Factors associated with wearing a facemask in shops in England following removal of a legal requirement to do so during the COVID-19 pandemic

Louise E Smith; Robert West; Henry W W Potts; Richard Amlôt; Nicola T Fear; G James Rubin; Susan Michie

doi:10.1111/bjhp.12684

Factors associated with wearing a facemask in shops in England following removal of a legal requirement to do so during the COVID-19 pandemic

Br J Health Psychol. 2024 Feb;29(1):3-19. doi: 10.1111/bjhp.12684. Epub 2023 Aug 3.

Authors

Louise E Smith^{1

2}, Robert West³, Henry W W Potts⁴, Richard Amlôt^{2

5}, Nicola T Fear^{1

6}, G James Rubin^{1

2}, Susan Michie⁷

Affiliations

¹ Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
² NIHR Health Protection Research Unit in Emergency Preparedness and Response, London, UK.
³ Department of Behavioural Science and Health, University College London, London, UK.
⁴ Institute of Health Informatics, University College London, London, UK.
⁵ Behavioural Science and Insights Unit, UK Health Security Agency, London, UK.
⁶ King's Centre for Military Health Research and Academic Department of Military Mental Health, King's College London, London, UK.
⁷ Centre for Behaviour Change, University College London, London, UK.

PMID: 37537895
DOI: 10.1111/bjhp.12684

Abstract

Objectives: We aimed to identify psychological factors associated with the use of facemasks in shops in England following removal of legal requirements to do so, and to compare associations with and without legal restrictions.

Design: Repeated cross-sectional online surveys (n ≈ 2000 adults) between August 2020 and April 2022 (68,716 responses from 45,682 participants) using quota sampling.

Methods: The outcome measure was whether those who had visited a shop for essentials in the previous seven days reported always having worn a facemask versus sometimes or not at all. Psychological predictor variables included worry, perceived risk and severity of COVID-19 and the perceived effectiveness of facemasks. Socio-demographic variables and measures of clinical vulnerability were also measured. For the period following removal of legal restrictions, multivariable regression was used to assess associations between the primary outcome variable and predictors adjusting for socio-demographic and clinical vulnerability measures. The analysis was repeated including interactions between psychological predictors and presence versus absence of legal restrictions.

Results: Worry about COVID-19, beliefs about risks and severity of COVID-19 and effectiveness of facemasks were substantially and independently associated with the use of facemasks. Removal of legal obligations to wear facemasks was associated with a 25% decrease in wearing facemasks and stronger associations between psychological predictors and wearing facemasks.

Conclusions: Legal obligations increase rates of wearing a facemask. Psychological factors associated with wearing a facemask could be targets for interventions aiming to alter rates of wearing a facemask. These interventions may be more effective when there are no legal obligations to wear a face covering in place.

Keywords: COVID-19; adherence; facemasks; infectious disease; pandemic management; protective behaviours; public health.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
COVID-19*
Cross-Sectional Studies
England
Humans
Masks
Pandemics

Abstract

Publication types

MeSH terms

Grants and funding