Based on an ongoing COVID-19 project with focus group interviews in the Norwegian population, we designed a survey to investigate people´s attitudes and opinions about infection control measures during the pandemic, their trust in the government and health care, and changes in daily life that may affect public health, in Norway and Sweden. We tested the survey on 10 Norwegian volunteers, and revised it based on their input. Although Norwegian and Swedish languages are closely related, and most people understand the other language well, a native speaking Swede translated the Norwegian version of the survey to Swedish to avoid any misunderstandings. We used the Norwegian version for Norwegian participants, and the Swedish version for Swedish participants. The questions were identical in the Norwegian and Swedish version, except for a few country-specific questions.
The questionnaire was developed for this study and covered the following COVID-19 related topics: Perceived threat from the pandemic, trust in the authorities, opinions about infection control measures, solidarity and social control, and changes in daily life during the pandemic. We also asked participants about sex, age, educational level and municipality of residence.
Most questions consisted of statements in which respondents rated how much they agreed or disagreed on a 6-point Likert scale, stating 1 “Strongly disagree” and 6 “Strongly agree” (5). We did not include a neutral category as we observed that people did not have neutral opinions in the focus group interviews. Instead, we applied a “do not know” category in statements about threat. Appendix 1a and b displays the entire surveys, with all questions and responses in both countries (1a: Norwegian and Swedish version; 1b: English version)
We used the University of Oslo's system for digital data collection (6). The study was anonymous and did not require approval by the Norwegian Center for Research Data or ethics committee for medical research, or the Swedish Ethical Review Authority (7, 8). The focus group interview study that informed the questionnaire was approved by the Norwegian Center for Research Data.
We disseminated a link to the questionnaire through the investigators’ Facebook pages using the “snowball method”, to persons 15 years or older in each country (9). We asked individuals to share the survey (request) with others in their networks.
We decided to close the survey when reaching at least 500 participants in each country. With 500 participants, the margin of error is about 4.5% around the point estimates, which we considered to be sufficiently accurate for our purpose (10).
We received responses in Norway from March 20–21 and in Sweden from April 10–15. Participants had to respond to all questions to be able to submit the survey. There was no time limit for completing the survey.
We analyzed the data descriptively, using Stata version 16.1 (StataCorp, College Station, Texas, United States). For analyses, we compared the distribution of responses on the 6-point Likert rating scale in the two countries. We did not have predefined hypotheses about potential differences between Norway and Sweden or between subgroups of the study populations, and did not perform statistical significance tests. We analyzed all responses to check if there was variation related to sex, age, municipality size, or educational level, and report where large differences between these subgroups were observed.
Patient and public involvement
Ten Norwegian volunteers, recruited through the authors’ networks, tested the first version of the Norwegian survey and commented regarding the understanding of the questions, time required to participate in the survey, and if they missed important topics. The survey was revised based on their comments before it was distributed to the public.