“A glass half-full of opportunities” The perceptions and lived experiences of Arabic-speaking immigrants using digital primary healthcare applications in Scania, Sweden. A qualitative content analysis study.

Abstract: Abstract Background: There is growing concern in Sweden about health inequity and unequal access to traditional primary healthcare among different socio-economic groups, predominantly immigrants. The use of information and communication technology in the health sector has been suggested as a potential tool to overcome healthcare accessibility and equity. Digital primary healthcare in Sweden was initiated in 2014, and it is still an under-researched area with no studies addressing the experiences of any immigrant groups on the use of digital primary healthcare in a Swedish setting. Aim: The overall aim of this study is to understand what the introduction of digital primary healthcare services means to Arabic-speaking immigrants in Scania, Sweden, and to discuss the potential role of digital primary healthcare in increasing primary healthcare access and equity. Methods: Through a qualitative content analysis, ten in-depth individual interviews were conducted, with in order to analyze the manifest and latent meaning of the informants’ experiences. Findings: Three overarching themes emerged from the analysis. Turning obstacles into advantages explains that digital primary healthcare was able to turn participant’s challenges at traditional primary healthcare into advantages. Resembling a roller coaster ride, enjoyable to those who can make it, but only for a while illustrates that digital primary healthcare works well but only for uncomplicated medical cases and that access requires digital literacy and different levels of Swedish/English depending on the provider used. Seeing a glass half-full of opportunities illustrates how participants see themselves as being part of the digital primary healthcare future. However, they still experienced a need for further development of the tools to increase accessibility. Conclusion: Digital primary healthcare offers potential solutions for the challenges experienced by immigrant groups with traditional primary healthcare; however, there are important limitations to accessibility and usage of the model. Offering bilingual consultation is the only current feasible digital option for immigrants who struggle with the Swedish language. Nonetheless, accessing these digital platforms still require basic Swedish/English and digital literacy for navigation and a Swedish/English proficiency for reporting a medical case, depending on the selected provider. As for the usage limitation, digital primary healthcare works only for mild health conditions.