4.2. Adherence to Testing
Students with lower levels of anxiety and greater satisfaction with university communications around P-ATS were more likely to adhere to PCR and antibody tests. Students who were dissatisfied with university communications were less adherent to PCR testing, as were those with higher anxiety. Anxiety levels in our higher education sample were higher than those detected in adult samples globally (21%) [19]. This further highlights the importance of efforts to protect mental wellbeing in university students during the implementation of national and local containment measures. This is supported by data from the staff focus group, where protecting the mental wellbeing of students in self-isolation was deemed to be essential to the success of future testing programmes.
The findings clearly indicate the need for clarity and the consistency of communications around testing approaches, test outcomes and self-isolation, promotion of positive wellbeing, and support for mental health during self-isolation and more broadly. Experiences of confinement during a pandemic can negatively impact the psychological wellbeing of young adults, including those in the general population [20] and specifically, those in a higher education context [21,22,23]. However, a one-size-fits-all approach to mental health support in this context is likely to be insufficient due to disparities in mental health outcomes of higher education students during the pandemic, with those in the health professions, younger and more affluent students faring better than other student groups [20]. Increased adherence to testing was also associated with higher perceived risk of COVID-19 to themselves (PCR test) or friends and family (antibody test). This supports a previous study which demonstrated a relationship between perceived COVID-19 risk and adverse mental health outcomes in a UK community sample earlier in the COVID-19 pandemic [24].