Observed and self-reported COVID-19 health protection behaviours on a university campus and the impact of a single simple intervention

Objectives Hygiene behaviours had been an essential component of attempts to slow the spread of SARS-CoV-2. Most data on adherence to these behaviours is collected via self-reporting, which can differ from observed behaviours. We quantified this discrepancy among a university sample and tested the impact of simple intervention on observed behaviour. Study design Cross-sectional questionnaire of behaviour on campus compared to direct observation on one day without, and one day with, additional signage. Methods We circulated an email inviting all staff and students at our university to complete a questionnaire asking how often they wear a mark or practice hand hygiene when entering campus buildings, and how often they practiced social distancing within campus buildings. We observed all entrants to the main building on one campus on a baseline day and on a day after installing a large sign reminding people that these behaviours were mandatory. Results In our survey, 172 out of 252 respondents (68%) reported always cleaning their hands, 225 out of 251 (90%) reported always wearing a face covering, and 124 out of 252 (49%) reported always maintaining social distancing. On the baseline day of observation, 50 out of 311 people (16.1%) cleaned their hands and 256 (82.3%) wore a face covering correctly. Out of 119 people whom we could assess, 9 (7%) maintained social distance from others. The signage was associated with significant improvements for cleaning hands (104 / 375 people: 27.7%), wearing a face covering (374 / 375; 99.8%) and maintaining social distance (79 / 144; 54.8%). Conclusions Greater use of observational methods will provide a more accurate measure of behaviour than the current reliance on self-report and allow interventions to be robustly tested.