Children and Adolescents' Behavioral Patterns in Response to Escalating COVID-19 Restriction Reveal Sex and Age Differences

authored by
Mira Paulsen, Anna Zychlinsky Scharff, Kristof de Cassan, Rizky Indrameikha Sugianto, Cornelia Blume, Holger Blume, Martin Christmann, Corinna Hauß, Thomas Illig, Rebecca Jonczyk, Norman Klopp, Verena Kopfnagel, Ralf Lichtinghagen, Henning Lucas, Anke Luhr, Frauke Mutschler, Thomas Pietschmann, Philipp-Cornelius Pott, Jana Prokein, Paula Schaefer, Frank Stahl, Nils Stanislawski, Jeannine von der Born, Bernhard M W Schmidt, Stefanie Heiden, Meike Stiesch, Nima Memaran, Anette Melk

Purpose: The COVID-19 pandemic affects students in a myriad of different ways. Our prospective, longitudinal study in a cohort of students in Hannover, Germany explores behavioral patterns during escalating COVID-19 restrictions. Methods: In total, 777 students between the age of 9 and 20 were assessed for their activity engagement, travel patterns, and self-assessed compliance with protective recommendations at six time points between June 2020 and June 2021 (3,564 observations) and were monitored for severe acute respiratory syndrome coronavirus 2 infection by nasal swab polymerase chain reaction and serum antibody titers. Results: Activity engagement decreased, but self-assessed compliance with measures such as mask wearing and social distancing was stable during escalating restrictions. Although we found no sex difference during the summer break, when incidence was lowest, females engaged in a higher variety of activities than males for all other time points. Older students engaged in more activities and self-assigned themselves lower compliance values than younger ones. Greater involvement in different activities was seen in households which traveled more frequently. Infection rate in our cohort was low (0.03% acute infections, 1.94% positive seroprevalence). Discussion: Our study supports the view that, overall, students show high compliance with COVID-19 recommendations and restrictions. The identification of subsets, such as female and older students, with higher risk behavioral patterns should be considered when implementing public information campaigns. In light of the low infection rate in our cohort, we conclude that in-person learning can occur safely if extensive protective measures are in place and the incidence in the general population remains moderate.

Institute of Technical Chemistry
Institute of Microelectronic Systems
Hannover Production Technology Centre
Institute of Innovation Research, Technology Management & Entrepreneurship
External Organisation(s)
Hannover Medical School (MHH)
Heinrich Pette Institute - Leibniz Institute for Experimental Virology (HPI)
Journal of adolescent health
No. of pages
Publication date
Publication status
Peer reviewed
ASJC Scopus subject areas
Public Health, Environmental and Occupational Health, Psychiatry and Mental health, Pediatrics, Perinatology, and Child Health
Sustainable Development Goals
SDG 3 - Good Health and Well-being
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