Abstract

Widespread use of face coverings is a key public health strategy to prevent the spread of COVID-19. However, few studies have examined why Americans use or do not use face coverings, and little is known about the most effective messaging strategies. This study explored perceptions of face coverings, including motivations and barriers for use, and examined reactions to messaging promoting the use of face coverings. Six virtual focus groups were conducted with 34 North Carolina residents in July 2020. Participants reported high compliance with face covering recommendations but often did not wear them around family, friends, and colleagues. The most prevalent motivation for the use of face coverings was to protect or respect other people, including high-risk populations and individuals. Other motivators were self-protection, responsibility, desire for control, requirements, and expert advice. Barriers included physical and social discomfort, confusion or misinformation, low perceived susceptibility to COVID-19, and perceptions of identity and autonomy. Even among individuals who frequently wear face coverings, there are opportunities to improve compliance. Messaging should highlight how face coverings protect the wearer and others around them, normalize the use of face coverings in social settings, and emphasize requirements. Positive messages that focus on unity, personal experiences and the rationale for face coverings are recommended.

Highlights

  • As of early December 2020, over 14 million confirmed cases and 276,000 deaths in the United States have been attributed to the novel coronavirus disease 2019 (COVID-19) pandemic [1]

  • Almost all participants reported wearing face coverings most or all of the time in the demographic survey (91%); notable instances where compliance could be improved were shared in the focus group discussions

  • I think you would have a lot more compliance if people thought that the mask was protecting them . . . because we look to protect ourselves first.”

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Summary

Introduction

As of early December 2020, over 14 million confirmed cases and 276,000 deaths in the United States have been attributed to the novel coronavirus disease 2019 (COVID-19) pandemic [1]. The Centers for Disease Control and Prevention (CDC) and White House Coronavirus Task Force recommend individuals wear face coverings in public settings to mitigate COVID-19 transmission, when physical. Res. Public Health 2020, 17, 9298; doi:10.3390/ijerph17249298 www.mdpi.com/journal/ijerph

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