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Table 1 Examples of Identified Barriers to Healthcare by Participants

From: Development and pilot testing of a health education program to improve immigrants’ access to Canadian health services

Language and Communication (Terminology describing sickness)When I was finally seen by a doctor, we talked, and he tried to get the story of what happened but at the time my English was not that good so I struggled to communicate what exactly had happened. So by the time I finally pieced my way into explaining what had happened it had already been another 20 to 30 min and by that time he didn’t have a lot of time for treatment left (Participant 23).
Adopting the Canadian System (Restricted Medication access)I find it so frustrating, cause’ I already know what [is wrong with me] and I know what I need, so I already don’t feel good, but I still have to go to the office … and wait there … and then get prescription and go to the pharmacy (Participant 12).
Adopting the Canadian System (Differentiating between services)In [my home country] you don’t go to the hospital for anything unless you are dying and have a surgery. So here, having to go to the hospital every time that my son had a cough or a fever or a …, you know, it was a real shock for me and I hated it (Participant 11).
At first it was just a different system from the one we are used to back home. Just the concept of a walk-in clinic being different from a family doctors office. That was just a weird thing to get used to (Participant 21).
Adopting the Canadian System (Perceived Shortage of Doctors)My impression is that, there is not enough doctors, not enough services … that you can access. For instance, in [my home country], there’s maybe too many doctors and too many services. And there is doctor offices at every corner of the street (Participant 12).
Adopting the Canadian System (Limited Options)[In my home country] it’s so easy to say when you are getting a diagnosis, like ‘oh, I will just go get a second opinion’, right? And I used to have that, but here where do you go to get a second opinion? You have one family doctor that you … took you so long to find who you might not know how to convince to think about other options (Participant 12).
Transportation (Language and Communication)[When I first came to Canada] people would tell us get on [that bus] and even then it was hard figuring out where to get off. Like, street names, you can read them but then it gets pronounced by someone and you’re looking out the window trying to see if you just past that (Participant 24).
Transportation (Limited Finances)The nearest medical centre, in terms of walking distance, was about a half an hour walk. And there were times where either my sister or I would be too sick to make the walk so our parents would have to carry us all that distance, so it definitely wasn’t easy getting there (Participant 23).
Transportation (Understanding Transit systems)Transportation in general was tough, in terms of figuring out just how much you’re paying for bus tickets, like, getting transfers. In Ottawa, there are the Gatineau buses and the Ottawa buses, so like just figuring out which bus to get on, and there’s obviously like a billion buses … (Participant 24)
Unfamiliar with Available Services[What is missing is] where do they start? Like where is the place for immigrants that you could go to and they could tell you, ‘well, if you actually need a dentist, or if you need a hairdresser, or if you need an optometrist, like these are the most popular, or these are the good ones in the city, or …’ you know? (Participant 11)
Limited Access to Family Doctors and SpecialistsSometime if I don’t get an appointment with a family doctor I just go to the walk in, you know what I need I have to wait probably 1 h max but still you know. Not like when you’re setting an appointment with the family doctor you have to wait for 2 to 3 days and like ok my fever will be gone by then. (Participant 12).
Limited Access to Family Doctors and SpecialistsWe had the probation period to wait and if your little one gets sick then that can get quite worrying, like if it is a very bad, you know like some kind of bad flu or something really even more threatening than that would be my concern. We did not know where to go and get help (Participant 10).