Other Titles
Telehealth, Cultural Tailoring & Co-Design: Mapping Equitable Digital Health Interventions for Immigrant, REfugee, and Racialized Populations [Title Slide]
Abstract
Background: Immigrants and refugees face significant barriers in accessing and using telehealth.(1,2) Although cultural tailoring and co-production approaches are recommended,(3) little is known about how deeply these practices are integrated into existing telehealth interventions for these populations.
Purpose: The purpose of this scoping review was to map the current evidence on telehealth interventions involving immigrants and refugees, assess how cultural tailoring was applied using the Cultural Sensitivity Framework, and evaluate the extent to which co-design approaches were used.
Methods: We conducted this scoping review following PRISMA-ScR.(4) Systematic search was undertaken in MEDLINE, CINAHL, Scopus, and Cochrane using telehealth, immigrant, and refugee-related terms. We included studies on telehealth interventions involving immigrants and refugees, screened by two reviewers. Findings were analyzed thematically using the Cultural Sensitivity Framework to identify the quality of cultural adaptation.(5,6)
Results: 92 studies were included. 84% (n=77) incorporated cultural or contextual tailoring at the surface level, including language translation (80.4%), alternative communication strategies (20%), flexible scheduling (16%), familiar platforms (16%), and the use of lay language and media (8.7%). Deep-structure adaptations were also identified: culturally relevant content (27%) and privacy considerations (6.5%). These adaptations improved telehealth accessibility and relevance for immigrants and refugees. 22% (n=20) applied community co-design; engagement was fragmented across app development, refinement, and evaluation phases.
Discussion: Findings demonstrate that while cultural tailoring is common in telehealth interventions involving immigrants and refugees, it is predominantly superficial and lacked deeper adaptations. Co-design remains underused and inconsistently applied. Strengthening collaborative research approaches via co-production is essential to develop culturally responsive telehealth solutions.
Implications for Nursing: For nursing research, findings highlight the need for co-produced telehealth interventions that utilize deep cultural adaptation. Nurse educators can use these insights to strengthen digital health training, which will support culturally responsive nursing practice.
Study Outcomes: This review identifies critical gaps in deep cultural adaptation and participatory design, offering a roadmap to guide future co-produced research.
Notes
References:
1. MacPherson M. Immigrant, Refugee, and Indigenous Canadians’ Experiences With Virtual Health Care Services: Rapid Review. JMIR Hum Factors. 2023 Oct 9;10:e47288.
2. Abasi A, Fatemi Aghda SA, Zahedian M, Jamshiddoust Miyanroudi Z, Bahariniya S, yazdani B, et al. An investigation into telemedicine utilization for refugee mental health: a systematic review. Global Health. 2025 May 26;21:31.
3. Naderbagi A, Loblay V, Zahed IUM, Ekambareshwar M, Poulsen A, Song YJC, et al. Cultural and Contextual Adaptation of Digital Health Interventions: Narrative Review. Journal of Medical Internet Research. 2024 July 9;26(1):e55130.
4. Veroniki AA, Hutton B, Stevens A, McKenzie JE, Page MJ, Moher D, et al. Update to the PRISMA guidelines for network meta-analyses and scoping reviews and development of guidelines for rapid reviews: a scoping review protocol. JBI Evid Synth. 2025 Mar 1;23(3):517–26.
5. Bobel MC, Al Hinai A, Roslani AC. Cultural Sensitivity and Ethical Considerations. Clin Colon Rectal Surg. 2022 Sept 13;35(5):371–5.
6. Naeem M, Ozuem W, Howell K, Ranfagni S. A Step-by-Step Process of Thematic Analysis to Develop a Conceptual Model in Qualitative Research. International Journal of Qualitative Methods. 2023 Oct 1;22:16094069231205789.
Sigma Membership
Iota Omicron, Rho Delta
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
DEI/BIPOC, Health Equity or Social Determinants of Health, Sustainable Development Goals, Telehealth, Telemedicine, Immigrants, Refugees, Nursing Interventions
Recommended Citation
Allana, Saleema; Jeyakumaran, Thuvaraha; Rathod, Dhruv; Khan, Maham; Ku, Darryl; Haider, Raza M.; Smye, Victoria; and Booth, Richard, "Cultural Tailoring and Co-Design of Telehealth Interventions with Immigrants and Refugees" (2026). International Nursing Research Congress (INRC). 225.
https://www.sigmarepository.org/inrc/2026/presentations_2026/225
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-08-26
Cultural Tailoring and Co-Design of Telehealth Interventions with Immigrants and Refugees
Toronto, Ontario, Canada
Background: Immigrants and refugees face significant barriers in accessing and using telehealth.(1,2) Although cultural tailoring and co-production approaches are recommended,(3) little is known about how deeply these practices are integrated into existing telehealth interventions for these populations.
Purpose: The purpose of this scoping review was to map the current evidence on telehealth interventions involving immigrants and refugees, assess how cultural tailoring was applied using the Cultural Sensitivity Framework, and evaluate the extent to which co-design approaches were used.
Methods: We conducted this scoping review following PRISMA-ScR.(4) Systematic search was undertaken in MEDLINE, CINAHL, Scopus, and Cochrane using telehealth, immigrant, and refugee-related terms. We included studies on telehealth interventions involving immigrants and refugees, screened by two reviewers. Findings were analyzed thematically using the Cultural Sensitivity Framework to identify the quality of cultural adaptation.(5,6)
Results: 92 studies were included. 84% (n=77) incorporated cultural or contextual tailoring at the surface level, including language translation (80.4%), alternative communication strategies (20%), flexible scheduling (16%), familiar platforms (16%), and the use of lay language and media (8.7%). Deep-structure adaptations were also identified: culturally relevant content (27%) and privacy considerations (6.5%). These adaptations improved telehealth accessibility and relevance for immigrants and refugees. 22% (n=20) applied community co-design; engagement was fragmented across app development, refinement, and evaluation phases.
Discussion: Findings demonstrate that while cultural tailoring is common in telehealth interventions involving immigrants and refugees, it is predominantly superficial and lacked deeper adaptations. Co-design remains underused and inconsistently applied. Strengthening collaborative research approaches via co-production is essential to develop culturally responsive telehealth solutions.
Implications for Nursing: For nursing research, findings highlight the need for co-produced telehealth interventions that utilize deep cultural adaptation. Nurse educators can use these insights to strengthen digital health training, which will support culturally responsive nursing practice.
Study Outcomes: This review identifies critical gaps in deep cultural adaptation and participatory design, offering a roadmap to guide future co-produced research.
Description
This scoping review mapped the existing literature around telehealth interventions for immigrants and refugees, identifying mostly surface-level cultural tailoring and limited co-design. Findings reveal major gaps in deep cultural adaptation and highlight the need for co-design in telehealth development. These findings suggest using culturally tailored tools for immigrant and refugee patients and recommend future directions for nursing research i.e. utilizing co-production approaches.