COVID-19 ON COLLEGE CAMPUSES

Testing Strategies and Encouraging Protective Behaviors

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College communities find themselves in uncharted territory as they face the challenges posed by COVID-19. Students are adjusting to new ways of learning, living, and staying safe on campus, even as many of them are undergoing important developmental changes that make them more prone to exploration, risk taking, and new forms of peer relationships. University administrators are rapidly developing, implementing, and revising programs to test student bodies for COVID-19 and respond in the case of a positive test result. Both testing and strategies to promote protective behaviors are needed to address COVID-19 on college campuses.

In response to these challenges, the National Academies of Sciences, Engineering, and Medicine developed guidance for colleges and universities on two pressing issues on campus: implementing testing programs and encouraging the adoption of COVID-19 protective behaviors. The guidance emphasizes the importance of communication, transparency, and student engagement. Click on a topic below to learn more.

COVID-19 Testing Strategies for Colleges

Encouraging Protective Behaviors on Campus

 

Strategies for Testing on College Campuses: Learning from the Fall 2020 Semester and Planning for the Future

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As the COVID-19 pandemic continues to disrupt higher education, many colleges and universities made the decision to reopen their campuses for the fall 2020 semester. For many universities, this meant developing and implementing a testing program, often on a very short timeline. The Societal Experts Action Network (SEAN) and the Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats engaged a diverse group of colleges and universities around the country to identify the key lessons learned about testing on college campuses. These lessons can be used for planning for the spring 2021 semester and beyond.

1	Testing as one component of a mitigation strategy based on a comprehensive, coherent plan with redundancies.		Additional mitigation efforts such as contact tracing, use of personal protective equipment, wastewater surveillance, and messaging to promote the adoption of protective behaviors need to be considered as part of a comprehensive response.
2	One size does not fit all.		Programs need to be tailored and strategies can be chosen to match the needs and circumstances of the particular institution. For example, whether a school is a commuter versus a non-commuter school, or urban versus rural, the degree to which programming is remote or in-person, the design of residence halls and dining facilities, and the prevalence and rate of transmission of COVID-19 in that particular area, will all inform how testing programs can be optimally designed.
3	Engaged leadership at the highest levels, interdisciplinary teams, and coordination across groups.		Many universities reported holding consistent, frequent virtual meetings for sharing best practices and planning.
4	Collaboration with local public health authorities and engagement with partners.		Collaboration and partnership can allow for leveraging of resources and sharing of best practices.
5	Routine collection and daily analysis of data to guide decision making, including dynamic prioritization of populations and testing frequency.		Surveys and focus groups of the campus community can inform understanding of the testing experience, compliance with mitigation behaviors, and challenges and barriers to participation. Uncertainty surrounding the pandemic necessitates consistent gathering of information to inform decision making.
6	Quick response to a positive test—communicating results and supporting isolation of positive individuals and quarantine of close contacts—to prevent further transmission of the virus.		Speed is critical, and offering care and assistance to those who test positive to get safely isolated within hours, not days, has shown to be effective at reducing transmission.
7	Adaptability and flexibility to implement different mitigation strategies as circumstances change.		Strategies will need to continue to adapt as new technology and new information become available and as the nature and scope of outbreaks change.
8	Adoption of an information technology infrastructure that respects data transparency and privacy while rapidly providing accurate information.		A convenient and consistent user interface for test registration, check-in, and results delivery is important. Establishing an efficient data system sufficient to inform timely decision making may require significant changes to existing IT systems.
9	Communication as an essential piece of the testing strategy.		Public facing dashboards and forums for sharing information such as weekly town hall discussions are examples of ways to share information with students, faculty, staff, and the public.
10	Engagement with the university and community, including students, in the development and implementation of the testing strategy and foster a culture of shared responsibility.		Participation in COVID-19 response activities may provide opportunities for experiential learning or internships. Building shared responsibility for prevention across the entire campus community in conjunction with the testing strategy is critical.

Read the Full Guidance

This guidance was informed by four public information gathering sessions with colleges and universities from across the country. The archived videos of these sessions are available here.

Encouraging Protective COVID-19 Behaviors Among College Students

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Many college students are undergoing important developmental and maturation processes that influence their behavior. Taking risks and making mistakes is normal and to be expected, though not always compatible with health and safety. Indeed, risk taking is part of growing up and becoming independent.

As administrators work to keep campuses safe from COVID-19 and encourage protective behaviors, they would benefit from being mindful of students’ developmental needs. Combining insights from developmental science with strategies from behavioral science and risk communication, SEAN developed guidance on encouraging behavior change among students. These five key tenets of adolescent development could help university leaders develop and implement COVID-19 behavior change strategies that are relevant to students:

• Many adolescents and young adults are socially driven, with a strong desire for reward and acceptance.
• Identity, agency, and autonomy are centrally important during the college years.
• College students are primed for exploration, and risk taking is a normative part of their development.
• Prosocial inclinations are strong among college-age students.

College students can enhance the creation and implementation of policies that affect them.

Habit-Promoting Strategies for College Students

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Habit-promoting strategies can be used to overcome barriers to behavior change and encourage positive behaviors among college students. The five strategies below have been adapted for college campuses from a previous SEAN rapid expert consultation.

1	Make the behavior easy to start and repeat.		College leaders could establish campus environments that encourage desirable behaviors, such as by making testing sites easily accessible, making testing a seamless process, distributing free masks, and installing sanitizing stations throughout the campus. Students also could be encouraged to hang their mask on their dorm room door or clip it to their ID card or backpack.
2	Make the Behavior Rewarding to Repeat.		Strategies for making protective behaviors rewarding are especially salient for adolescents and young adults because their motivational systems are reward focused. Examples include turning masks into status symbols and introducing a competitive or collaborative element to wearing or designing masks (e.g., supporting student-led collaboration or competition among dorms, disciplinary departments, or athletic team).
3	Tie the Behavior to an Existing Habit.		People are more likely to repeat a behavior when they stack it onto an existing habit. Students could be encouraged to tie mask wearing to phone use, by leaving their mask near their phone, or receiving text or pop-up phone reminders or apps related to COVID-19 protective behaviors.
4	Alert People to Behaviors that Conflict with Existing Habits, and Provide Alternative Behaviors. Because college students are inclined to exercise agency and autonomy, telling them only what they cannot do may lead to pandemic fatigue and associated risky behaviors.		Instead, it would help to highlight safe ways for college students to interact and socialize. Examples include giving students the agency, authority, responsibility, and guidance to establish and maintain the health of their own “social pods,” or supporting club, team, or student leaders in planning and providing COVID-safe social activities.
5	Provide Specific Descriptions of Desired Behaviors.		When individuals understand specifically is expected of them, they are more likely to adopt the desired behavior. Colleges could invite students to design, draw, paint, or build objects connected to campus life that depict 6- to 12-foot distances.

Read the Full Guidance

Communication Strategies

College leaders can use risk communication strategies to encourage COVID-19 protective behaviors among students. The risk communication strategies below are adapted to include insights from developmental science.

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1	Use Clear, Consistent, and Transparent Messaging, with Attention to Mode of Transmission.		Messages from different units on campus and city administrators should be accurate, consistent in content and tone, and transparent regarding procedures and data. Social media platforms are an essential source of messaging and information for college students, and they can be leveraged to convey clear, consistent, and transparent messages from authoritative sources.
2	Avoid Undue Attention to the Frequency of Socially Undesirable Behaviors, Instead Emphasizing Responsibility.		Telling college students about the risks or prevalence of an undesirable behavior may actually make them more likely to engage in that behavior. It could be more effective to appeal to college students’ developing sense of responsibility to do their part in slowing the spread of COVID-19.
3	Foster Efficacy and Avoid Fatalism, with Attention to Student Agency.		As adolescents and young adults are developing their sense of agency, they can be supported in making positive choices and effecting change by adopting protective measures.
4	Appeal to the Collective Good of One’s Community, Focusing on Prosocial Behavior and Activism.		Adolescents and young adults are primed for prosocial behavior and student activism. Students could be encouraged to make COVID-19 mitigation a campus-wide cause, especially if their activism is tied to their identity as responsible and mature people who are representing the college-age population.
5	Use Trusted Messengers, Amplified by Social Media and Other Influencers.		In addition to trusting their families, friends, and experts, younger college students in particular engage with external influencers on platforms such as YouTube, TikTok, Twitch, Instagram, SnapChat, and other social media. Social media influencers can amplify messages from trusted experts about protective behaviors to students.
6	Tailor the Framing of the Message to the Audience, with Attention to the Risk–Reward Calculus.		For college students who prize the ability to socialize with peers and perceive the risks of COVID-19 as low, socializing will seem worth the risk. Because death rates in their age group are relatively low, more effective framing might focus on how being infected will affect other people, such as peers or family members who are immunocompromised or otherwise at risk; who is most likely to suffer; how activities may be curtailed if infection rates increase; or how students’ grades may be impacted if they become ill.
7	Link Prevention Behaviors to Identities, with Attention to Campus Affiliations.		Because college is an important time for students to develop and explore their sense of identity, appealing to them as members of their college campus, dorm, major, fraternity, sorority, club, or team may be especially effective in establishing social norms. Examples include behavioral pledges and social media campaigns designed to reinforce social norms, and the use of such slogans as “Bruins keeping each other safe” and “Tigers support Tigers.”
8	Highlight Social Disapproval of a Target Audience Member’s Failure to Comply When It Occurs, without Overemphasizing Risk.		While campuses need students to regard behaviors that can spread COVID-19 as socially unacceptable, they also should be cautious about the emphasis they place on risk. Some college students perceive risk-taking activities as inherently fun and exciting, so highlighting the risk of going to bars or parties could motivate them to take those risks. Instead, colleges and universities can focus on emphasizing messages that enforce positive social norms.
9	Highlight the Growing Prevalence of Behavior Change, Using Positive Messaging.		For college students, positive messaging can be more effective than a focus on negative behaviors or outcomes. Examples include such messages as “More than X% of students on our campus say they wear masks every day” or “Our state is #1 in the country in terms of mask wearing.” Frequent reminders of lower infection and transmission rates and how outbreaks have been minimized have anecdotally been successful.
10	Avoid Repeating Misinformation, Even to Debunk It.		Efforts to debunk misinformation can have the unintended effect of reinforcing false beliefs. Instead of calling attention to misinformation, repeating the truths about COVID and protective measures is more likely to be effective. Universities could provide information to help students, staff, and parents communicate COVID safety information effectively to people who may not recognize the importance of preventing its spread.

Read the Full Guidance

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