Efficient dissemination of information is an important part of public health work, and it is especially important in exceptional situations, like the one that arose during the coronavirus (Covid-19) pandemic. A report from the Norwegian Institute of Public Health found that communicating information about Covid-19 plays a huge role in reducing infections, and places a low to no burden on children and adolescents [1]. Nevertheless, a survey of the adult population in Norway showed that “a significant proportion of the population faces a variety of challenges in dealing with health information” (p. 12) [2]. If this is true for adults, how do adolescents perceive the information they receive about Covid-19?
Covid-19 is a flu-like respiratory infection that, in January of 2020, started to spread from China to many countries around the world. Covid-19 is transmitted through droplets and close contact, and appears to have a higher mortality rate than the flu, making it a priority to reduce its spread among the population [3]. The World Health Organization declared Covid-19 a “serious incident of significance to international public health” in January 2020, and in March 2020 it was declared a pandemic. Many European countries, including Norway, implemented radical measures to reduce the spread of Covid-19 in the population. These measures were similar to those taken in 107 other countries, and included closing kindergartens and schools [4]. People who had traveled abroad or between southern and northern Norway, and those with flu-like symptoms were obligated to quarantine at home for 2 weeks. Anyone who was not considered an essential worker (i.e., who performed tasks critical to society) was encouraged to work from home, and students across Norway received online teaching only.
The Norwegian health authorities provided official recommendations and information to the public several times per day through the media, through the Norwegian Institute of Public Health’s websites, and through the governmental website Helsenorge.no. These recommendations were comprehensive and targeted various groups, such as at-risk groups, pregnant women and children, persons in quarantine, persons with symptoms, health care personnel, as well as other occupational groups. The recommendations changed over time as the situation developed, and many experts commented on the situation in the media, sometimes with viewpoints that contradicted the official recommendations of health authorities.
Given the importance of the successful dissemination of information in public health, it is useful to look at the characteristics that contribute to this success. Some have argued that, for its dissemination to be successful, information has to be applicable, diverse, reliable, and comprehensible [5]. Among other things, applicable information refers to information that is relevant for tackling a health issue and appropriate to local practice. Diverse information targets a variety of people who might have different needs (such as children, adolescents, adults, pregnant women, and older people). Reliable information is based on evidence [5] and enables the individual to better protect him/herself and thus experience a sense of mastery of the situation. A Chinese study concluded that “erroneous knowledge could lead to ineffective preventive measures by the population and increase the risk of infection” (p. 302) [6]. Finally, to be comprehensible, information must be easily understood by its recipients [5].
Most information provided during the pandemic targeted adults [7] and was probably challenging for children and adolescents to navigate [8]. Indeed, key messages need to be adapted in an age-appropriate way. Not only might children and adolescents be interested in different topics than adults, but research suggests that adolescents process information differently than adults, as their brains are still developing [9,10,11]. Furthermore, girls and boys in adolescence may understand and interpret information differently. Girls generally have better reading skills than boys [12], which may impact both the speed at which they read and their comprehension of written information about the virus. One study found small gender differences in mental health literacy among adolescents [13]. Females were able to recognize and label mental health problems more correctly than males, and the prevalence of a disorder within a gender was related to the recognition of that disorder by the gender [13]. Bjørnsen et al. [14] also found small gender differences in mental health literacy, but they concluded that overall differences might be smaller than once assumed.
Information provided to children and adolescents must be applicable, reliable, and comprehensible, but it must also be tailored to their age group. The Norwegian authorities were aware of this, and held a special press conference on March 16th 2020, during which the Prime Minister, Erna Solberg, the Minister of Children and Families, and the Minister of Education and Integration answered questions that children had submitted. No similar press conference was held for adolescents, whose daily lives have been affected by the pandemic in unprecedented ways. Indeed, being confined to their homes with limited social contact may have a bigger impact on adolescents than on younger children and adults [15, 16]. Adolescence is a period in which many explore different options related to vocation, relationships, and other areas before making commitments [17], and this was not possible in traditional ways during the pandemic. Moreover, adolescence is a developmental period, when information might be obtained, understood, and handled differently than in other age groups [18]. Most adolescents do not develop severe symptoms when infected with Covid-19 [19], which might make then less inclined to seek out information due to a lower perceived risk [20]. One study found that higher perceived risk among adolescents was associated with the presence of risk factors for and knowledge of Covid-19, and that knowledge was related to better compliance with preventive measures [21], suggesting that improving knowledge about Covid-19 could be a good strategy to increase protective behavior in this age group [21]. Abbott et al. [20] criticized messaging efforts aimed at adolescents in the USA, which stressed that it is unlikely the virus would make them seriously ill. They argued that adolescents may have been more motivated to engage in protective behaviors if they were reminded about the possible consequences of infection for people in high-risk groups, such as older people [20]. Yang et al. [21] came to the same conclusion, and found that protecting family and friends at risk was a motivating factor for adolescents to adhere to preventive measures.
Adolescents may also be less likely to follow guidelines because they seek greater autonomy; they may prefer to listen to friends for guidance and information, instead of listening to more reliable information from adults or official institutions [22]. The potential consequences of adolescents not seeking information or following guidelines may be a public health risk, as they could spread the virus to more vulnerable populations. Disseminating effective information tailored to adolescents could help promote safe behaviors and prevent the spread of Covid-19 [23]. It is therefore important to examine how adolescents perceived the information provided on Covid-19 through the media and other sources.
Results from an international study showed that 61% of Norwegian 9th graders used traditional media channels, such as TV and newspapers, to stay informed about Covid-19 [24]. The Norwegian Media Authority’s annual report (2020) showed that many children and adolescents read news on social media, and that proportion increased with increasing age [25]. The same report also showed that more girls than boys read, watch, and listen to news in general. A total of 52% of 9–10-year-olds and 96% of 15–18-year-olds get their daily news from social media [25]. YouTube, Snapchat, TikTok, and Instagram were the most popular social media platforms among those aged 9–18 years [25]. Whether these same platforms are preferred in a time of crisis is unknown. A survey based on approximately 1300 individuals, aged 16 years and above, showed that confidence in the Norwegian media is generally high [26]. However, it is not known whether adolescents have high confidence in the media when it comes to information about the Covid-19 pandemic. In general, trust can be divided into trust in other people and trust in institutions. The latter is important, as it also includes trust in the government, the municipality, the judiciary, the police, and the media [24]. In a previous survey, Norwegian 9th graders (N = 6271) had overall high confidence in Norwegian authorities [24]. A Swiss study found that trust in authorities was associated with compliance with Covid-19-related public health measures [27].
Study aim
This study examined how adolescents perceived information about Covid-19 provided by the media and other sources, and about what topics adolescents reported they lacked information during the first months of the Covid-19 pandemic. Another aim of the study was to identify which social media platforms and media adolescents used to gather information, and how they evaluated the reliability and utility of these sources. In addition, we examined how adolescents perceived the Covid-19 pandemic, and how they were affected by the measures taken. Other aims were to examine gender differences in the overall satisfaction with information provided about Covid-19, in the extent to which the pandemic affected everyday life, and in concerns about becoming infected with Covid-19.
