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Indoor Public Mask-Wearing Behavior Changes in Response to National, State, and Local COVID-19 Policies
Joshua R Vest1, Shama Cash-Goldwasser, Eleanor Peters Bergquist
1Department of Health Policy & Management, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, Indiana (Drs Vest and Halverson); Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana (Drs Vest and Embi); Resolve to Save Lives, New York City, New York (Drs Cash-Goldwasser and Peters Bergquist); Marion County Public Health Department, Indianapolis, Indiana (Dr Caine); and Indiana University School of Medicine, Indianapolis, Indiana (Dr Embi).
Objective:
To estimate changes in public mask-wearing behavior in response to public health policies during COVID-19.
Design:
Panel of observed public mask-wearing.
Setting:
Counts of adult behavior in Marion County, Indiana, between November 15, 2020, and May 31, 2021.
Determinants Of Interest:
(1) Removal of state masking requirement; (2) introduction of the National Strategy for the COVID-19 Response and Pandemic Preparedness; (3) the Centers for Disease Control and Prevention (CDC) recommendation that vaccinated individuals did not need to wear masks in public; and (4) COVID-19 vaccine availability.
Outcome:
Percent observed with correct mask-wearing.
Analyses:
Fixed-effects models estimated the association between policies and mask-wearing.
Results:
Ending Indiana's mask requirement was not associated with changes in correct mask-wearing. The CDC's recommendation was associated with a decrease of 12.3 percentage points in correct mask-wearing (95% CI, -23.47 to -1.05; P = .032).
Conclusions:
Behavior encouraged by local mask requirements appeared to be resilient to changes in state policy. CDC recommendations appeared influential.
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