Environmental control. Environmental control refers to the ability of the person to control nature and to plan and direct factors in the environment that affect them.
If persons come from a cultural group in which there is less belief in internal control(feeling that one does have some control) and more in external control(feeling that one does not have control), there may be a fatalistic view in which seeking health care is viewed as useless.
A.S. uses prayers, amulets as external control tool even at times when treatment does not take place. Mother expressed that they dedicated a sacrifice if the child heals.