Behavior Responses and Attitude of the Public to COVID-19 Pandemic During Movement Restrictions in Saudi Arabia

Mostafa A Abolfotouh,1– 3 Adel F Almutairi,1– 3 Ala’a Banimustafa,1– 3 Soheir A Hagras,4 Majed Al Jeraisy1– 3 1King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 2King Saud Bin-Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 3King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia; 4Inaya Medical College, Riyadh, Saudi ArabiaCorrespondence: Mostafa A AbolfotouhKing Abdullah International Medical Research Center (KAIMRC)/King Saud Bin-Abdulaziz University for Health Sciences (KSAU-HS), Ministry of National Guard- Health Affairs, Riyadh, 11426, Saudi ArabiaTel +966 (11) 429-4460; +966 503659204Fax +966 (11) 429-4440Email mabolfotouh@gmail.comBackground: The behavior of the general public and the adoption of precautionary measures during a pandemic determine the fate of the country in the absence of any specific cure. This study aimed to determine the public attitude and behavior responses to the COVID-19 pandemic in Saudi Arabia during movement restrictions, and the predictors of behavioral responses.Methods: A community-based cross-sectional study of 2470 adult individuals in Saudi Arabia, 17– 29 April 2020 was conducted via Survey Monkey, using an anonymous validated e-questionnaire. Data were collected on demographic characteristics, COVID-19-related attitudes, and behavioral responses in terms of; precautionary measures, preparedness, and self-quarantine activities, to be responded to by 4-point Likert scales. Multiple linear regression analyses were performed to identify the significant predictors of compliance with different behaviors. Significance was considered at p< 0.05.Results: Participants reported positive attitudes towards governmental actions (95%), self-hygiene (93.2%), social distancing (97.1%) and choice of healthy food (89.6%), and negative attitudes towards the current worldwide situation of the pandemic (81.0%) and hearing someone tested positive (77.8%) or died from COVID-19 (83.7%). High rates of compliance to behavior were reported by only 55.8% of participants in terms of precautionary measures (71.3%), preparedness (38.4%), and self-quarantine activities (46.1%). After adjusting for all possible confounders, the total attitude score was a significant predictor of the total scores of precautionary measures (t=12.01, p< 0.001), preparedness (t=9.29, p< 0.001), self-quarantine activities (t=12.05, p< 0.001), and overall behavior response (t=14.09, p< 0.001). Other significant predictors of higher overall behavior response scores were female gender (t=7.22, p< 0.001) and non-Saudi nationality (t=3.40, p< 0.001).Conclusion: This study provides baseline data on the behavioral response to the national COVID-19 pandemic in Saudi Arabia. The levels of compliance to behavior response and attitude to COVID-19 pandemic were less than satisfactory. Socio-demographics influence public behavior and protective health measures. COVID-19 awareness programs are recommended.Keywords: SARS-CoV-2, lockdown, perception, behavior, compliance, preparedness, precautionary measures, self-quarantine