Compliance with recommendations limiting COVID-19 contagion among university students in Sweden: associations with self-reported symptoms, mental health and academic self-efficacy

Non-compliance with COVID-19 Health Recommendations: Five- and Ten-Month Effects on Mental Health and Academic Self-efficacy Among University Students in Sweden

BACKGROUND

Addressing the effects of non-compliance with health-related recommendations in pandemics is needed for informed decision-making. This longitudinal study investigated the effects of non-compliance on mental health and academic self-efficacy among university students in Sweden.

METHODS

Baseline assessments were conducted in May 2020, with follow-ups after 5 and 10 months. Students (n = 3123) from 19 universities completed online questionnaires covering compliance, mental health, and academic self-efficacy. Effects of non-compliance were estimated using causal inference and multilevel multinomial regression.

RESULTS

Non-compliant students constituted a minority, but their proportion increased over time. Regarding mental health and academic self-efficacy, few differences were observed between compliant and non-compliant students. When differences were identified, non-compliant students experienced fewer negative effects on mental health and academic self-efficacy than compliant students.

CONCLUSION

The findings may suggest that non-compliance may have involved a trade-off between increased individual freedom and mitigating negative outcomes. Addressing the research gap on non-compliance effects is crucial for informed decision-making and promoting the common good. This may guide strategies balancing individual autonomy and collective well-being during future pandemics.

PRE-REGISTRATION

Center for Open Science (OSF), https://accounts.osf.io/login?service=https://osf.io/37dhm/ .

Academic self-efficacy: Associations with self-reported COVID-19 symptoms, mental health, and trust in universities' management of the pandemic-induced university lockdown

Objective: To investigate perceived changes in academic self-efficacy associated with self-reported symptoms of COVID-19, changes in mental health, and trust in universities' management of the pandemic and transition to remote education during lockdown of Swedish universities in the spring of 2020. Methods: 4495 participated and 3638 responded to self-efficacy questions. Associations were investigated using multinomial regression. Results: Most students reported self-experienced effects on self-efficacy. Lowered self-efficacy was associated with symptoms of contagion, perceived worsening of mental health and low trust in universities' capacity to successfully manage the lockdown and transition to emergency remote education. Increased self-efficacy was associated with better perceived mental health and high trust in universities. Conclusion: The initial phase of the pandemic was associated with a larger proportion of students reporting self-experienced negative effects on academic self-efficacy. Since self-efficacy is a predictor of academic performance, it is likely that students' academic performance will be adversely affected.

Mental health problems among adolescents during the COVID-19 pandemic: a repeated cross-sectional study from Sweden

OBJECTIVE

Most international studies have concluded that exposure to the COVID-19 pandemic was associated with worse mental health. Sweden implemented lighter restrictions than many other countries. We evaluated the association between changes in exposure of COVID-19 restrictions and changes in mental health problems among Swedish adolescents.

METHOD

Repeated cross-sectional data were derived from the Stockholm school survey, mandatory for all students in municipal schools and voluntary for students in private schools. Unexposed students were assessed in the year 2020 and exposed were assessed in 2022. Mental health was assessed using items similar to the psychosomatic problem scale. All variables were dichotomised, and a non-parametric logistic regression was used to evaluate associations.

RESULTS

A significant positive association was found between exposure of COVID-19 restrictions and self-reports of five to seven mental health problems a week for girls (odds ratio (OR) 1.29, 95% confidence interval (CI) 1.18-1.41), but a non-significant association was found for boys (also after controlling for relevant covariates). Among boys and girls (shown), changes in mental health during the pandemic were moderated by social support from parents (OR 2.23, 95% CI 1.98-2.51), bullying victimisation (OR 2.24, 95% CI 2.06-2.66), a sensation-seeking temperament (OR 1.40, 95% CI 1.24-1.58) and school achievement (OR 1.34, 95% CI 1.18-1.51).

CONCLUSIONS

Compared with boys, adolescent girls self-reported worse mental health following COVID-19 exposure. Girls may have been more affected by social distancing regulations in Sweden during the pandemic than boys and may require additional psychosocial support post-pandemic. Social support from parents may play an important role.

Effects of COVID-19 contagion in cohabitants and family members on mental health and academic self-efficacy among university students in Sweden: a prospective longitudinal study

OBJECTIVE

This study used causal inference to estimate the longitudinal effects of contagion in cohabitants and family members on university students' mental health and academic self-efficacy during the COVID-19 pandemic.

DESIGN

A prospective longitudinal study including a baseline online measurement in May 2020, and online follow-ups after 5 months and 10 months. Participants were recruited through open-access online advertising.

SETTING

Public universities and university colleges in Sweden.

PARTICIPANTS

The analytical sample included 2796 students.

OUTCOME MEASURES

Contagion in cohabitants and in family members was assessed at baseline and at the 5-month follow-up. Mental health and academic self-efficacy were assessed at the 5-month and 10-month follow-ups.

RESULTS

Mild symptoms reported in cohabitants at baseline resulted in negative mental health effects at follow-up 5 months later, and mild baseline symptoms in family members resulted in negative effects on academic self-efficacy at follow-ups both 5 and 10 months later.

CONCLUSIONS

Notwithstanding the lack of precision in estimated effects, the findings emphasise the importance of social relationships and the challenges of providing students with sufficient support in times of crisis.

Near-source passive sampling for monitoring viral outbreaks within a university residential setting

Wastewater-based epidemiology (WBE) has proven to be a powerful tool for the population-level monitoring of pathogens, particularly severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). For assessment, several wastewater sampling regimes and methods of viral concentration have been investigated, mainly targeting SARS-CoV-2. However, the use of passive samplers in near-source environments for a range of viruses in wastewater is still under-investigated. To address this, near-source passive samples were taken at four locations targeting student hall of residence. These were chosen as an exemplar due to their high population density and perceived risk of disease transmission. Viruses investigated were SARS-CoV-2 and its variants of concern (VOCs), influenza viruses, and enteroviruses. Sampling was conducted either in the morning, where passive samplers were in place overnight (17 h) and during the day, with exposure of 7 h. We demonstrated the usefulness of near-source passive sampling for the detection of VOCs using quantitative polymerase chain reaction (qPCR) and next-generation sequencing (NGS). Furthermore, several outbreaks of influenza A and sporadic outbreaks of enteroviruses (some associated with enterovirus D68 and coxsackieviruses) were identified among the resident student population, providing evidence of the usefulness of near-source, in-sewer sampling for monitoring the health of high population density communities.

A multisite, quasiexperimental trial of a college course to support student mental health during the COVID-19 pandemic

OBJECTIVE

The purpose of this study was to investigate the acceptability, appropriateness, feasibility, and preliminary effectiveness of a three-credit college Wellness and Resilience Course (WRC) for improving student mental health and well-being outcomes in the context of the coronavirus disease 2019 (COVID-19) pandemic.

METHOD

Undergraduate students aged 18-24 years old on five campuses in Western Pennsylvania or West Virginia who had either enrolled in the WRC (n = 81) or were attending university as usual (i.e., not enrolled in the WRC; n = 171) participated in surveys at baseline (beginning of semester), end of semester, and 3-month follow-up during the Spring and Fall 2020 semesters.

RESULTS

Overall, students rated the WRC as acceptable, appropriate, and feasible. From baseline to the end of semester, students who received the WRC reported significant improvements in psychological flexibility (d = 0.30), mindfulness (d = 0.42), distress tolerance (d = 0.36), and use of dysfunctional and adaptive coping skills (d = 0.32), compared with students who did not receive the WRC. At follow-up, all gains remained statistically significant and students who received the WRC additionally reported significant improvements in stress (d = 0.44) and life satisfaction (d = 0.35) compared with students who did not receive the WRC.

CONCLUSIONS

These findings offer preliminary evidence that college courses focused on mental wellness may be an important component of campus strategies to increase universal access to mental health support and skills. This study was registered on clinicaltrials.gov on April 8, 2020.

Design and Implementation of Survey Quality Control System for Qatar's First National Mental Health Survey: Case Study

BACKGROUND

All World Mental Health (WMH) Surveys apply high standards of data quality. To date, most of the published quality control (QC) procedures for these surveys were in relation to face-to-face interviews. However, owing to the social restrictions that emerged from the COVID-19 pandemic, telephone interviews are the most effective alternative for conducting complex probability-based large-scale surveys.

OBJECTIVE

In this paper, we present the QC system implemented in the WMH Qatar Survey, the first WMH Survey conducted during the COVID-19 pandemic in the Middle East. The objective of the QC process was to acquire high data quality through the reduction of random errors and bias in data collection.

METHODS

The QC design and procedures in this study were adapted to the telephone survey mode in response to the COVID-19 pandemic. We focus on the design of the QC indicator system and its implementation, including the investigation process, monitoring interviewers' performance during survey fielding and applying quality-informed interventions.

RESULTS

The study team investigated 11,035 flags triggered during the 2 waves of the survey data collection. The most triggered flags were related to short question administration duration and multiple visits to the same survey questions or responses. Live monitoring of the interviews helped in understanding why certain duration-related flags were triggered and the interviewing patterns of the interviewers. Corrective and preventive actions were taken against interviewers' behaviors based on the investigation of triggered flags per interviewer and live call monitoring of interviews. Although, in most cases, the interviewers required refresher training sessions and feedback to improve their performance, several interviewers discontinued work because of low productivity and a high number of triggered flags.

CONCLUSIONS

The specific QC procedures implemented in the course of the WMH Qatar Survey were essential for successfully meeting the target number of interviews (N=5000). The QC strategies and the new indicators customized for telephone interviews contributed to the flag investigation and verification process. The QC data presented in this study shed light on the rigorous methods and quality monitoring processes in the course of conducting a large-scale national survey on sensitive topics during the COVID-19 pandemic.

Study environment and the incidence of mental health problems and activity-limiting musculoskeletal problems among university students: the SUN cohort study

OBJECTIVE

To determine the association between different aspects of study environment and the incidence of mental health problems and activity-limiting musculoskeletal problems.

DESIGN, SETTING AND PARTICIPANTS

We recruited a cohort of 4262 Swedish university students of whom 2503 (59%) were without moderate or worse mental health problems and 2871 (67%) without activity-limiting musculoskeletal problems at baseline. The participants were followed at five time points over 1 year using web surveys.

EXPOSURES

Self-rated discrimination, high study pace, low social cohesion and poor physical environment measured at baseline.

OUTCOMES

Self-rated mental health problems defined as scoring above cut-off on any of the subscales of the Depression, Anxiety and Stress Scale. Self-rated activity-limiting musculoskeletal problems in any body location assessed by the Nordic Musculoskeletal Questionnaire.

STATISTICAL ANALYSIS

Discrete survival-time analysis was used to estimate the hazard rate ratio (HR) of each exposure-outcome combination while adjusting for gender, age, living situation, education type, year of studies, place of birth and parental education as potential confounders.

RESULTS

For discrimination, adjusted HRs were 1.75 (95% CI 1.40 to 2.19) for mental health problems and 1.39 (95% CI 1.12 to 1.72) for activity-limiting musculoskeletal problems. For high study pace, adjusted HRs were 1.70 (95% CI 1.48 to 1.94) for mental health problems and 1.25 (95% CI 1.09 to 1.43) for activity-limiting musculoskeletal problems. For low social cohesion, adjusted HRs were 1.51 (95% CI 1.29 to 1.77) for mental health problems and 1.08 (95% CI 0.93 to 1.25) for activity-limiting musculoskeletal problems. For perceived poor physical study environment, adjusted HRs were 1.20 (95% CI 0.99 to 1.45) for mental health problems and 1.20 (95% CI 1.01 to 1.43) for activity-limiting musculoskeletal problems.

CONCLUSIONS

Several aspects of the study environment were associated with the incidence of mental health problems and activity-limiting musculoskeletal problems in this sample of Swedish university students.

Anxiety and associated factors among Vietnamese students during COVID-19 pandemic: A cross-sectional study

Mental health care for students in general, particularly anxiety, is a significant problem that needs more attention, especially during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to describe the prevalence of anxiety and examine the associated factors among students during the COVID-19 pandemic in Vietnam. A cross-sectional study was conducted from August to September 2021 among 5730 students. An online survey was used to collect sociodemographic information, and the generalized anxiety disorder questionnaire (GAD-7) was used to assess anxiety symptoms among Vietnamese students. Results showed that the prevalence of anxiety among study participants was 16.2% (95% confidence interval [CI]: 15.3%-17.2%). Factors related to anxiety among students were gender, type of housemate, COVID-19 exposure/infection status, vaccination status, health status, academic performance, and social relationships during the COVID-19 pandemic. A significant number of students experienced anxiety during COVID-19, and this rate was related to several factors. Psychological interventions are required to support students during and after the COVID-19 pandemic and other health crises. Further studies are required to confirm our findings.

Mental health indicators in Sweden over a 12-month period during the COVID-19 pandemic - Baseline data of the Omtanke2020 Study

BACKGROUND

The ongoing COVID-19 pandemic has had an unprecedented impact on the lives of people globally and is expected to have profound effects on mental health. Here we aim to describe the mental health burden experienced in Sweden using baseline data of the Omtanke2020 Study.

METHOD

We analysed self-reported, cross-sectional baseline data collected over a 12-month period (June 9, 2020-June 8, 2021) from the Omtanke2020 Study including 27,950 adults in Sweden. Participants were volunteers or actively recruited through existing cohorts and, after providing informed consent, responded to online questionnaires on socio-demographics, mental and physical health, as well as COVID-19 infection and impact. Poisson regression was fitted to assess the relative risk of demonstrating high level symptoms of depression, anxiety, and COVID-19 related distress.

RESULT

The proportion of persons with high level of symptoms was 15.6 %, 9.5 % and 24.5 % for depression, anxiety, and COVID-19 specific post-traumatic stress disorder (PTSD), respectively. Overall, 43.4 % of the participants had significant, clinically relevant symptoms for at least one of the three mental health outcomes and 7.3 % had significant symptoms for all three outcomes. We also observed differences in the prevalence of these outcomes across strata of sex, age, recruitment type, COVID-19 status, region, and seasonality.

CONCLUSION

While the proportion of persons with high mental health burden remains higher than the ones reported in pre-pandemic publications, our estimates are lower than previously reported levels of depression, anxiety, and PTSD during the pandemic in Sweden and elsewhere.

Predicting Compliance with Sanitary Behaviors among Students in Higher Education During the Second COVID-19 Wave: The Role of Health Anxiety and Risk Perception

To limit the spread of COVID-19, public authorities have recommended sanitary behaviors such as handwashing, mask-wearing, physical distancing, and social distancing. We recruited a large sample of higher education students in Belgium (N = 3201-3441) to investigate the role of sociodemographic variables, mental health, previous COVID-19 infections, academic involvement, and risk perception on adherence to these sanitary behaviors. This cross-sectional study took place during the second COVID-19 wave in Belgium, between February and March 2021. Analyses showed that living alone, being female, later in the academic curriculum, having higher general and health anxiety, higher academic involvement, and higher risk perception were positively associated with adherence to the four aforementioned sanitary behaviors. Conversely, previous infection with COVID-19 and having been quarantined were negative predictors. Our results show a set of predictors highly similar for the four sanitary behaviors. We discuss potential initiatives to increase adherence to sanitary behaviors in this group of highly educated youngsters.

Worsened Anxiety and Loneliness Influenced Gaming and Gambling during the COVID-19 Pandemic

Aim: To study the prevalence and patterns of problematic gaming and gambling during the COVID-19 pandemic and the association with psychiatric traits and major types of anxiety categories. Method: 1067 young adults participated in both wave 3 (2018) and wave 4 (2021) of the SALVe Cohort. Associations with psychiatric symptoms and anxiety were examined using logistic regression and Chi-square tests. Results: Problematic gaming decreased by 1.3 percentage points to 23.2% since the start of the pandemic, while problematic gambling increased by 0.9 percentage points to 6.5% in w4. Average time spent playing video games/day decreased from 2.2 h (w3) to 1.7 h (w4), while increases in gaming activity were associated with worsened feelings of loneliness (p = 0.002), depression (p < 0.001), and anxiety (p < 0.01) during the pandemic. Predictors for problematic gaming at w4 were previous problematic gaming and social anxiety (p = < 0.001 and 0.01, respectively). Moreover, previous problem gambling also predicted problem gambling at w4 p < 0.001. All anxiety categories were associated with both problematic gaming and gambling when adjusted for age and sex. However, after adjusting for depression and insomnia, social anxiety was associated with problematic gaming (p < 0.001), while panic was associated with problem gambling (p < 0.001). Conclusion: Overall, problematic gaming has decreased since the start of the pandemic, while problem gambling has increased. Worsened feelings of loneliness, depression, and anxiety during the pandemic are associated with increased gaming. Moreover, the association between problematic gaming and gambling and anxiety is independent of depression and sleep problems.

A Delphi method on the positive impact of COVID-19 on higher education institutions: Perceptions of academics from Malaysia

The COVID-19 pandemic has drastically altered the education sector. Rather than the impact of COVID-19, many higher education institutions (HEIs) are on the verge of insolvency due to a lack of digital transformation readiness and poor business models. The bleak financial future many HEIs will face while others may be forced to close their doors completely will erode HEIs’ ability to fulfil their societal responsibilities. However, HEIs that have survived and maintained their operations anticipate the transition to online learning or the effects of any economic crisis, including university closures in the short, medium, or long term. The entire educational ecosystem was forced to transform its operations quickly and entirely to an online teaching-learning scenario in just a few weeks. Notably, HEIs that have long offered online courses worldwide can easily transition to digital teaching and learning when necessary. The second roundtable session’s result of the International Higher Education Conference, organized by INTI International University on March 31 2022, was used to organize a Delphi method to identify further factors that positively impact HEIs by COVID-19. The importance of these factors was then determined using Kendall’s coefficient of concordance. Recommendations on how HEIs should move towards institutional sustainability during the endemic phase are presented accordingly.

Application of data mining technology in college mental health education

In order to improve education and teaching methods and meet the “heart” needs of college students in the era of big data, this paper analyzes the application of data mining technology in college mental health education, and introduces database technology and decision tree algorithm to support college mental health work. This process verifies the feasibility of this kind of system with the help of an example. Using the test standards outlined in this document, 1.5 previous test tasks were completed within the timeframe. During the system test, the error rate was 14% and the number of tests was 7%.However, the error rate in the development stage is 11%, which is lower than 19% of the old version. The error rate in the acceptance stage is 14%, which is lower than 5% of the old version. That is to say, most of the errors were found in time in the system analysis and design stage. 14% of the problems found in the development stage are basically small problems in the interface display, which do not need major changes. However, the old version also includes design defects found in the development stage, and only large-scale rewriting of the involved modules. In the research process, the work of mental health in Colleges and universities has been promoted. At this time, the law of psychological changes of college students has been summarized. Therefore, the support of data mining technology can better meet the needs of mental health education in Colleges and universities.

Symptoms of COVID-19 contagion in different social contexts in association to self-reported symptoms, mental health and study capacity in Swedish university students

Objective

The present study investigates if symptoms of COVID-19 contagion in different social contexts (cohabitants, family, acquaintances, and others) are associated with university students' own self-reported symptoms of COVID-19 contagion, mental health, and study capacity. This was investigated by a cross-sectional survey administrated in Sweden during the first wave of the COVID-19 pandemic, at the time when universities were locked down to limit viral spread and contagion.

Results

Mild to moderate symptoms of COVID-19 in cohabitants and family members were associated with student’s self-reported symptoms of contagion, while no associations could be seen in relation to mental health and study capacity. Symptoms of COVID-19 contagion in acquaintances and others were not associated with students’ self-reported symptoms, nor with their mental health and study capacity.

To conclude, during the initial lockdown of universities students’ self-reported symptoms of contagion were mainly associated with cohabitants and family members, while symptoms of contagion in different social contexts were not associated with mental health and study capacity. Findings suggest that lockdown of universities may have contributed to limiting infection pathways, while still allowing students to focus on their studies despite significant contagion among others known to the student.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13104-022-06009-z.

Emotional Intelligence and Academic Self-Efficacy in Relation to the Psychological Well-Being of University Students During COVID-19 in Venezuela

Due to the COVID-19 pandemic, educational centers and universities in Venezuela have closed their physical plants and are migrating to emergency remote education to continue with academic programs. This empirical study aimed to analyze the predictive capacity of academic self-efficacy and emotional intelligence skills on each of the dimensions of psychological well-being. We employed a cross-sectional predictive design. The sample comprised 277 university students, of which 252 were female (91.00%). Their ages ranged from 18 to 45 years, with a mean of 20.35 (SD = 2.29). Non-probabilistic chance sampling was used. For data collection, we used an anonymous online form, contacted students by mail, and invited them to participate in the study. Questionnaires were available between 217 and 227 days of decreed quarantine in Venezuela. The results indicated average levels of academic self-efficacy (Me = 4; IQR = 2), emotional intelligence: clarity (Me = 27; IQR = 10), attention (Me = 25; IQR = 10) y repair (Me = 25; IQR = 12), and psychological well-being (Me = 35; IQR = 5). We found differences according to sex and age, specifically in emotional regulation (z = 3.73, p < 0.001, d = 0.438) and in bonds of psychological well-being (z = 2.51, p = 0.012, d = 0.276) favoring men (Me = 33, IQR = 9; Me = 8, IQR = 1), respectively. Regarding age, statistically significant differences were found in the group of students older than 21 years with higher perception of psychological well-being (z = 3.69, p < 0.001, d = 0.43) and in each of its dimensions. Emotional intelligence and academic self-efficacy were found to be significant predictors of psychological well-being and its dimensions, specifically on control (R 2-Cox = 0.25, R 2-Nagelkerke = 0.34, 69.90% of total correct classification), links (R 2-Cox = 0.09, R 2-Nagelkerke = 0.12, 65.07% of total correct classification), projects (R 2-Cox = 0.32, R 2-Nagelkerke = 0.46, 78.40% of total correct classification), acceptance (R 2-Cox = 0.17, R 2-Nagelkerke = 0.23, 68.28% of total correct classification), and total well-being (R 2-Cox = 0.52, R 2-Nagelkerke = 0.71, 87.16% of total correct classification). It was concluded that emotional intelligence and academic self-efficacy are protective psychological resources of psychological well-being that should be promoted at university to mitigate the negative effects of the pandemic on the mental health of young people.

Associations between compliance with covid-19 public health recommendations and perceived contagion in others: a self-report study in Swedish university students

Objective

During the COVID pandemic, government authorities worldwide have tried to limit the spread of the virus. Sweden’s distinctive feature was the use of voluntary public health recommendations. Few studies have evaluated the effectiveness of this strategy. Based on data collected in the spring of 2020, this study explored associations between compliance with recommendations and observed symptoms of contagion in others, using self-report data from university students.

Results

Compliance with recommendations ranged between 69.7 and 95.7 percent. Observations of moderate symptoms of contagion in “Someone else I have had contact with” and “Another person” were markedly associated with reported self-quarantine, which is the most restrictive recommendation, complied with by 81.2% of participants. Uncertainty regarding the incidence and severity of contagion in cohabitants was markedly associated with the recommendation to avoid public transportation, a recommendation being followed by 69.7%. It is concluded that students largely followed the voluntary recommendations implemented in Sweden, suggesting that coercive measures were not necessary. Compliance with recommendations were associated with the symptoms students saw in others, and with the perceived risk of contagion in the student’s immediate vicinity. It is recommended that voluntary recommendations should stress personal relevance, and that close relatives are at risk.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13104-021-05848-6.