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Abstract
This Masters thesis addresses the public health issue of suboptimal HPV vaccination rates among rural adolescent African American females by examining the socio-ecological predictors of HPV vaccination and the importance of gynecological care. It was hypothesized that social norms for gynecological care and trust in healthcare providers would predict vaccination. Participation in a womens health exam was hypothesized to mediate the relation between social norms and vaccination, and trust in healthcare providers and vaccination. Knowledge about HPV was predicted to mediate the relation between social norms and vaccination. Hypotheses were tested using logistic structural equation modeling with data from 205 mothers of African American female adolescents. Results indicated that social norms predict vaccination, partially mediated by a womens health exam. Trust predicted vaccination, but this pathway was not mediated by a womens health exam. Knowledge about HPV was not found to be a predictor of vaccination.