Spiritual Health Locus of Control and COVID-19 Booster Intentions Among Hispanic Americans: A Culturally Grounded Extension of the Extended Parallel Process Model.
Kim Joon J, Jun Jungmi J, Zambrano Rodriguez Viviana Carolina VC
Declining uptake of COVID-19 boosters poses significant public health concerns. Hispanic Americans, who have experienced disproportionate pandemic impacts, report lower uptake of updated boosters than non-Hispanic White adults, partly attributable to vaccine hesitancy. Although religiosity plays a central role in Hispanic communities, little is known about how spiritually grounded beliefs shape cognitive and emotional responses to vaccination. This study integrates the extended parallel process model (EPPM) with spiritual health locus of control (SHLOC) to examine how exposure to faith-based and governmental vaccine information influences booster intention through spiritually grounded efficacy appraisals. Using an online survey of Hispanic American adults (N = 349), we tested a structural equation model linking SHLOC, perceived threat, efficacy beliefs, fear, and vaccination intentions. Results indicated that active SHLOC, reflecting beliefs in divine partnership in health, increased response efficacy and indirectly promoted booster intention and vaccine advocacy, whereas passive SHLOC, reflecting divine determinism, reduced self-efficacy and indirectly discouraged booster intention. Perceived threat was positively associated with fear, and efficacy beliefs emerged as the strongest predictors of booster intention. Mediation analyses supported serial pathways from message exposure to SHLOC to efficacy to intention, identifying spiritually grounded control beliefs as a culturally embedded mechanism in vaccine decision making. Findings suggest that faith-based engagement can function as either a protective or risk communication channel, depending on whether messages reinforce divine partnership or determinism. The study advances EPPM by identifying SHLOC as a culturally grounded antecedent to efficacy appraisal and offers implications for culturally responsive vaccine communication in Hispanic communities.