COVID-19 Mitigation Among College Students: Social Influences, Behavioral Spillover, and Antibody Results

ABSTRACT

By fall 2020, students returning to U.S. university campuses were mandated to engage in COVID-19 mitigation behaviors, including masking, which was a relatively novel prevention behavior in the U.S. Masking became a target of university mandates and campaigns, and it became politicized. Critical questions are whether the influences of injunctive norms and response efficacy on one behavior (i.e. masking) spill over to other mitigation behaviors (e.g. hand-washing), and how patterns of mitigation behaviors are associated with clinical outcomes. We conducted a cross-sectional survey of college students who returned to campus (N = 837) to explore these questions, and conducted COVID-19 antibody testing on a subset of participants to identify correlations between behaviors and disease burden. The results showed that college students were more likely to intend to wear face masks as they experienced more positive injunctive norms, liberal political views, stronger response efficacy for masks, and less pessimism. Latent class analysis revealed four mitigation classes: Adherents who intended to wear face masks and engage in the other COVID-19 mitigation behaviors; Hygiene Stewards and Masked Symptom Managers who intended to wear masks but only some other behaviors, and Refusers who intended to engage in no mitigation behaviors. Importantly, the Hygiene Stewards and Refusers had the highest likelihood of positive antibodies; these two classes differed in their masking intentions, but shared very low likelihoods of physical distancing from others and avoiding crowds or mass gatherings. The implications for theories of normative influences on novel behaviors, spillover effects, and future messaging are discussed.

Acknowledgments

The authors thank the members of the Data4Action Research Group: Dee Bagshaw, Clinical & Translational Science Institute, Cyndi Flanagan, Clinical Research Center, Abhinay Gontu, Department of Veterinary and Biomedical Sciences, Margeaux Gray, Dept. of Biobehavioral Health, Suresh Kuchipudi, Animal Diagnostic Lab, Vivek Kapur, Dept. of Animal Science and the Huck Institutes of Life Sciences, Stephanie Lanza, Dept. of Biobehavioral Health and the Prevention Research Center, James Marden, Dept. of Biology & Huck Institutes of the Life Sciences, Susan McHale, Dept. of Human Development and Family Studies and the Social Science Research Institute, Glenda Palmer, Social Science Research Institute, Andrew Read, Depts. of Biology and Entomology, and the Huck Institutes of the Life Sciences, Sophie Rodriguez, Huck Institutes of the Life Sciences, Connie Rogers, Dept. of Nutritional Sciences and the Huck Institutes of the Life Sciences, Natalie Rydzak, Huck Institutes of the Life Sciences, Sreenidhi Srinivasan, Huck Institutes of the Life Sciences, and Charima Young, Penn State Office of Government and Community Relations.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Office of the Provost and the Clinical and Translational Science Institute, the Huck Institutes of the Life Sciences, and the Social Science Research Institute at the Pennsylvania State University.