Defense Date
2024
Document Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Social and Behavioral Health
First Advisor
Dina T. Garcia, Ph.D., M.P.H., M.Ed.
Second Advisor
Maria D. Thomson, Ph.D., M.Sc.
Third Advisor
Emmanuel A. Taylor, M.Sc., Dr.PH.
Fourth Advisor
Roy T. Sabo, Ph.D.
Fifth Advisor
Luis A. Valdez, Ph.D., M.P.H.
Abstract
Background: The Hispanic/Latino (H/L) population, the largest minoritized group in the U.S., represents 19.5% of the total population. Despite this growth, H/L individuals—particularly Black H/L men—face significant barriers to accessing preventive healthcare, including lower adoption of cancer prevention measures like the HPV vaccine. This disparity is especially concerning given that cancer is the leading cause of death among H/Ls, and HPV-related cancers disproportionately impact this group. Although an effective vaccine is available, HPV vaccination rates remain low, underscoring the need for enhanced vaccination efforts. The goal of this dissertation was to explore how racialization experiences of Black H/L men influence their HPV vaccination uptake, information-seeking behaviors, and communication preferences.
Methods: A secondary analysis of BRFSS data (2014–2022) from 30 states with HPV vaccination modules was conducted, yielding an final analytic sample (N=718) that included (n=83) Black H/L men and (n=635) White H/L men who reported completing the HPV vaccine series. This analysis aimed to characterize HPV vaccine uptake among H/L men aged 18–34 using weighted logistic regression. Semi-structured interviews with (N=22) Black H/L men in Greater Richmond, VA, were conducted to understand participants' knowledge of HPV and the HPV vaccine and examine influences on their decision-making regarding vaccination. Finally, based on insights from the first two studies, two focus groups (N=6) were held with Black H/L men. vaccine communication messages were developed using Health Communication Theory (HCT). The testing of tailored vaccine messages process was grounded in the Osgood-Schramm Communication Theory (CT) model aiming to effectively communicate the importance of HPV vaccination uptake to the target audience.
Results: Findings revealed low HPV vaccine uptake among Black H/L men compared to White H/L counterparts and limited knowledge of HPV and the HPV vaccine among Black H/L men, along with significant influences on their decision making about the HPV vaccination. HCT strategies like framing and tailoring, emerged as an effective approach in conveying messages to Black H/L men.
Conclusion: this dissertation underscores the barriers Black H/L men face in accessing preventive healthcare, particularly the HPV vaccine, despite its availability. The findings highlight the need for interventions to address these challenges. The low vaccine uptake and limited knowledge among Black H/L men emphasize the importance of tailored health communication intervention, such as framing and tailoring, to improve vaccine adoption. Given the impact of racialization and systemic racism, future research should explore how these factors shape health behaviors and outcomes, while also examining broader social and structural determinants of vaccination decisions. This will refine strategies to reduce disparities and improve healthcare access for Black H/L men.
Rights
© The Author
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
12-30-2024
Included in
Community Health and Preventive Medicine Commons, Epidemiology Commons, Health Communication Commons, Interpersonal and Small Group Communication Commons, Other Public Health Commons, Public Health Education and Promotion Commons
