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.