Compliance with COVID-19 Preventive Guidelines Among Minority Communities: the Case of Israeli Arabs

The Arab ethnic minority makes up 21% of Israel's population and accounted for 40.5% of confirmed cases during the second wave of COVID-19. This study aims to assess the characteristics of compliance with the guidelines of the Ministry of Health and related factors that can explain the outbreak of COVID-19 among the Arab population during the second wave.

A cross-sectional online survey was conducted among 810 respondents from the Arab community during October 2020. The survey was distributed via social media such as Facebook and WhatsApp. The health belief model items, the theory of reasoned action items, trust in formal institutions, and pandemic fatigue were assessed, and a path analysis was performed.

Positive correlations were demonstrated between both personal and social networks compliance (nuclear family, extended family, friends, etc.) and perceived severity of COVID-19, trust in formal institutions, attitudes toward compliance, and subjective norms (r = .12 to r = .64, p < .001, N = 810). Pandemic fatigue was negatively correlated with personal and social networks compliance, perceived severity of COVID-19, trust in institutions, attitudes toward compliance, and subjective norms (r =  - .21 to r =  - .48, p < .001). Positive correlations were evident between compliance with quarantine and perceived severity of COVID-19 and attitudes (r = .31 and r = .28, p < .001, respectively). Personal compliance was significantly lower among men (M = 3.93, SD = 0.94) and younger respondents (M = 4.14, SD = 0.71), while social networks compliance was lower among Muslims (M = 3.78, SD = 0.75). The negative relationship between pandemic fatigue and personal compliance was mediated by lower perceived severity of COVID-19, attitudes toward compliance, and subjective norms (p < .001). The negative relationship between pandemic fatigue and social network compliance was mediated by lower trust in institutions and subjective norms (p < .001). Lower perceived severity of COVID-19 mediated the relationship between higher pandemic fatigue and lower quarantine compliance (p = .003).

The results highlight the important of perception of the disease severity, social and subjective norms, and the central role of trust in determining adherence to guidelines. Thus, increasing trust on authorities and planning tailored-maid interventions can raise compliance with the preventive guidelines and prevent the spread of the virus. Such interventions will address the characteristics of minority populations and take into account the implications of the guidelines and the possibility that may lead to fatigue, which in turn will lead to non-compliance with those guidelines.