Assocation Between In-person Instruction and COVID-19 Risk (Campus&Corona)

Relationship Between In-person Instruction and COVID-19 Incidence Among University Students: A Prospective Cohort Study

Whether university teaching on campus with infection control measures in place is associated with higher risk of COVID-19 than online instruction, is unknown. The investigators will assess this by conducting repeated surveys among students at universities and university colleges in Norway, where some instruction is given in-person, and some is provided online (hybrid model). The investigators will ask about the students' COVID-19 status, and how much in-person and online instruction the students are getting. The investigators will estimate the association between in-person instruction and COVID-19-risk using multivariate regression, controlling for likely confounders. The investigators will also assess whether type of instruction is associated with how satisfied the students are with the instruction the students are offered, their quality of life, and learning outcomes.

Study Overview

• Status: Active, not recruiting
• Conditions: Infection; Infection Control
• Intervention / Treatment: Behavioral: Online instruction; Behavioral: In-person instruction

Detailed Description

The investigators are inviting all universities and university colleges in Norway to take part. All students at institutions that agree to participate will receive an SMS (alternatively an e-mail) inviting them to take part in the study. The invitation includes a link that directs participants to a web-based informed consent-form and questionnaire. The investigators will use the University of Oslo's solutions for online consent form, web-based survey (Nettskjema), and secure storage of research data (TSD).

The investigators will ask the participants if the participants have been tested for COVID-19, the results of such a test, how much in-person instruction the students have been offered, and how much online instruction the students have been offered. The investigators will also inquire about other risk factors for COVID-19 and background variables that may be included as potential adjustment factors (confounders) in the analyses (see Attachment 1 - Questionnaire).

The investigators will survey the students every two weeks by new invitations by SMS or e-mail. The study period will last as long as the universities maintain their arrangement with in-person instruction for only select groups of students. The investigators plan for a study period that lasts for the remainder of 2020. The investigators will ask for the participants consent to link the survey results to information on study programme, basis for admission, study status, academic results, sex and age from the Common Student System.

The investigators will run multivariate regressions to test whether there is an association between in-person instruction and the outcomes.

In-person instruction is a continuous variable, defined as

(Number of days offered in-person instruction) / (Number of days offered in-person instruction + Number of days offered online instruction)

The investigators will control for potentially confounding variables, including year of study program, field of study, age, and gender. The investigators plan for separate analyses for each participating university/university college, and a pooled analysis across institutions.

• Study Type: Observational
• Enrollment (Actual): 26754

Contacts and Locations

Study Locations

• Norway
  • Oslo, Norway, 0130
    • Oslo Metropolitan University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: N/A
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

All university of university college students who agree to participate.

Description

Inclusion Criteria:

• Student in first, second, or third year at university or university college
• Agrees to participate (signed consent form)

Exclusion Criteria:

-

Study Plan

How is the study designed?

Number of groups / cohorts

14

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Students, Higher Education Institution 1; All first, second, and third year students at Higher Education Institution 1 who agree to take part in study.	Behavioral: Online instruction; For some courses and groups of students, instruction is primarily offered digitally, so that the students can participate from outside campus.; Behavioral: In-person instruction; For some courses and groups of students, instruction is primarily offered in-person, on campus (or elsewhere).
Students, Higher Education Institution 2; All first, second, and third year students at Higher Education Institution 2 who agree to take part in study.	Behavioral: Online instruction; For some courses and groups of students, instruction is primarily offered digitally, so that the students can participate from outside campus.; Behavioral: In-person instruction; For some courses and groups of students, instruction is primarily offered in-person, on campus (or elsewhere).
Students, Higher Education Institution 3; All first, second, and third year students at Higher Education Institution 3 who agree to take part in study.	Behavioral: Online instruction; For some courses and groups of students, instruction is primarily offered digitally, so that the students can participate from outside campus.; Behavioral: In-person instruction; For some courses and groups of students, instruction is primarily offered in-person, on campus (or elsewhere).
Students, Higher Education Institution 4; All first, second, and third year students at Higher Education Institution 4 who agree to take part in study.	Behavioral: Online instruction; For some courses and groups of students, instruction is primarily offered digitally, so that the students can participate from outside campus.; Behavioral: In-person instruction; For some courses and groups of students, instruction is primarily offered in-person, on campus (or elsewhere).
Students, Higher Education Institution 5; All first, second, and third year students atHigher Education Institution 5 who agree to take part in study.	Behavioral: Online instruction; For some courses and groups of students, instruction is primarily offered digitally, so that the students can participate from outside campus.; Behavioral: In-person instruction; For some courses and groups of students, instruction is primarily offered in-person, on campus (or elsewhere).
Students, Higher Education Institution 6; All first, second, and third year students at Higher Education Institution 6 who agree to take part in study.	Behavioral: Online instruction; For some courses and groups of students, instruction is primarily offered digitally, so that the students can participate from outside campus.; Behavioral: In-person instruction; For some courses and groups of students, instruction is primarily offered in-person, on campus (or elsewhere).
Students, Higher Education Institution 7; All first, second, and third year students at Higher Education Institution 7 who agree to take part in study.	Behavioral: Online instruction; For some courses and groups of students, instruction is primarily offered digitally, so that the students can participate from outside campus.; Behavioral: In-person instruction; For some courses and groups of students, instruction is primarily offered in-person, on campus (or elsewhere).
Students, Higher Education Institution 8; All first, second, and third year students at Higher Education Institution 8 who agree to take part in study.	Behavioral: Online instruction; For some courses and groups of students, instruction is primarily offered digitally, so that the students can participate from outside campus.; Behavioral: In-person instruction; For some courses and groups of students, instruction is primarily offered in-person, on campus (or elsewhere).
Students, Higher Education Institution 9; All first, second, and third year students at Higher Education Institution 9 who agree to take part in study.	Behavioral: Online instruction; For some courses and groups of students, instruction is primarily offered digitally, so that the students can participate from outside campus.; Behavioral: In-person instruction; For some courses and groups of students, instruction is primarily offered in-person, on campus (or elsewhere).
Students, Higher Education Institution 10; All first, second, and third year students at Higher Education Institution 10 who agree to take part in study.	Behavioral: Online instruction; For some courses and groups of students, instruction is primarily offered digitally, so that the students can participate from outside campus.; Behavioral: In-person instruction; For some courses and groups of students, instruction is primarily offered in-person, on campus (or elsewhere).
Students, Higher Education Institution 11; All first, second, and third year students at Higher Education Institution 11 who agree to take part in study.	Behavioral: Online instruction; For some courses and groups of students, instruction is primarily offered digitally, so that the students can participate from outside campus.; Behavioral: In-person instruction; For some courses and groups of students, instruction is primarily offered in-person, on campus (or elsewhere).
Students, Higher Education Institution 12; All first, second, and third year students at Higher Education Institution 12 who agree to take part in study.	Behavioral: Online instruction; For some courses and groups of students, instruction is primarily offered digitally, so that the students can participate from outside campus.; Behavioral: In-person instruction; For some courses and groups of students, instruction is primarily offered in-person, on campus (or elsewhere).
Students, Higher Education Institution 13; All first, second, and third year students at Higher Education Institution 13 who agree to take part in study.	Behavioral: Online instruction; For some courses and groups of students, instruction is primarily offered digitally, so that the students can participate from outside campus.; Behavioral: In-person instruction; For some courses and groups of students, instruction is primarily offered in-person, on campus (or elsewhere).
Students, Higher Education Institution 14; All first, second, and third year students at Higer Education Institution 14 who agree to take part in the study.	Behavioral: Online instruction; For some courses and groups of students, instruction is primarily offered digitally, so that the students can participate from outside campus.; Behavioral: In-person instruction; For some courses and groups of students, instruction is primarily offered in-person, on campus (or elsewhere).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
COVID-19 incidence	Self-reported positive test results	Through study completion, i.e. 4 months.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Quality of life	Self-reported ("Overall, how satisfied are you with life right now?")	Through study completion, i.e. 4 months.
Satisfaction with teaching	Self-reported ("Overall, how satisfied have you been with the teaching you have received in the past 14 days?")	Through study completion, i.e. 4 months.
COVID-19 testing incidence	Self-reported	Through study completion, i.e. 4 months.
Learning outcome	Exam results from Common Student System	End of term, December 2020.

Collaborators and Investigators

• Sponsor: Oslo Metropolitan University
• Collaborators: Norwegian Institute of Public Health
• Investigators: Principal Investigator: Atle Fretheim, PhD, Oslo Metropolitan University

Publications and helpful links

Helpful Links

• Pre-print version of study report manuscript.

Study record dates

Study Major Dates

• Study Start (Actual): September 4, 2020
• Primary Completion (Actual): December 31, 2020
• Study Completion (Anticipated): August 31, 2021

Study Registration Dates

• First Submitted: August 25, 2020
• First Submitted That Met QC Criteria: August 26, 2020
• First Posted (Actual): August 27, 2020

Study Record Updates

• Last Update Posted (Actual): May 6, 2021
• Last Update Submitted That Met QC Criteria: May 2, 2021
• Last Verified: May 1, 2021

More Information

Terms related to this study

• Keywords: COVID-19; College; University; Campus; Social distancing; Digital instruction; In-person instruction; Higher education institutions
• Additional Relevant MeSH Terms: Pathologic Processes; Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; RNA Virus Infections; Virus Diseases; Respiratory Tract Infections; Respiratory Tract Diseases; Pneumonia, Viral; Pneumonia; Lung Diseases; Disease Attributes; COVID-19; Infections; Communicable Diseases
• Other Study ID Numbers: 172155

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: We plan to make the full data set publicly available, after ensuring the re-identification of individuals is not possible.
• IPD Sharing Time Frame: From spring 2021 and for at least 5 years.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No