Evidence map›Paper›PMID 41593594›Full record

ArticleBMC public health2026

Digital health literacy and immigrants' access to digitalized healthcare: a comparative study of Spain, and Sweden - implications for public health policy.

Inés Rey Hidalgo, Marta M Pisano-González, Cristina Fernández García, Karin Schölin Bywall, Sarah Wamala Andersson, Beatrice Avagnina, Ana Fernández-Feito, IDEAHL consortium

Abstract readComparative Study
In one paragraph

Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Inés Rey HidalgoEuropean Projects Office, Foundation for the Promotion of Scientific Research and Technology in Asturias (FICYT), St. Cabo Noval, 11, Oviedo, Asturias, 33007, Spain.
Marta M Pisano-GonzálezHealth Research Institute of the Principality of Asturias (ISPA), Av. Hospital Universitario, Oviedo, Asturias, 33011, Spain. martamaria.pisanogonzalez@asturias.org.ORCID http://orcid.org/0000-0002-6485-9370
Cristina Fernández GarcíaHealth Research Institute of the Principality of Asturias (ISPA), Av. Hospital Universitario, Oviedo, Asturias, 33011, Spain.
Karin Schölin BywallSchool of Health, Care and Social Welfare. Division of Public Health Sciences, Mälardalen University, Universitetsplan 1, Västerås, 722 20, Sweden.
Sarah Wamala AnderssonSchool of Health, Care and Social Welfare. Division of Public Health Sciences, Mälardalen University, Universitetsplan 1, Västerås, 722 20, Sweden.
Beatrice AvagninaConsulta Europa Projects & Innovation SL (CE), Las Palmas de Gran Canaria, St. Leopoldo Matos, 16, Las Palmas, 35006, Spain.
Ana Fernández-FeitoHealth Research Institute of the Principality of Asturias (ISPA), Av. Hospital Universitario, Oviedo, Asturias, 33011, Spain.
IDEAHL consortium

Funding

HORIZON EUROPE Framework Programme GA 101057477
6 · The paper itself

Abstract

backgroundAs healthcare systems undergo rapid digital transformation digital health literacy has become a critical determinant of equitable access to health services. Immigrants often additional challenges in navigating digital health resources due to language barriers, cultural differences and structural inequalities. This study aimed to compare the experiences of immigrants in Spain and Sweden in accessing and using digital health information, and to identify strategies to enhance digital health literacy within these populations.

methodsA comparative qualitative study was conducted in Sweden and Spain within the framework of the IDEAHL Project (Improving Digital Empowerment for Active Healthy Living). Participants were recruited through non-governmental organisations and community spaces supporting immigrant integration. Data were collected using semi-structured interviews, group discussions, and photovoice techniques. In Sweden, sessions were audio-recorded and transcribed verbatim, whereas in Spain, detailed field notes were taken and validated by facilitators. A comparative thematic analysis was conducted to identify commonalities and differences.

resultsA total of 44 immigrants (20 in Sweden and 24 in Spain) participated in the study. Across both countries, participants frequently used digital platforms such as Google and YouTube to search for health-related information. However, they encountered persistent barriers related to language, digital skills, trust in online content and access. Swedish participants emphasised empowerment and the need for culturally adapted digital tools, while Spanish participants highlighted structural barriers such as legal status. limited access to e-Health services, and reliance on traditional healthcare providers. Both groups expressed a strong need for trustworthy, accessible, and easy-to-understand digital health content, as well as greater involvement of healthcare professionals in guiding digital health use.

conclusionsImproving digital health literacy among immigrant populations requires coordinated action from healthcare professionals, policymakers, and primary care providers. Strategies should include multilingual and interactive digital tools, training in critical evaluation skills, and co-design approaches that actively involve immigrants in the development of digital health solutions. The similarities observed between Spain and Sweden suggest that inclusive, person-centred strategies can be effectively adapted across diverse European contexts to promote digital equity and health system resilience.

Indexed as

Digital HealthEmigrants and ImmigrantsHealth LiteracyHealth PolicyHealth Services AccessibilityAdultFemaleHumansMaleMiddle AgedQualitative ResearchSpainSwedenDigital health literacyHealth equityImmigrantsSpainSweden

Identifiers

PMID41593594
PMCPMC12918215

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.