Association of masking policies with mask adherence and distancing during the SARS-COV-2 pandemic

Puttock, Eric J.; Marquez, J.A.; YoungPhD, Deborah R.; Shirley, Abraelle M.; Han, Bing; McKenzie, Thomas L.; Smith, Nicole J.; Manuel, Kathleen; Hoelscher, Deanna M.; Spear, Suzanne E.; Ruiz, Monica S.; Smith, Charlotte; Krytus, Kimberly; Martínez, Irene; So, Hosung; Levy, Marian; Nolan, Vikki G.; Bagley, Erika J.; Mehmood, Amber; Thomas, Joy Goens; Apedaile, Lily; Ison, Shelby E.; Barr-Anderson, Daheia J.; Heller, John G.; Cohen, Deborah A.

doi:10.1016/j.ajic.2022.04.010

Cited by 9 publications

(5 citation statements)

References 8 publications

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“…To that point, we did find a 66% adherence to state or local masking policies. This finding supports the results of another national-level systematic observation study that found that mask mandates result in a 3-fold increase in adherence to mask wearing [ 25 ]. Additionally, our finding showed that local policies—such as those implemented by private businesses in Georgia requiring or recommending mask wearing by their customers even though there was no mask mandate in place at the state level—may be influential in prompting preventive behaviors even in broader environmental and legislative contexts where such behaviors are not deemed important.…”

Section: Discussionsupporting

confidence: 89%

Maintaining Adherence to COVID-19 Preventive Practices and Policies Pertaining to Masking and Distancing in the District of Columbia and Other US States: Systematic Observational Study

Ruiz¹,

McMahon²,

Latif³

et al. 2023

JMIR Public Health Surveill

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Background Prior to the development of effective vaccines against SARS-CoV-2, masking and social distancing emerged as important strategies for infection control. Locations across the United States required or recommended face coverings where distancing was not possible, but it is unclear to what extent people complied with these policies. Objective This study provides descriptive information about adherence to public health policies pertaining to mask wearing and social distancing and examines differences in adherence to these policies among different population groups in the District of Columbia and 8 US states. Methods This study was part of a national systematic observational study using a validated research protocol for recording adherence to correct mask wearing and maintaining social distance (6 feet/1.83 meters) from other individuals. Data were collected from December 2020 to August 2021 by research team members who stationed themselves in outdoor areas with high pedestrian traffic, observed individuals crossing their paths, and collected data on whether individuals’ masks were present (visible or not visible) or worn (correctly, incorrectly, not at all) and whether social distance was maintained if other individuals were present. Observational data were entered electronically into Google Forms and were exported in Excel format for analysis. All data analyses were conducted using SPSS. Information on local COVID-19 protection policies (eg, mask wearing requirements) was obtained by examining city and state health department websites for the locations where data were being collected. Results At the time these data were collected, most locations in our study required (5937/10,308, 57.6%) or recommended (4207/10,308, 40.8%) masking. Despite this, more than 30% of our sample were unmasked (2889/10136, 28.5%) or masked incorrectly (636/10136, 6.3%). Masking policy was significantly related to correct masking with locations that required or recommended masking (66% correct masking vs 28/164, 17.1% in locations that did not require masking, P<.001). Participants who maintained social distance from others were more likely to be correctly masked than those who were not (P<.001). Adherence to masking policy by location was significant (P<.001); however, this was driven by 100% compliance in Georgia, which did not require masks at any point during the data collection period. When the same analysis was conducted for compliance with mask requirements and recommendations, there was no significant difference by location. Overall adherence to masking policies was 66.9% Conclusions Despite a clear relationship between mask policies and masking behavior, one-third of our sample was nonadherent to those policies, and approximately 23% of our sample did not have any mask, either on or visible. This may speak to the confusion surrounding “risk” and protective behaviors, as well as pandemic fatigue. These results underscore the importance of clear public health communication, particularly given variations in public health policies across states and localities.

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Section: Discussionsupporting

confidence: 89%

Maintaining Adherence to COVID-19 Preventive Practices and Policies Pertaining to Masking and Distancing in the District of Columbia and Other US States: Systematic Observational Study

Ruiz¹,

McMahon²,

Latif³

et al. 2023

JMIR Public Health Surveill

Self Cite

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“…These strategies require widespread adherence to create meaningful community-level transmission reduction. Use of these public health strategies varied around the globe as each country assessed its own risk and capacity to take specific prevention steps [ 5 , 6 ]. Some countries enacted full lockdowns to enforce social distancing, whereas others left it up to their citizens to decide their level of comfortable interaction [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Masking Behaviors in the Absence of Local Mandate—An Observational Study from Hillsborough County, Florida

Pecoraro

Bakour

Oberne

et al. 2022

IJERPH

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The purpose of this study was to understand the predictors of masking—especially age, race/ethnicity and gender—in Hillsborough County Florida, a region without mask mandates. Masking and social distancing behaviors of individuals were observed in Hillsborough County during one-week intervals in July 2021, August 2021 and Late September—early October 2021. Demographic and behavioral observations were recorded and logistic regression was utilized to determine the odds ratio of wearing a mask amongst various groups. Overall, masking ranged from 36.80% to 48.64%, peaking during the second observation period. Masking rates were highest amongst people of color, women and seniors. Establishments posting mask-negative language, such as “masks NOT required,” saw a 46% decrease in the odds of masking compared to establishments without mask-related signage (thereby defaulting to no mandate). Understanding who engaged in masking and social distancing behaviors will provide local public health officials with a deeper understanding of the effectiveness of previously used strategies, which can be leveraged in future surges of COVID-19 and other emergencies to create maximum impact. Lessons learned regarding policy implementation and understanding patterns of uptake of health guidelines are important for the continuous improvement of public health practice.

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“…The four observational studies found either a positive or a neutral relationship between face covering use or face covering policy and physical distancing. Three observational studies found no significant relationship between face covering use (self) or face covering policy and physical distancing [ 37 : two studies], [ 39 ], while the fourth observational study found that physical distancing was greater in those who wore face coverings, and also that it was greater when a face covering mandate was implemented [ 40 ].…”

Section: Resultsmentioning

confidence: 99%

Effect of face-covering use on adherence to other COVID-19 protective behaviours: A systematic review

Millest,

Saeed,

Symons

et al. 2024

PLoS ONE

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During the COVID-19 pandemic, concerns were raised that face covering use may elicit risk compensation; a false sense of security resulting in reduced adherence to other protective behaviours such as physical distancing. This systematic review aimed to investigate the effect of face covering use on adherence to other COVID-19 related protective behaviours. Medline, Embase, PsychInfo, EmCare, medRxiv preprints, Research Square and WHO COVID-19 Research Database were searched for all primary research studies published from 1st January 2020 to 17th May 2022 that investigated the effect of face covering use on adherence to other protective behaviours in public settings during the COVID-19 pandemic. Papers were selected and screened in accordance with the PRISMA framework. Backwards and forwards citation searches of included papers were also conducted on 16th September 2022, with eligible papers published between 1st January 2020 and that date being included. A quality appraisal including risk of bias was assessed using the Academy of Nutrition and Dietetics’ Quality Criteria Checklist. This review is registered on PROSPERO, number CRD42022331961. 47 papers were included, with quality ranging from low to high. These papers investigated the effects of face covering use and face covering policies on adherence to six categories of behaviour: physical distancing; mobility; face-touching; hand hygiene; close contacts; and generalised protective behaviour. Results reveal no consistent evidence for or against risk compensation, with findings varying according to behaviour and across study types, and therefore confident conclusions cannot be made. Any policy decisions related to face coverings must consider the inconsistencies and caveats in this evidence base.

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Association of masking policies with mask adherence and distancing during the SARS-COV-2 pandemic

Cited by 9 publications

References 8 publications

Maintaining Adherence to COVID-19 Preventive Practices and Policies Pertaining to Masking and Distancing in the District of Columbia and Other US States: Systematic Observational Study

Maintaining Adherence to COVID-19 Preventive Practices and Policies Pertaining to Masking and Distancing in the District of Columbia and Other US States: Systematic Observational Study

Masking Behaviors in the Absence of Local Mandate—An Observational Study from Hillsborough County, Florida

Effect of face-covering use on adherence to other COVID-19 protective behaviours: A systematic review

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