HPV vaccine acceptance among African-American mothers and their daughters: an inquiry grounded in culture

ABSTRACT

Background: Much of the research on African-Americans’ HPV vaccine acceptance has largely focused on racial/ethnic differences related to cognitive, socio-economical, and structural factors that contribute to differences in HPV vaccine acceptance and completion. A growing body of literature suggest that cultural factors, such as mistrust of healthcare providers (HCPs) and the healthcare system, religion, and social norms related to appropriate sexual behaviors, also plays a prominent role in their HPV vaccine acceptance. However, these studies were limited in their use of theoretical approaches necessary to conceptualize and operationalize culture.

Objective: To explore the influence of culture on African-American mothers’ and daughters’ HPV vaccine acceptance using the PEN-3, a culturally-centered conceptual framework.

Methods: Grounded theory techniques were used to explore cultural factors that influenced the acceptance of the HPV vaccine among African-American mothers (n = 28) and their daughters (n = 34).

Results: Positive attitudes towards vaccination stemmed from beliefs that the HPV vaccine has cancer prevention benefits and that vaccinations in general protected against infectious diseases. Negative attitudes stemmed from beliefs that the HPV vaccine was too new, not effective, daughters were too young, and that vaccines were not a one-size-fits-all intervention. Majority of mothers and daughters indicated that their religious doctrine did not impede their HPV vaccination decisions. For a few mothers, religious beliefs could not be separated from their HPV vaccination decisions and ultimately deterred HPV vaccine acceptance. HCP recommendations were valued however mothers were often dissatisfied with the detail of information communicated. Support networks provided both positive and negative types of social support to mothers and daughters. The media highlighted the cancer prevention benefits of the HPV vaccine and unintentionally communicated negative information of the HPV vaccine, which deterred HPV vaccine acceptance.

Conclusion: Study findings can inform the development of culturally appropriate interventions that advances the evidence on cervical cancer prevention.

KEYWORDS:

• Culture
• human papillomavirus
• HPV vaccine acceptance
• African American
• females

Acknowledgements

This project was supported by NIH grant no 3R25CA057711 are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. We also thank our study participants, and the administrators and staff at the Greensboro Department of Health and Highpoint Health Department in Guilford, NC.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Kayoll V. Galbraith-Gyan http://orcid.org/0000-0001-7032-7234

Additional information

Funding

This work was supported by the National Institutes of Health/National Cancer Institute [grant no 5R25CA057711-23]; National Institutes of Health [grant no 3R25CA057711]; Jonas Nurse Leaders Scholarship [grant no 5057703]; and Sigma Theta Tau International Honor Society of Nursing Alpha Alpha Chapter.