The Role of Religiosity in HPV Vaccination

Abstract This dissertation clarified the roles that religiosity play in human papillomavirus (HPV) vaccination among Christian parents of unvaccinated adolescents. Although religiosity has been cited as a potent driver of vaccine decisions, its exact role has been unclear, making it hard to intervene effectively. Existing studies suggest that the uncertainty in the role of religiosity in HPV vaccination may be due to the non-monolithic nature of religiosity and variation in the psychosocial factors (threat appraisal, coping appraisal, and attitudes) emphasized in HPV messages. Understanding the role of religiosity is necessary to guide the development of interventions to increase HPV vaccination among religious parents. I administered a survey first to explore the association between three dimensions of religiosity (i.e., organizational, non-organizational, and intrinsic religiosity) and the intention to seek HPV information. Second, I examined the interdependent roles of the psychosocial factors to identify what factor may be more important to address when designing an HPV messaging intervention. Third, I created and tested an attitude-based religiously framed HPV message that addressed anti-vaccination religious beliefs using a randomized controlled trial. My findings showed no association between the three domains of religiosity and information-seeking intention. It also identified attitude towards vaccination as a mediator of the association between coping appraisal and vaccination intention. Finally, the religiously framed message targeted at parent's anti-vaccination attitudes effectively increased parents' vaccination intention compared to a secular HPV vaccination message from the Centers for Disease Control and prevention. In summary, this dissertation suggests that religiosity may not play a role in HPV information-seeking intention unless there is a deliberate effort to leverage religiosity to influence vaccination decisions. However, religiosity may play a positive role in increasing HPV vaccination intention through a scripture-embedded HPV vaccination message (merging scriptural references and scientific facts) that targets anti-vaccination religious beliefs. Therefore, future faith-based interventions can increase HPV vaccination among religious parents by identifying their most practiced religiosity domains, their anti-vaccination religious beliefs, and designing scripture-embedded messaging interventions to address their barrier beliefs. This approach may promote health equity in HPV vaccination by ensuring equitable messaging for religious parents.