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BMC Public Health
Published in: BMC Public Health 1/2022

Open Access 01-12-2022 | COVID-19 | Research

Face mask use during the COVID-19 pandemic: how risk perception, experience with COVID-19, and attitude towards government interact with country-wide policy stringency

Authors: Annelot Wismans, Peter van der Zwan, Karl Wennberg, Ingmar Franken, Jinia Mukerjee, Rui Baptista, Jorge Barrientos Marín, Andrew Burke, Marcus Dejardin, Frank Janssen, Srebrenka Letina, José María Millán, Enrico Santarelli, Olivier Torrès, Roy Thurik

Published in: BMC Public Health | Issue 1/2022

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Abstract

Background

During the 2020 COVID-19 pandemic, governments imposed numerous regulations to protect public health, particularly the (mandatory) use of face masks. However, the appropriateness and effectiveness of face mask regulations have been widely discussed, as is apparent from the divergent measures taken across and within countries over time, including mandating, recommending, and discouraging their use. In this study, we analyse how country-level policy stringency and individual-level predictors associate with face mask use during the early stages of the global COVID-19 pandemic.

Method

First, we study how (self and other-related) risk perception, (direct and indirect) experience with COVID-19, attitude towards government and policy stringency shape face mask use. Second, we study whether there is an interaction between policy stringency and the individual-level variables. We conduct multilevel analyses exploiting variation in face mask regulations across countries and using data from approximately 7000 students collected in the beginning of the pandemic (weeks 17 through 19, 2020).

Results

We show that policy stringency is strongly positively associated with face mask use. We find a positive association between self-related risk perception and mask use, but no relationship of mask use with experience with COVID-19 and attitudes towards government. However, in the interaction analyses, we find that government trust and perceived clarity of communication moderate the link between stringency and mask use, with positive government perceptions relating to higher use in countries with regulations and to lower use in countries without regulations.

Conclusions

We highlight that those countries that aim for widespread use of face masks should set strict measures, stress self-related risks of COVID-19, and use clear communication.
Appendix
Available only for authorised users
Footnotes
1
Additional analyses disaggregating the indirect experience with COVID-19 variable into confirmed COVID-19 and “I think I had it” leads to the same results and conclusions. For the direct experience with COVID-19 variable, the number of observations in the confirmed COVID-19 category was too small (n = 17) to conduct reliable sensitivity analyses.
 
2
We conducted robustness analyses using alternative calculations for the face mask policy stringency variable (taking the index average of the same period but then a) including the 14 days before the survey period; and b) including the two months before the survey period). These analyses led to similar results and conclusions. The categorization of the countries using the alternative stringency variables remains identical.
 
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Metadata
Title
Face mask use during the COVID-19 pandemic: how risk perception, experience with COVID-19, and attitude towards government interact with country-wide policy stringency
Authors
Annelot Wismans
Peter van der Zwan
Karl Wennberg
Ingmar Franken
Jinia Mukerjee
Rui Baptista
Jorge Barrientos Marín
Andrew Burke
Marcus Dejardin
Frank Janssen
Srebrenka Letina
José María Millán
Enrico Santarelli
Olivier Torrès
Roy Thurik
Publication date
01-12-2022
Publisher
BioMed Central
Keyword
COVID-19
Published in
BMC Public Health / Issue 1/2022
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-022-13632-9

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