How to make sense of information about COVID-19 and the vaccine from the authorities? A qualitative study of migrants' experiences in two Swedish communities.

The COVID-19 pandemic highlighted the communication challenges faced by public authorities in reaching all groups in society. The overall aim of this study is to gain an in-depth understanding of the experiences of non-native Swedish speaking residents in two multicultural municipalities in metropolitan Stockholm regarding the reception and understanding of COVID-19 and vaccination information from authorities. In addition, the aim is to identify sustainable communication approaches for culturally appropriate linguistic translation of health messages. Between May 2022 and December 2023, interviews were conducted with residents (n = 76) in two areas of Stockholm, Sweden. We used qualitative thematic analysis to develop themes. We developed five themes: Understanding and learning about COVID-19 and the vaccine; Conflicting knowledge bases; Whom to trust; Views on official communication and actions; and Preparing the local community for a future health crisis. For the non-native Swedish speaking residents in this study, understanding the authorities' information about COVID-19 and vaccination was complicated, and receiving information in their own mother tongue was important to facilitate understanding. Deciding what sources and information to trust was a multifaceted and difficult task. For authorities to communicate trustworthy information in a public health crisis, such as the COVID-19 pandemic, the findings point to the importance of language, community engagement, authorities working with local health facilities, community actors, trusted leaders and religious organisations, and the value of verbal and culturally adapted information. We suggest that Antonovsky's concept of Sense of Coherence should be considered for successful health crisis communication aimed at behaviour change and the importance of local community preparedness for future health crises. The results suggest that culturally and linguistically sensitive messages that consider people's social realities, not least those most vulnerable in society, can support their sense of purpose in changing their behaviour in a crisis, but also inform policy guidance in health care. Trial registration The study protocol has been preregistered on the Open Science Framework (osf.io/rt47j).