In this study, the vast majority of respondents reported that they had received sufficient information about the coronavirus. This information was disseminated through a variety of channels, both formal and informal. Press conferences from the government, health authorities’ websites and Norwegian news were reported to be the most relevant channels for all groups. Moreover, the majority of migrants reported high levels of trust in the Norwegian government and health authorities. Results were relatively similar among the five migrant groups. However, one difference that stood out was that the Polish group reported less trust than other groups in the effect of the recommendations on health and the Norwegian health authorities and government. All groups reported high levels of adherence to preventive measures but a perception that Norwegians do so to a lesser degree.
Concerning perception of health, the prevalence of self-reported suspected or confirmed COVID-19 cases was similar among all migrant groups. However, the reported level of COVID-19 infection risk varied among the groups, being twice as high for Tamils as compared to Somalis and Arabic speaking respondents. In addition, most migrants reported high self-perception of health, but this self-perception also varied among migrant groups. This variation is in line with the latest Norwegian study from SSB [18]. Somalis more often reported excellent or very good health, which concurs with the results of other studies in Norway [19, 20]. The higher COVID-19 infection risk and lower health levels reported by the Tamils could be explained by the fact that they are the oldest group among our respondents. These results correspond with the previous study on migrants performed in 2008 [18].
We are not aware of previous studies or reports on the different channels available for migrants to access health information. In this study, formal channels were considered more important than the informal ones by all migrant groups, which might be surprising given that this information is in Norwegian. However, and even if we posed questions in the respondents' mother tongues, the study population reported high levels of participation in the labor market and is, therefore, probably more integrated than other migrants in the same groups. Nonetheless, migrants with Somali background found informal channels to be more important than other groups did. This result can be explained by the strong oral culture in the Somali society [21]. In a context where much information about COVID-19 is being distributed via several channels, as reported by the respondents, gathering trustworthy information in migrants’ mother-tongue in a specific channel would facilitate migrants’ access to information.
Research about migrants’ trust in public institutions in Europe is scarce. In a study including 26 European countries, Norway within them, Röder and Mühlau found that migrants had high levels of trust in host-country public institutions. Although health services were not evaluated in that study, trust in politicians was assessed [22, 23] and the results are consistent with the high level of trust in the Norwegian government obtained in our study. Results from the Polish group in our study are in line with the studies conducted in UK and Norway that showed that Polish migrants do not fully trust the host-country health services. These studies suggested the differences in the health system organization and treatment approaches they found in Norway compared to those in Poland as an explaining factor [24, 25]. Poles reported especially low levels of trust regarding how the government was handling the pandemic and was listening to their opinions. On the other side, trust among persons with Somali background in how the government has dealt with the pandemic was significantly higher than that among all other groups. While there were few respondents from Somalia, a possible explanation may be that the government had a proactive campaign targeting this group at the time of the survey. Working migrants, a group in which Poles are overrepresented, were not specifically targeted. Qualitative research on these issues is needed to get a deeper understanding of the different answers.
We are not aware of other studies on migrants following health preventive measures for COVID-19. The high self-reported adherence and the perception that Norwegians followed recommendations to a lesser extent than our groups require more research and could be exaggerated to please the researcher. A further study should be performed to compare our results with Norwegians self-reported information on how they follow the rules.
Study Strengths and Limitations
To our knowledge, this is the first study among migrants to study their access to information about COVID-19, trust in health authorities and adherence to recommendations. A strength in our study was that Inncovid.Norge is formed by researchers and health workers from the five migrant groups recruited. Knowing the communities and key persons in these environments facilitated the recruitment and achieving the targeted number of participants. However, the study has some limitations. First, the Somali speaking group is under-represented in our sample with only 33 respondents. Second, the results were obtained via a web-based questionnaire and although we used different channels and networks to reach the respondents within the five-selected migrant groups, selection bias may be present. Generally, respondents to our questionnaire were not representative of their populations, especially regarding their high employment status. They also differed in terms of gender and age, for which reason we weighted the results for the main outcomes. However, the different groups present characteristics as expected regarding length of stay and other variables. Thus, our results should be interpreted with caution for the generalizability of the findings to the migrant population in Norway.