Date of Conferral

10-28-2026

Date of Award

October 2026

Degree

Ph.D.

School

Health Sciences

Advisor

German Gonzalez

Abstract

Limited research has examined misinformation, cultural beliefs, and language accessibility together in relation to COVID-19 vaccine hesitancy among refugee and immigrant adults. Guided by the socioecological model, this quantitative, cross-sectional study analyzed electronic questionnaires from N = 120 consenting Pennsylvania residents aged 18 or older who identified as immigrants, refugees, asylees, or humanitarian parolees and used social media for COVID-19 health information. Pearson correlations and separate multiple linear regression models examined associations with continuous vaccine hesitancy scores, adjusting for age, gender, education, U.S. residency, and weekly social media use. Greater misinformation exposure (B = 0.394, p < .001) and higher cultural-belief scores (B = 0.211, p < .01) were associated with greater hesitancy. Better language accessibility was associated with lower hesitancy (B = −0.365, p < .001). The demographic and social media model explained 21.9% of the variation in hesitancy scores (R² = .219) and was statistically significant, F(15, 104) = 1.94, p < .05, although most variation remained unexplained. Greater weekly social media use was associated with greater hesitancy (B = 0.024, p < .05). Compared with high school/GED education, less than high school education was associated with lower hesitancy (B = −0.672, p < .01); WhatsApp use was associated with lower hesitancy than Facebook use (B = −0.345, p < .05). These findings point to the need for credible, culturally responsive vaccine communication in preferred languages and across relevant online channels. The associations identify communication priorities but do not establish causal effects.

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