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Accepted for/Published in: JMIR Public Health and Surveillance

Date Submitted: Jun 7, 2022
Date Accepted: Mar 7, 2023
Date Submitted to PubMed: Mar 15, 2023

The final, peer-reviewed published version of this preprint can be found here:

Maintaining Adherence to COVID-19 Preventive Practices and Policies Pertaining to Masking and Distancing in the District of Columbia and Other US States: Systematic Observational Study

Ruiz MS, McMahon MV, Latif H, Vyas AN

Maintaining Adherence to COVID-19 Preventive Practices and Policies Pertaining to Masking and Distancing in the District of Columbia and Other US States: Systematic Observational Study

JMIR Public Health Surveill 2023;9:e40138

DOI: 10.2196/40138

PMID: 36888910

PMCID: 10132825

Maintaining adherence to COVID-19 preventive practices and policies: a systematic observational study of masking and distancing in the District of Columbia and other US states

  • Monica S. Ruiz; 
  • Mercedes V McMahon; 
  • Hannah Latif; 
  • Amita N Vyas

ABSTRACT

Background:

Prior to the development of effective vaccines against SARS CoV-2, masking and physical distancing emerged as important strategies for infection control. Locations across the US required or recommended face coverings where distancing was not possible, but it is unclear to what extent people complied with these policies.

Objective:

The purpose of this paper is to provide descriptive information about adherence to mask wearing and social distancing and to examine differences in adherence among different population groups.

Methods:

This observational study was part of a national systematic observation study using a validated research protocol for recording masking and distancing in high-traffic outdoor locations.

Results:

At the time these data were collected, most locations in our study required (57.6%) or recommended (40.8%) masking. Despite this, more than 30% of our sample were unmasked (28.5%) or masked incorrectly (6.3%). Masking policy was significantly related to correct masking with locations that required or recommended masking (66% correct masking v. 17.1% in locations that did not require masking, P<.001). Additionally, participants who were 6+ feet away from others were more likely to be correctly masked than those who were not (P<.001). Adherence to masking policy by location was found to be significant where masking was required (P<.001) however, this was driven by 100% compliance in Georgia, which did not require masks at any point during the data collection period. When the same analysis was conducted for compliance with mask requirements and recommendations, there was no significant difference by location. Overall adherence to mask requirements or recommendations was 66.9%.

Conclusions:

Despite a clear relationship between mask policies and masking behavior, a third of our sample was non-adherent to those policies and approximately 23% of our sample did not have any mask, either on or visible. This may speak to the confusion surrounding “risk” and protective behaviors, as well as pandemic fatigue. These results underscore the importance of clear public health communication, particularly in the face of patchwork policies that vary from state to state or even business to business. Clinical Trial: N/A


 Citation

Please cite as:

Ruiz MS, McMahon MV, Latif H, Vyas AN

Maintaining Adherence to COVID-19 Preventive Practices and Policies Pertaining to Masking and Distancing in the District of Columbia and Other US States: Systematic Observational Study

JMIR Public Health Surveill 2023;9:e40138

DOI: 10.2196/40138

PMID: 36888910

PMCID: 10132825

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