Factors associated with contact tracing compliance among communities of color in the first year of the COVID-19 pandemic

Abstract

Rationale: The disproportionate impact of COVID-19 on communities of color has raised questions about the unique experiences within these communities not only in terms of becoming infected with COVID-19 but also mitigating its spread. The utility of contact tracing for managing community spread and supporting economic reopening is contingent upon, in part, compliance with contact tracer requests.

Objective: We investigated how trust in and knowledge of contact tracers influence intentions to comply with tracing requests and whether or not these relationships and associated antecedent factors differ between communities of color.

Method: Data were collected from a U.S. sample of 533 survey respondents from Fall (2020) to Spring 2021. Multi-group SEM tested quantitative study hypotheses separately for Black, AAPI, Latinx, and White sub-samples. Qualitative data were collected via open-ended questions to inform the roles of trust and knowledge in contact tracing compliance.

Results: Trust in contact tracers was associated with increased intentions to comply with tracing requests and significantly mediated the positive relationship between trust in healthcare professionals and government health officials with compliance intentions. Yet, the indirect effects of trust in government health officials on compliance intentions were significantly weaker for the Black, Latinx, and AAPI samples compared to Whites, suggesting this strategy for increasing compliance may not be as effective among communities of color. Health literacy and contact tracing knowledge played a more limited role in predicting compliance intentions directly or indirectly, and one that was inconsistent across racial groups. Qualitative results reinforce the importance of trust relative to knowledge for increasing tracing compliance intentions.

Conclusions: Building trust in contact tracers, more so than increasing knowledge, may be key to encouraging contact tracing compliance. Differences among communities of color and between these communities and Whites inform the policy recommendations provided for improving contact tracing success.

Keywords: Contact Tracing; Health literacy; Infectious diseases; Minority health disparities; Public health; Racism; Trust in health care/services.

Fig. 1

Model predicting trust in contact tracers, contact tracing knowledge, and likelihood of compliance with contact tracing requests for four racial groups. A = AAPI, B = Black, L = Latinx, W = White. *p < .05, **p < .001.