eFigure 1. Associations of Social Distancing, Disinfecting Behaviors, and News Monitoring With Adolescent Attitudes About COVID-19 Severity and Social Responsibility
eFigure 2. Associations of Hoarding Behavior With Adolescent Attitudes About COVID-19 Severity and Social Responsibility
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Oosterhoff B, Palmer CA. Attitudes and Psychological Factors Associated With News Monitoring, Social Distancing, Disinfecting, and Hoarding Behaviors Among US Adolescents During the Coronavirus Disease 2019 Pandemic. JAMA Pediatr. Published online June 29, 2020. doi:10.1001/jamapediatrics.2020.1876
What are the psychological factors associated with adolescent pandemic-related behaviors during the early stages of the coronavirus disease 2019 outbreak in the United States?
In this survey study of 770 adolescents, attitudes about the pandemic severity, social responsibility values, social trust, and self-interest were differentially associated with news monitoring, social distancing, disinfecting behaviors, and hoarding behavior.
Emphasizing the severity of the coronavirus disease 2019 pandemic and the social implications of pandemic-related behaviors may be important for teens in the United States.
As coronavirus disease 2019 (COVID-19) spreads across the world, it is critical to understand the psychological factors associated with pandemic-related behaviors. This perspecitve may be especially important to study among adolescents, who are less likely to experience severe symptoms but contribute to the spread of the virus.
To examine psychological factors associated with adolescents’ behaviors during the COVID-19 pandemic.
Design, Setting, and Participants
This self-reported survey conducted from March 20 to 22, 2020, recruited a population-based sample of adolescents via social media to complete an anonymous survey. Participants were eligible if they had internet access, lived in the United States, and were aged 13 to 18 years.
Main Outcomes and Measures
Outcomes included COVID-19 news monitoring, social distancing, disinfecting, and hoarding behaviors during the 7 days after the United States declared a national emergency. The psychological factors were attitudes about COVID-19 severity, social responsibility values, social trust, and self-interest. The a priori hypotheses were that greater attitudes about the severity of COVID-19, greater social responsibility, and greater social trust would be associated with greater news monitoring, social distancing, and disinfecting, whereas greater self-interest would be associated with more hoarding.
The sample included 770 adolescents collected via convenience sampling (mean [SD] age, 16.3 [1.1] years; 575 girls [74.7%]). Many teens reported not engaging in pure social distancing (528 [68.6%]), but they were monitoring the news (688 [89.4%]) and disinfecting daily (676 [87.8%]). Some teens reported hoarding (152 [19.7%]). Attitudes about the greater severity of COVID-19 were associated with more social distancing (β = 0.18; 95% CI = 0.10 to 0.25), disinfecting (β = 0.16; 95% CI = 0.08 to 0.23), and news monitoring (β = 0.26; 95% CI = 0.18 to 0.33) but also more hoarding (β = 0.08; 95% CI = 0.01 to 0.16). Greater social responsibility was associated with more disinfecting (β = 0.24; 95% CI = 0.17 to 0.32) and news monitoring (β = 0.14; 95% CI = 0.07 to 0.22) and less hoarding (β = −0.07; 95% CI = −0.14 to −0.01). Greater self-interest values were associated with less social distancing (β = −0.08; 95% CI = −0.15 to −0.01) and more hoarding (β = 0.08; 95% CI = 0.01 to 0.15). Greater social trust was associated with less hoarding (β = −0.09; 95% CI, −0.16 to −0.02).
Conclusions and Relevance
The results of this survey study suggest that emphasizing the severity of COVID-19 and the social implications of pandemic-related behaviors may be important for teens, particularly for those who are not following preventive health behaviors or who are engaging in hoarding.
The novel coronavirus disease 2019 (COVID-19) was declared a pandemic on March 11, 2020,1 and a US national emergency on March 13, 2020. As of March 22, 2020, there were more than 290 000 confirmed cases worldwide2 and more than 15 000 confirmed cases in the United States.3 Current global efforts are largely focused on slowing the spread and social effects of the virus, which relies on the compliance of individuals with social distancing and proper hygiene recommendations.4 Similarly, engagement in antisocial behaviors, such as hoarding, may result in broader social and medical effects of the pandemic by contributing to shortages of food and other resources within communities. As COVID-19 continues to spread and overload the medical systems in the United States and in countries around the world, it is critical to understand the psychological factors that are associated with pandemic-related preventive behaviors (ie, monitoring the news for updates, social distancing, and hygiene or disinfecting), along with antisocial behaviors (ie, hoarding supplies).
We examined psychological factors associated with news monitoring, social distancing, disinfecting, and hoarding behaviors among a large sample of US adolescents. Adolescence is a developmental period characterized by expanding autonomy and greater salience of peer relationships,5 which may contribute to prioritization of peer social interactions over the current social distancing recommendations. Further, pediatric patients appear to experience less severe symptoms or more asymptomatic cases of COVID-19 compared with adults6; thus, adolescents may be more likely to engage in behaviors that contribute to the spread of the infection (eg, lack of distancing and hygiene behaviors) and may be less likely to monitor emerging news stories about the virus.
Several psychological factors likely contribute to variation in the way youth are responding to the COVID-19 pandemic. For instance, attitudes about the severity of COVID-19, including the belief that COVID-19 is similar to influenza, likely vary and may be associated with preventive behaviors (or lack thereof). Others have recognized the importance of community attachments—including greater social responsibility values, social trust, and prioritizing others over the self—for engagement in prosocial behavior and avoidance of antisocial behavior.7,8 Because COVID-19 symptoms appear to be less severe among pediatric patients, efforts to contain the virus may be motivated by community rather than personal motives. Thus, we propose that attitudes toward the severity of COVID-19 and community attachments will be especially relevant for adolescents’ news monitoring, social distancing, disinfecting, and hoarding behaviors given that COVID-19 poses a lower personal threat to teenagers and larger threat to others.
This study involved collecting a convenience sample of adolescents from the United States shortly after COVID-19 was declared a national emergency. Data for this study were collected from 8 am on March 20 through 5 pm on March 22, 2020. This study involved no more than minimal risk, and thus passive parental consent was used. On selecting into the study, participants were given a link to a letter explaining the study and asked to provide this letter to their parents. All youth who provided informed written assent were invited to participate. Those who completed the initial survey were entered into a drawing for a $250 Amazon gift card. This study was approved by the institutional review board at Montana State University and, where applicable, followed the American Association for Public Opinion Research (AAPOR) reporting guideline.
English-speaking adolescents aged 13 to 18 years who were US residents and had access to social media were eligible to participate in this study. This study was advertised on various social media platforms (Facebook, Instagram, Twitter, and Reddit). Participants self-selected into the study and completed a 10-minute survey. This method of recruitment was chosen for multiple reasons. First, the social implications of COVID-19 were quickly evolving during the time of recruitment, thus requiring data to be collected in a very short time. Second, state-mandated high school closures made community-based data collection unfeasible. Third, many online data collection platforms (eg, Mturk) do not provide access to adolescent participants, thus limiting the ability to collect data from a nationally representative sample.
The survey instrument consisted of 31 items measuring COVID-19–related experiences, community attachments, and demographic questionnaires. Questions concerning COVID-19 experiences, including those assessing social distancing, disinfecting behavior, hoarding behavior, news monitoring, and COVID-19 severity attitudes, were created for this study. Questions concerning community attachments were taken from previously validated measures for adolescent samples,9 and questions concerning demographic characteristics were taken from past research with adolescent samples.8 The survey was pilot tested among the research team before data collection but was not pilot tested with adolescent participants to facilitate rapid data collection in response to the social changes that accompanied the COVID-19 pandemic. Cronbach α scores are reported below as an indicator of internal consistency for measures that contain multiple items, with α > .60 indicating acceptable reliability.10 The survey instrument is publicly available on the OSF platform (Center for Open Science).11
Social distancing was measured using 5 items (α = .70) developed for this study. Respondents indicated the frequency at which they spent time in person with friends, extended family, teachers, neighbors, and any other person who did not live with them in the past 7 days on a 5-point scale ranging from not at all (1 point) to very often (5 points). Items were reverse coded, and mean scores were calculated with higher values indicating greater social distancing.
Disinfecting behaviors were measured with 4 items (α = .64) developed for this study. Respondents indicated the frequency at which they used hand sanitizer, washed their hands, cleaned their phones, and used disinfecting wipes in the past 7 days on a 6-point scale ranging from not at all (1 point) to multiple times a day (6 points). Mean scores were calculated with higher values indicating greater disinfecting behavior.
Hoarding behaviors were assessed with a single item that asked respondents how often they hoarded supplies from a grocery store or department store in the past 7 days. Responses were given on a 5-point scale ranging from not at all (1 point) to very often (5 points), with higher values indicating more hoarding behaviors.
COVID-19 news monitoring was measured with a single item in which respondents rated the extent to which they followed news coverage of COVID-19 on a 5-point scale ranging from not at all (1 point) to a great deal (5 points). Higher values indicated greater COVID-19 news monitoring.
Attitudes about the severity of COVID-19 were measured with 4 items (α = .80) in which youth rated their agreement with statements de-emphasizing the severity of the virus (eg, “The coronavirus is just ‘the flu.’”). Responses were given on a 7-point scale ranging from strongly disagree (1 point) to strongly agree (7 points). Responses were reverse coded, and mean scores were calculated with higher values indicating the attitude that COVID-19 is severe.
Social responsibility values were measured with 3 items (α = .83) in which respondents rated how important it is to consider the needs of other people, make sure that all people are treated fairly, and think about how their actions affect people in the future.9 Responses were give on a 5-point scale ranging from not at all important (1 point) to extremely important (5 points). Mean values were calculated so that higher values indicated more social responsibility.
Social trust was measured with 3 items (α = .82) taken from past research7 (ie, “Most people can be trusted,” “Most people are fair,” and “Most people are helpful”). Responses were given on a 7-point scale ranging from strongly disagree (1 point) to strongly agree (7 points). Mean scores were calculated with higher values indicating higher social trust.
Self-interest values were measured with 2 items (r = 0.30) in which youth rated how important it is to put their own needs before the needs of others and to do what they want regardless of what other people might want.9 Responses were given on a 5-point scale ranging from not at all important (1 point) to extremely important (5 points). Mean scores were calculated so that higher values indicated more self-interest.
Adolescents reported their age, sex, race/ethnicity, parents’ educational level, and family financial strain. Parents’ educational level was recoded on a 3-point scale as neither parent completed high school (1), at least 1 parent completed high school (2), and at least 1 parent completed college (3). Participants also reported on their political ideology on a 5-point scale ranging from very conservative (1 point) to very liberal (5 points), with an option to indicate “I don’t know.”
Multiple regressions were used to test the primary study hypotheses. For these analyses, social distancing, disinfecting behavior, COVID-19 news monitoring, and hoarding behavior were specified as the dependent variables, and attitudes about COVID-19 severity, social responsibility values, social trust, and self-interest values were specified as the primary independent variables. All models included adolescent sex, age, race (coded 1 for white and 0 for nonwhite), ethnicity (coded 1 for Hispanic and 0 for non-Hispanic), family financial strain, parents’ educational level, and political ideology as covariates. Models were estimated using the lm function in the R statistical program, version 184.108.40.206 Low levels of missing data (<6.5%) were estimated using multiple imputation. Effects with 2-sided α < .05 were considered to be statistically significant. The raw data used for the study are publicly available.11
The initial survey was completed by 789 adolescents residing in the United States and aged 13 to 18 years. Owing to the convenience sampling design, information regarding the response rate was unavailable. The mean (SD) age of the respondents was 16.3 (1.1) years. The sample primarily included 10th (156 [19.8%]), 11th (242 [30.7%]), or 12th (248 [31.4%]) graders, with fewer 9th graders (107 [13.6%]) and college students (31 [3.9%]). Five participants did not report their grade level. A small number of participants indicated that they were unaware of COVID-19 (n = 10) or that their school had not yet closed and thus strict social distancing was not possible (n = 9). These participants were removed from analyses, resulting in the final analytic sample of 770 respondents.
The sample consisted of more girls (575 [74.7%]) than boys (156 [20.3%]), with 39 (5.1%) identifying as nonbinary. The sample primarily self-identified as white (558 [72.5%]), followed by Hispanic/Latino (117 [15.2%]), African American or black (43 [5.6%]), Asian American/Pacific Islander (78 [10.1%]), American Indian/Alaska Native (24 [3.1%]), or other (23 [3.0%]). Participants could identify as multiple racial/ethnic identities, thus producing values greater than our sample size and 100%. As a proxy for family financial strain,13 youths were asked whether their families had enough money to buy almost anything they wanted (54 [7.0%]), had no problem buying the things they needed and sometimes enough to buy special things (410 [53.2%]), had just enough money for the things they needed (245 [31.8%]), or had a hard time buying the things they needed (61 [7.9%]).
Means (SDs) and bivariate correlations among study variables as well as frequencies of news monitoring, social distancing, disinfecting, and hoarding behaviors during the 7 days after COVID-19 was declared a national emergency are presented in Table 1 and Table 2. Overall, only 242 respondents (31.4%) engaged in pure social distancing (no in-person contact with those outside their household) compared with 528 (68.6%) who did not practice social distancing during this period. Respondents frequently engaged in various disinfecting behavior, with 676 (87.8%) reporting that they engaged in at least 1 type daily. In addition, a small subset of youths engaged in hoarding behaviors (152 [19.7%]) at least a little during this period. A small subset of youths (82 [10.6%]) indicated that they did not follow COVID-19–related news at all or just a little, with the remaining 688 (89.4%) following COVID-19 news at least somewhat.
Table 3 and Table 4 present estimates from 4 multivariate regression models for adolescents’ social distancing, disinfecting, news monitoring, and hoarding behaviors. When examining social distancing and after accounting for demographic characteristics, youth who endorsed attitudes about the greater severity of COVID-19 engaged in greater social distancing (β = 0.18; 95% CI = 0.10 to 0.25). In addition, greater self-interest values were associated with less social distancing (β = −0.08; 95% CI = −0.15 to −0.01). When examining disinfecting behavior, youth who endorsed attitudes about the greater severity of COVID-19 (β = 0.16; 95% CI = 0.08 to 0.23) and social responsibility values (β = 0.24; 95% CI = 0.17 to 0.32) also engaged in increased disinfecting behaviors. Attitudes about the severity of COVID-19 (β = 0.26; 95% CI = 0.18 to 0.33) and social responsibility values (β = 0.14; 95% CI = 0.07 to 0.22) were also associated with more frequent news monitoring. When examining hoarding behavior, youth who endorsed attitudes about the greater severity of COVID-19 (β = 0.08; 95% CI = 0.01 to 0.16) and those who endorsed greater self-interest values (β = 0.08; 95% CI = 0.01 to 0.15) engaged in greater hoarding behavior, whereas those who endorsed greater social trust (β = −0.09; 95% CI = −0.16 to −0.02) and social responsibility (β = −0.07; 95% CI = −0.14 to −0.01) values engaged in less hoarding behavior. Significant results are displayed in eFigures 1 and 2 in the Supplement.
COVID-19 is an imminent public health concern. To manage the spread and social effects of this pandemic, it is imperative that US citizens engage in preventive behaviors, such as social distancing and personal hygiene, stay up to date on virus-related news, and limit their engagement in hoarding behaviors that can result in a shortage of resources for communities. Understanding individual differences in these behaviors is especially important among teenagers, who may be less likely to present with symptoms even when carrying the virus6 and who may experience greater social pressure to avoid limiting social contact with peers. Findings from this study indicate that adolescents’ beliefs about the severity of the virus, the extent to which they value social responsibility, their social trust, and their prioritization of their own self-interest over others were independently associated with their news monitoring, social distancing, disinfecting, and hoarding behavior in the days after the United States declared COVID-19 a national emergency.
Results from this study have important implications for the social response in the United States to the COVID-19 pandemic. Adolescents’ perceptions of COVID-19 severity were associated with greater social distancing, disinfecting, and news monitoring but also greater hoarding behavior with generally moderate effect sizes. These findings are consistent with past research that found that youth were more likely to engage in socially responsible environmental behaviors in historical years when they were more aware of environmental pollution issues.14 Concern about social issues may motivate adolescents to act in socially responsible ways,15 and these findings highlight the potential importance of ensuring that adolescents view the COVID-19 virus as a serious threat in a way that does not encourage hoarding. These efforts may be aided by informing adolescents about potential asynchronies between the effects of COVID-19 on adolescents vs adults.
We also found that increased social responsibility values were associated with greater disinfecting, less hoarding, and more news monitoring, whereas self-interest values were associated with less social distancing and more hoarding. Effect sizes for social responsibility were generally moderate, whereas effect sizes for self-interest appeared smaller. Social trust was also associated with less hoarding, with a small effect. Although these values may demonstrate considerable stability and may be slow to change, past research16 has found that adolescents embraced social responsibility as a value to live by if they believed that the United States was a fair society. Directly targeting these psychological beliefs may be an effective medium to promote positive health behaviors. Findings from this study stress the importance of increasing adolescents’ social responsibility values and decreasing self-interest values as a preventive measure for future pandemics and public health concerns.
Findings should be interpreted in the context of certain limitations. Data were cross-sectional, and causal or temporal interpretations cannot be made. Community attachments may encourage prosocial responding to the COVID-19 pandemic. However, COVID-19 attention and engagement in these prosocial behaviors may also promote greater social responsibility, higher social trust, and less self-interest. Future research is needed to examine within-person, longitudinal associations between community attachments and COVID-19 behaviors. Although our sample was recruited from across the United States, participants self-selected into this study via social media, which may be prone to selection bias. Further, respondents were primarily white and female, which may limit the generalizability of our findings. Future studies would benefit from examining social distancing motivation in a more diverse sample of adolescents. Although approximately 1 in 5 respondents reported hoarding to some extent in the days after COVID-19 was declared a national emergency, it is unclear whether they were hoarding with a family member, for a family member, or for themselves. In addition, disinfecting behaviors were measured with only 4 items, and the scale had low internal consistency. Future research would benefit from assessing the context surrounding adolescent hoarding behavior and from the inclusion of a wider range of disinfecting behaviors.
Overall, our findings highlight that adolescents’ beliefs about COVID-19 and community attachments may represent important attitudes and psychological factors that inform their response to the COVID-19 pandemic. Future research is needed to monitor changes in adolescents’ attitudes about COVID-19 and community attachments as the pandemic unfolds. Consistent with developmental theory,16 these efforts would benefit from characterizing heterogeneity in trajectories of change and identifying subpopulations of adolescents who demonstrate more rapid changes in community attachments, attitudes about COVID-19, and COVID-19 behaviors over time. Such efforts may help in tailoring efficacious interventions for improving the COVID-19 pandemic response.
Accepted for Publication: April 23, 2020.
Corresponding Author: Benjamin Oosterhoff, PhD, Department of Psychology, Montana State University, PO Box 173440, Bozeman, MT 59717 (email@example.com).
Published Online: June 29, 2020. doi:10.1001/jamapediatrics.2020.1876
Author Contributions: Dr Oosterhoff had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: Both authors.
Acquisition, analysis, or interpretation of data: Both authors.
Drafting of the manuscript: Both authors.
Critical revision of the manuscript for important intellectual content: Both authors.
Statistical analysis: Both authors.
Obtained funding: Oosterhoff.
Administrative, technical, or material support: Oosterhoff.
Conflict of Interest Disclosures: None reported.
Funding/Support: This study was supported by the Center for American Indian and Rural Health Equity (CAIRHE) (Dr Oosterhoff).
Role of the Funder/Sponsor: Funding from CAIRHE was used to support the design and the conduct of the study. The sponsor had no role in the collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
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