{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T11:37:11Z","timestamp":1784547431826,"version":"3.55.0"},"reference-count":64,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["Dr 2021-06276"],"award-info":[{"award-number":["Dr 2021-06276"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>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\u2009=\u200976) 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\u2019 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\u2019s 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\u2019s 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.<\/jats:p>\n                  <jats:p>Trial registration<\/jats:p>\n                  <jats:p>The study protocol has been preregistered on the Open Science Framework (osf.io\/rt47j)<\/jats:p>","DOI":"10.1371\/journal.pgph.0004489","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T18:36:27Z","timestamp":1765391787000},"page":"e0004489","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["How to make sense of information about COVID-19 and the vaccine from the authorities? A qualitative study of migrants\u2019 experiences in two Swedish communities"],"prefix":"10.1371","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5303-9166","authenticated-orcid":true,"given":"Sofie","family":"B\u00e4\u00e4rnhielm","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baidar","family":"Al-Ammari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soorej Jose","family":"Puthoopparambil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattias","family":"Strand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6274-0571","authenticated-orcid":true,"given":"\u00d6nver","family":"Cetrez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,12,10]]},"reference":[{"key":"pgph.0004489.ref001","author":"Statistics Sweden"},{"key":"pgph.0004489.ref002","article-title":"Patterns in COVID-19 mortality and morbidity in Sweden during the pandemic year March 2020-February 2021","author":"G Andersson","year":"2021","journal-title":"Stockholm Research Reports in Demography"},{"key":"pgph.0004489.ref003","article-title":"Lives saved, lives lost and under-reported Covid-19 deaths: Excess and non-excess mortality in relation to cause-specific mortality during the Covid-19 pandemic in Sweden","author":"E Mussino","year":"2023","journal-title":"Stockholm Research Reports in Demography"},{"issue":"1","key":"pgph.0004489.ref004","doi-asserted-by":"crossref","first-page":"4919","DOI":"10.1038\/s41467-023-40568-4","article-title":"Inequalities in COVID-19 severe morbidity and mortality by country of birth in Sweden","volume":"14","author":"M Rostila","year":"2023","journal-title":"Nat Commun"},{"issue":"4","key":"pgph.0004489.ref005","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1093\/eurpub\/ckad073","article-title":"COVID-19 vaccine hesitancy among first-generation immigrants living in Sweden","volume":"33","author":"S Svallfors","year":"2023","journal-title":"Eur J Public Health"},{"issue":"49","key":"pgph.0004489.ref006","doi-asserted-by":"crossref","first-page":"7476","DOI":"10.1016\/j.vaccine.2023.11.016","article-title":"\u201cWho is Anders Tegnell?\u201d Unanswered questions hamper COVID-19 vaccine uptake: A qualitative study among ethnic minorities in Sweden","volume":"41","author":"S Herzig van Wees","year":"2023","journal-title":"Vaccine"},{"key":"pgph.0004489.ref007"},{"issue":"2","key":"pgph.0004489.ref008","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.pec.2020.12.025","article-title":"Critical observations on and suggested ways forward for healthcare communication during COVID-19: pEACH position paper","volume":"104","author":"SJ White","year":"2021","journal-title":"Patient Educ Couns"},{"key":"pgph.0004489.ref009","doi-asserted-by":"crossref","DOI":"10.5888\/pcd17.200245","article-title":"Culture Matters in Communicating the Global Response to COVID-19","volume":"17","author":"CO Airhihenbuwa","year":"2020","journal-title":"Prev Chronic Dis"},{"key":"pgph.0004489.ref010"},{"key":"pgph.0004489.ref011","doi-asserted-by":"crossref","first-page":"786838","DOI":"10.3389\/fpsyg.2022.786838","article-title":"Trauma and Trust: How War Exposure Shapes Social and Institutional Trust Among Refugees","volume":"13","author":"J Hall","year":"2022","journal-title":"Front Psychol"},{"issue":"2","key":"pgph.0004489.ref012","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1093\/heapro\/daq012","article-title":"How can health promotion interventions be adapted for minority ethnic communities? Five principles for guiding the development of behavioural interventions","volume":"25","author":"G Netto","year":"2010","journal-title":"Health Promot Int"},{"key":"pgph.0004489.ref013","author":"S Ekblad","year":"2021"},{"key":"pgph.0004489.ref014","article-title":"Stora skillnader i \u00f6verd\u00f6dlighet v\u00e5ren 2020 utifr\u00e5n f\u00f6delseland","author":"Kristina","year":"2020","journal-title":"L\u00e4kartidningen"},{"key":"pgph.0004489.ref015","unstructured":"Stockholm Dept. Of Communicable Disease Control and Prevention. 2024."},{"key":"pgph.0004489.ref016","doi-asserted-by":"crossref","DOI":"10.3389\/fcomm.2025.1645922","article-title":"Experiences of health informers working with intercultural communication in Stockholm, Sweden during COVID-19: a qualitative study","volume":"10","author":"SM Eklund","year":"2025","journal-title":"Front Commun"},{"key":"pgph.0004489.ref017","article-title":"A multilingual telephone service for crisis communication with migrant groups: Swedish experiences of responding to the COVID-19 pandemic","author":"S B\u00e4\u00e4rnhielm","year":"2024","journal-title":"Springer Science and Business Media LLC"},{"key":"pgph.0004489.ref018","unstructured":"Socioekonomiskt faktablad med karta. 2023."},{"key":"pgph.0004489.ref019","unstructured":"Socioekonomiskt faktablad med karta. 2022."},{"issue":"11","key":"pgph.0004489.ref020","doi-asserted-by":"crossref","first-page":"2428","DOI":"10.3390\/ijerph15112428","article-title":"Perspectives on the Measles, Mumps and Rubella Vaccination among Somali Mothers in Stockholm","volume":"15","author":"A Jama","year":"2018","journal-title":"Int J Environ Res Public Health"},{"key":"pgph.0004489.ref021","volume-title":"The Assyrians \u2013 Fifty Years in Sweden","author":"S Lundgren"},{"key":"pgph.0004489.ref022","author":"\u00d6 Cetrez","year":"2005"},{"key":"pgph.0004489.ref023","volume-title":"En minoritets odyss\u00e9","author":"F Deniz","year":"1999"},{"key":"pgph.0004489.ref024","author":"HR Johns\u00e9n","year":"2023"},{"key":"pgph.0004489.ref025","volume-title":"Qualitative Research & Evaluation Methods","author":"MQ Patton","year":"2002"},{"key":"pgph.0004489.ref026","author":"J\u00e4rvaveckan 2023 slutrapport"},{"issue":"2","key":"pgph.0004489.ref027","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"V Braun","year":"2006","journal-title":"Qualitative Research in Psychology"},{"key":"pgph.0004489.ref028","volume-title":"Kvalitativa metoder i medicinsk forskning","author":"K Malterud","year":"2014"},{"key":"pgph.0004489.ref029","author":"S Kvale","year":"2007"},{"key":"pgph.0004489.ref030","author":"QSR International Pty Ltd","year":"2018"},{"issue":"1","key":"pgph.0004489.ref031","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s13690-024-01237-0","article-title":"Norwegian \u201cdugnad\u201d as a rhetorical device in public health communication during the COVID-19 pandemic. A qualitative study from immigrant\u2019s perspectives","volume":"82","author":"R Herrero-Arias","year":"2024","journal-title":"Arch Public Health"},{"issue":"4","key":"pgph.0004489.ref032","first-page":"54","article-title":"The Language of Pandemic and its Significance in Effective Communication","volume":"3","author":"MA Haji Sismat","year":"2021","journal-title":"jhsss"},{"key":"pgph.0004489.ref033","article-title":"Kriskommunikation och segregation i en pandemi","author":"P Esaiasson","year":"2020","journal-title":"Institutionen F\u00f6r Journal Medier Och Kommun G\u00f6teb Univ"},{"key":"pgph.0004489.ref034","doi-asserted-by":"crossref","DOI":"10.4000\/aad.6483","article-title":"Legitimizing Crisis Management during COVID-19","volume":"28","author":"R Wodak","year":"2022","journal-title":"aad"},{"key":"pgph.0004489.ref035","article-title":"Social Determinants and Indicators of COVID-19 Among Marginalized Communities: A Scientific Review and Call to Action for Pandemic Response and Recovery","volume":"17","author":"WS Brakefield","year":"2022","journal-title":"Disaster Med Public Health Prep"},{"issue":"1","key":"pgph.0004489.ref036","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1186\/s12939-022-01747-9","article-title":"The evolvement of trust in response to the COVID-19 pandemic among migrants in Norway","volume":"21","author":"R Herrero-Arias","year":"2022","journal-title":"Int J Equity Health"},{"key":"pgph.0004489.ref037","first-page":"01","article-title":"Top ten global health threats for 2019: the WHO list","volume":"5","author":"I Qayum","year":"2019","journal-title":"J Rehman Med Inst"},{"key":"pgph.0004489.ref038","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.coi.2021.05.009","article-title":"Vaccine hesitancy in migrant communities: a rapid review of latest evidence","volume":"71","author":"AS Tankwanchi","year":"2021","journal-title":"Curr Opin Immunol"},{"issue":"19","key":"pgph.0004489.ref039","doi-asserted-by":"crossref","first-page":"11971","DOI":"10.3390\/ijerph191911971","article-title":"Improving COVID-19 Vaccine Uptake among Black Populations: A Systematic Review of Strategies","volume":"19","author":"M Adeagbo","year":"2022","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"pgph.0004489.ref040","doi-asserted-by":"crossref","first-page":"1517","DOI":"10.1186\/s12889-023-16410-3","article-title":"Addressing COVID-19 inequities using bidirectional crisis and emergency risk communication and vaccine clinic interventions: a descriptive study","volume":"23","author":"AM Lohr","year":"2023","journal-title":"BMC Public Health"},{"key":"pgph.0004489.ref041","article-title":"Defining the determinants of vaccine uptake and undervaccination in migrant populations in Europe to improve routine and COVID-19 vaccine uptake: a systematic review","author":"A Crawshaw","journal-title":"The Lancet Infectious Diseases"},{"key":"pgph.0004489.ref042","doi-asserted-by":"crossref","DOI":"10.2307\/j.ctvw049wf.14","volume-title":"The psychological legacy of the Sayfo: An intergenerational transmission of fear and distrust","author":"\u00d6 Cetrez","year":"2017"},{"key":"pgph.0004489.ref043","author":"D Gaunt","year":"2017"},{"issue":"3","key":"pgph.0004489.ref044","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1177\/1363461514536358","article-title":"Rethinking historical trauma","volume":"51","author":"LJ Kirmayer","year":"2014","journal-title":"Transcult Psychiatry"},{"issue":"5","key":"pgph.0004489.ref045","doi-asserted-by":"crossref","first-page":"83","DOI":"10.3390\/brainsci8050083","article-title":"The Effects of Trauma, with or without PTSD, on the Transgenerational DNA Methylation Alterations in Human Offsprings","volume":"8","author":"NA Youssef","year":"2018","journal-title":"Brain Sci"},{"issue":"1","key":"pgph.0004489.ref046","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1037\/tra0000302","article-title":"Trauma across generations and paths to adaptation and resilience","volume":"10","author":"A Lehrner","year":"2018","journal-title":"Psychol Trauma"},{"key":"pgph.0004489.ref047","volume-title":"Unraveling the mystery of health: how people manage stress and stay well","author":"A Antonovsky","year":"1987","edition":"1"},{"key":"pgph.0004489.ref048","doi-asserted-by":"crossref","first-page":"844891","DOI":"10.3389\/fpsyg.2022.844891","article-title":"Meaning Making Following Trauma","volume":"13","author":"CL Park","year":"2022","journal-title":"Front Psychol"},{"issue":"9954","key":"pgph.0004489.ref049","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1016\/S0140-6736(14)61603-2","article-title":"Culture and health","volume":"384","author":"AD Napier","year":"2014","journal-title":"Lancet"},{"key":"pgph.0004489.ref050","doi-asserted-by":"crossref","first-page":"104903","DOI":"10.1016\/j.healthpol.2023.104903","article-title":"Belief in COVID-19 related conspiracy theories around the globe: A systematic review","volume":"137","author":"EA Fotakis","year":"2023","journal-title":"Health Policy"},{"key":"pgph.0004489.ref051","doi-asserted-by":"crossref","unstructured":"Garz M, Zhuang M. Media coverage and pandemic behaviour: Evidence from Sweden. 2023.","DOI":"10.1002\/hec.4814"},{"issue":"2","key":"pgph.0004489.ref052","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1093\/bjsw\/bcl343","article-title":"Resilience across Cultures","volume":"38","author":"M Ungar","year":"2006","journal-title":"British Journal of Social Work"},{"key":"pgph.0004489.ref053","doi-asserted-by":"crossref","DOI":"10.1007\/978-94-007-7923-5","volume-title":"Refuge and resilience: promoting resilience and mental health among resettled refugees and forced migrants","author":"L Simich","year":"2014"},{"key":"pgph.0004489.ref054","first-page":"1","article-title":"The Neoliberal Face of the \u201cLocal Turn\u201d in Governance of Refugees in Turkey: Participatory Action Research in Karacabey, Bursa","author":"A Kaya","year":"2023","journal-title":"J Int Migr Integr"},{"issue":"5","key":"pgph.0004489.ref055","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1177\/1363459312438564","article-title":"The resilient subject: exploring subjectivity, identity and the body in narratives of resilience","volume":"16","author":"K Aranda","year":"2012","journal-title":"Health (London)"},{"issue":"20","key":"pgph.0004489.ref056","doi-asserted-by":"crossref","first-page":"13346","DOI":"10.3390\/ijerph192013346","article-title":"When a Pandemic Strikes: Resilience of Swedish Academics in the Face of Coronavirus","volume":"19","author":"\u00d6A Cetrez","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"pgph.0004489.ref057","volume-title":"Gender trouble","author":"J Butler","year":"1990"},{"key":"pgph.0004489.ref058","volume-title":"Introduction to syndemics: A critical systems approach to public and community health","author":"M Singer","year":"2009"},{"issue":"46","key":"pgph.0004489.ref059","doi-asserted-by":"crossref","DOI":"10.1073\/pnas.2303640120","article-title":"Inequality and COVID-19 in Sweden: Relative risks of nine bad life events, by four social gradients, in pandemic vs. prepandemic years","volume":"120","author":"A Altmejd","year":"2023","journal-title":"Proc Natl Acad Sci U S A"},{"key":"pgph.0004489.ref060","author":"U Bronfenbrenner","year":"1979"},{"key":"pgph.0004489.ref061","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.nedt.2017.06.002","article-title":"Methodological challenges in qualitative content analysis: A discussion paper","volume":"56","author":"UH Graneheim","year":"2017","journal-title":"Nurse Educ Today"},{"key":"pgph.0004489.ref062","volume-title":"Health, Culture, and Community","author":"BD Paul","year":"1955"},{"key":"pgph.0004489.ref063","doi-asserted-by":"crossref","DOI":"10.1016\/j.mayocp.2020.05.041","article-title":"Community Engagement With Vulnerable Populations","volume":"95","author":"ML Wieland","year":"2020","journal-title":"Mayo Clin Proc"},{"issue":"2","key":"pgph.0004489.ref064","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1177\/00333549211065514","article-title":"Community-Engaged Bidirectional Crisis and Emergency Risk Communication With Immigrant and Refugee Populations During the COVID-19 Pandemic","volume":"137","author":"ML Wieland","year":"2022","journal-title":"Public Health Rep"}],"container-title":["PLOS Global Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0004489","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T18:36:33Z","timestamp":1765391793000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0004489"}},"subtitle":[],"editor":[{"given":"Myung-Bae","family":"Park","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,12,10]]},"references-count":64,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12,10]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pgph.0004489","relation":{},"ISSN":["2767-3375"],"issn-type":[{"value":"2767-3375","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,10]]}}}