson Kayla-Cassidy, Dennard Alitza, Wax Liam, Bynum Zorah, Wax Noa, Johnson Stephanie, Osunkwo Ifeyinwa, Sudhakar Shiv, Robinson Elwood, Sollers John J
Аннотация
OBJECTIVE: This study examined the relationship between healthcare-seeking behavior and health locus of control orientations among individuals with sickle cell disease, specifically investigating whether mental health service utilization predicts internal versus external control beliefs while accounting for demographic factors.
METHODS: Thirty-two African American adults with sickle cell disease were recruited from a Southeastern Comprehensive Sickle Cell center. Participants completed the Multidimensional Health Locus of Control scale (MHLC), which assesses internal control beliefs and external orientations including control by doctors, other people, powerful others, and chance factors. Hierarchical linear regression analyses examined mental health service utilization as a predictor of different locus of control dimensions while controlling age and gender.
RESULTS: Mental health service utilization emerged as a significant predictor of internal health locus of control, accounting for 39.2% of the variance (R² = 0.392, F(3,28) = 6.015, p = 0.003). Individuals who engaged with mental health services demonstrated significantly stronger beliefs that their health outcomes were primarily determined by their own actions and behaviors (β = 0.568, p = 0.002). Mental health service utilization did not significantly predict any external locus of control dimensions, including control by doctors, other people, powerful others, or chance factors. Demographic variables (age and gender) did not emerge as significant moderators in the final models.
CONCLUSIONS: The specific association between mental health service engagement and enhanced internal control beliefs suggests that psychological interventions may serve dual functions in chronic disease care: addressing mental health symptoms while simultaneously reinforcing adaptive health cognitions that promote broader healthcare engagement. These findings support integrating mental health services into comprehensive sickle cell care programs and suggest that interventions targeting locus of control beliefs may effectively promote proactive healthcare behaviors among individuals managing chronic conditions.
METHODS: Thirty-two African American adults with sickle cell disease were recruited from a Southeastern Comprehensive Sickle Cell center. Participants completed the Multidimensional Health Locus of Control scale (MHLC), which assesses internal control beliefs and external orientations including control by doctors, other people, powerful others, and chance factors. Hierarchical linear regression analyses examined mental health service utilization as a predictor of different locus of control dimensions while controlling age and gender.
RESULTS: Mental health service utilization emerged as a significant predictor of internal health locus of control, accounting for 39.2% of the variance (R² = 0.392, F(3,28) = 6.015, p = 0.003). Individuals who engaged with mental health services demonstrated significantly stronger beliefs that their health outcomes were primarily determined by their own actions and behaviors (β = 0.568, p = 0.002). Mental health service utilization did not significantly predict any external locus of control dimensions, including control by doctors, other people, powerful others, or chance factors. Demographic variables (age and gender) did not emerge as significant moderators in the final models.
CONCLUSIONS: The specific association between mental health service engagement and enhanced internal control beliefs suggests that psychological interventions may serve dual functions in chronic disease care: addressing mental health symptoms while simultaneously reinforcing adaptive health cognitions that promote broader healthcare engagement. These findings support integrating mental health services into comprehensive sickle cell care programs and suggest that interventions targeting locus of control beliefs may effectively promote proactive healthcare behaviors among individuals managing chronic conditions.