Complexity awareness among university students in Switzerland during the Covid-19 pandemic

Public health challenges relating to Covid-19 are highly complex and reasons behind preventive measures can be difficult to understand. Complexity awareness, an important part of healthy literacy, may help young people to understand the situation and act accordingly. However, we could not find any tools to assess complexity awareness during a pandemic in the literature. The purpose of this study was to develop pandemic-specific items to assess complexity awareness and explore relationships with sociodemographic characteristics in university students. Based on critical health literacy concepts and expert knowledge from public health, we developed four survey items, which were answered by 3616 Swiss university students online as part of the COVID-19 International Student Well-Being Study. Relationships between awareness and sociodemographic characteristics were explored using logistic regression and odds ratio (OR). Results showed that 49.6% of the students demonstrated limited and 50.4% demonstrated high complexity awareness. Being female (OR = 1.26; 95% CI 1.07-1.47), having highly educated parents (OR = 1.29; 95% CI 1.06-1.57), and being at a practically oriented university (OR = 0.79; 95% CI 0.64-0.97) was associated with high awareness. Covid-19-related complexity awareness varied significantly among university students, indicating that they have difficulties in dealing with complex information and processes in this pandemic. The results call for action to support students in understanding the complexity of this pandemic and to investigate complexity awareness in the general population. Lay Summary There is a large amount of complex information and misinformation around Covid-19 available. Complexity awareness refers to awareness about these complex issues which may help young people to identify and process appropriate information. We were interested how sociodemographic characteristics relate to complexity awareness in young people. Thus, in May 2020, we conducted a survey at four universities in Switzerland, with more than 3500 students participating and asked, for example, how strong students rate the at that time available scientific evidence to guide political decision-making regarding Covid-19. We also asked them about some personal characteristics, such as gender and parental education. Despite the highly educated sample, we found that only about half of the students demonstrated high-complexity awareness. We found that students who were women or who had at least one parent with a university degree were more likely to demonstrate high complexity awareness. In contrast, students at a practically compared to a research-oriented university were less likely to demonstrate high-complexity awareness. Our results indicate that even highly educated university students have difficulties in dealing with complex information and processes regarding the Covid-19 pandemic. Thus, university students should be specifically targeted to empower them to deal with complex information and processes around Covid-19.