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Safely Social: Promoting and Sustaining Adolescent Engagement in Social Distancing During the COVID-19 Pandemic

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Safely Social: Promoting and Sustaining Adolescent Engagement in Social Distancing During the COVID-19 Pandemic

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Purpose: Adolescents are at risk for violating COVID-19 social distancing measures due to salient developmental needs for autonomy and relatedness. This intensive longitudinal study investigated the initiation and sustainment of adolescents’ daily social distancing behaviors. Methods: Focus group and daily-diary approaches were used to collect 6,216 assessments from a nationwide American adolescent sample (n=444; Mage=15.1; 40% male; 42% Black, 40% White, 10% Latinx, 6% Asian American, 2% Native American) over the course of 14 days at the onset of the COVID-19 pandemic. Results: When adolescents were motivated by preventing others from getting sick, they were more likely to engage in social distancing (same-day: B=.50, SE=.09, 95% CI [.32, .68] p<.001; next-day: B=.49, SE=.09, 95% CI [.31, .67] p<.001). Daily social support from friends (same-day: B=.04, SE =.02, 95% CI [.01, .08] p<.05; next-day: B=.08, SE=.02, 95% CI [.05, .12] p<.001), connectedness with friends via technology (same-day: B=.23, SE=.04, 95% CI [.14, .32] p<.001; next-day: B=.12, SE=.05, 95% CI [.03, .21] p<.001), and practical knowledge about ways to prevent contracting and transmitting COVID-19 (same-day: B=.12, SE=.02, 95% CI [.08, .17] p<.001; next-day: B=.05, SE=.02, 95% CI [.01, .10] p< .05) positively predicted adolescents’ same- and next-day engagement in social distancing. Conclusions: Adolescents who were motivated by the desire to protect others were more likely to engage in social distancing. In addition, adolescents who learned about preventative health behaviors for mitigating COVID-19, received peer support, and remained virtually connected with friends were more likely to engage in daily social distancing at the onset of the pandemic.
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Adolescent Social Distancing
Safely Social: Promoting and Sustaining Adolescent Engagement
in Social Distancing During the COVID-19 Pandemic
Ming-Te Wang, Ed.D.
*
, Christina L. Scanlon, M.S., Meng Hua, Ph.D., and Juan Del Toro, Ph.D.
School of Education, Department of Psychology, and Learning Research & Development Center, University of Pittsburgh, Pittsburgh, PA
Article history: Received January 11, 2021; Accepted March 16, 2021
Keywords: Motivation; Engagement; Social distancing; Adolescence; Public health; COVID-19
ABSTRACT
Purpose: Adolescents are at risk for violating COVID-19 social distancing measures owing to salient
developmental needs for autonomy and relatedness. This intensive longitudinal study investigated the
initiation and sustainment of adolescentsdaily social distancing behaviors.
Methods: Focus group and daily-diary approaches were used to collect 6,216 assessments from a
nationwide American adolescent sample (n¼444; M
age
¼15.1; 40% male; 42% black/African American,
40% white/European American, 10% Latinx, 6% Asian American, 2% Native American) over the course of
14 days at the onset of the COVID-19 pandemic.
Results: When adolescents were motivated by preventing others from getting sick, they were more likely to
engage in social distancing (same day: B¼.50, SE ¼.09, 95% condence interval [CI] [.32, .68] p<.001; next
day: B¼.49, SE ¼.09, 95% CI [.31, .67] p<.001). Daily social support from friends (same day: B¼.04, SE ¼
.02, 95% CI [.01, .08] p<.05; next day: B¼.08, SE ¼.02, 95% CI [.05, .12] p<.001), connectedness with
friends via technology (same day: B¼.23, SE ¼.04, 95% CI [.14, .32] p<.001; next day: B¼.12, SE ¼.05, 95%
CI [.03, .21] p<.001), and practical knowledge about ways to prevent contracting and transmitting COVID-19
(same day: B¼.12, SE ¼.02, 95% CI [.08, .17] p<.001; next day: B¼.05, SE ¼.02, 95% CI [.01, .10] p<.05)
positively predicted adolescentssame- and next-day engagement in social distancing.
Conclusions: Adolescents who were motivated by the desire to protect others were more likely to engage in
social distancing. In addition, adolescents who learned about preventative health behaviors for mitigating
COVID-19, received peer support, and remained virtually connected with friends were more likely to engage
in daily social distancing at the onset of the pandemic.
Ó2021 Published by Elsevier Inc. on behalf of Society for Adolescent Health and Medicine.
Scientists have identied social distancing as one of the best
public health responses available during the COVID-19 pandemic
[1]; however, limitations on social contact and activities pose
unique challenges for adolescents. In April 2020, adolescents
began experiencing barriers to meeting developmental needs for
peer interactions when schools and recreational spaces were
closed or heavily restricted by public health mandates. Adoles-
cence is also a time when youth establish competence and au-
tonomy from adults by engaging in normative risk-taking
behaviors [2,3]. The concern is that adolescents may exercise
their autonomy by violating COVID-19 social distancing orders to
meet their needs for social interaction. Hence, it is critical to
understand why adolescents engage in social distancing and
what sustains daily engagement in these behaviors during the
pandemic.
Conicts of interest: The authors have no conicts of interest to disclose.
*Address correspondence to: Ming-Te Wang, 230 South Bouquet Street,
Pittsburgh, PA 15213.
E-mail address: mtwang@pitt.edu (M.-T. Wang).
www.jahonline.org
1054-139X/Ó2021 Published by Elsevier Inc. on behalf of Society for Adolescent Health and Medicine.
https://doi.org/10.1016/j.jadohealth.2021.03.014
Journal of Adolescent Health xxx (2021) 1e8
Adolescent Motivations and Social Distancing
Individuals have basic psychological needs, and it is the pur-
suit of these psychological needs that propels human behavior
and predilection. [4,5] Autonomy (i.e., perceived control) and
relatedness (i.e., social connection to others) are two salient
psychological needs during adolescence [6], meaning that ado-
lescentsdecisions about whether to engage and persist in an
activity depend on how autonomous and socially connected to
others they feel within a given context.
Autonomous motivations (i.e., doing an activity because one
wants, rather than has, to do it) represent adolescentsemerging
need for a sense of volition in their world and are strongly pre-
dictive of prosocial behaviors (i.e., behaviors reecting positive
social norms and consideration for others) [7]. Researchers have
also found that autonomous prosocial behaviors (i.e., pleasure-
or volition-based as opposed to pressure-based or compulsory
prosocial behaviors) beget an increased likelihood of engaging in
future prosocial behaviors [8]. In the case of COVID-19, we expect
that adolescents who endorse autonomous motivations for
engaging in social distancing will be more likely to follow these
guidelines than those engaging in social distancing due to an
adult- or government-issued mandate.
Prosocial motivations (i.e., doing an activity because it is
benecial for others) pertain directly to adolescentsneed for
relatedness. The act of supporting and helping others (i.e., pro-
social behaviors) has been found to increase social belongingness
[9,10] and decrease social withdrawal and stress [9e11]. Like
autonomous motivations, adolescentsprosocial motivations
have been associated with a higher likelihood of engaging in
future prosocial behaviors [12,13]. Given that social distancing is
a prosocial behavior (e.g., a means of extending consideration to
others during the pandemic), we expect that adolescents who
identify with prosocial motivations (e.g., wanting to protect
others from illness) will be more likely to engage in social
distancing.
Although there has been some preliminary evidence that
autonomous and prosocial motivations may inuence adoles-
centsdecisions to engage in public health measures [14 ], it is
unclear how these motivations function day-to-day during an
extended crisis. Hence, longitudinal research is needed to
determine adolescentsdriving motivations behind their social
distancing behavior.
Sustaining long-term social distancing in adolescents
Motivation researchers have suggested that utility valuedor
the perceived usefulness of a task as it relates to future goalsdis
a primary determinant of engagement and persistence in a task
[4]. Considering that youth are more likely to engage in a
behavior when they understand the rationale or value the utility
of said behavior [4], it is critical that adolescents understand the
purpose behind social distancing and attain appropriate knowl-
edge about COVID-19. However, whether COVID-19 knowledge
promotes adolescentsengagement in social distancing may
depend on the type of knowledge the adolescent possesses. In
particular, practical knowledge (i.e., knowledge about how to do
something, such as methods for preventing disease infection and
transmission) and descriptive knowledge (i.e., factual knowledge
that informs but does not instruct, such as infection and mor-
tality statistics) may function differently for promoting or
undermining social distancing behaviors [15].
Practical knowledge about COVID-19, its transmission, and
how social distancing decreases this transmission is essential for
adolescentsengagement in these behaviors. By supplying in-
formation about COVID-19 and illustrating social distancings
role in mitigating infection rates, we may activate adolescents
autonomous and prosocial motivations while simultaneously
encouraging these youth to make informed decisions about so-
cial distancing. On the contrary, descriptive knowledge may
invoke sensationalistic attention that increases negative emotion
and undermines adolescentssense of being able to competently
cope with COVID-19erelated stressors [16,17]. Indeed, inade-
quate information has been associated with feelings of fear and
confusion [18], and negatively framed news media regarding
infection and death rates has been found to be instrumental in
stoking this fear [19].
Adolescentslong-term engagement in social distancing is
also necessarily tied to the pursuit of relatedness and autonomy
needs [6,20]. In particular, social distancing may challenge ado-
lescentsneed to connect with friends. Fortunately, technology
has presented youth with a myriad of choices regarding online
social connectedness, a phenomenon we refer to as virtual
connectedness. Such opportunities to remain social and autono-
mous despite social distancing also allow adolescents to expe-
rience the rewards and stress-reducing benets associated with
providing and receiving social support [8,21]. Indeed, studies
have found that adolescents who experience peer social support
tend to have higher school and community engagement [22,23].
Hence, we hypothesize that adolescents who are able to virtually
connect with and feel supported by their peers during COVID-19
are more likely to engage in social distancing on a day-to-day
basis.
The Present Study
Adolescents may have difculty adhering to social distancing
policies during COVID-19 due to their increased psychological
needs for autonomy and social interaction. Using focus group and
daily-diary approaches with a nationwide American sample, we
investigated adolescentsmotivations behind daily social
distancing behaviors and the psychosocial factors that sustained
same- and next-day engagement in social distancing at the onset
of the COVID-19 pandemic.
To ensure ecological validity, we rst engaged an adolescent
focus group in a discussion about the reasons behind their social
distancing behaviors. These responses were used to construct
items for our daily-diary assessments. Daily-diary approaches
provide a rich perspective into adolescentsreal-time daily ex-
periences and behaviors, thereby minimizing systematic recall
bias and permitting in-depth analysis of within-person processes
over time [24]. We hypothesized that autonomous and prosocial
The primary motivating factor behind adolescents’ social
distancing was the desire to protect others. Adolescents
with opportunities to meet needs for autonomy and
relatedness were more likely to sustain their daily
engagement in social distancing. Schools and policy-
makers hoping to encourage adolescents’ social
distancing should consider appealing to adolescents’
developmental needs.
M.-T. Wang et al. / Journal of Adolescent Health xxx (2021) 1e82
motivations would contribute to adolescentsdaily engagement
in social distancing. We also postulated that adolescents with
more practical knowledge about how to prevent the spread of
COVID-19, higher levels of peer support, and more virtual
connectedness would be more likely to sustain their daily social
distancing behaviors.
Methods
Participants
This study used data from an ongoing nationwide longitudi-
nal project examining how school and family experiences inu-
ence adolescent well-being. The original study recruited a
national sample of adolescents via a representative, random
sampling method. When COVID-19 was declared a national
emergency in the United States (March 2020), the original lon-
gitudinal study was leveraged by inviting a subsample of ado-
lescents to participate in a 14-day daily-diary study focusing on
COVID-19erelated stress and adjustment. As a condition of
participation, participantsstate governments had to have issued
stay-at-home orders to reduce community spread of COVID-19.
In the United States, these orders were voluntary; however,
they involved the mandated closure of schools and nonessential
business, effectively limiting activities one could do within the
community. As such, families were encouraged to stay home to
stay safe.
Approximately 75% of the qualied participants agreed to
partake in the daily-diary study. The nal sample included 444
adolescents aged 13e18 years from 38 states (M
age
¼15.1; 40%
male; 42% black/African American, 40% white/European Amer-
ican, 10% Latinx, 6% Asian American, 2% Native American; 63%
qualied for free lunch). This subsample differed by socio-
demographic characteristics from the original sample in only one
way: It had slightly more participants from the northeast and
south regions (vs. west and midwest) as compared with the
original study sample (see Table 1). This difference was attrib-
uted to the fact that states in the northeast and south regions
were more likely to have already implemented stay-at-home
orders closing nonessential businesses and schools at the time
of study recruitment.
Procedures
All consented adolescents and their parents rst completed
baseline measures and demographic information. Adolescents
then completed daily diaries between 5
P
.
M
. and 12
A
.
M
. using
their Internet-capable devices across 14 days between April 8
and 21, 2020. Participants received two to four daily reminders to
complete the daily diary via e-mail or text message. Parents
received $20 for completing the baseline survey; adolescents
received $40 for completing the baseline and daily-diary surveys.
All materials and procedures were reviewed and approved by the
authors university institutional review board.
Measures
Daily social distancing. We used a single item to capture the
extent to which adolescents engaged in social distancing every
day. We included examples based on the Centers for Disease
Control and Preventions guidelines in the item prompt (e.g.,
remain out of congregate settings and avoid mass gatherings;
maintain at least 6 feet from others who are not from your
household in both indoor and outdoor spaces; try to stay at home
and avoid physical contact with people) to ensure conceptual
clarity. Item responses fell along a 5-point scale ranging from 1
(not at all)to5(a great deal). The item was developed and vali-
dated through four virtual focus groups with 12 adolescents (50%
male; 60% qualied for free lunch; 40% white, 60% other race),
expert validation (i.e., 1 survey methodologist, 1 psychologist,
and 1 public health researcher), and cognitive pretesting to
ensure that the item wording had adequate construct validity
and was comprehended as we intended.
Motivations behind social distancing behaviors. We used the same
youth focus groups to learn about adolescentsmotivations for
initially engaging in social distancing and factors that might in-
uence their engagement in these behaviors over time. These
focus group interviews identied six salient, common motivators
for social distancing: social responsibility, protecting self, pro-
tecting others, government mandate, parent rules, and friend
instructions.
During the daily-diary assessment period, adolescents who
reported engaging in social distancing on any given day were
asked to identify which of the six potential motivations for social
distancing resonated with them. An otheroption was provided
along with an open-ended text box; however, only 3% of ado-
lescents selected this option. A review of these responses indi-
cated that they could be assimilated into one of the
preestablished six categories.
Daily peer support and virtual connectedness. We measured the
extent to which adolescents felt supported by their friends each
day with items from the Relationship Quality Inventory [25] (e.g.,
I felt supported by a friend), which had a 5-point response scale
ranging from 1 (not at all)to5(a lot). We also measured whether
adolescents connected with friends via technology (e.g., I talked
to or interacted with friends on a computer or cellphone today)
to assess the extent of their virtual peer connectedness.
Table 1
Adolescent participants' demographic characteristics (N ¼444)
Characteristics %
Age
Age 13e14 years 30.0
Age 15e16 years 37.6
Age 17e18 years 32.5
Gender
Female 60.0
Male 40.0
Race
Black or African American 44.4
White or European American 39.2
Latinx 8.6
Asian American 6.3
Native American 1.5
Parent's highest education
High school/GED or less 24.8
Some college or more 75.2
Qualication for free lunch 62.2
U.S. region
Northeast 55.1
Midwest 7.7
South 20.3
West 16.9
M.-T. Wang et al. / Journal of Adolescent Health xxx (2021) 1e83
Daily practical and descriptive knowledge about COVID-
19. Adapted from the Factual Knowledge Scale [15], we assessed
adolescentsexposure to practical knowledge about COVID-19
using a 5-point response scale (1 ¼nothing at all;5¼a lot).
Specically, we asked about practical knowledge (e.g., ways to
prevent contracting and transmitting COVID-19; Today, how
much did you learn about ways to reduce your chance of getting
coronavirus?) and descriptive knowledge (e.g., Today, how
much did you learn about the number of people being infected
by or dying from coronavirus?). The key difference between
these two types of knowledge is that one type (i.e., practical)
involves actionable steps for prevention, while the other (i.e.,
descriptive) solely deals with COVID-19 infection and mortality
statistics.
Covariates. We included time-level covariates (i.e., numerical
day of reporting (1e14) and weekend versus weekday) as well as
the following child-level covariates collected from child or
parent reports: (1) age, (2) gender, (3) race, (4) free lunch status
before the pandemic as a proxy for socioeconomic status, (5)
grade point average from the prior year, and (6) parentshighest
level of education. As our participants lived across the United
States, we included pandemic-related covariates regarding the
type of community (i.e., urban, suburban, rural) and localized
severity of COVID-19 (i.e., infection statistics for each partici-
pants specic state) to provide context for our results.
Analytic plan
This study investigated the extent to which adolescentsmoti-
vations for social distancing, knowledge about COVID-19, and peer
social support predicted their daily engagement in social
distancing. We conducted longitudinal multilevel modeling in
MPlus with daily observations (Level 1) nested within participants
(level 2). The outcomes of interest were same- and next-day
engagement in social distancing at Level 1. All Level 1 predictors
were person-mean centered. All analyses controlledfor Level 1 and
Level 2 covariates. The intraclass correlation (days within person)
indicated that 54% of the outcome variance was at the person level
and 46% of the variancewas at the daily level,thus justifying the use
of a multilevel modeling approach.
Missing data
The amount of missing data at both the daily and child levels
was low. Of the possible 6,216 daily-diary assessments (14 days,
444 adolescents), there was only 6.9% missing data at the daily
level (n¼432 missing daily assessments). There were varying
levels of missing data at the child level: 100% of participants
completed baseline and demographic surveys; 66% did not miss
any daily assessments; 22% missed 1e2 days; and 6% missed
3e4 days. On average, each youth completed 13 of 14 total daily-
diary assessments.
Littles missing completely at random test suggested data
were missing completely at random,
c
2
(14) ¼9.51, p¼.09.
Adolescents with complete data did not differ from those with
missing data on any key constructs or demographic character-
istics. To retain all adolescents in analyses, we accounted for
missing data through full information maximum likelihood
estimation. We achieved similar results by using a multiple
imputation approach with 20 imputed data sets to handle
missing data.
Results
Descriptive statistics
Table 2 shows that youth most commonly referenced social
responsibility (59.7%), not wanting to personally get sick (49.6%),
city lockdown (46.5%), and preventing others from getting sick
(41.8%) as motivations behind their social distancing behavior.
Table 3 presents the means, standard deviations, and zero-order
correlations among daily- and child-level variables. Across
14 days, 317 adolescents (71.4% of participants) reported
engaging in social distancing to a great deal on at least 1 day, and
1,981 days (34.3% of the total daily assessments) included
adolescent reports of social distancing to a great deal. In addition,
153 adolescents (34.5% of the participants) reported not
engaging in any social distancing at all on at least 1 day, and
558 days (9.7% of the total days) included adolescent reports of
not engaging in social distancing at all.
Motivating factors behind social distancing behaviors
Among the six possible motivators for social distancing, only
preventing others from getting sick (same-day effect: B¼.50, p<
.001; next-day effect: B¼.49, p<.001; see Model 2, Table 4)
positively predicted same- and next-day engagement in social
distancing. That is, when adolescents framed social distancing as
an autonomous prosocial behavior, they were more likely to do it.
In the words of an adolescent from our focus group, I do it [social
distancing] to keep people safe. Like, its really not a big deal, and
it makes me feel good, so I just do it.
Daily engagement in social distancing
As shown in model 3, Table 4, daily peer social support (same-
day effect: B¼.04, p<.05; next-day effect: B¼.08, p<.001),
virtual connectedness (same-day effect: B¼.23, p<.001; next-
day effect: B¼.12, p<.001), and practical knowledge about
COVID-19 (same-day effect: B¼.12 , p<.001; next-day effect:
B¼.05, p<.05) positively predicted adolescentssame- and
Table 2
Adolescents' reasons to engage in social distancing behaviors
Label Why do you socially distance? %
Social responsibility It is my social responsibility to help slow the spread of the COVID-19. 59.7
Protecting self I do not want to personally get sick. 49.6
Protecting others I do not want to infect other people. 46.5
Government mandate My state/city is on lockdown. 41.8
Parent rules My parents have made social distancing a rule I have to follow. 38.4
Friend instructions My friends told me I should socially distance. 9.3
M.-T. Wang et al. / Journal of Adolescent Health xxx (2021) 1e84
Tabl e 3
Zero-order correlations between daily-level (level 1) and child-level (level 2) variable
Variable Mean (SD)
Daily-level variables 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Day 1 13.03 (2.17)
Weekend .03** 1 .28 (.45)
Practical knowledge .08*** .03*1 3.15 (1.43)
Descriptive knowledge .02 .01 .57*** 1 2.80 (1.41)
Peer support .00 .00 .27*** .26*** 1 3.02 (1.42)
Virtual connectedness .05** .02 .14*** .13*** .34*** 1 .73 (.44)
Social distancing .04** .02 .28*** .22*** .23*** .20*** 1 3.68 (1.42)
Child-level variables 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
White versus black 1 .45
White versus other race .48*** 1 .23
Male versus female .00 .05 1 .40
Age .16** .05 .15** 1 9.04 (1.55)
Pay lunch versus free lunch .36*** .05 .02 .20*** 1 .62
Parent education .15** .07 .09*.08 .39*** 1 4.61 (1.80)
Grade point average .26*** .05 .13** .09*.28*** .21*** 1 2.11 (1.30)
Infection cases .16** .16*** .07 .13** .04 .03 .05 1 32,688.65 (29,475.39)
Suburban versus Urban .14** .02 .05 .18*** .35*** .17*** .03 .03 1 .29
Rural versus Urban .19** .06 .05 .21*** .10*.05 .10*.23*** .22*** 1 .11
Social responsibility .13*.07 .04 .08 .16*** .13*.13*.04 .08 .01 1 .60
Protecting self .01 .02 .08 .07 .12*.05 .07 .10*.10 .05 .29*** 1 .50
Protecting others .18*** .02 .05 .06 .20*** .10*.15** .04 .10*.11*.23*** .47*** 1 .42
Government mandates .06 .03 .07 .08 .15** .07 .10*.01 .13** .01 .07 .23*** .20*** 1 .46
Parent rules .06 .01 .05 .02 .15** .09 .03 .03 .03 .03 .15** .25*** .23*** .25*** 1 .38
Friend instruction .03 .03 .02 .04 .06 .08 .07 .03 .11*.00 .13*.20*** .24*** .14** .28*** 1 .09
*p<.05; ** p<.01; *** p<.001.
M.-T. Wang et al. / Journal of Adolescent Health xxx (2021) 1e85
next-day engagement in social distancing. Descriptive knowl-
edge did not predict social distancing. Although boys, white
youth, and those qualied for free lunch were less likely to
engage in social distancing, these same- and next-day associa-
tions did not vary by gender, race, or free-lunch status.
Sensitivity analysis
We tested the direction of effects between adolescents
engagement in social distancing and their experience of peer
support and virtual connectedness. Social distancing behaviors
did not predict peer support or virtual connectedness, thereby
supporting our hypotheses.
Discussion
Social distancing has introduced unique challenges for ado-
lescents during COVID-19. Using focus group and daily-diary
approaches within a nationwide sample, we determined that
underlying developmental needs for autonomy and relatedness
inuence adolescentsdecisions to engage in and sustain social
distancing behavior. Adolescents who were motivated by the
desire to protect others were more likely to engage in social
distancing. Furthermore, adolescents who (1) were exposed to
practical knowledge about the risks and prevention measures
associated with COVID-19 and (2) felt virtually connected to and
supported by peers were more likely to engage in daily social
distancing at the onset of the pandemic.
Adolescent motivations and social distancing during COVID-19
Of the six potential reasons behind adolescentssocial
distancing, the desire to prevent others from getting sick was
most likely to predict youthssocial distancing behaviors. Moti-
vations associated with compulsory social distancing (e.g., my
parents/friends/state regulations made me do it) did not predict
adolescentssocial distancing behaviors. Notably, adolescents
motivations behind engaging in social distancing were primarily
altruistic (i.e., volitional and aimed at protecting others) in na-
ture. Indeed, scholars have asserted that giving support to others
can be both rewarding and stress reducing [9,10]. Engagement in
altruistic or loving behavior toward othersdespecially during
times of crisis or mass traumadhas also been associated with
increased resilience and mental health [26,27]. Consequently,
those aiming to encourage adolescentssocial distancing should
emphasize that these behaviors are a good way to keep yourself
and others safe during the pandemic.
Sustaining adolescentssocial distancing behaviors during
COVID-19
Three primary factors helped adolescents sustain daily
engagement in social distancing: practical knowledge about
COVID-19, perceived peer support, and virtual connectedness.
Adolescents who were frequently exposed to preventative health
information were more likely to increase their social distancing.
These ndings align with research surrounding adolescents
autonomous and prosocial motivations [6,28]: By providing
Table 4
Multilevel models predicting adolescents' same- and next-day engagement in social distancing over a 14-day period
Same-day engagement in
social distancing
Next-day engagement in
social distancing
Level 1 (within-person effects) Model with covariates only Model with level 2 predictors Model with level 1 and level 2
predictors
Model with level 1 and level
2 predictors
B 95% CI B 95% CI B 95% CI B 95% CI
Day .01 (.00)** [.00,.02] .01 (.00)*[.00, .02] .01 (.00)*[.00, .02] .01 (.00)*[.00, .02]
Weekend .04 (.03) [.10, .02] .05 (.03) [.11, .01] .04 (.03) [.10, .02] .04 (.03) [.11, .02]
Practical knowledge .12 (.02)*** [.08, .17] .05 (.02)*[.01, .10]
Descriptive knowledge .01 (.02) [.05, .03] .01 (.02) [.03, .05]
Peer support .04 (.02)*[.01, .08] .08 (.02)*** [.05, .12]
Virtual connectedness .23 (.04)*** [.14, .32] .12 (.05)*** [.03, .21]
Level 2 (between-person effects)
B 95% CI B 95% CI B 95% CI B 95% CI
White versus black .10 (.12) [.33, .14] .30 (.13)*[.55, .05] .27 (.12)*[.51, .03] .28 (.11)*[.52, .04]
Other versus black .18 (.13) [.44, .08] .30 (.14)*[.58, .03] .33 (.13)*[.59, .07] .34 (.14)*[.61, .08]
Boys versus girls .55 (.08)*** [.70, .40] .55 (.08)*** [.70, .39] .51 (.08)*** [..66, .36] .49 (.08)*** [.65, .34]
Age .06 (.03)*[.01, .11] .06 (.03)*[.00, .12] .04 (.03) [.01, .10] .05 (.03) [.01, .10]
Pay lunch versus free lunch .20 (.10)*[.01, .39] .22 (.10)*[.02, .43] .25 (.10)*[.06, .45] .25 (.10)*[.05, .45]
Parent education .04 (.03) [.01, .09] .02 (.03) [.03, .08] .02 (.03) [.04, .07] .01 (.03) [.04, .07]
Grade point average .03 (.03) [.08, .09] .03 (.03) [.09, .04] .02 (.03) [.08, .04] .01 (.03) [.07, .05]
Infection case .02 (.01) [.00, .03] .01 (.01) [.00, .03] .01 (.01) [.00, .03] .01 (.01) [.00, .03]
Suburban versus urban .02 (.09) [.16, .21] .07 (.10) [.13, .26] .10 (.10) [.09, .29] .09 (.10) [.11, .28]
Rural versus urban .36 (.11)*** [.15, .57] .56 (.12)*** [.33, .79] .49 (12)*** [.26, .72] .48 (.12)*** [.25, .71]
Social responsibility .14 (.09) [.03, .31] .08 (.08) [.09, .24] .08 (.08) [.09, .24]
Protecting self .18 (.08)*[.34, .01] .15 (.08) [.31, .01] .14 (.08) [.30, .03]
Protecting others .59 (.09)*** [.40, .77] .50 (.09)*** [.32, .68] .49 (.09)*** [.31, .67]
Government mandates .05 (.08) [.21, .11] .08 (.08) [.23, .08] .05 (.08) [.20, .11]
Parent rules .11 (.09) [.08, .29] .11 (.09) [.07, .29] .13 (.09) [.05, .31]
Friend instruction .10 (.15) [.20, .40] .08 (.15) [.21, .37] .08 (.15) [.21, .37]
-2 log likelihood 12,739.0 12,063.8 11,961.7 11,785.6
AIC 12,743.0 12,067.8 11,965.7 11,789.6
BIC 12,750.8 12,075.6 11,973.4 11,797.3
*p<.05; ** p<.01; *** p<.001.
M.-T. Wang et al. / Journal of Adolescent Health xxx (2021) 1e86
youth with practical information, we promote autonomy and
utility value, and by emphasizing the prosocial nature of social
distancing, we encourage a sense of connectedness to others.
In consideration of these ndings, public health administra-
tors and the media may be able to promote social distancing
behaviors among adolescents by providing targeted practical
information about the coronavirus, how to engage in appropriate
social distancing, and how social distancing prevents contagion
and protects others. It is noteworthy that descriptive knowledge
about infection and mortality statistics was not linked to
engagement in social distancing. Since the onset of COVID-19,
media has been saturated with infection and mortality statis-
tics as opposed to recovery rates or rates of vaccine distribution.
Our results align with extant research indicating that these
daunting statistics may be ineffective at promoting social
distancing, but effective at promoting fear and anxiety [29,30].
When interacting with adolescents, adults should consider how
youth might react to and operationalize various types of infor-
mation about COVID-19.
Furthermore, adolescents with higher peer social support and
virtual connectedness were more likely to sustain their social
distancing behaviors. Adolescentstenacity to remain relationally
connected to peers despite physical distancing illustrates how
autonomy and relatedness needs can spark adaptive functioning
in times of distress. The fulllment of these needs can be seen in
the array of adolescentscreative, volitional ways of using tech-
nology to overcome the challenges of remaining social from afar
during COVID-19 (e.g., online gaming platforms, social media).
Yet, the idea of virtually connecting with peers appears to rely
on the availability of technology, which may pose a problem for
youth from socioeconomically disadvantaged backgrounds [31].
Low-income youthsnancial circumstances may also make so-
cial distancing more challenging due to reliance on public re-
sources (e.g., public transportation, soup kitchens). Indeed, our
results indicated that adolescents who qualied for free school
lunches were less likely to engage in social distancing. This
nding aligns with research indicating that social distancing may
be a privileged behavior associated with pervasive socioeco-
nomic inequities in America [32]. In response, we need to
consider more equitable ways to promote social interaction and
public health behaviors for low-income youth so that they can
remain safely social during COVID-19.
Limitations
This work is a rst step into understanding trends in ado-
lescentssocial distancing at the onset of a pandemic. Because of
the rapid response nature of this work, we were unable to reach a
saturation of themes from our focus group. Future qualitative
inquiries should seek out additional adolescent motivations for
conforming to public health measures. Future quantitative work
should investigate how well-observed patterns hold across
contexts and time points during COVID-19, whether there are
associations with adolescentspsychological well-being, and if
group differences exist based on youths prepandemic levels of
social support.
Our longitudinal study design was able to account for within-
and between-person effects that allowed us to examine how key
constructs changed and shaped each other within and across
days; however, future research can use within-day event
sequencing or experimental designs to establish stronger causal
inference. Finally, our nationwide sample had disproportionately
small representations of Americans living in certain regions (e.g.,
midwest). Researchers should replicate our study with
geographically different samples to increase the generalizability
of key ndings. Considering that many adolescents are returning
to in-person schooling, researchers should also examine whether
adolescent motivations similarly drive other COVID-19 public
health behaviors, such as mask wearing.
Implications
This study sheds light on the motivations driving adolescents
social distancing behavior at the onset of COVID-19. To increase
the likelihood of compliance, any social distancing or other
relevant pandemic-related public health measures targeting
adolescents may frame these behaviors as prosocial, autono-
mous, and altruistic, making certain to highlight that social
distancing protects both yourself and others. Moreover, it is
imperative to counter potential threats to adolescentsneeds for
autonomy and relatedness by (1) providing useful, valid, and
accessible information about COVID-19 and (2) ensuring that
adolescents have access to technology so that they can receive
virtual, socially distanced peer support. As the pandemic con-
tinues to disrupt daily life, it is imperative that adults and public
health ofcials emphasize the autonomous, prosocial nature of
social distancing so as to increase the likelihood that adolescents
will engage in sustained preventative measures. In doing so, we
can proactively support adolescentspsychological needs while
keeping them safe during the COVID-19 crisis.
Acknowledgments
Author Contributions: MTW designed the study; wrote the
introduction, method, result, and discussion sections; CLS draf-
ted the introduction, literature review, and discussion sections;
MH and JDT conducted the analysis and drafted portions of the
result section. All authors read, provided feedback on, and
approved the nal manuscript.
Funding Sources
This study is funded by Spencer Foundation, Grant
#201600067.
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During the 2014–2016 West Africa Ebola epidemic, transmission chains were controlled through contact tracing, i.e., identification and follow-up of people exposed to Ebola cases. WHO recommendations for daily check-ups of physical symptoms with social distancing for 21 days were unevenly applied and sometimes interpreted as quarantine. Criticisms arose regarding the use of coercion and questioned contact tracing on ethical grounds. This article aims to analyze contact cases' perceptions and acceptance of contact monitoring at the field level. In Senegal, an imported case of Ebola virus disease in September 2014 resulted in placing 74 contact cases in home containment with daily visits by volunteers. An ethnographic study based on in-depth interviews with all stakeholders performed in September–October 2014 showed four main perceptions of monitoring: a biosecurity preventive measure, suspension of professional activity, stigma attached to Ebola, and a social obligation. Contacts demonstrated diverse attitudes. Initially, most contacts agreed to comply because they feared being infected. They adhered to the national Ebola response measures and appreciated the empathy shown by volunteers. Later, acceptance was improved by the provision of moral, economic, and social support, and by the final lack of any new contamination. But it was limited by the socio-economic impact on fulfilling basic needs, the fear of being infected, how contacts' family members interpreted monitoring, conflation of contacts as Ebola cases, and challenging the rationale for containment. Acceptance was also related to individual aspects, such as the professional status of women and health workers who had been exposed, and contextual aspects, such as the media's role in the social production of stigma. Ethnographic results show that, even when contacts adhere rather than comply to containment through coercion, contact monitoring raises several ethical issues. These insights should contribute to the ethics debate about individual rights versus crisis public health measures.