Currently submitted to: JMIR Human Factors
Date Submitted: Jun 27, 2026
Open Peer Review Period: Jun 21, 2026 - Aug 16, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Designing for Equity: Community-Informed Design Requirements for a Digital Primary Care Tool in Marginalized Toronto Communities
ABSTRACT
Background:
Digital health technologies can improve access to primary care, but many fail to address the linguistic, cultural, and contextual needs of marginalized populations. Human factors and participatory design approaches can help ensure that digital health tools are accessible, usable, and responsive to users need.
Objective:
To identify community-informed design requirements for a digital primary care tool and translate them into actionable design recommendations and low-fidelity wireframes.
Methods:
A community-based participatory needs assessment was conducted with 17 adults from marginalized communities in Toronto, including immigrants, refugees, racialized individuals, and LGBTQ2S+ members. Participants completed surveys, semi-structured interviews exploring barriers to primary care access and expectations for digital health technologies. Technology-related data were analyzed using thematic analysis in NVivo 20.0. Two independent reviewers coded transcripts and developed themes that informed design-requirements and wireframes.
Results:
Eighteen themes were identified across functional and non-functional requirement domains. Functional requirements included appointment management, access to medical records, provider communication, healthcare navigation, and holistic care supports. Non-functional requirements emphasized language accessibility, ease of use, privacy, security, trust, and cultural responsiveness. Language support emerged as the most influential factor affecting adoption. Participants highlighted multilingual interfaces, real-time translation, step-by-step onboarding, low-connectivity access, provider gender selection, and culturally tailored resources. These findings informed low-fidelity wireframes demonstrating how community insights can guide digital health design.
Conclusions:
Community-based participatory research and human factors approaches can generate actionable requirements for digital primary care technologies. Translating community needs into design requirements and wireframes provides foundation for developing accessible, usable, and culturally responsive digital health tools. Clinical Trial: Not Applicable
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.