Critical discursive psychology as methodology for exploring ambivalence around the HPV vaccine amongst marginalised groups

Abstract

Background: Public vaccinations rely on individual acceptance and uptake. The Human Papilloma Virus (HPV) vaccine was introduced internationally to protect against common strands of the HPV virus which can lead to cervical cancer, and other male cancers. Preadolescent females are primarily targeted by vaccine campaigns, although some countries have included males. Ethnicity, intellectual disability and gender remain unexplored in the HPV literature. Qualitative, critical discursive methodologies are underutilised in public health psychology and can provide rich socio-cultural understandings around vaccine ambivalence. This paper presents methodological insights around the contributions of a qualitative, critical discursive methodology for understandings around the HPV vaccine by marginalised groups. Method: Critical discursive psychology informed the design and analysis for a larger study which focused on young people’s (aged 16-26) constructions of the HPV vaccine in Scotland. Young people from either a Black Minority Ethnic (BME) background or with an intellectual disability took part in qualitative focus group discussions (n=59). Methodological challenges included recruitment, access and ethical issues. Findings: Use of critical discursive psychology yielded insights into how marginalisation of vulnerable groups occurs and is co-constructed in discourse. Findings centred on a number of apparent discursive tensions around the potential risk to self versus other and estrangement from the vaccine. Discussion: Public health psychology can contribute to vaccination interventions through the contribution of qualitative, critical discursive methodologies, despite methodological challenges. This approach yielded rich, complex data about HPV vaccine ambivalence. We discuss the implications in view of current public health debates.