Human Papilloma Virus (HPV) Vaccination Among Rural African American Primary Caregivers and Daughters

African American women living in the rural South are twice as likely as Caucasian women to
develop cervical cancer and die of invasive cervical cancer at a higher rate than any other
racial/ethnic group in the US (1). Reasons for low HPV vaccination rates among rural African
Americans are not well understood. HPV vaccination compliance is likely influenced by
barriers to health care access, misinformation regarding vaccinations, religious beliefs
related to sexual health and behaviors, and mistrust of the medical community (2, 3).
Because the vaccination of minors requires primary caregiver consent, vaccination commitment
and compliance is strongly influenced by family beliefs and communication regarding health
and sexuality. To date, little research has examined the cultural, familial, and
intrapersonal influences on HPV vaccination compliance among rural African American women.
This study will address these gaps in the literature and provide data needed to develop
effective interventions and health promotion materials to encourage HPV vaccination among
rural African American women.

From a pool of approximately 800 families who are participating in ongoing longitudinal
research through the Center for Family Research at the University of Georgia, the
investigators will recruit 200 rural female African American youth aged 13-17 who have not
received the HPV vaccine and their primary caregivers (n=200) into an observational,
prospective study on vaccination commitment and compliance. The investigators hypotheses are
as follows:

1. Sociocultural factors that rural African Americans experience, including
discrimination, previous health care experience, religious beliefs, and community norms
regarding HPV vaccination and adolescent sexual behavior, will forecast primary
caregivers' HPV vaccination commitment and compliance for their daughters. The
investigators also predict that primary caregivers' HPV-related knowledge and attitudes
will mediate this association.

2. Sociocultural factors will influence sexual health-related family communication and
interaction, primary caregivers' and youths' HPV-related attitudes, and HPV vaccination
commitment and compliance.

3. Primary caregivers' attitudes, youths' attitudes, and family health communication will
contribute to youths' and caregivers' vaccination commitment and compliance.

4. Youths' sexual behavior will influence their attitudes, family health communication,
and vaccination commitment and compliance.