Background: The practice of preventive health behaviors, such as regular handwashing, use of hand sanitizers, wearing facemasks in public, and maintaining safe physical distance can help contain the spread of the COVID-19 virus. Purpose: This study aimed to understand factors that influence university students' COVID-19 preventive behaviors by using the social ecological model (SEM). Methods: A total of 112 students shared their experiences with COVID-19 including their preventive behaviors by responding to an open-ended question via Qualtrics. Data were analyzed using thematic analysis. Results: The analysis resulted in various preventive factors across five levels of SEM--perceived responsibility for one's health; lack of health insurance coverage; support of preventive measures for the protection of loved ones; dyad health communication; satisfaction with enforcement measures to protect students by universities; health safety prioritization by employers; downplaying susceptibility to the virus; media hype of the virus; and politicization of the virus and lack of regulations; lack of regulations to mandate precautionary measures; and mistrust of information sources. Translation to Health Education Practice: Since the COVID-19 pandemic is ongoing, the findings of this study can be used by college and university administrators to empower and motivate students to engage in COVID-19 preventive measures.