The Power of Familiar Voices: Building HPV Vaccine Trust in Rural Communities

By Gabriel Benavidez, MPH, PhD

It has been almost two decades since HPV vaccination was introduced in the U.S. to the public, and significant public health effort and resources have been dedicated to increasing coverage. These efforts have been quite remarkable. In 2016, about 43% of adolescents aged 13–17 were up to date with the HPV vaccination series. By 2024, 63% of adolescents in this age group were up to date, which represents a 20% increase in less than 10 years. A significant achievement that should be celebrated.

Unfortunately, despite this progress, disparities in HPV vaccination coverage remain. Adolescents living in rural communities continue to lag 10–15% behind their urban peers in HPV vaccination initiation and series completion. In the current climate of mistrust toward national health institutions, such as the Centers for Disease Control and Prevention, there is a real concern this rural–urban gap may widen further in the years ahead.

One consistent finding across multiple studies is that parents overwhelmingly trust the recommendation of their personal doctor when it comes to HPV vaccination. In fact, research shows that a doctor’s direct encouragement makes parents five times more likely to vaccinate their child against HPV. Public health programs have therefore relied heavily on doctors as trusted messengers. However, this strategy has limitations in rural settings. Many parents simply lack regular access to medical doctors or they interact with the health care system too infrequently to receive those recommendations at the right time. This reality highlights a pressing need: rural communities still need trusted messengers, and those messengers are often familiar, local voices.

In many rural regions, especially across the Southeastern U.S., faith leaders such as pastors and priests, play an influential role in guiding personal and family decision-making. Their voices are trusted in matters of spirituality and also in shaping everyday health and life choices.

Importantly, church settings are not limited to pastors alone. Congregations often include doctors, nurses, teachers, public health professionals, and other community leaders. Within the shared setting of faith, these individuals can serve as powerful advocates — not speaking solely in their professional roles, but as fellow church members who embody the community’s values and concerns.

This faith-based context provides a unique opportunity to connect health with spirituality, stewardship, and family well-being. Previous research has shown promise in leveraging churches for health promotion, but the intersection of faith and cancer prevention remains underexplored and underutilized.

Trusted messengers in rural America extend beyond churches as well. In rural and Native American communities, tribal elders carry immense authority. In small, close-knit towns, trust may rest with the local high school football coach, who is seen as a role model for youth and families. Barbers and hairstylists often serve as confidants where health topics come up naturally in conversation. Small business owners, civic leaders, school board members, mayors, and even local sheriffs frequently hold positions of influence.

In rural health, who delivers the message often matters more than the message itself. By engaging these familiar and respected figures, public health professionals can embed cancer prevention messages in the relationships and institutions people already trust.

Here at Baylor University, a Christian university in Waco, Texas, we are developing a readiness survey to better understand how local pastors view potential partnerships around HPV vaccination promotion. The goal is not to impose programs, but to listen and learn:

• Which churches feel ready to host educational interventions directly for their congregations?
• Where might a “train-the-trainer” model be more appropriate to equip pastors, lay leaders, or health ministry members to share accurate information themselves?
• How might trust in HPV vaccination be centered in existing, familiar relationships?

By asking these questions, we aim to identify the most effective, respectful ways to engage faith communities in this HPV vaccination promotion work.

Long-term, our vision is to build sustainable faith–health partnerships that normalize cancer prevention conversations in rural communities. Trusted messengers can reduce hesitancy, fill gaps left by limited health care access, and make health recommendations resonate more deeply with local values.

Harnessing the power of familiar voices, from pastors to coaches, from barbers to elders, offers a promising pathway to close the rural–urban gap in HPV vaccination and protect the next generation from preventable cancers.

Learn more about the importance of faith-based HPV vaccination efforts in this St. Jude HPV Cancer Prevention Program fact sheet.

About the author

Gabriel Benavidez, MPH, PhD, is an epidemiologist and assistant professor in the department of public health at Baylor University. He earned an MPH from Baylor University and PhD in epidemiology from the Arnold School of Public Health at the University of South Carolina. A Robert Wood Johnson Foundation Health Policy Research Scholar alumnus, Dr. Benavidez focuses on addressing health care disparities among socially disadvantaged populations, including racial and ethnic minorities, rural communities, and individuals of low socioeconomic status. His innovative research integrates spatial and traditional epidemiologic methods to improve health care access and reduce cancer-related morbidity and mortality.