## 4 Discussion  
In this study we aimed to explore knowledge about, the risk perception level of, and adherence to preventive and control measures for, COVID-19, as well as potential barriers and facilitators among a large sample of Italian undergraduate university students. The consideration of factors unique to this age group is pivotal to inform the design, communication and implementation of public health interventions. These insights are not only valuable for the ongoing mitigation of the current COVID-19 pandemic but may also serve to inform prevention and control strategies of health decision-makers and public health organizations for possible future pandemics. Our findings indicate that most study participants were knowledgeable about COVID-19, and the overall level of knowledge was quite comparable to similar national [17,18] \begin{table}
\begin{tabular}{l c c} \hline \hline  & \multicolumn{2}{c}{**Correct Answers**} \\ \cline{2-3}  & **N** & **\%** \\ \hline When I sneeze/cough, I cover my mouth and nose with my elbow flexed if & 1059 & 80 \\ I don’t have a tissue & 1089 & 82.3 \\ I remove the mask by holding the ear loops or ties without touching & 400 & 30.2 \\ the front & 1019 & 77 \\ I don’t touch the mask while using it & 1264 & 95.5 \\ \hline \hline \end{tabular}
\end{table} 
Table 3: Adherence to NPIs. and international studies [19; 20]. Such figures did not come as a surprise, as the Italian government has taken all the appropriate actions in updating their webpage, providing information regarding prevention and guidelines to educate the public about the disease. Moreover, during this period, the mass media, the main source of information reported in the present study, have given continuous and timely updates on the pandemic. The mass media have a significant influence both on the knowledge and risk perception of the public. As expected, students studying medical or life science majors were significantly more knowledgeable than those studying other majors. Considering that a paucity of knowledge may lead to nonchalant behavior, making it difficult to curb the disease, health education programs aimed at improving COVID-19 knowledge in less aware groups may be helpful to support people in maintaining safe practices. Moreover, as a high-knowledge group, medical or life science university students can spread their knowledge and strong risk awareness to the individuals around them. Indeed, health literacy was found to protect medical students from fear [21]. Compared with students studying non-medical/life-science subjects, medical or life-science students have less fear of falling ill with COVID-19 as has been previously documented [22]. Therefore, enhancing health literacy skills should be considered a strategic approach to protect health. The finding that the perceived risk of vulnerability to COVID-19 was relatively higher than the \"fear of falling ill with COVID-19\" could reflect to some extent the students' attention to COVID-19, together with a false sense of confidence regarding their safety. In Italy, the mass media have documented young adults mingling with others in large groups, not wearing face masks and ignoring community pandemic guidelines, thinking they are less likely to have severe cases of COVID-19, and ignoring the possibility they may pass the infection to others unknowingly. Evidence exists that increased cases of COVID-19 among young adults are followed by increases among older adults four to fifteen days later, suggesting that younger people are transmitting COVID-19 to them [23]. The fact that only one-third of the sample did not touch their face mask while using it is a matter of concern. If potentially contaminated hands touch the face mask put over the mouth and nose, subjects are at risk for infection.