Who adheres to mask-wearing guidelines—and who doesn’t?

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Mask wearing has been a hot topic—with lukewarm popularity.

To better understand which subset of people are most inclined to follow mask-wearing guidelines, several USF College of Public Health (COPH) students set out to observe people over several weeks last year, from midsummer to early fall. The students conducted their research at a variety of places around Tampa Bay, including the Westshore Mall, a Publix in Tampa Palms, a Target in Brandon and even the Marshall Student Center on the USF campus. 

Their findings were summarized in a series of three posters, presented at USF Health Research Day in February.

“Throughout the state of Florida, masking policies have been modified at various stages of the pandemic, which has led to mixed messaging,” said Mae Horne, a senior majoring in public health and microbiology who presented the “Local Signage as a Factor in Determining Community Masking Behavior” poster. “The objective was to understand more about the populations that adhere to masking recommendations and those who don’t. Using the data collected during three different periods throughout Tampa [late July, late August and late September] we aimed to identify observable differences in perceived demographic (age, gender, race/ethnicity) and neighborhood adherence to mask and social distancing guidelines.”

In the first poster, “Trends in child masking behaviors in the Tampa area surrounding the start of the 2021-2022 school year,” the students compared child mask wearing around the start of the school year (Aug. 23-29, to be precise) to the two other observation periods in July and September. The poster was presented by Alexis Robinson, who graduated in May with her BSPH.

Not surprisingly, said the researchers, mask wearing among children was up during the period in August.

“Factors contributing to the significantly increased odds of children wearing a full-coverage mask seen at the end of August likely includes local messaging related to masking recommendations, such as the Hillsborough County School Board mandating masking for students on August 18, 2021,” said recent COPH MPH graduate Jessica Pecoraro, who concentrated in epidemiology and mentored the students involved in all three posters through the research process. “Additionally, at this time, children were also not yet able to be vaccinated against SARS-CoV-2, and the Delta variant was surging.” 

With the second poster, presented by COPH undergrads Catherine Moreau and YaMaya Barley, the students looked at mask-wearing behaviors among different racial and ethnic groups and found that non-White racial and ethnic groups “maintained a statistically significantly increased odds of fully wearing a mask, compared with whites.”

“This finding was in line with what was being seen in other locations, and it, too, wasn’t necessarily surprising,” said Pecoraro. “The reason why masking rates could vary between groups might be cultural norms, living with older family members (thus taking extra precautions to avoid bringing the virus home to especially susceptible family members) or working jobs that require interaction with the public (such as a customer service role) that increases potential exposure and a feeling of susceptibility that could carry through to their daily lives.”

Lastly, the students wanted to see how mask-wearing signage influenced whether people wore masks. Across all three observation periods, the odds of people wearing masks increased when there was signage recommending or requiring masks versus when no signage was present. Interestingly, there were decreased odds of people wearing masks when there was signage saying masks weren’t required compared to when there was no signage at all.

“These results allowed us to draw the conclusion that positive public health messaging can directly impact the behavior of the generalized population,” Horne noted.

The studies are important, said the students, because understanding patterns, gaps and determinants of prevention measures helps public health practitioners understand what populations follow public health guidance as it’s provided and who would benefit from a different approach in how guidance is delivered.

“To effectively prevent infection in a situation such as SARS-CoV-2, widespread adherence to prevention strategies is needed to effectively reduce morbidity and mortality rates,” Pecoraro explained. “Understanding where the gaps are helps us know where to focus our outreach efforts on the future. Our studies provide evidence that 1.) The public might have needed to better understand the role children can play in the spread of SARS-CoV-2 to see better mask adherence amongst the younger ages. 2.) Groups with lower masking rates would likely benefit from focused outreach and public health awareness to increase masking adherence and 3.) Clear and unified public health messaging is important in implementing widespread public health strategies, such as masking.”

Story by Donna Campisano, USF College of Public Health