A study led by researchers at Virginia Commonwealth University investigating social distancing behavior by college students in seven countries during the early days of the COVID-19 pandemic finds that across cultures, students were more likely to practice social distancing if they believed two things: that it would protect against COVID-19 and that it was an action they could easily carry out.
The most effective public health messaging, the researchers found, emphasized these points, rather than messaging that focused primarily on the threat of COVID-19. The goal of the study was to understand what communication strategies would be most effective in convincing students to undertake a primarily altruistic action: reducing their social and community interactions amid a public health emergency.
“Knowing what and how to communicate is so important, especially in the midst of a public health emergency, and this study gave us some specific results to do just that,” said lead author Jeanine Guidry, Ph.D., an assistant professor in the Richard T. Robertson School of Media and Culture in the College of Humanities and Sciences and director of the Media+Health Lab at VCU.
The study, “Social Distancing During COVID-19: Threat and Efficacy Among University Students in Seven Nations,” was published in the journal Global Health Promotion. It involved a survey of 2,359 university students in the United States, China, Italy, the Netherlands, Belgium, Romania and Kuwait.
The study involved researchers from VCU; Huazhong University of Science and Technology in Wuhan, China; California State University; Texas Tech University; the University of Cagliari in Italy; Tilburg University/University of Antwerp in Belgium; and the University of Amsterdam in the Netherlands.
As part of the study, the researchers tested messaging using the Extended Parallel Process Model, a theoretical framework that suggests the level of a perceived threat is not enough—that effective messaging must also convince the audience that whatever measure is being recommended will work and that they can easily carry it out.
“This study showed that while perceived severity of and susceptibility to COVID-19 were significant predictors, they only worked if the efficacy appraisals were significant as well,” Guidry said.
Kellie Carlyle, Ph.D., an associate professor in the Department of Health Behavior and Policy in the VCU School of Medicine and a co-author of the study, said the findings show that simply trying to scare people into taking action is not enough.
“Health behavior change theory tells us that scaring people isn’t enough—we have to give people a solution and convince them it will work,” she said. “Our results support these theoretical propositions and serve as an important reminder that building efficacy—or confidence—in both people’s abilities to protect themselves and others is vital to achieving our public health goals.”
Co-author Nicole O’Donnell, Ph.D., an assistant professor in the Robertson School and associate director of the Media+Health Lab, noted that the project involved an extraordinary amount of coordination among international collaborators, and required the management of a survey in English, Dutch, Arabic, Italian, Romanian and Mandarin.
By investigating whether there were country-level differences in social distancing by college students, the researchers were able to explore why some students may be taking more protective measures against COVID-19 than others, O’Donnell said.
“For example, we found that students at a school in Romania reported higher social distancing behavior than students from the U.S., China, the Netherlands and Belgium,” she said. “Public health professionals can use this information to see how Romania communicated social distancing, and consider the reasons why their communication was so effective.
“Across cultures, we found that it was important for students to feel confident in their abilities to social distance,” she added. “Public health messages and policies that aim to build confidence in protective behaviors may be especially helpful.”
While the study focuses on the early days of COVID-19—between March 31 and April 15, 2020—its findings could be invaluable for future epidemics and pandemics.
“Sometimes we forget there was a period of almost a year when we lived with the pandemic, and no vaccines were available yet—and all we had to protect ourselves were preventive measures such as social distancing,” Guidry said. “So for a long time social distancing, together with other preventive measures, were all we had to protect us and those we love. Understanding better what a specific population group in several nations believed and acted like is important not just for this pandemic, but for future outbreaks as well.
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