Bi-directional associations between mask usage and beliefs about reasons for masking before and after the downgrading of the legal status of COVID-19 in Japan: A longitudinal study

Abstract

It is important to clarify the bi-directional associations between mask usage and mask-usage motivations. Therefore, this study clarified the changes in mask usage and beliefs about reasons for masking before and after the downgrading of the legal status of COVID-19 in Japan and analyzed the bi-directional associations between the two. Online surveys were conducted in two sets among people aged 20–69 years living in Japan: the first before the downgrading of the legal status of COVID-19, between April 18–19, 2023; and the second afterward, June 6–15, 2023. After a total of 291 participants completed both surveys, associations between using masks and beliefs about reasons for doing so were analyzed using a cross-lagged panel model. Mask usage decreased slightly but significantly between the first and second sets. Of the eight beliefs regarding mask usage, slight but significant decreases were observed in terms of relief and information effects. There was also a significant association between socio-psychological reasons other than infection risk avoidance (such as norm and relief) during the first set and mask usage during the second set. Contrarily, mask usage during the first set was significantly associated with the reasons for infection risk avoidance during the second set. The impact of downgrading COVID-19's legal status in Japan on mask usage and reasons for masking was found to be limited. In terms of promoting or mitigating mask usage, the significance of risk communication based on socio-psychological reasons other than infection risk avoidance such as norms and relief was highlighted.