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Ncheka JM, Menon JA, Davies EB, Paul R, Mwaba SOC, Mudenda J, Wharrad H, Toutounchi P, Glazebrook C. Factors influencing COVID-19 health protective behaviours in Zambian university students with symptoms of low mood. BMC Public Health 2023; 23:336. [PMID: 36793103 PMCID: PMC9930037 DOI: 10.1186/s12889-023-15073-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 01/17/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Health protective behaviours are crucial in the prevention of the spread of COVID-19, particularly in university students who typically live and study in large groups. Depression and anxiety are common in students and can impact young people's motivations to follow health advice. The study aims to assess the relationship between mental health and COVID-19 health-protective behaviours in Zambian university students with symptoms of low mood. METHODS The study was a cross-sectional, online survey of Zambian university students. Participants were also invited to take part in a semi-structured interview to explore views about COVID-19 vaccination. Invitation emails were sent explaining the study aims and directed students who self-identified as having low mood in the past two weeks to an online survey. Measures included COVID-19 preventive behaviours, COVID-19-related self-efficacy, and Hospital and Anxiety Depression scale. RESULTS A total of 620 students (n=308 female, n=306 male) participated in the study, with a mean participant age of 22.47±3.29 years (range 18-51). Students reported a mean protective behaviour score of 74.09/105 and 74% scored above the threshold for possible anxiety disorder. Three-way ANOVA showed lower COVID-19 protective behaviours in students with possible anxiety disorder (p=.024) and those with low self-efficacy (p<0.001). Only 168 (27%) said they would accept vaccination against COVID-19, with male students being twice as likely to be willing to accept COVID-19 vaccination (p<0.001). Of 50 students interviewed. 30 (60%) expressed fears about the vaccination and 16 (32%) were concerned about a lack of information. Only 8 (16%) participants expressed doubts about effectiveness. CONCLUSION Students who self-identify as having symptoms of depression have high levels of anxiety. The results suggest that interventions to reduce anxiety and promote self-efficacy might enhance students' COVID-19 protective behaviours. Qualitative data provided insight into the high rates of vaccine hesitancy in this population.
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Affiliation(s)
- Joyce M. Ncheka
- grid.12984.360000 0000 8914 5257Department of Psychiatry, School of Medicine, University of Zambia, Lusaka, Zambia
| | - J. Anitha Menon
- grid.12984.360000 0000 8914 5257Department of Psychology, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia ,grid.411365.40000 0001 2218 0143Department of International Studies, American University of Sharjah, Sharjah, UAE
| | - E Bethan Davies
- grid.4563.40000 0004 1936 8868Institute of Mental Health, NIHR MindTech MedTech Co-Operative, The University of Nottingham, Nottingham, UK ,grid.4563.40000 0004 1936 8868Clinical Neurosciences and Mental Health, School of Medicine, The University of Nottingham, Nottingham, UK
| | - Ravi Paul
- grid.12984.360000 0000 8914 5257Department of Psychiatry, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Sydney O. C. Mwaba
- grid.12984.360000 0000 8914 5257Department of Psychology, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | - John Mudenda
- grid.508092.60000 0004 5947 8201Lusaka Apex Medical University, Lusaka, Zambia
| | - Heather Wharrad
- grid.4563.40000 0004 1936 8868School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Parisa Toutounchi
- grid.4563.40000 0004 1936 8868Clinical Neurosciences and Mental Health, School of Medicine, The University of Nottingham, Nottingham, UK
| | - Cris Glazebrook
- Institute of Mental Health, NIHR MindTech MedTech Co-Operative, The University of Nottingham, Nottingham, UK. .,Clinical Neurosciences and Mental Health, School of Medicine, The University of Nottingham, Nottingham, UK.
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