=Paper= {{Paper |id=Vol-2815/CERC2020_paper17 |storemode=property |title=Understanding the Impact of COVID-19 on Behavior Changes and Decision Making of Chinese Students and Researchers in the UK |pdfUrl=https://ceur-ws.org/Vol-2815/CERC2020_paper17.pdf |volume=Vol-2815 |authors=Hui Yang,Huiru Zheng,Xi Liu |dblpUrl=https://dblp.org/rec/conf/cerc/YangZL20 }} ==Understanding the Impact of COVID-19 on Behavior Changes and Decision Making of Chinese Students and Researchers in the UK== https://ceur-ws.org/Vol-2815/CERC2020_paper17.pdf
COVID-19 Research and Smart Healthcare
   1


        Understanding the Impact of COVID-19 on Behavior
       Changes and Decision Making of Chinese Students and
                     Researchers in the UK

                                       Hui Yang1, Huiru Zheng2*, Xi Liu1

       1 School of Social Work, China University of Labor Relations, Beijing, China,100048;
                                    redyanghui@163.com;
            2 School of computing, Ulster University, Northern Ireland, UK, BT37 0QB;
                                     h.zheng@ulster.ac.uk
                                 *:corresponding author



             Abstract With the outbreak of COVID-19 in Wuhan and the subsequent
            worldwide pandemic, oversea Chinese students and researchers (CSRs) have
            been hit twice, i.e. worrying about their families during the first phase and then
            experiencing the pandemic outbreak in a foreign country (UK) as a second hit.
            This study surveyed 179 CSRs in the UK via an online questionnaire to
            understand their behavioral patterns, risk assessment, and decision-making
            intentions during the two phases of the pandemic. The survey showed that (1)
            CSRs have experienced greater changes in behaviors such as leaving their
            rooms and going outisde, engaging social interaction, hygiene habits, and
            hoarding; and fewer changes in physical health, daily routines, and sleep
            patterns; (2) During the second phase, the concerning on risk of contracting
            COVID-19 was significantly increased from 7.8% to 20%; (3) About 60% of
            CSRs were not confident that they would get effective help in the UK, which
            was mainly related to the UK's pandemic prevention policy, public awareness,
            NHS ambulance service regulations, and the medical treatment of COVID-19 in
            the UK; and (4) A quarter of CSRs had returned or were planning to return to
            China, and nearly 3/4 of CSRs had decided to remain in the UK because of
            factors such as academic work, financial pressure (flight tickets have become
            very expensive), potential risk of infection on travel, taking a wait-and-see
            attitude, or being optimism that the pandemic would be over soon.

             Keywords: COVID-19 and oversea Chinese; COVID-19 and behavior change;
            COVID-19 and decision marking


  1         Introduction

  COVID-19, the infection caused by a novel coronavirus, broke out in Wuhan, Hubei
  province, China, around early January, 2020, and then swept through most parts of
  China. When the epidemic had been well-controled in China, unfortunately the
  epidemic has evolved into a global pandemic, as announced by the World Health
  Organization (WHO)[1]. Oversea Chinese students and researchers (CSRs) are unique
Copyright © 2020 for this paper by its authors.
Use permitted under Creative Commons License          275                                        CERC 2020
Attribution 4.0 International (CC BY 4.0).
                                                            COVID-19 Research and Smart Healthcare
  2

 in the sense that they have been going through both these two phases of COVID-19
 pandemic; During first phase they worried about their families and friends back in
 China, and then in the second phase they have been worrying about themselves in a
 foreign country. Moreover, during the coronavirus crisis anti-Asian crimes were up
 21% in the UK [2], therefore CSRs have to bear the threat and pain caused by
 stigmatization during the pandemic. In addition, according to the International
 Students in the UK Report 2020[3] published by the Association of British
 Universities, the number of international students from mainland China in the UK has
 reached 12.6 million (undergraduate and above), accounting for 35% of all non-EU
 students, as of 2018--2019 academic year statistics, and this is a big number. The
 above three factors make CSRs as a group, being worth investigating their behaviors
 during COVID-19 pandemic. What is the impact of this crisis on daily life of CSRs in
 the UK? Do they think they are safe? And what do they think about their chances of
 getting effective medical support in the UK? Answers to these questions will help UK
 understand the needs of CSRs, so that the country might become more attractive to
 CRSs, and even to international students from other countries as well.
    Since the outbreak of the pandemic, research has been carried out on the status of
 various groups in China affected by the pandemic, such as the anxiety levels of
 public, medical staff, university students (Zhao et al[4]; Hu et al[5]) and the impact of
 the pandemic on the status of international students studying abroad (ABCP[6]), but
 limit research has been conducted for addressing the above questions on the impact of
 the pandemic on individual lifestyle of international students.


 2          Methods

 2.1        Participants and Study Design

 Participants were recruited through the Chinese Students and Scholars Associations in
 the UK and the CSRs social media Wechat Groups. The survey was designed in
 Chinese, and recruitment was carried out via Chinese social media platform WeChat,
 which is the most popular social media platform among the Chinese community, and
 most UK universities and Chinese Students and Scholars Associations have a public
 account. The survey was launched at a Chinese survey platform Wenjuanxin
 (https://www.wenjuan.com/s/mq2Mvqs/). The study received ethical approval from
 the Research Ethical Committee of Faculty of Computing, Engineering and Building
 Environments, Ulster University, UK.


 2.2        Research Aim

    The aim of this research is to carry out a survey on behavior changes among CSRs
 (including undergraduate students, post-graduate students, PhD researchers, post-
 docs, and visiting researchers from China) in the UK when the COVID-19 outbroke
 in China and the UK.



CERC 2020                                    276
COVID-19 Research and Smart Healthcare
                                                                                          3

 2.3     Survey Design

    The study was conducted using a self-administered questionnaire. The
 questionnaire was designed to collect information on CSRs in the UK on their
 concerns and daily behaviors during the pandemic. It included four sections: (1)
 Participants' demographics information, such as educational status and study/research
 area; (2) Behavioral changes after the outbreak in China and the following pandemic
 in the UK. Questions focus on the impact of COVID-19 on the participant's social
 communication, shopping, sleep, hygiene, health, and information source related to
 the COVID-19; (3) Self-assessment of an individual's risk to the COVID-19 and the
 reasons; (4) Reasons behind behavioral decision-making.


 2.4     Statistical Analysis

    Data were analyzed using SPSS (v 25). All variables were analysed using
 frequencies and descriptive statistics to determine the number and percentages for
 each variable.


 3       Results

 The results consist of four parts: (1) Demographics information of participants; (2)
 Behavioral changes during the Pandemic; (3) Perceived risk and support; and (4)
 Decision making and reasons behind.


 3.1      Demographics of participants
    This section includes five pieces of information about the participant's age group,
 gender, the region of hometown, education level, and study area in the UK. We
 received 179 questionnaires which are 100% valid. Of the 179 participants, 97 (54%)
 were female and 82 (46 %) were male. The age range of participants was between 18
 and 34 years, among which 145 (81%) participants were aged 18 to 28 years.
 As shown in Figure 1 and Figure 2, a total of 89% of the participants' educational
 backgrounds were undergraduate, postgraduate, and doctoral. The majority (75%) of
 all participants studied in Northern Ireland.




                                            277                                       CERC 2020
                                                      COVID-19 Research and Smart Healthcare
  4



                             undergra                      75%
                             duate
                9%
                      38%                       18%
           2%                Postgrad                                Northern
                             uate                                    Ireland
      9%                     PhD           7%                        Scotland

                             postdoct                                England
                             oral
                27%
                             visiting
                             scholar



       Fig. 1. Education Background             Fig. 2. Geographical Area of Study

   As shown in Figure 3,participants were originally coming from 26 regions of
 China. 12.8% were from the Guangdong Province, followed by 11.2% from Beijing
 and 6.1% were from the Shaanxi Province.




CERC 2020                               278
COVID-19 Research and Smart Healthcare
                                                                                                               5


      Guangd…                                                                                     23
       Beijing                                                                          20
      Shaanxi                                                       13
     Liaoning                                                  12
        Fujian                                                 12
        Hebei                                             11
       Henan                                         9
   Shandong                                      8
    Shanghai                                 7
     Zhejiang                            6
       Tianjin                           6
       Shanxi                            6
        Anhui                            6
      Neimen…                        5
       Jiangxi                       5
      Sichuan                    4
          Jilin                  4
        Gansu                    4
      Jiangsu                3
       Hunan                 3
        Hubei                3
     Heilongj…               3
       Hainan            2
     Guangxi             2
      Yunnan        1
      Ningxia       1
               0     2       4       6       8       10   12        14   16   18   20        22   24   26


                                 Fig. 3. Geographic Distribution of GSRs


 3.2     Behavioral Changes of Students in the Pandemic

    The pandemic has affected people's behavior and daily life. The CSRs, including
 undergraduate students, post-graduate students, PhD researchers, post-docs, and
 visiting researchers from China, in the UK may have been hit twice by this pandemic
 in two main stages: 1. the COVID-19 broke out in China; 2. the COVID-19 broke out
 in the UK. It is important to understand how the pandemic has an impact on their
 daily life, communication, attitude to future career and how they search for
 information and they may seek support when they need.
    This section investigates changes in the behavior of CSRs in the aftermath of the
 outbreak, including how they first learned about the news, attitudes toward wearing



                                                           279                                              CERC 2020
                                                               COVID-19 Research and Smart Healthcare
  6

 masks as a foreigner in the UK, changes in the time when they began searching for
 information, and changes in their lifestyles.

 Question3.2.1:From which source you heard the outbreak?
 Family / neighbors, schoolmates, friends / Internet (news medias, social media) /
 others
   Most (152,85%) of participants heard this news about pandemic from the internet
 (news, social media, etc.),7% of participants got this news from neighbors,
 schoolmates, friends,and 8% of participants learned from family members.

  Question3.2.2:Did you put on face masks after you heard the outbreak of COVID-
 19? YES / NO / Maybe later/ Wanted but didn’t
    Almost 32% of participants wore the mask after the COVID-19; while there were
 31% of participants chose to go unmasked; 19% said they might wear masks in the
 future, and 18% wanted to wear a mask, but for some reason, they didn't.

 Question3.2.3 :Time spent searching for information about COVID-19
 compared to time spent searching for information in the past.
 Much less / a little less / same / a little more / much more (1-5)

                   50%
                   40%
                   30%
                   20%
                   10%
                    0%
                           much     a little     no     a little   much
                           more     more       change    less      less



            Fig. 4. The Time Change for Searching COVID-19 Related Information

    As shown in Figure 4,most participants (45.3%) spend a little more time to search
 for information about COVID-19; and some participants (13.3%) spend much more
 time to search for information about COVID-19. In total, 58.8% of participants have
 spent more time on information searching than before and only 16% of participants
 reduced the searching time.

 Question3.2.4:When COVID-19 outbreak occurred in China, how did it
 impact on your daily life changed? (stage 1)
 1None change-2--3-4 -5 Change a lot
    The changes in lifestyle frequency were compiled based on actual observations of
 international students, but there was no direction in the item, which could lead to
 misunderstanding by readers. According to the frequency of leaving the room,


CERC 2020                                      280
COVID-19 Research and Smart Healthcare
                                                                                                7

 participating in social activities and meeting new friends all decreased, while hygienic
 habits such as washing hands increased, and stockpiling of goods increased based on
 the rush of supermarkets in the UK. Sleep, daily routines and physical symptoms are
 difficult to show direction based on the current survey.
    As shown in Figure 5,when COVID-19 outbreak started in China, the following
 four daily behaviors have changed the most from:- "Frequency of leaving your
 room"(27%,48), "Frequency of going out for social activities"(30%,53),
 "Hygienic habits (handwashing, etc.) "(30%,53), "Stocking essentials (food/hand
 washer/tissues, etc.) "(33%,59). Basically, about 1/3 of the participants chose
 "change a lot". The four daily behaviors remained the same were" physical Health
 symptoms (headache/sore throat/stomachache, etc.), " "Meeting new friends",
 "Sleeping", "Daily routine".
    It can be seen that there is a big change in the existing behaviors and habits of
 interacting with others, while non- interpersonal behaviors such as "physical health
 symptoms", "sleep", and "daily routines" have not changed much. "Making new
 friends", on the other hand, maybe because the original life has not changed much, so
 there is not much change.



    Frequency of gettiing out of your room

           Frequency of going out for social
                       actives

        Hygienic habits(hand washing ,etc.)

             Stocking essentials(food/hand
                   washer/tisses,etc.)

                         Meeting new friends

                                    Sleeping

                                Daily routine

                          Physical symptoms

                                                0    20   40     60       80     100   120

          Change a lot     More change    Some change     Little change        None chane


                                 Fig. 5. Change in Behavior (stage 1)

 Question3.2.5:When COVID-19 outbreak occurred in the UK, how did
 it change on your daily life? (stage2 ) ( 1None change-2-3-4-5 Change a
 lot )


                                                    281                                      CERC 2020
                                                                 COVID-19 Research and Smart Healthcare
  8

    With the outbreak in the UK, this stage added the question asking about wearing a
 mask, and it was clear that over 55% of the participants changed very much on this
 option. As shown in Figure 6,when the COVID-19 outbreak happened in the UK, the
 five behaviors that participants changed most in their daily life were " Wearing
 mask", " Frequency of going out for social activities", " Frequency of leaving your
 room", " Stocking essentials (food/hand washer/tissues, etc.) ","Hygienic habits"; The
 three behaviors that remained none change in the participants' daily life were "
 Physical health symptoms (headache/sore throat/stomachache, etc.) ", " Sleeping",
 and " Daily routine".



      Frequency of getting out of your room


            Frequency of going out for social
                        actives


        Hygienic habits (hand washing, etc.)


             Stocking essentials (food/hand
                  washer/tissues, etc.)


                                  wear mask


                                    Sleeping


                                Daily routine


        Physical symptoms (headache/sore
            throat/stomachache, etc.)

                                                0 10 20 30 40 50 60 70 80 90 100110120

            Change     more changes      Some changes     Little change   None change
            a lot

                                 Fig. 6. Change in Behavior (stage 2)


 3.3        Perceived Risk and Support
   It is also important how CSRs perceive their own risk/safety at both stages. This
 section includes 5 questions: the assessment of the likelihood of being diagnosed;


CERC 2020                                          282
COVID-19 Research and Smart Healthcare
                                                                                               9

 confidence in receiving effective medical assistance when needed; the reasons for that
 confidence assessment; the support expected; and the support received.

 Question3.3.1: How likely you thought you would be diagnosed as COVID-19?
 Please indicate the extent to which you agree with each of the following statements
 using one of the three options.(high possibility; uncertain; high possibility)


                                              stage I         stage II

                   80%
                              60%
                   60%              55%

                   40%                             32% 34%                       29%

                   20%                                                      8%
                    0%
                            low possibility        uncertain             high possibility

                           Fig. 7. Possibility of Diagnosed as COVID-19

    It can be seen that in stage I(Figure 7), the number of participants who think they
 could have a high risk of infection is relatively small, only 7.82%; mostly(60%)think
 that they could have a very low risk of infection, etc., and about 32% of participants
 think that there is uncertainty.

    In stage II, the number of participants who thought there was uncertainty about
 infection increased by 2%, while the proportion of those who thought there was a high
 risk of infection increased significantly, with the proportion rising by more than 20%
 from 8% to nearly 1/3(29%) of the participants.

 Question3.3.2: How much confidence you have for receiving effective medical
 treatment in case you were diagnosed with COVID-19? Please indicate the extent to
 which you agree with each of the following statements using one of the three options
 (low confidence; uncertain; high confidence).




                                                        283                                 CERC 2020
                                                            COVID-19 Research and Smart Healthcare
  10


                                 3%

                            9%                                       Totally unconfiden
                                        28%
                                                                     unconfident

                      28%                                            neutral
                                                                     confident
                                      32%                            very confident




                    Fig. 8. Confidence in Receiving Effective Treatment

    Whether or not you have access to effective medical assistance is the most
 important indicator of international students' sense of security. More than half (60%)
 of participants have low confidence in this, of which nearly half (28%) participants
 have no confidence at all, and the rest also have very low confidence. Nearly one-
 third of participants (28%) are neutral about this, and only about 12% (9%+3%)
 participants are confident about this.

 Question 3.3.3: Why do you think so? (up to three selections)
    Among the reasons for getting effective support(as shown in Figure 10),
 participants showed high confidence in the option of "the support from the local
 (Chinese) student union or consulate"; it reflects the active support they have
 provided. On the "language factor", although some participants had some confidence,
 overall no one showed high confidence in this factor; on all other options low
 confidence was more prominent, reflecting the overall low confidence of participants
 in the various environmental factors involved.




CERC 2020                                     284
COVID-19 Research and Smart Healthcare
                                                                                                                              11



             Previous medical experience in the UK

                                  NHS medical ability

                            The UK epidemic policy

                        The NHS medical procedures

                                      I am a foreigner

                                      Language factor

                                    economic factors

         local people’s awareness of protections

                 The status of outbreak in my area

     The work of the local student union or local…

                                         Back to family

              China’s experience and effectiveness

                                 China’s medical care

                                                unclear

                                                            0         5    10      15    20     25    30        35     40

                            a lot conidence               more confidence          some confidence
                            little confidence             none

             Fig. 9. Summary of Reasons for Confidence in Receiving Effective Treatments

                                 Table1 chi-square test: the reason for effective treatment


                                                            little         some         more         a lot of        chi-
   Q45                                        none
                                                           confidence      confidence   confidence   confidence      square sig



   Unclear                                           3                 3            7            1                          0.412


   China’s medical care                              9                 7            1            1                          0.081


   China’s experience and effectiveness              8                12            5            2              1           0.627


   Back to family                                    6                 6            2                                       0.323

   The work of the local student union
                                                     2                 1            5            6              2        0.000*
   or local consulate

   The status of the outbreak in my area             9                11           10            2              1           0.973

   local people’s awareness of
                                                     19               21            9                                    0.003*
   protections




                                                                     285                                                    CERC 2020
                                                                             COVID-19 Research and Smart Healthcare
  12


   economic factors                              3           7          2                                0.283


   Language factor                              15           16         15                               0.068


   I am a foreigner                             20           23         13                               0.006*


   The NHS medical procedures                   32           36         25               7           1   0.093


   The UK epidemic policy                       34           37         20               7           1   0.006*


   NHS medical ability                          16           24         14               8           5   0.049*

   Previous medical experience in the
                                                 9           17         12               6           3   0.281
   UK




    According to the results of the chi-square test (Table1), the participants' opinions
 were significantly different on these options, such as "the local population's awareness
 of protection", "I am a foreigner", "the UK's pandemic prevention policy", "NHS
 pandemic prevention and medical care level" and "policy of the local federation or
 consulate".

 Question3.3.4: At your area, which is your most desired anti-epidemic help? (up to
 three selections)

              medical care                                                                   61%

    anti-epidemic items                                                              56%

          financial support                                                        52%

    oversea study policy                                                 44%

            mental support                             22%

        health consultation                     12%

                         other          3%

                                 0%       10%    20%    30%       40%        50%    60%        70%

                                        Fig. 10. Summary of Desired Support

    Over 50% of the demanding options are "medical care"、 "anti-pandemic items"
 and "financial support". It means that at this stage, material needs related to pandemic
 protection are most important to the participants. Subsequently, the options for
 international students were "oversea study policy", "mental support", and "health
 counseling for medical care and pandemic prevention". About 3% of the participants
 chose "Other" and all of them indicate "Airfare", "Airline tickets", and such on.




CERC 2020                                                286
COVID-19 Research and Smart Healthcare
                                                                                          13

 Question3.3.5: When COVID-19 outbreak in the UK, what’s kind of supports did the
 following groups provided you? (multiple selections)

                                 Others
                  Local student union /…
                       Local University…
               Local schoolmates and…
      University and Teacher in China
    Schoolmates and friends in China
                       Family member

                                           0       50    100 150 200 250 300 350 400

               Other spport               oversea study policy          medical care
               health consultation        financial support             mental support
               anti-epideminc items

                               Fig. 11. Overview of Support Received

   The "medical care," which ranks first in Figure 10, was provided relatively little by
 seven support groups. The "anti-pandemic items" and "mental support" were both
 provided a lo by the seven support groups.



                                     all support

                          2%
                                   11%                        Others
            26%
                                                              oversea study policy
                                          7%
                                                              medical care

                                          11%                 health consultation
                                                              financial support
                                         7%                   mental support

               36%                                            anti-epideminc items


                               Fig. 12. Percentage of Support Received

    Participants have received the most support in the form of "mental support",
 followed by "anti-pandemic items", "health counseling for medical care and pandemic
 prevention" and" oversea study policy ", "financial support" and "medical care", and
 finally, "other elements of uncertainty".

                                                        287                              CERC 2020
                                                                    COVID-19 Research and Smart Healthcare
  14




    anti-epideminc items
            mental support
         financial support
       health consultation
              medical care
     oversea study policy

                              0           200         400          600          800           1000

            family    Schoolmates and friends in China       University and Teacher in China


                                  Fig. 13. Received Support from China

    The support received from families is mainly "anti-pandemic material", "mental
 support "and "financial support" for vaccination. The support from Chinese
 classmates and friends is mainly "mental support", "anti-pandemic material" and
 "health consultation" for anti-pandemic information. Chinese universities and teachers
 mainly provided support in forms of "mental support", "anti-pandemic material" and
 "oversea study policy".


    anti-epideminc items
            mental support
         financial support
       health consultation
              medical care
     oversea study policy
                     Others

                              0          50       100        150          200         250        300

             Local schoolmates and        Local University   Local student union /          others
             friends                      /community         consulate


                                  Fig. 14. Received Support from the UK

    Local students/friends mainly provided "mental support " and "anti-pandemic
 material " support to CSRs. Local universities/communities provided "mental support
 " as well as support on "oversea study policy" . Local Chinese student


CERC 2020                                           288
COVID-19 Research and Smart Healthcare
                                                                                           15

 unions/consulates mainly provide "anti-pandemic material ", "mental support",
 "health consultation" for pandemic-prevention information and "oversea study
 policy".


 3.4      CSRs’ Decision Making and Reasons Behind
    This part includes 2 questions: the CSRs' decision and the reasons to support
 decision making.
 Question3.4.1: After the COVID-19outbreak occurred in the UK, your decision is?
 Plan to go back; Already go back; Stay at ease, believing the epidemic will pass;
 Temporally stay in the UK, acting depends on the situation; Want to go back but have
 to stay in the UK.
                 decision intention

                                                                back or stay
    35%
    30%
    25%
    20%
    15%                                                            26%         back and
    10%                                                                        plan to
     5%                                            74%                         back
     0%
                                                                               stay at
                                                                               UK




  Fig. 15. Distribution of Five Decisions                Fig. 16. Final Decision

   In terms of specific choices, “wait-and-see” is the most popular choice, at 33%.
 This was followed by those who thought the pandemic would pass and waited with
 confidence (28%). The rest participants are those who have gone back, intend to go
 back, and want to go back but have to stay(Figure 15).

    If we distinguish between suburbs based on the current intention to go back or not,
 the current situation is as shown above (Figure 16). Only about 1/4 of participants
 have returned or are planning to return, and nearly 3/4 of participants are still staying
 in the UK whether they want to or not.

 Question3.4.2: The reasons you made the decision? (up to 3 selections)




                                             289                                          CERC 2020
                                                                          COVID-19 Research and Smart Healthcare
  16


                                      The reason for stay or not

            financial
      family require
        safe medical
          other back
          study task
       previous plan
        infecion risk
                other

                        0%           10%         20%           30%        40%         50%

                                 back or plan to back        stay at uk


                                 Fig. 17. Reasons Behind the Decision Making

                                 Table2 Chi-square Test: reasons behind the decision
       Choice reason                         stay          back           chi-square sig
     other                                       4                 3                 0.289
     other back                                  0             13                    0.000*
     *family require                             6             24                    0.000*
     same as previous                          32              14                    0.394
     financial issue                           55                  4                 0.000*
     infection risk on the way                 71                  2                 0.000*
     study task                                71                  8                 0.000*
     safe medical consideration                81              33                    0.188
     sum                                      320            101


    We can see from the results of Chi-square test (Table2) that there are significant
 differences between the two types of choices for participants to go back or not. The
 participants who choose "stay" are mainly based on the economic factor, the risk of
 cross-infection on the road, and the task of studying afterward; these are mostly
 objective factors.The participants who chose "back" were mainly based on
 interpersonal factors such as "the request of family members" and "all other
 international students around have gone back".


 4           Discussion
 The outbreak of the pandemic in China has made CSRs make significant changes in
 their lifestyles and behaviors, such as taking more protective measures than local
 people. When the outbreak had not yet broken out and the UK government was not


CERC 2020                                                290
COVID-19 Research and Smart Healthcare
                                                                                         17

 enforcing home quarantine, CSRs had already begun to make significant changes in
 "wearing masks", "leaving their rooms less often", "having less contact outside", and
 "changing their hygiene habits".
    Behavioral changes were in the area of multiple interpersonal interactions and little
 change in self- related aspects such as sleep, routines, and physical and mental
 symptoms.
    CSRs have multiple factors influencing their assessment of their own well-being in
 the event of a foreign pandemic. In general, with the outbreak of pandemics in the
 UK, CSRs think that they are more likely to be infected with pandemics, and they are
 less confident that they will be able to get effective medical treatment, based on their
 awareness of the UK government's "Buddhist anti-pandemic" measures and their
 status as foreigners. More than half (60%) of participants have low confidence in this,
 and only about 12% (9%+3%) participants are more confident about it.
    CSRs in crisis need medical assistance support most, followed by support such as
 anti-pandemic items and financial support, and then " soft support" such as oversea
 study policy, and mental support. CSRs receive the most support in the form of anti-
 pandemic items and mental support, and almost all of these resources are provided at
 both home and abroad. Financial support is mainly provided by families. The work of
 local student federations/consulates (distributing anti-pandemic materials and
 providing information on pandemic prevention) has had a significant effect. It is
 almost impossible for CSRs to secure the content of the overall national regulation,
 such as the UK's pandemic prevention policy, medical and ambulance protection, and
 China's aviation policy for pandemic prevention requirements.
    As of July 5, there were significant differences between the two final behavioral
 decision choices of CSRs to "go back to China" and "stay in the UK". The three-
 quarters of participants chose to stay in the UK, which included the proactive choices
 of "want back, have to stay","wait and see how the pandemic develops" and those
 believe the pandemic will pass(stay and ease). The participants who chose to "stay in
 the UK" were influenced by a variety of factors, such as academic needs, financial
 pressure (flight restrictions), risk of cross-contamination on the road, and their
 original plans, etc. The participants who chose to "go back" were influenced by
 interpersonal factors, such as "family" and "people around them have left".
    In conclusion, the majority (3/4) of participants stayed in the UK although they
 experienced two pandemic shocks in the UK and did not think they have enough
 safety in the pandemic. On the one hand, it is based on the security of pandemic
 prevention materials, psychological care, and study abroad related policies at home
 and abroad, and on the other hand, it is also based on the consideration of future
 development. In terms of the "fight or flight" mode of crisis response, 1/4 chose to run
 away and 3/4 chose to fight.


 5       Limitation of this study
 This study had some limitations. Firstly, our sample was small. Furthermore,
 limitations of the current study include the use of a self-designed questionnaire and


                                            291                                      CERC 2020
                                                             COVID-19 Research and Smart Healthcare
  18

 the reliance upon self-reporting in the midst of the constantly changing prevalence of
 COVID-19. In addition, this study focused on changes in CSRs’ behavioral change,
 risk of COVID-19 infection, confidence in receiving effective assistance, and final
 choice to return home or not, and did not measure their psychological statuses, such
 as anxiety and depression levels. Future studies could add this component and be
 comparable to most current studies in China (health care workers, university students,
 and other groups).


 6          Conclusion

 The conclusion of this paper is: Despite the fact that CSRs has a significantly higher
 assessment of infection risk in the second stage (34% uncertain, 29% high risk), and
 perceive themselves as less likely and less confident to be rescued (60% low
 confidence), 3/4 of the participants still chose to stay in the UK based on a number of
 realistic and subjective factors (subsequent studies, flight tickets, risk of infection on
 the road, etc.). As a result, our findings are based on cross-sectional data from local
 convenient samples. However, in reality, from May to July, there have been some
 changes in the UK's epidemic prevention and control policies and public responses.
 The future study could explore the changes in the mindset of CSRs and the influence
 of relevant factors in this changing environment of epidemic prevention and control in
 the UK.


 7          Reference:
  1. WORLD HEALTH ORGANIZAITON,WHO director-general’s opening remarks at the
     media briefing on COVID-19 11 March 2020.
    https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-
    media-briefing-on-covid-19---11-march-2020
  2. Anti-Asian crimes up 21% in UK during coronavirus crisis. The Guardian, May 13, 2020.
  3. Association of British Universities, International Student Statistics in UK 2020.
     https://www.studying-in-uk.org/international-student-statistics-in-uk/
  4. Hongyu Zhao, Xiaoyi He, Guanhua Fan, Liping Li, Qingjun Huang, Qinming Qiu, Zhewei
     Kang, Taifeng Du, Ling Han, Lei Ding, Haiyun Xu: COVID-19 infection outbreak
     increases anxiety level of general public in China: involved mechanisms and influencing
     fac- tors. Journal of Affective Disorders, volume 276:446-452 (2020).
     https://doi.org/10.1016/j.jad.2020.07.085
  5. Wei Hu, Li Su, Juan Qiao, Jing Zhu, Yi Zhou: Countrywide quarantine only mildly in-
     creased anxiety level during COVID-19 outbreak in China. Preprint, (2020).
     https://doi.org/10.1101/2020.04.01.20041186
  6. ABCP (Association of British Chinese Professors): The Impact of COVID-19 on Chinese
     Applicants' Decisions to Pursue a University Degree in the UK in 2020-21 Academic
     Year, Results from an Online Survey, (2020). http://abcp.org.uk/covid-19-2020-survey-
     report/




CERC 2020                                     292