Factors Associated with Cloth Face Covering Use Among Adults During the COVID-19 Pandemic — United States, April and May 2020

• DOI: 10.15585/mmwr.mm6928e3
• Publication Date: 2020-07-14T15:27:53Z
• Authors: Kiva A. Fisher; John P. Barile; Rebecca J. Guerin; Kayla L. Vanden E...; Alexiss Jeffers; Lin H. Tian; Amanda Garcia-Wil...; Brian Gurbaxani; William W. Thompson; Christine E. Prue
• Keywords: Adult; Male; Health Knowledge, Attitudes, Practice; Adolescent; Pneumonia, Viral; Racial Groups; Masks; COVID-19; Middle Aged; United States; 3. Good health; Young Adult; 03 medical and health sciences; 0302 clinical medicine; Socioeconomic Factors; Residence Characteristics; Surveys and Questionnaires; Ethnicity; Humans; Female; Coronavirus Infections; Pandemics; Aged

On April 3, 2020, the White House Coronavirus Task Force and CDC announced a new behavioral recommendation to help slow the spread of coronavirus disease 2019 (COVID-19) by encouraging the use of a cloth face covering when out in public (1). Widespread use of cloth face coverings has not been studied among the U.S. population, and therefore, little is known about encouraging the public to adopt this behavior. Immediately following the recommendation, an Internet survey sampled 503 adults during April 7-9 to assess their use of cloth face coverings and the behavioral and sociodemographic factors that might influence adherence to this recommendation. The same survey was administered 1 month later, during May 11-13, to another sample of 502 adults to assess changes in the prevalence estimates of use of cloth face coverings from April to May. Within days of the release of the first national recommendation for use of cloth face coverings, a majority of persons who reported leaving their home in the previous week reported using a cloth face covering (61.9%). Prevalence of use increased to 76.4% 1 month later, primarily associated with increases in use among non-Hispanic white persons (54.3% to 75.1%), persons aged ≥65 years (36.6% to 79.2%), and persons residing in the Midwest (43.7% to 73.8%). High rates were observed in April and by May, increased further among non-Hispanic black persons (74.4% to 82.3%), Hispanic or Latino persons (77.3% to 76.2%), non-Hispanic persons of other race (70.8% to 77.3%), persons aged 18-29 years (70.1% to 74.9%) and 30-39 years (73.9% to 84.4%), and persons residing in the Northeast (76.9% to 87.0%). The use of a cloth face covering was associated with theory-derived constructs that indicate a favorable attitude toward them, intention to use them, ability to use them, social support for using them, and beliefs that they offered protection for self, others, and the community. Research is needed to understand possible barriers to using cloth face coverings and ways to promote their consistent and correct use among those who have yet to adopt this behavior.