Using a Black Feminist Lens to Examine Black Maternal Intention to Vaccinate their Children Against Human Papillomavirus

Abstract

Human papillomavirus (HPV) is the leading sexually transmitted infection that serves as the primary causative agent for HPV-related cancers. In the United States, Black individuals have higher HPV incidence rates and lower HPV vaccination uptake compared to their racial/ethnic counterparts. This disproportionate reality has contributed to significantly higher HPV-related cancers among the Black community. Given the recommended age of HPV vaccination starts at age nine, it is imperative to understand Black maternal perspectives toward the HPV vaccine. Guided by two complementary frameworks: Health Belief Model and Black Feminist Thought this dissertation sought to examine the relationship between Black maternal HPV vaccine intention and the following potential contributors to this behavior:1) health beliefs, including perceived susceptibility, severity barriers and benefits, 2) intrapersonal cultural factors, including racial pride, present time-orientation (PTO) and future time-orientation (FTO), and 3) interpersonal factors, including religiosity, medical mistrust and gendered racial microaggressions. A total of 146 Black maternal figures completed an online survey that assessed for vaccine intention, HPV-related knowledge/beliefs, racial pride, PTO, FTO, religiosity, medical mistrust and gendered racial microaggressions. A majority of the participants had a moderately rated intent to vaccinate their children against HPV, despite virtually all participants reporting limited knowledge about HPV related information. Additionally, future-time orientation, present-time orientation, religiosity and gendered racial microaggression stress served as moderators of significance when the relationships between health beliefs and vaccine intention. Notably, when comparing moderation effects of both PTO and FTO, moderate vigilance toward the present and low vigilance toward the future had significant moderating effects on the negative relationship between perceived barriers and vaccine intention, emphasizing the importance of temporal balance as it relates to their children’s current and future health status. A qualitative analysis that examined the construct of Black motherhood potential cues to action that impact vaccine intention among study participants yielded several overarching themes across at total of six research questions including: 1) Unconditional Love, 2) Educational Empowerment, 3) Holistic Support, 4) Guidance, 5), Provider, 6) Developmental Appropriateness, 7) No or Limited Discussion, 8) Familial Factors, 9) Educational/Informative, 10) No Medical Mistrust, 11) Some Mistrust, 12) Complete Mistrust, 13) Religious Influence, 14) No Religious Influence, 15) Decision Making, 16) Safety Concerns, and 17) Prevention. Clinical implications of these research findings and relevance to the future are discussed.