Understanding the telehealth access through an intersectional lens: Experience of Mandarin-speaking consumers accessing health services from a tertiary hospital in Australia

Background: Mandarin-speaking consumers requiring interpreter services face significant barriers to telehealth access in Australia, often due to systemic and cultural disconnects which widens healthcare access disparities. This qualitative cross-cultural cross-lingual study explored the perspectives of Mandarin-speaking individuals at a metropolitan hospital in Queensland to identify barriers, enablers, and solutions for equitable telehealth access. Methods: Three Mandarin cross-lingual focus groups were conducted. Situated within the interpretive research paradigm and informed by intersectional critical inquiry, consumers described their perspectives on lived experiences interacting with the tertiary healthcare system while accessing telehealth and requiring interpreter services. Analysis was conducted by two researchers, starting with open coding, cross-checking and application of an intersectional lens. Results: Eight Mandarin-speaking consumers and two carers attended three cross-lingual focus groups with qualified real-time interpreters. The analysis revealed six themes: 1) lack of telehealth awareness; 2) clinicians are gatekeepers of telehealth services; 3) the healthcare system is monolingual; 4) navigating the healthcare system is disempowering; 5) power is transferred to interpreters and carers; and 6) alternative solutions do not align with participants needs. Participants expressed openness to telehealth but emphasised the need for culturally sensitive and clearly communicated options. Conclusion: This study reveals significant challenges accessing telehealth for Mandarin-speaking consumers needing interpreter services in metropolitan Queensland and highlights that clinician assumptions and the monolingual nature of healthcare services as major barriers. While video interpreting is often recommended, participants preferred simple, safe, and culturally appropriate communication strategies. Co-designing telehealth solutions with multicultural consumers can prevent the deepening of existing inequities and to foster inclusive healthcare practices.