This dissertation examines vaccination rates for Human Papillomavirus (HPV) among college women 18-26 years of age who participated in the American College Health Association’s National College Assessment (ACHA-NCHA). Utilizing secondary data, this research sought to report HPV vaccination rates among a racially diverse population and to identify potential barriers to vaccination. The ACHA-NCHA survey provided a large sample size (N=68,193) in which to perform a binary logistic regression analysis. Demographic characteristics were analyzed as potential barriers to HPV vaccination. Additionally, lack of certain health behaviors were explored as potential barriers to HPV vaccination. In this study, White/non-Hispanic women had a higher HPV vaccination rate when compared to minority women. The binary regression analysis demonstrated that minority women were less likely to receive the HPV vaccine. Furthermore, it was determined that as the age of the respondents increased, the likelihood of receiving the vaccine decreased. Health behaviors that were predictive of receiving the HPV vaccine included receiving the Hepatitis B and Influenza vaccine, number of sexual partners and receiving sexually transmitted disease information. Women who received a gynecological exam were almost twice as likely to receive the vaccine, as were women who had parental health insurance coverage. One aim of The Affordable Care Act (2010) is to decrease disparities in health care. Drawing attention to potential barriers to HPV vaccination allows policy makers to make informed decisions regarding future activities to reduce disparities. Health promotion activities should be targeted to specific populations in an effort to increase HPV vaccination rates.

Black Americans experience influenza vaccination rates that are lower than the rates of other ethnic groups. Low influenza vaccination rates among the Black community are associated with higher influenza infection rates, influenza-related hospitalizations, and higher influenza mortality rates. There is a belief within the Black American community that the medical establishment does not have the Black American patient in its best interest, leading to feelings of distrust. The purpose of this study was to determine if the distrust of the medical community is a relevant factor in the low influenza vaccination rates of Black Americans aged 18 and older in Baltimore, Maryland. The study also examined the belief that the influenza vaccine causes the flu and the effect this belief may have on influenza vaccination rates. The public health critical race theory served as the framework for the study. Previously validated survey instruments, the Health Care System Distrust Scale and the Adult Influenza Immunization Survey, were obtained with permission and used to collect data from the members of a Baltimore city church. The study used chi-square analysis, multivariable logistic regression, and narrative discussion to address the research questions and analyze the data of 105 completed surveys. Results of the study determined that distrust of the medical community was not a relevant factor in the influenza vaccination rates of study participants, and that participants' vaccination status was influenced by factors other than distrust. Implications for social change included improving the influenza vaccination rate among Black Americans and decreasing their influenza mortality rates.