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. 2021 Feb 12;55(1):82-88.
doi: 10.1093/abm/kaaa109.

Theory-based Behavioral Predictors of Self-reported Use of Face Coverings in Public Settings during the COVID-19 Pandemic in the United States

John P Barile  1   2 , Rebecca J Guerin  2 , Kiva A Fisher  3 , Lin H Tian  4 , Andrea H Okun  2 , Kayla L Vanden Esschert  3 , Alexiss Jeffers  5 , Brian M Gurbaxani  3 , William W Thompson  6 , Christine E Prue  7
Affiliations

Theory-based Behavioral Predictors of Self-reported Use of Face Coverings in Public Settings during the COVID-19 Pandemic in the United States

John P Barile et al. Ann Behav Med. .

Abstract

Background: Investigating antecedents of behaviors, such as wearing face coverings, is critical for developing strategies to prevent SARS-CoV-2 transmission.

Purpose: The purpose of this study was to determine associations between theory-based behavioral predictors of intention to wear a face covering and actual wearing of a face covering in public.

Methods: Data from a cross-sectional panel survey of U.S. adults conducted in May and June 2020 (N = 1,004) were used to test a theory-based behavioral path model. We (a) examined predictors of intention to wear a face covering, (b) reported use of cloth face coverings, and (c) reported use of other face masks (e.g., a surgical mask or N95 respirator) in public.

Results: We found that being female, perceived importance of others wanting the respondent to wear a face covering, confidence to wear a face covering, and perceived importance of personal face covering use was positively associated with intention to wear a face covering in public. Intention to wear a face covering was positively associated with self-reported wearing of a cloth face covering if other people were observed wearing cloth face coverings in public at least "rarely" (aOR = 1.43), with stronger associations if they reported "sometimes" (aOR = 1.83), "often" (aOR = 2.32), or "always" (aOR = 2.96). For other types of face masks, a positive association between intention and behavior was only present when observing others wearing face masks "often" (aOR = 1.25) or "always" (aOR = 1.48).

Conclusions: Intention to wear face coverings and observing other people wearing them are important behavioral predictors of adherence to the CDC recommendation to wear face coverings in public.

Keywords: COVID-19; Face covering; Face mask; Planned behavior; Prevention; Social norms.

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Figures

Fig. 1.
Fig. 1.
Theoretical model of assessed paths for face covering use in public. Direct paths from all exogenous variables to behavior were estimated but not included for graphical simplicity. The statistical model also included the covariates of age, gender, and urbanicity as predictors of face cover intentions and use.
Fig. 2.
Fig. 2.
Johnson–Neyman plot. The center lines (red) represent the strength of the association between intention to wear a face covering and face covering use at each value of seeing other people wearing a face covering (cloth face coverings, left; other types of face coverings, right). The outer lines (blue) represent the 95% confidence intervals around these associations. 95% confidence intervals that do not include an odds ratio of one are considered statistically significant.
See this image and copyright information in PMC

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