Diversity of health literacy strengths and challenges among migrant patients with inflammatory rheumatic diseases: a qualitative exploration

Abstract Objectives The aims of this study were to (1) explore the health literacy strengths and challenges of migrant patients with inflammatory rheumatic diseases and limited Norwegian language proficiency, and (2) generate and describe typologies of health literacy strengths and challenges within this patient group. Methods The study was inspired by the Ophelia process for co-designing health literacy interventions. Semi-structured individual interviews were conducted with 19 migrant patients who used interpreters during consultations with health professionals. Participants had various language backgrounds and were recruited from two rheumatology specialist departments. Interviews were audio-recorded, transcribed verbatim, and analysed using thematic analysis. Results Participants described a diversity of health literacy strengths and challenges. Four health literacy typologies were generated, illustrating varying patterns of strengths and challenges. Some challenges were exacerbated by participants’ situation as a migrant with limited Norwegian proficiency. Navigating the healthcare system and actively engaging with health professionals were common challenges. The intersection of the different challenges could further hinder migrant patients’ ability to navigate and utilize healthcare information and services. However, strengths such as supportive social networks could mitigate some issues. Conclusion The findings from this study highlight a nuanced understanding of health literacy strengths and challenges among migrant patients with inflammatory rheumatic diseases and limited Norwegian language proficiency. The study contributes to the growing body of work inspired by the Ophelia principles. Knowledge from this study will be used to develop vignettes to facilitate idea-generating workshops as part of a larger study co-designing health literacy-informed interventions. Key messages Health literacy challenges can be exacerbated by being a migrant with limited proficiency in the country’s majority language. Intersection of health literacy challenges can further hinder migrant patients’ ability to utilize health information and services. Health professionals must recognize and build upon migrant patients’ health literacy strengths while considering the health literacy responsiveness of their services.