Psychosocial factors associated with mask-wearing behavior during the COVID-19 pandemic

Although increasing evidence has supported the efficacy of masks to prevent the spread of the coronavirus (COVID-19), inconsistent and noncompliant mask-wearing behavior has been observed among members of the society. Because mask-wearing is often considered a social contract, it is important to understand the psychosocial factors that influence people's mask-wearing behavior in order to implement the necessary steps to respond to the pandemic. Based on the protection motivation theory (PMT), this study examined the cognitive factors (threat and coping appraisals) that contribute to mask-wearing behavior and the intention to engage in health protective behavior until the end of the pandemic. Furthermore, we examined the roles of social (perceived social norm) and affective (fear) factors in mask-wearing behavior and intention. The sample included 981 voluntary adults in the United States who completed an online survey for this study between 15 October 2020 and 28 November 2020. The results of hierarchical multiple regressions showed that all PMT variables (severity, susceptibility, response efficacy, and self-efficacy) were associated with mask-wearing behavior and intention to engage in health protective behavior until the end of the pandemic. Perceived social norm and fear provided unique, additive contributions to the predictability of mask-wearing behavior and intention. Overall findings suggest the importance of considering cognitive, social, and affective factors altogether in order to better understand an individual' intention and behavior toward mask wearing during the pandemic.