Adolescents' experiences of the information they received about the coronavirus (Covid-19) in Norway: a cross-sectional study

Intention to Vaccinate against COVID-19 in Adolescents: A Systematic Review

BACKGROUND

Multiple COVID-19 vaccines have been approved for use in adolescents; these vaccines play a critical role in limiting the transmission and impact of COVID-19. This systematic review aims to summarize the willingness of adolescents aged 10 to 19 years to receive the COVID-19 vaccination and the factors influencing their decision.

METHODS

A search of literature published between January 2018 and August 2022 was performed in Medline©, EMBASE©. and CINAHL© electronic databases. Studies published in English that assessed adolescents' intentions to receive the COVID-19 vaccine were included. Qualitative studies and those unrelated to the COVID-19 vaccine were excluded. The study was conducted based on the PRISMA guidelines.

RESULTS

Of the 1074 articles retrieved, 13 were included in the final review. Most studies were conducted in the US (n = 3) and China (n = 3). The pooled prevalence of COVID-19 vaccine acceptance among adolescents was 63% (95% CI: 52-73%). Factors influencing intent to vaccinate were divided into five categories: "Socio-demographic determinants"; "Communication about COVID-19 pandemic and vaccination"; "COVID-19 vaccine and related issues"; "COVID-19 infection and related issues" and "Other determinants". The enablers were sociodemographic factors including older age, higher education level, good health perception, and parental norms in terms of parental vaccination acceptance; perceived vaccine effectiveness and safety; a desire to protect themselves and others; recent vaccination; and anxiety. The barriers were concerns over vaccine effectiveness, safety, and long-term side effects; low perceived necessity and risk of infection; and needle phobia.

CONCLUSIONS

This review highlighted that adolescents' intent to vaccinate is driven by a desire to protect themselves and others. However, concerns over vaccine effectiveness, safety, and long-term side effects hinder COVID-19 vaccine uptake. To improve vaccination acceptance, policymakers should address adolescents' concerns via more targeted public health messaging, while schools should leverage peer norms to positively influence vaccination intent.

Socioeconomic Deprivation and Inequalities in Mental Well-Being during the COVID-19 Pandemic among Adolescents

The COVID-19 pandemic highlighted the existing inequalities in education and mental health. The aim of this study was to examine socioeconomic disadvantages and mental well-being inequalities among Slovenian adolescents in October 2020. The study used nationally representative data from 3052 adolescents aged 14 and 18 (Mage = 14.4 and 18.4). The WHO-5 Well-Being Index (WHO-5) was used to measure mental well-being and risk for depression. Multinomial logistic regression was used to identify differences in the pattern of associations regarding sociodemographic characteristics and experiences during the pandemic with poor well-being and risk for depression. Our study found that adolescents from socially disadvantaged families faced poorer conditions as regards academic performance, had fewer opportunities to socialise with friends online, and were more likely to feel lonely; they reported lower levels of mental well-being and were at a higher risk for depression. The unemployment of both parents and adolescents' perceptions of family wealth were found to be the most important predictors of depression risk. In addition, experiencing deprivation and economic hardship during the pandemic was also identified as a significant predictor. The study concludes that social and economic conditions were critical determinants of adolescents' mental health during the pandemic and that effective intervention is needed to promote their well-being and reduce inequalities.

Trajectories of child mental health, physical activity and screen-time during the COVID-19 pandemic considering different family situations: results from a longitudinal birth cohort

BACKGROUND

Many authors have described a significant mental health burden on children and adolescents during the COVID-19 pandemic, possibly moderated by social disparities. This analysis explores whether pre-pandemic family circumstances might be related to different aspects of child health during the pandemic.

METHODS

We analyzed trajectories of health-related outcomes in children aged 5 to 9 years (T7 to T11) using the Ulm SPATZ Health study, a population based birth cohort study (baseline 04/2012-05/2013) conducted in the South of Germany. Outcomes were children's mental health, quality of life, and lifestyle, such as screen time and physical activity. We conducted descriptive statistics of maternal and child characteristics before and throughout the pandemic. We defined three different groups of pre-pandemic family situations and used adjusted mixed models to estimate differences in means associated with the time during the pandemic vs. before the pandemic in (a) all children and in (b) children belonging to specific pre-pandemic family situations.

RESULTS

We analyzed data from n = 588 children from whom at least one questionnaire was completed between T7 and T11. When not considering the pre-pandemic family situation, adjusted mixed models showed statistically significant lower mean scores of health-related quality of life among girls during vs. before the COVID-19 pandemic (difference in means (b): - 3.9 (95% confidence interval (CI): - 6.4, - 1.4). There were no substantial differences in mental health, screen time, or physical activity in boys or girls. When considering pre-pandemic family situations, boys with mothers having symptoms of depression or anxiety showed a substantial loss of health-related quality of life on the subscale of friends (b: - 10.5 (95% CI: - 19.7, - 1.4)). Among girls in this group, 60% of the 15 assessed outcomes were negatively associated with a remarkable loss in health-related quality of life (e.g., KINDL-physical well-being difference in means: - 12.2 (95% CI: - 18.9, - 5.4)). Furthermore, a substantial increase in screen time was found (+ 2.9 h (95% CI: 0.3, 5.6)).

CONCLUSION

Our results suggest that the health (and behavior) of primary school-aged children is possibly impacted by the COVID-19 pandemic, with adverse consequences differing by gender and very likely by the pre-pandemic family situation. Especially in girls having a mother with depression or anxiety symptoms, the adverse consequences of the pandemic on mental health seem to be aggregated. Boys showed fewer adverse trajectories, and it needs to be further assessed which factors exactly are behind the (socio-economic) factors, such as maternal working habits and limited living space, when analyzing the effect of the pandemic on children's health.

Knowledge of Teenagers and Young Adults about COVID-19 and Compliance with Social Distancing Guidelines

OBJECTIVES

Understanding the coronavirus disease 2019 (COVID-19) knowledge and personal preventive behaviors of younger individuals is important as it can affect not only their own health but also the health of other potentially more vulnerable individuals. The aims of this study were to explore the knowledge of teenagers and young adults about COVID-19 and assess their personal preventive behavior.

METHODS

We developed a 14-item questionnaire to conduct a cross-sectional online survey. Survey responses with missing variables were excluded. SPSS was used to perform the analyses, including descriptive statistics.

RESULTS

Thirty-five participants, 15 to 27 years of age, completed the survey between May 2020 and March 2021. Thirty-one (88.57%) reported feeling sufficiently informed to avoid the risk of COVID-19 transmission. The most frequent sources of COVID-19 information were social media (68.6%) and parents (68.6%), whereas the least were teachers (11.4%). Thirty-three (94.29%) participants reported practicing social distancing, citing the main reasons to keep oneself, family members, and others safe. Thirty-three (94.29%) identified taking classes online instead of going to school as an example of social distancing, 26 (74.29%) calling friends on the telephone, and 24 (68.57%) going on a walk alone. Twelve (34.29%) chose eating infected foods and 8 (22.86%) touching animals, including pets, as transmission means for COVID-19. When asked about COVID-19 prevention, 34 (97.14%) reported that COVID-19 can be prevented by avoiding close contact with people who are sick, 31 (88.57%) by covering coughs and sneezes with a tissue, and 8 (22.86%) by avoiding contact with animals, including pets.

CONCLUSIONS

We found high awareness of COVID-19, but also identified important knowledge gaps about COVID-19 and preventive measures. Digital platforms and social media campaigns can be important sources for providing evidence-based and age-appropriate information about COVID-19 and recommendations for safe activities to reduce social isolation during the pandemic and its negative mental health effects. This study also suggests that teachers may be an underused source of accurate information about COVID-19. These findings can be used to develop effective educational interventions to help combat the COVID-19 pandemic and its impact on young individuals.

Exploring pandemic-related health literacy among adolescents in Germany: a focus group study

Background

Health literacy enables people to cope efficiently with health threats, such as the COVID-19 pandemic. However, little is known about health literacy among adolescents in general and especially in the context of pandemics. This study aimed to explore pandemic-related health literacy among adolescents by addressing cognitive, behavioral, conative, and affective components of the multidimensional health literacy construct.

Methods

Four online focus groups with 24 adolescents aged 13-17 years from four German federal states were conducted during the COVID-19 pandemic in May and June 2021. Data were analyzed using qualitative content analysis.

Results

Regarding the cognitive and behavioral components of pandemic-related health literacy, adolescents reported to use a broad range of traditional and digital media and personal information sources. The adolescents considered pandemic-related information to be good and easy to understand, when the information is presented in a concise and structured manner. The participants stated difficulties in finding, understanding, and evaluating pandemic-related information regarding particular protective measures. The adolescents described themselves to be critical when evaluating pandemic-related information and reported a high level of adherence to protective measures. Regarding the conative and affective components of health literacy, the adolescents explained that their wish to protect their loved ones from getting infected was the predominant motive for adherence to protective measures. They were convinced that people of their age play a role in pandemic containment. The adolescents reported sometimes making exceptions from adhering to protective measures to cope with negative feelings they experienced during the pandemic.

Conclusions

This study provides insights on how measures to improve pandemic-related health literacy among adolescents may be tailored to their needs. Prompt, concise, structured, and comprehensible preparation and communication of pandemic-related information in addition to educational efforts to strengthen health-related cognitive skills and critical health literacy may be supportive to reduce barriers in finding, understanding, and evaluating pandemic-related content.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13690-022-00937-9.

Multidisciplinary Student Groups Support Digital Education as a Public Health Precautional Action to Prevent Spread of COVID-19 Infection: A Mixed Methods Study

Background

Health personnel had greater odds of contracting COVID-19 during its first wave in Norway, compared with all working-age individuals. Students in health care, but also in social care and teacher education programs may be exposed to the risk of being infected themselves and to infect others through their mandatory practical training. Online education may reduce their risk of becoming patients and spreaders both in their private lives and during their mandatory training.

Aim

To explore the extent to which unvaccinated professional students fear transmission of SARS-CoV-2 from fellow students and from public transportation during the third wave.

Materials and Methods

In this cross-sectional study, 3148 students in health care, social care, and teacher education programs and 32 supervisors completed online questionnaires consisting of open and closed questions (mixed methods) after participating in digital interprofessional learning (IPL) small-group seminars (49.6% and 65% response rates, respectively). On a 6-point Likert scale (0–5), all means concerning fear were around 3, with overlapping confidence intervals. Fear of infecting high-risk individuals seemed higher than fear of contracting the virus themselves. High levels of loyalty to and trust in state and health authorities were expressed. Medical-related terminology was frequently used, such as the one-meter distance rule, infection tracking, national guidelines, and hand sanitizer, which implies high levels of health literacy. They expressed strong support for online course delivery (mean 4.5) ahead of practical training as a precautionary public health action.

Conclusion

These students did not have high levels of fear of contracting the virus from other students or public transport. They expressed a higher fear of infecting others than being infected themselves. The major implication for the public and the educational system is that students, even in a country with low death rates, support digital education as a public health precautional action to prevent the spread of infection.

Lifestyle changes, mental health, and health-related quality of life in children aged 6-7 years before and during the COVID-19 pandemic in South Germany

BACKGROUND

The measures against the COVID-19 pandemic are challenging for children and parents, and detrimental effects on child health are suggested especially from lock-down measures and school closings.

METHODS

We conducted a cross-sectional analysis using a population based longitudinal (birth-) cohort study (SPATZ study) conducted in the South of Germany. Data included all 6 or 7 year old children for whom a questionnaire was completed during first grade of school. Consequently, we were able to analyze children being in first grade before the first lockdown in Germany (≤ 15th March 2020), as well as children being in first grade during the pandemic (> 15th March 2020). We conducted descriptive statistics and estimated the associations between the two time periods, before and during the pandemic, and various outcomes of child health using multivariable adjusted linear or logistic regression modeling. The analysis was stratified by gender.

RESULTS

Results among n = 362 children aged six or seven years showed substantially lower mean scores of health-related quality of life (difference in means: - 5.5, 95% confidence interval (CI) - 9.0, - 2.0), and higher mean scores in total emotional and behavioral difficulties (difference in means: 2.0, 95% CI 0.2, 3.8) in girls during vs. before the COVID-19 pandemic using multivariable linear regression modeling. In addition, weekly screen-time was increased in boys by 3.5 h (95% CI 0.6, 6.4). We did not find substantial differences in sleep quality, physical activity, and time spent with books, neither in boys nor in girls, however, the limited sample size has to be considered.

CONCLUSION

Child health (and behavior) of first grade school children is possibly impacted by the COVID-19 pandemic with adverse consequences possibly differing by gender.