Exploring barriers to adherence to COVID-19 infection control measures and advice among immigrants in Norway: A qualitative study.

Background: Since the beginning of the COVID-19 pandemic, various infection control measures and advice have been issued by different authorities across the world to prevent the spread of the infection and associated mortality. However, the support for and ability to follow recommendations varies across countries and populations. In Norway, studies have shown that immigrants bear a higher burden of COVID-19 infections, hospitalizations, and associated mortality compared with the general population. This warrants investigation into how people from different backgrounds understand and act in response to COVID-19 measures and advice. Aim: This qualitative study explored the experiences and perceptions of immigrants in respect of attitudes and barriers to adherence to COVID-19 measures and advice. Methods: In-depth interviews were conducted with immigrants from nine different country backgrounds. Data was analyzed using thematic analysis. Results: The analyses reflected barriers at three different levels: individual, cultural, and systemic. At the individual level, language, information barriers and material barriers formed sub-themes. At the cultural level, expectations relating to collectivistic cultural practice emerged. At the systemic level, poor translation and late dissemination, and overload and frequent modification of information were evident. Conclusion: This study provides enhanced understanding of how and what immigrants perceive as barriers to adherence to COVID-19 measures and advice. Understanding immigrants' perspectives is crucial to tailoring policies and improving information dissemination among different groups in the future.