Abstract
BACKGROUND: Telehealth applications and mobile services have been growing in popularity. As their reach expands service across international boundaries, it remains unclear to what extent Chinese immigrants residing in the United States are using China-based medical applications and the factors impacting their uptake. Although transnational telehealth apps are beneficial in bridging cultural and linguistic gaps, they come with distinct risks and challenges that need to be further explored. OBJECTIVES: The study had three aims: (1) estimate the prevalence of China-based telehealth app usage by Chinese migrants in the US, (2) identify factors associated with China-based telehealth apps utilization among Chinese migrants in the US, and (3) describe how Chinese migrants in the US are using and can use China-based telehealth apps remotely from the US. METHODS: Four focus groups (n = 17) and a cross-sectional survey (n = 227) were conducted among recent Chinese immigrants to the US (arrived in the past 10 years). RESULTS: Overall, 15% indicated usage of China-based telehealth apps while living within the US. Use of China-based telehealth apps while living in the US was associated with: higher perceived frequency of experiencing healthcare discrimination in the US (odds ratio (OR): 1.43, 95% CI: 1.14-1.80), younger age (OR: 7.86, 95% CI: 1.32-47.01), female sex (OR: 4.29, 95% CI: 1.50-12.23), living in a community with a large Chinese community (OR: 9.53, 95% CI: 1.90-47.79), and lack of medical insurance (OR: 51.59, 95% CI: 3.88-685.70). Some Chinese migrants living in the US are using China-based telehealth apps to consult with medical providers in China as their first line of medical consultation. CONCLUSION: Findings suggest uptake of China-based telehealth are partially driven by negative experiences within the US healthcare system. These results are indicative of possible shortcomings in existing healthcare services that diminish the capacity to appropriately address the needs of immigrant communities and groups.