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. 2021 Nov 15;21(1):2099.
doi: 10.1186/s12889-021-12175-9.

Global trends and predictors of face mask usage during the COVID-19 pandemic

Elena Badillo-Goicoechea #  1 , Ting-Hsuan Chang #  2 , Esther Kim  3 , Sarah LaRocca  3 , Katherine Morris  3 , Xiaoyi Deng  4 , Samantha Chiu  4 , Adrianne Bradford  4 , Andres Garcia  4 , Christoph Kern  5 , Curtiss Cobb  3 , Frauke Kreuter  4   6   7 , Elizabeth A Stuart  8   9
Affiliations

Global trends and predictors of face mask usage during the COVID-19 pandemic

Elena Badillo-Goicoechea et al. BMC Public Health. .

Abstract

Background: Guidelines 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.

Methods: We 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.

Results: Mask-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.

Conclusion: The 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.

Keywords: COVID-19; Face mask; Mask usage; SARS-CoV-2.

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Conflict of interest statement

Frauke Kreuter consulted with Facebook from August 2018 – June 2020. Esther Kim, Sarah LaRocca, and Katherine Morris are employed at Facebook and assisted with the interpretation of the results and editing of the manuscript. All other authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Weighted self-reported weekly mask usage prevalence by country, (Weights adjust each country sample to their corresponding national population.) grouped by A) countries with consistently high face mask usage, B) countries that transitioned from low to high face mask usage, C) countries that had consistently low face mask usage, D) countries that showed irregular trends over time. Panel 1A) Mask usage for countries with consistently high face mask usage. Panel 1B) Mask usage for countries that transitioned from low face mask usage to high usage. Panel 1C) Mask usage for countries that had consistently low face mask usage. Panel 1D) Mask usage for countries that showed irregular trends over time
Fig. 2
Fig. 2
Predicted probability of face mask usage by individual characteristics for selected countries given various categories of A) month, B) gender, C) urbanicity, D) having gone to a restaurant, café or shopping center, E) having socialized outside of the household, and D) having attended a large public event. Panel 2A) By month (04 = April, 10 = October). Panel 2B) By gender (Yes = Female, No = Not Female). Panel 2C) By urbanicity (Yes = Urban, No = Not Urban). Panel 2D) By going out to a restaurant, café, or shopping center. Panel 2E) By socializing outside the household. Panel 2F) By attending a large public event
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