Abstract B021: Barriers to HPV vaccine acceptability among Arab American young adults: A mixed methods study

Abstract Background: Arab Americans are a growing yet underrepresented population in U.S. health research, particularly in cancer prevention. Their prior classification as “White” in federal data has obscured distinct cultural, linguistic, and structural barriers to care. While the HPV vaccine is a key tool in preventing several cancers, uptake remains low among young adults in the 18–26 “catch-up” age group. This is the first study to examine HPV vaccine acceptability among Arab American young adults, a population largely absent from national HPV data. Guided by the Health Belief Model and NIMHD Research Framework, this mixed methods study explored barriers, facilitators, and decision-making influences around HPV vaccination. Methods: We recruited 35 Arab American young adults (ages 18–26) to participate in focus groups followed by survey completion. The survey included validated scales assessing HPV knowledge (total 12 items), decision-making (7), immunization attitudes (access and cost) (6), feelings toward vaccination (side effects and risk) (2), acculturation (3), patient provider relationship (2), and familism (2). Additional items captured insurance, education, physical activity, smoking, and language proficiency. Quantitative and qualitative data were integrated to assess convergence and divergence. Results: All participants were unvaccinated. The sample was gender balanced (48.6% male); 40% were foreign born and 94.3% spoke a language other than English at home. Most (82.9%) had health insurance. Behavioral risks included daily smoking (25.7%) and physical activity (28.5% exercised 4 hours/week; 14.3% reported none). Survey scores showed moderate HPV knowledge (M = 7.68, SD = 2.26; range: 0–12) however, focus groups revealed low baseline knowledge, with many learning about HPV for the first time during discussion. Convergence emerged around vaccine concerns: 65.7% were worried about side effects, 51.4% feared future cancer, 48.6% cited cost, and 20% reported provider access issues. Family influence was widely reported (63%), especially among females (66.7% vs. 17.7% of males), while males cited peer influence (41.2% vs. 27.8%). Despite strong motivation to prevent disease inclusive of cancer (M= 3.62, SD= 0.46), divergence emerged between intent and action. Focus group narratives described vaccine delay tied to life milestones (e.g., marriage), low prioritization of health, fatalistic beliefs, and generational disconnects. While provider trust was rated moderately (M = 3.33, SD = 1.19), qualitative findings highlighted dismissal, cultural mismatch, and language barriers. Conclusions: Arab American young adults face layered cultural, structural, and interpersonal barriers to HPV vaccination. Addressing these barriers is essential to promoting vaccine equity and reducing HPV related cancer disparities in this underserved population. Citation Format: Alia Komsany, Sarah Young, Orysya Soroka, Laura Pinheiro, Perla Chebli, Rahma Ibrahim, Erica Phillips. Barriers to HPV vaccine acceptability among Arab American young adults: A mixed methods study abstract. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B021.