Project description:Recent popular press authors have proposed that men are less likely to wear face masks during the COVID-19 pandemic. We investigate this notion in the current article by analyzing three extant datasets. We also assess the mediating effect of eight different face mask perceptions in the relation between gender and face mask wearing via the Face Mask Perceptions Scale. Across the three datasets, the sample-size weighted meta-analytic correlation between gender and face mask wearing was not statistically significant, and no face mask perception was a consistent mediator of this effect. Gender did have significant relations with two face mask perceptions, however. Men were more likely to perceive face masks as infringing on their independence, whereas women were more likely to perceive face masks as uncomfortable. Therefore, although gender does not relate to whether a person wears a face mask, it does relate to face mask perceptions. We offer several suggestions for research and practice from these results, such as the positioning of face mask wearing alongside passive health behaviors, the broader study of face mask perceptions' outcomes beyond face mask wearing, as well as the creation of interventions to target differing face mask perceptions across genders.
Project description:Face masks are an important component in controlling COVID-19, and policy orders to wear masks are common. However, behavioral responses are seldom additive, and exchanging one protective behavior for another could undermine the COVID-19 policy response. We use SafeGraph smart device location data and variation in the date that US states and counties issued face mask mandates as a set of natural experiments to investigate risk compensation behavior. We compare time at home and the number of visits to public locations before and after face mask orders conditional on multiple statistical controls. We find that face mask orders lead to risk compensation behavior. Americans subject to the mask orders spend 11-24 fewer minutes at home on average and increase visits to some commercial locations-most notably restaurants, which are a high-risk location. It is unclear if this would lead to a net increase or decrease in transmission. However, it is clear that mask orders would be an important part of an economic recovery if people otherwise overestimate the risk of visiting public places.
Project description:BackgroundGuidelines and recommendations from public health authorities related to face masks have been essential in containing the COVID-19 pandemic. We assessed the prevalence and correlates of mask usage during the pandemic.MethodsWe examined a total of 13,723,810 responses to a daily cross-sectional online survey in 38 countries of people who completed from April 23, 2020 to October 31, 2020 and reported having been in public at least once during the last 7 days. The outcome was individual face mask usage in public settings, and the predictors were country fixed effects, country-level mask policy stringency, calendar time, individual sociodemographic factors, and health prevention behaviors. Associations were modeled using survey-weighted multivariable logistic regression.ResultsMask-wearing varied over time and across the 38 countries. While some countries consistently showed high prevalence throughout, in other countries mask usage increased gradually, and a few other countries remained at low prevalence. Controlling for time and country fixed effects, sociodemographic factors (older age, female gender, education, urbanicity) and stricter mask-related policies were significantly associated with higher mask usage in public settings. Crucially, social behaviors considered risky in the context of the pandemic (going out to large events, restaurants, shopping centers, and socializing outside of the household) were associated with lower mask use.ConclusionThe decision to wear a face mask in public settings is significantly associated with sociodemographic factors, risky social behaviors, and mask policies. This has important implications for health prevention policies and messaging, including the potential need for more targeted policy and messaging design.
Project description:BackgroundFace mask use has been associated with declines in COVID-19 incidence rates worldwide. A handful of studies have examined the factors associated with face mask use in North America during the COVID-19 pandemic; however, much less is known about the patterns of face mask use and the impact of mask mandates during this time. This information could have important policy implications, now and in the event of future pandemics.ObjectiveTo address existing knowledge gaps, we assessed face mask usage patterns among British Columbia COVID-19 Population Mixing Patterns (BC-Mix) survey respondents and evaluated the impact of the provincial mask mandate on these usage patterns.MethodsBetween September 2020 and July 2022, adult British Columbia residents completed the web-based BC-Mix survey, answering questions on the circumstances surrounding face mask use or lack thereof, movement patterns, and COVID-19-related beliefs. Trends in face mask use over time were assessed, and associated factors were evaluated using multivariable logistic regression. A stratified analysis was done to examine effect modification by the provincial mask mandate.ResultsOf the 44,301 respondents, 81.9% reported wearing face masks during the 23-month period. In-store and public transit mask mandates supported monthly face mask usage rates of approximately 80%, which was further bolstered up to 92% with the introduction of the provincial mask mandate. Face mask users mostly visited retail locations (51.8%) and travelled alone by car (49.6%), whereas nonusers mostly traveled by car with others (35.2%) to their destinations-most commonly parks (45.7%). Nonusers of face masks were much more likely to be male than female, especially in retail locations and restaurants, bars, and cafés. In a multivariable logistic regression model adjusted for possible confounders, factors associated with face mask use included age, ethnicity, health region, mode of travel, destination, and time period. The odds of face mask use were 3.68 times greater when the provincial mask mandate was in effect than when it was not (adjusted odds ratio [aOR] 3.68, 95% CI 3.33-4.05). The impact of the mask mandate was greatest in restaurants, bars, or cafés (mandate: aOR 7.35, 95% CI 4.23-12.78 vs no mandate: aOR 2.81, 95% CI 1.50-5.26) and in retail locations (mandate: aOR 19.94, 95% CI 14.86-26.77 vs no mandate: aOR 7.71, 95% CI 5.68-10.46).ConclusionsStudy findings provide added insight into the dynamics of face mask use during the COVID-19 pandemic. Mask mandates supported increased and sustained high face mask usage rates during the first 2 years of the pandemic, having the greatest impact in indoor public locations with limited opportunity for physical distancing targeted by these mandates. These findings highlight the utility of mask mandates in supporting high face mask usage rates during the COVID-19 pandemic.
Project description:With the COVID-19 pandemic still raging and the vaccination program still rolling out, there continues to be an immediate need for public health officials to better understand the mechanisms behind the deep and perpetual divide over face masks in America. Using a random sample of Americans (N = 615), following a pre-registered experimental design and analysis plan, we first demonstrated that mask wearers were not innately more cooperative as individuals than non-mask wearers in the Prisoners' Dilemma (PD) game when information about their own and the other person's mask usage was not salient. However, we found strong evidence of in-group favouritism among both mask and non-mask wearers when information about the other partner's mask usage was known. Non-mask wearers were 23 percentage points less likely to cooperate than mask wearers when facing a mask-wearing partner, and 26 percentage points more likely to cooperate than mask wearers when facing a non-mask-wearing partner. Our analysis suggests social identity effects as the primary reason behind people's decision whether to wear face masks during the pandemic.
Project description:The 2019 novel coronavirus (COVID-19) pandemic is associated with increases in psychiatric morbidity, including depression. It is unclear if people with depressive symptoms understand or apply COVID-19 information differently to the general population. Therefore, this study aimed to examine associations between depression, health beliefs, and face mask use during the COVID-19 pandemic among the general population in Hong Kong. This study gathered data from 11,072 Hong Kong adults via an online survey. Respondents self-reported their demographic characteristics, depressive symptoms (PHQ-9), face mask use, and health beliefs about COVID-19. Hierarchical logistic regression was used to identify independent variables associated with depression. The point-prevalence of probable depression was 46.5% (n = 5,150). Respondents reporting higher mask reuse (OR = 1.24, 95%CI 1.17-1.34), wearing masks for self-protection (OR = 1.03 95%CI 1.01-1.06), perceived high susceptibility (OR = 1.15, 95%CI 1.09-1.23), and high severity (OR = 1.33, 95%CI 1.28-1.37) were more likely to report depression. Depression was less likely in those with higher scores for cues to action (OR = 0.82, 95%CI 0.80-0.84), knowledge of COVID-19 (OR = 0.95, 95%CI 0.91-0.99), and self-efficacy to wear mask properly (OR = 0.90 95%CI 0.83-0.98). We identified a high point-prevalence of probable major depression and suicidal ideation during the COVID-19 outbreak in Hong Kong, but this should be viewed with caution due to the convenience sampling method employed. Future studies should recruit a representative probability sample in order to draw more reliable conclusions. The findings highlight that COVID-19 health information may be a protective factor of probable depression and suicidal ideation during the pandemic. Accurate and up-to-date health information should be disseminated to distressed and vulnerable subpopulations, perhaps using digital health technology, and social media platforms to prompt professional help-seeking behavior.
Project description:ObjectivePrior studies of universal masking have not measured face-mask compliance. We performed a quality improvement study to monitor and improve face-mask compliance among healthcare personnel (HCP) during the coronavirus disease 2019 (COVID-19) pandemic.DesignMixed-methods study.SettingTertiary-care center in West Haven, Connecticut.PatientsHCP including physicians, nurses, and ancillary staff.MethodsFace-mask compliance was measured through direct observations during a 4-week baseline period after universal masking was mandated. Frontline and management HCP completed semistructured interviews from which a multimodal intervention was developed. Direct observations were repeated during a 14-week period following implementation of the multimodal intervention. Differences between units were evaluated with χ2 testing using the Bonferroni correction. Face-mask compliance between baseline and intervention periods was compared using time-series regression.ResultsAmong 1,561 observations during the baseline period, median weekly face-mask compliance was 82.2% (range, 80.8%-84.4%). Semistructured interviews were performed with 16 HCP. Qualitative analysis informed the development of a multimodal intervention consisting of audit and passive feedback, active discussion, and increased communication from leadership. Among 2,651 observations during the intervention period, median weekly face-mask compliance was 92.6% (range, 84.6%-97.9%). There was no difference in weekly face-mask compliance between COVID-19 and non-COVID-19 units. The multimodal intervention was associated with an increase in face-mask compliance (β = 0.023; P = .002).ConclusionsFace-mask compliance remained suboptimal among HCP despite a facility-wide mandate for universal masking. A multimodal intervention consisting of audit and passive feedback, active discussion, and increased communication from leadership was effective in increasing face-mask compliance among HCP.
Project description:Faces are one of the key ways that we obtain social information about others. They allow people to identify individuals, understand conversational cues, and make judgements about others' mental states. When the COVID-19 pandemic hit the United States, widespread mask-wearing practices were implemented, causing a shift in the way Americans typically interact. This introduction of masks into social exchanges posed a potential challenge-how would people make these important inferences about others when a large source of information was no longer available? We conducted two studies that investigated the impact of mask exposure on emotion perception. In particular, we measured how participants used facial landmarks (visual cues) and the expressed valence and arousal (affective cues), to make similarity judgements about pairs of emotion faces. Study 1 found that in August 2020, participants with higher levels of mask exposure used cues from the eyes to a greater extent when judging emotion similarity than participants with less mask exposure. Study 2 measured participants' emotion perception in both April and September 2020 -before and after widespread mask adoption-in the same group of participants to examine changes in the use of facial cues over time. Results revealed an overall increase in the use of visual cues from April to September. Further, as mask exposure increased, people with the most social interaction showed the largest increase in the use of visual facial cues. These results provide evidence that a shift has occurred in how people process faces such that the more people are interacting with others that are wearing masks, the more they have learned to focus on visual cues from the eye area of the face.
Project description:IntroductionWidespread mask use is an important intervention for control of the coronavirus disease 2019 pandemic. However, data on the factors affecting mask use are lacking. In this observational study, we evaluated the proportion of and factors influencing face mask use and related hygiene practices.MethodsWe observed randomly selected members from the public in 367 venues across Singapore, and recorded the proportion of individuals with full compliance with mask use and mask hygiene (hand hygiene before and after touching the mask or face). Logistic regression analyses were used to determine variables associated with mask and hand hygiene compliance.ResultsWe made 3,821 observations - 2,149 (56.2%) females, 3,569 (93.4%) adults (≥21 years), 212 (5.5%) children (6-20 years) and 40 (1.0%) children (2-5 years). The overall full compliance rate (correct mask use), poor compliance rate (incorrect mask use) and absent mask use were 84.5%, 12.9% and 2.6%, respectively. The factors - male gender, fabric mask usage and crowded indoor venues - were associated with lower mask compliance. Face or mask touching behaviour was observed in 10.7% and 13.7% of individuals observed, respectively. Only one individual performed hand hygiene before and after touching the mask.ConclusionThe rate of mask compliance was high, probably due to legislation mandating mask usage. However, specific factors and crowded indoor venues associated with lower mask compliance were identified. We also noted an issue with the absence of hand hygiene before and after face or mask touching. These issues may benefit from targeted public health messaging.
Project description:Face mask recommendations are conflicting across the world during the coronavirus disease 2019 (COVID-19) pandemic. While universal face mask wearing is a useful non-pharmaceutical preventive strategy, little is known about the perception of mask wearing during a pandemic. This study aimed to examine people's face mask use in China and Europe. An online survey was conducted among residents in China, Austria, Germany, and Switzerland from the 1st to 10th of April 2020. With a convenience sampling approach, 655 valid answers were received including 267 Chinese and 388 European residents (261 from Austria, 101 from Germany, 26 from Switzerland). Self-reported face mask wearing status and related perceptions were assessed. Compared with the Europeans, Chinese participants showed a stronger pro-masking tendency. Subjective norm was an important predictor of face mask wearing in public. Wearing of face masks in the Chinese sample was also associated with risk perception as well as obedience to advice from local health authority. Discrepancies in face mask wearing suggest that targeted measures to promote face mask wearing are needed in Europe. Globally coordinated guidelines on pandemics are also warranted to face the next waves of COVID-19 and other infectious respiratory diseases.