Exploring the relationship between race, spiritual beliefs, and HPV vaccine acceptability in a Midwestern city

Background:   Acceptability of the Human Papillomavirus (HPV) vaccine could significantly reduce the incidence and mortality rate of cervical cancer, which disproportionately affects underserved and ethnic minority populations.  Although spirituality has been studied in its association with how cancer patients cope with their disease, more could be explored regarding how it may influence preventive behaviors, such as receiving the HPV vaccine.  The purpose of this study was to understand the relationship between mothers’ race, spiritual beliefs, and cervical cancer prevention through HPV vaccine acceptability for daughters. 

Methods:  Based on a review of the literature and theoretical models, a written survey instrument was developed and 106 mothers with adolescent daughters in the Greater Cincinnati area completed the survey. The data were analyzed using bivariate analyses and analyses of variance to examine relationships between mothers’ knowledge, behaviors, and attitudes regarding HPV vaccine, and her race and spiritual beliefs. 

Results:  In this sample, mothers' spiritual beliefs were not associated with whether or not their daughters received the HPV vaccine (X² (1) = .069, p= .793).  Mothers with stronger spiritual beliefs were more likely to have talked to their daughters about the HPV vaccine (X² (1) = 5.063, N = 102, p = .024) even though spiritual beliefs were not associated with the mothers’ knowledge and attitudes. African-American mothers (60% of this sample) were more likely to have stronger spiritual beliefs (X² (2) = 5.864, N = 103, p = .053) and less likely to be knowledgeable about the HPV vaccine (X² (2) = 13.361, N = 106, p= .001).  Regardless of race, mothers with lower annual household incomes (less than $40,000) showed a more favorable attitude toward the HPV vaccine in agreeing that the HPV vaccine should be a routine childhood immunization.

Conclusions:  Understanding the variables that may influence HPV vaccine acceptability is an important part of planning a reproductive health promotion intervention.  Mothers’ spiritual beliefs might positively affect communication with daughters regarding the HPV vaccine, and offering the vaccine as part of a routine immunization program may be a favorable option for lower income families, regardless of spiritual beliefs and race.  Understanding these factors could lead to effective framing and acceptance of messages, greater acceptability of the HPV vaccine, and eventually a reduction in health outcome disparities.