Date of Conferral

3-23-2026

Degree

Ph.D.

School

Health Sciences

Advisor

Naomi Deshore

Abstract

Arkansas’s COVID-19 vaccine rates were among the lowest for African Americans in Arkansas, who were hesitant to accept the vaccine. The purpose of this qualitative phenomenological study was to explore the lived experiences of African American adults in Pulaski County, Arkansas, and to explore factors influencing COVID-19 vaccine hesitancy and access to health care services. Guided by Andersen’s health care utilization model, the study focused on predisposing, enabling, and need-based factors shaping health care decision making. Data were collected through semi-structured interviews with 8 African American adults and analyzed using directed content analysis. Findings from the analysis revealed 365 codes, which were clustered into 12 themes, that vaccine hesitancy was influenced by concerns regarding vaccine safety and mistrust of health care institutions, rooted in historical and contemporary experiences of racial bias, exposure to misinformation, and structural barriers to care, including transportation challenges and limited access to reliable health information. Participants also described emotional and psychological responses, such as fear, anxiety, and uncertainty, that shaped perceptions of risk and decisions about preventive care. The findings may contribute to positive social change by identifying modifiable individual and systemic factors that influence health care utilization. Application of these findings may inform culturally responsive public health interventions, provider education and cultural competence initiatives, and policy efforts aimed at reducing structural barriers, strengthening patient–provider trust, improving vaccine confidence, and promoting more equitable access to preventive health care services within African American communities.

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