Associations of COVID-19 risk perception, eHealth literacy, and protective behaviors among Chinese college students following vaccination: a cross-sectional study

Background: ： In spite of strict regulation of COVID-19 preventative measures and containment in China, there are still confirmed cases sporadically occuring in many cities. College students are at a high risk of being infected, especially with the approach of vacation; thus, identifying the status and related factors of protective behaviors among them after receiving vaccination will be crucial for epidemic control. This study aimed to gather information on the protective behaviors and to identify the associations of COVID-19 risk perception, eHealth literacy and protective behaviors for Chinese college students following vaccination Methods: : A cross-sectional survey of college students who engaged in protective behaviors post vaccination was conducted using the COVID-19 risk perception scale and eHealth literacy scale in one of the groups. Multiple linear regression analysis was used to confirm the correlation between COVID-19 risk perception, eHealth literacy and protective behaviors for Chinese college students. Results: : A total of 5641 Chinese college students were included. Male students comprised 59.01% with an average age of (21.39±2.75) years and most students rating their health as very good (44.85%) or pretty good (46.98%). A smaller percentage (13.76%) believed that they would likely or most likely be infected with COVID-19 after getting vaccinated. In addition, more than 1 in 10 (10.35%) college students had ever suspected to suffer from post-vaccination reactions following the COVID-19 vaccination. The mean score of protective behaviors was (26.06±3.97) at the middle level. Approximately one-third (30.42%) of the students always or often did not wear a mask when going out. Some college students (29.25%) did not keep at least 1 meter away from others in social situations. Older female college students who were in good health and perceived as being at a low risk of getting infected with COVID-19 did not expect to engage in post-vaccination protective measures. Those with a higher level of perceived risk, severe risk perception and eHealth literacy and a lower level of unknown risk perception were more likely to engage in further protective behaviors after getting vaccinated. Conclusions: : Overall, the level of protective behaviors among Chinese college students following vaccination could use improvement, especially for male, younger college students in poor health. This study revealed the predictive effects of risk perception and eHealth literacy on protective behaviors, recommending that the negative and positive effects of risk perception should be balanced in epidemic risk management, and eHealth literacy promotion should also be emphasized for public health and social measures.