Caregiver perceptions of healthcare barriers across traditional and digital contexts: a mixed-methods analysis

As digital health expanded during COVID-19, understanding how caregivers perceive differences between traditional and digital care became critical. In a purposive sample of female caregivers of school-age children with elevated mental health symptoms (n = 47), we used a convergent mixed-methods design to compare reported experiences across modalities. Thematic analysis revealed that participants described different barrier patterns: financial concerns were reported in both contexts, but with different characteristics (insurance/copays vs. device/subscription costs). Participants reported distinct digital challenges, relational connection loss, digital literacy gaps, and privacy concerns, while facilitators also differed. Traditional care narratives emphasized interpersonal support, while digital care highlighted accessibility and personalization. Social identity intersections were referenced more frequently in traditional care narratives, though demographic correlations suggested continued relevance in digital contexts. These pandemic-era findings from female caregivers generate hypotheses for designing inclusive digital health approaches and highlight areas for longitudinal research tracking actual transitions between care modalities.