The importance of internal health beliefs for employees' participation in health promotion programs

•Employees with higher internal health locus of control (HLOC) behave healthier.•Higher internal HLOC makes health promotion program participation more likely.•Incorporating HLOC in health promotion programs could enhance participation.

ObjectiveTo 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.MethodBetween 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.ResultsHigher 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.ConclusionEmployees 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.