A Multi-Country Cross-Sectional Study of Knowledge and Worry About COVID-19 Among Higher Education Students During the First Wave of the Pandemic (preprint)

Background: Public health measures such as physical distancing and distance learning have been implemented during the COVID-19 pandemic. Having inadequate COVID-19 related knowledge can lead to excessive worrying as well as negative COVID-19 outcomes. Our study aimed to assess COVID-19 related knowledge and its association with worries among higher education (HE) students during the first wave of COVID-19. Methods A cross sectional survey, COVID-19 International Students Well-being Study (C-19 ISWS) was conducted in 133 Higher Education Institutions (HEIs) in 26 countries between April 27 and July 7, 2020. A stratified convenience sampling technique was used. Descriptive, bivariate, mixed effect logistic regression analysis were conducted using R software. Results Out of 127,362 respondents, 72.1 % were female, and 76.5% did not report a previous history of confirmed COVID-19. Majority of those without the previous infection 81,645 (83.7%) were from 21 European countries while the rest 15,850 (16.3%) from 5 non-European countries. The most frequent correct response to COVID-19 related knowledge questions among respondents was having the virus without having symptoms (94.3%). Compared to participants with good knowledge, the odds of being worried of acquiring SARS-COV-2 infection with poor knowledge was 1.05 (95%CI:1.03,1.08) and the odds of being worried of contracting severe COVID-19 was 1.36 (95%CI:1.31,1.40). Conclusion COVID-19 related knowledge was independently associated with both worry of acquiring SARS-COV-2 infection as well as contracting severe COVID-19. We recommend scaling up of awareness campaigns through media to increase the comprehensive COVID-19 related knowledge in order to tackle excessive worries about acquiring severe COVID-19.

Sexual health and COVID-19: Protocol for a scoping review (preprint)

Background: Global responses to the COVID-19 pandemic have exposed and exacerbated existing socioeconomic and health inequities that disproportionately affect the sexual health and well-being of many populations, including people of color, ethnic minority groups, women, and sexual and gender minority populations. Although there have been several reviews published on COVID-19 and health disparities across various populations, none have focused on sexual health. We plan to conduct a scoping review that seeks to fill several of the gaps in the current knowledge of sexual health in the COVID-19 era. Methods: : A scoping review focusing on sexual health and COVID-19 will be conducted. We will search (from January 2020 onwards) CINAHL, Africa-Wide Information, Web of Science Core Collection, Embase, Gender Studies Database, Gender Watch, Global Health, WHO Global Literature on Coronavirus Disease Database, WHO Global Index Medicus, PsycINFO, MEDLINE and Sociological Abstracts. Grey literature will be identified using Disaster Lit, Google Scholar, governmental websites and clinical trials registries (e.g. ClinicalTrial.gov, World Health Organization, International Clinical Trials Registry Platform and International Standard Randomized Con-trolled Trial Number registry). Study selection will conform to Joanna Briggs Institute Reviewers’ Manual 2015 Methodology for JBI Scoping Reviews. Only English language, original studies will be considered for inclusion. Two reviewers will independently screen all citations, full-text articles, and abstract data. A narrative summary of findings will be conducted. Data analysis will involve quantitative (e.g. frequencies) and qualitative (e.g. content and thematic analysis) methods. Discussion: Original research is urgently needed to mitigate the risks ofCOVID-19 on sexual health. The planned scoping review will help to address this gap.

Disentangling Depression in Belgian Higher Education Students Amidst a COVID-19 Lockdown (preprint)

Background: The surge of COVID-19 infections has prompted many countries to take unprecedented policy measures. In Belgium, the authorities implemented a nation-wide stay-at-home order for several months. Evidence of the mental health effect of such measures is scarce. A recent review by Brooks et al. has compiled a defined list of stressors affecting people's mental health under quarantine during previous epidemic settings. This study aims to test the association between these stressors and the mental health of students attending higher education during the stay-at-home order in Belgium. Methods: In this cross-sectional study, 18,301 students from 13 higher education institutions (HEI) participated in an online survey between 26 April and 11 May 2020. Structural equation modeling was used to assess associations between potential stressors and depressive symptoms severity scores and to assess the mediation effect of stressors between duration of exposure and depressive symptoms severity. Results: The stressors proposed by Brooks et al. were found to be associated with depressive symptoms severity. The stressors 'perceived academic stress', 'institutional dissatisfaction' and 'fear of being infected' were associated with substantially higher depressive symptoms severity scores. The association between duration of exposure and depressive symptoms severity was mediated by 'academic stress'. Being in a steady relationship and living together with others were both associated with a lower depressive symptoms severity. Conclusion: Findings underline the need for a student-centered approach and mental health prevention. Authorities and HEIs should consider whether and if so, how a stay-at-home order should be implemented.