The coronavirus pandemic has become a focus almost all over the world because the process of spreading this virus is very fast even in Indonesia [1]. Severe Acute Respiratory Syndrome Coronavirus 2 is the cause of the infectious disease Coronavirus Disease 2019 (COVID-19) [2]. WHO has determined January 30, 2020 that the incidence of COVID-19 becomes a Public Health Emergency of Worldwide Concern (KMMD) and March 11, 2020 is the beginning of the establishment of the COVID-19 pandemic [3]. WHO explained that the global incidence of COVID-19 in June 2021 recorded 172 million cases and a total of 3.7 million deaths. According to South-East Asia mapping, Indonesia is in 2nd position with 1.8 million cases and 51 thousand deaths (CFR = 2.8%) [4]. Indonesia has experienced the COVID-19 pandemic for more than a year, which is marked by the ongoing increase in COVID-19 cases every day. The increase in COVID-19 cases not only has an impact on the national health sector, but almost all sectors such as social, economic, tourism, public transportation and others that have received negative impacts from the increase in the spread of the COVID-19 virus [5].

Due to the increasing spread of this virus, efforts were made to handle the COVID-19 pandemic, namely by issuing policies such as Social Distancing, Lockdown, Large-Scale Social Restrictions, New Normal Adaptation, and Implementation of Community Activity Restrictions. In the process, the policy issued was considered unable to reduce the number of COVID-19 transmission, so the government took the initiative to issue a new policy in the form of providing COVID-19 vaccination which in its implementation was still balanced with health protocols [6]. 

Health protocols are a manifestation of community behavior in breaking the chain of transmission of COVID-19 [7]. However, indiscipline against health protocols has an impact on increasing COVID-19 cases per day. In an effort to overcome the impact of public incivility on the behavior of implementing health protocols, the government seeks education and media dissemination such as billboards, flyers, banners and distribution of masks. In addition, the government issued policies regarding health protocols such as hand washing campaigns, mask use, and social distancing [8]. 

Based on data from the COVID-19 Task Force from October to December, the number of health protocol compliance has decreased. Mask adherence was 55% (down 28%), and social distancing and crowd avoidance rates were 39% (down 20%). Based on data from the COVID-19 Task Force, cases as of December 20 increased, recording 47,108 compared to the previous month, which was 36,599 cases [9]. Based on a comparison of the trend graph of health protocol compliance with the addition of positive cases, it can be concluded that the decline in health protocol compliance is in line with the increase in the addition of positive COVID-19 cases [10]. 

Previous research has suggested that aspects of knowledge can affect compliance, because a good understanding of the problem, its impact and prevention efforts, can influence a person in complying with a recommendation. Furthermore, attitude, by having a positive response or perception to a problem, can affect the action to be taken. Then motivation, having a desire from oneself, recommendations that must be done can be aspects/factors that can influence community compliance [11]. Research conducted by Mariana et al. [12] community leaders can influence compliance, because with positive attitudes and behaviors of community leaders can be role models for the surrounding community [12].

The spread of COVID-19 based on Provincial data in June 2021, the top case reports in DKI Jakarta Province, West Java Province, and Central Java Province [13]. Data on the percentage of compliance with wearing masks in West Java Province in May decreased from the previous month, from 80.69% to 73.59% and the presentation of social distancing compliance from 78.07% to 72.56% [9]. Data confirmed positive for COVID-19 in Garut Regency according to the top age group in the productive age group of 20-50 years, and according to the top gender in women [14]. Data on the level of compliance with health protocols in May 2021 in Garut Regency is in 3rd place not complying with the use of masks, and not complying with social distancing. This means that compliance with health protocols in Garut Regency is still quite low [9]. Kadungora sub-district consists of two Puskesmas, namely Puskesmas Kadungora and Puskesmas Rancasalak. Based on data in June 2021, 237 cases of COVID-19 at the Kadungora Health Center were recorded, and at the Rancasalak Health Center, 157 cases were recorded. Kadungora Health Center is the Puskesmas in Kadungora District with the highest COVID-19 cases. The level of compliance in implementing health protocols in Kadungora District is still low. The reason for not complying with this health protocol is because they do not know the benefits of using masks and health protocols, people also still think that using masks makes them crowded and troublesome. Then, there is no desire or motivation for the community to implement health protocols, and the community also does not get information or reprimands from community leaders when they do not implement health protocols. Meanwhile, sex differences and age differences are not one of the benchmarks for people to comply with health protocols. The purpose of this study is to determine factors related to community compliance in implementing health protocols as Prevention of COVID-19 Transmission.

This type of research uses quantitative research with analytical survey studies, and Cross Sectional design. The research was conducted in Kadungora sub-district in July 2021. The population for this study is the community in Kadungora District. The sample size in this study was determined using the Binomunal Proportion formula, a total sample of 105 respondents was obtained. The random sampling technique was used to determine the research sample, with criteria: people aged from 17 years to 55 years, and can speak Indonesian. Data collection using questionnaires, consisting of willingness to be respondents, characteristics of respondents, compliance with the implementation of health protocols, knowledge, attitudes, motivations, and roles of community leaders.

This study used descriptive and analytical analysis, descriptive was used to see the frequency distribution, then a chi square test was carried out to see the relationship between compliance with the implementation of health protocols knowledge, attitudes, motivations, and the role of community leaders with community compliance in implementing health protocols.

Table 1 shows the proportion of compliance with the implementation of health protocols among the public, most of whom do not comply with implementing health protocols, which is 62 (59%).

Table 2 shows that the proportion of knowledge of the public, almost all of whom are highly knowledgeable with 92 (87.6%). The proportion of attitudes towards health protocols, most of them are positive with 59 (56.2%). The proportion of motivation in implementing health protocols, most have high motivation with 57 (54.3%). The proportion of the role of community leaders in the implementation of 5M, mostly plays a role with 54 (51.4%).

Table 1: Frequency Distribution of Community Compliance in the Implementation of Health Protocols

Table 2: Frequency Distribution of Factors related to Community Compliance in the Implementation of Health Protocols

Table 3: Chi Square Test Factors related to Community Compliance in the Implementation of Health Protocols

Table 3 shows that variables related to community compliance in implementing health protocols are knowledge (p = 0.021) and = 10.080 (1.258-80.752), attitude (p = 0.000) and = 6.927 (2.754-17.426), and motivation (p = 0.000) and = 7.955 (3.146-20.114). While public figures cannot be proven.

This study examines compliance with the implementation of health protocols, the results show that most people do not comply with implementing health protocols by 59%. The results of this study are lower than Anggreni and Safitri's [15] research, namely most of the level of public compliance with health protocols in the non-compliance category of 84.7% [15]. The results of conservation in the field about health protocols are wearing masks, washing hands, maintaining distance, avoiding crowds, and reducing mobility. Health protocols that are difficult for the community to implement are reducing mobility. This is due to the work of the community, most of which is as a trader who requires people to always go out of the house. While the purpose of reducing mobility is not to travel from one place to another, so that many people fall into the category of non-compliance.

In addition, the most dominant health protocol is to use masks. Most people already know that the corona virus is a disease that is easily transmitted, so the use of masks can prevent contracting COVID-19. According to Meri, et al. [16] the spread of the COVID-19 virus which is easily transmitted through droplets and contact with infected surfaces. So that the use of masks and washing has become an obligation that must be applied [16]. In addition, a study in Vietnam states that preventing the transmission of COVID-19 is by washing hands and using masks [17]. 

This research shows the relationship between knowledge and community compliance in implementing health protocols. This research is in line with previous research that states that knowledge is related to COVID-19 prevention compliance [18]. Then another study showed that knowledge is related to compliance with COVID-19 health protocols. Therefore, the provision of health information is needed to increase knowledge and compliance with health protocols [19]. 

Knowledge is one of the factors that can shape a thought or attitude. The better the knowledge of the individual, the better the thoughts or attitudes that will be formed to create good actions/behaviors. People who know well about the importance of health protocols as a form of preventing the transmission of COVID-19, tend to have a positive attitude or thought towards IEC so that people will act obediently in implementing health protocols [20]. 

Based on observations, most of the last education of the community is in the category of higher education (high school). With highly educated people, usually people have more experience or additional information from various parties. So that highly educated people already have an overview or information and it is not difficult to receive new information. In theory, a person's level of education is one of the factors that can affect individual knowledge. If an individual's education and knowledge are good, then the individual's behavior will also be good [21]. By being highly educated and having good knowledge, people will tend to behave well. Most people already know about COVID-19 and how to prevent it by implementing health protocols. Various information is now easy to obtain, so with this convenience people can increase their knowledge, especially about COVID-19. Public knowledge can be a basis to encourage individuals to have good COVID-19 prevention behaviors. So that having good knowledge can make individuals act well and behave in implementing health protocols [22]. 

Attitudes are related to community compliance in implementing health protocols. This study is in line with previous research which stated that attitudes are related to compliance with COVID-19 health protocols [23]. Other studies have shown that attitudes are related to compliance with COVID-19 health protocols [23]. According to the theory explained by Mar'at [24], attitudes have 3 interrelated components. The components of forming attitudes consist of cognitive which contains knowledge, beliefs, and beliefs, affective (emotional) related to a person's ability to judge an object, conative (behavior) that has a tendency to act. It can be concluded that attitude is prediposing for the formation of an action. People who have a positive attitude towards information or recommendations for health protocols, then tend to act following the recommendations directed, while people who have negative attitudes will tend to act not following or even not obeying the recommendations of health protocols [24]. 

Based on observations, the community has a supportive attitude in compliance with health protocols and adjusts to the knowledge gained about health protocols. There is socialization about COVID-19 and health protocols so that people trust and can comply with health protocols. This proves that people who have a supportive attitude can make people obedient to implement. The community has believed and supported effective prevention with health protocols. The public has received prior information, either directly or indirectly, regarding health protocols is an effort to prevent the transmission of COVID-19. This is proven by the public agreeing with 74.1% of the health protocol statement as a way to avoid contracting COVID-19. Community attitudes are one of the factors that can affect obedience, individuals who have a good attitude, then these individuals tend to act well too. Individual attitudes can be formed based on cognitive. Cognitive is the process of understanding by interacting with information so that it can cause individual confidence in the information obtained. So that attitude can be an encouragement to be able to behave properly towards health protocols [22]. 

Motivation is related to community compliance in implementing health protocols. This is in line with previous research which states that motivation with compliance with COVID-19 health protocols has a significant relationship [23]. Other studies have shown that motivation is related to obedience [25].  Motivation is a drive both from within and from outside the individual that aims to move and encourage attitudes and changes in his behavior. Motivation comes from the observation of an object so that it can cause loneliness that can encourage individuals to do or do something. This means that if the community has the motivation in itself to prevent COVID-19, then the community has the desire or motivation to comply with implementing health protocols [26].

Based on observations, people have high motivation in implementing health protocols. The results of the test conducted that motivation is closely related to compliance with health protocols. Motivation can be interrelated with attitudes, people who have confidence and trust in COVID-19 and have the desire not to contract COVID-19, then with good motivation and attitude, people will apply health protocols as a result of good attitudes and motivation. People's attitudes and motivations can be improved by getting encouragement from health workers. The intended encouragement can be health promotion, empowerment, and others. People have the motivation or desire to implement health protocols to prevent the transmission of COVID-19. This is proven by the motivation of the public to agree that 72.3% of people implement health protocols because they realize that COVID-19 is a contagious disease. Motivation is one of the driving factors that can affect compliance in the use of personal protective equipment. Based on the form of motivation comprises intrinsic motivation and extrinsic motivation. Intrinsic motivation comes from the individual himself, aspects that can give rise to intrinsic motivation include needs and desires that exist in individuals which include needs, interests, pleasures, and curiosity, because this intrinsic motivation does not require reward and punishment [27]. 

Community leaders are not proven to be related to community compliance in implementing health protocols. Community leaders are part of the community itself, but have influence in their environment, because they have good insight and knowledge [28]. Community leader support is basically socializing about health programs (health protocols), so that people are willing to accept and participate. It is hoped that this support can improve the community to behave and comply to prevent the transmission of COVID-19 [29]. 

Based on observations, community leaders have played a role in health protocols, because community leaders have carried out their roles or duties. This can be seen by community leaders who disseminate or install information about health protocols as a form of disseminating information to the public. But some people argue that community leaders do not reprimand their citizens if there are those who do not use masks. This can be one of the factors that affect community non-compliance in implementing health protocols, namely there is no reprimand for people who do not use masks. By not being given reprimands and warnings, people will feel that if they do not use masks outside the home it is not a problem, having such thoughts / perceptions will affect the level of compliance with health protocols. So in this study the role of community leaders is not a benchmark for compliance with health protocols. So that in this study there is no relationship between community leaders and compliance with health protocols. This is in line with other studies that state that public figures with compliance are not significantly associated [1].

This study concluded that most respondents were compliant in implementing health protocols.  Compliance in carrying out health protocols can be influenced by knowledge, attitude, and motivation. Meanwhile, the role of public figures cannot be proven as a risk factor. It is recommended for health workers to continue to educate the public about the importance of implementing health protocols as an effort to prevent the transmission of COVID-19.

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