Barriers and facilitators to remote healthcare services use: perspectives of women and providers

Abstract

Abstract Background The remote health services (RHS) proliferation raises concerns regarding relatively low use among minorities. Arab women in Israel belong to a minority that experiences health disparities, stigmatization, social and economic marginalization. This study aimed to identify barriers and facilitating means to RHS use relevant to Arab women in Israel from the perspective of women, primary care physicians (PCPs), and nurses. Methods Semi-structured interviews were conducted with 25 Arab women, 18 PCPs, and 4 nurses from different parts in Israel between December 2023-March 2024. We used a positive deviance approach by interviewing 14 women who succeeded in using RHS and 11 who did not. Interviews were audiotaped, transcribed, and thematically analyzed using Atlas qualitative analysis software. Findings The data distilled three main barriers to RHS use: sociocultural- importance of close relations with PCPs, privacy concerns of revealing the body or conversing with unfamiliar physicians, strict supervision by the family (Bedouin society); logistical-limited internet access and infrastructure, personal- unawareness to RHS, digital literacy, normative conceptions of limited quality of care and believing that only some health conditions are suitable for RHS. Facilitating means to RHS use: gender roles-women’s role as family health caretakers, mothers maintaining work-family balance and younger women generation feeling responsible for the older generation RHS adoption, accessibility- wider access to care due to limited transportation. Conclusions It is important to identify facilitating conditions (e.g., training opportunities, social, technological support), cultured elements (gender roles, limited mobility), and trust to adopting RHS by minority populations. The study provide data for developing requirements to ensure more equitable access to RHS to Arab women including addressing privacy concerns, guidelines for RHS-related information dissemination, and for RHS providers. Key messages • The findings help develop approaches and means to improve RHS use for Arab women from diverse backgrounds by identifying barriers associated with access, culture, and normative conceptions. • Developing RHS systems into routine care must ensure equitable use across social groups and address economic, logistical, and sociocultural barriers and guidelines for RHS information dissemination.