Face Mask Use Conditionally Decreases Compliance With Physical Distancing Rules Against COVID-19: Gender Differences in Risk Compensation Pattern

Effect of face-covering use on adherence to other COVID-19 protective behaviours: A systematic review

During the COVID-19 pandemic, concerns were raised that face covering use may elicit risk compensation; a false sense of security resulting in reduced adherence to other protective behaviours such as physical distancing. This systematic review aimed to investigate the effect of face covering use on adherence to other COVID-19 related protective behaviours. Medline, Embase, PsychInfo, EmCare, medRxiv preprints, Research Square and WHO COVID-19 Research Database were searched for all primary research studies published from 1st January 2020 to 17th May 2022 that investigated the effect of face covering use on adherence to other protective behaviours in public settings during the COVID-19 pandemic. Papers were selected and screened in accordance with the PRISMA framework. Backwards and forwards citation searches of included papers were also conducted on 16th September 2022, with eligible papers published between 1st January 2020 and that date being included. A quality appraisal including risk of bias was assessed using the Academy of Nutrition and Dietetics' Quality Criteria Checklist. This review is registered on PROSPERO, number CRD42022331961. 47 papers were included, with quality ranging from low to high. These papers investigated the effects of face covering use and face covering policies on adherence to six categories of behaviour: physical distancing; mobility; face-touching; hand hygiene; close contacts; and generalised protective behaviour. Results reveal no consistent evidence for or against risk compensation, with findings varying according to behaviour and across study types, and therefore confident conclusions cannot be made. Any policy decisions related to face coverings must consider the inconsistencies and caveats in this evidence base.

Factors associated with compliance with barrier gestures and social distancing measures in France

BACKGROUND

The COVID-19 pandemic led many countries to drastically limit social activities. The objective of this study is to describe the factors associated with compliance with protective measures and social distancing in the general adult population in France, between March and December 2020 (first and second waves of the epidemic), before vaccination began at the end of December 2020.

METHOD

The data come from the CoviPrev repeated cross-sectional descriptive survey, conducted between March 2020 and December 2022 in metropolitan France. The data collected from March to December 2020 (19 survey waves), from a panel representative of the general population, were used. Three periods were defined: the first epidemic wave (March-April), the inter-wave period (May-June) and the second epidemic wave (November-December). A compliance score was constructed to measure systematic compliance with the five main measures. The association between systematic compliance and different variables (sociodemographic, mental health, level of health literacy, perceived severity of COVID-19, confidence in government, perceived effectiveness of the measures) was described using bivariate and multivariate logistic regression models, using the statistical software R.

RESULTS

Systematic compliance with the preventive measures changed over time. Regardless of the period, being a woman, being over 50, perceiving COVID-19 as severe, having a high level of health literacy or anxiety were positively associated with compliance. Having a child under 16 years of age and perceiving the measures as effective were positively associated with compliance with the protective measures during the epidemic waves; conversely, having a high level of depression, living alone, not working were negatively associated in the first epidemic wave. Finally, during the inter-wave period, living in an area heavily affected during the first wave and having a high level of education were positively and negatively associated with systematic compliance with the preventive measures, respectively.

CONCLUSION

The factors associated with compliance with the protective measures and social distancing evolved during the epidemic. Monitoring this evolution, in order to adapt communication and awareness strategies, is essential in the context of pandemic response.

People interact closer when a face mask is worn but risk compensation is at best partial

BACKGROUND

Wearing a face mask and keeping a minimal distance from others are common nonpharmaceutical interventions that governments may mandate or recommend to contain the spread of infectious diseases. The article addresses the following questions: (i) Do people interact closer when the face mask is worn? (ii) Do people interact closer because they believe that the mask reduces the risk of contagion? (iii) If the mask induces people to interact closer, does the increase in risk entailed by shorter distances entirely offset the decrease in risk offered by the mask?

METHODS

With a view to maximizing both the external and the internal validity of the study, between 2021 and 2022 we performed a large field experiment on real-life interactions (n > 4500) and a controlled laboratory experiment in virtual reality.

RESULTS

Converging between the field and the lab, the results indicate that in general people interact closer when the mask is worn, and in particular when they believe that the mask reduces the risk of contagion. However, even assuming a very low filtration efficacy and an extremely large distance-reducing effect of the mask, the counteracting effect of shorter interpersonal distances is never strong enough to entirely offset the mask's protection.

CONCLUSION

The distance-reducing effect of the mask is real but warrants no serious objection against a face mask policy.

A planned behavior theory-based explanatory model of protective behavior against COVID-19, with an age perspective

In this study, an explanatory model of protective behaviors against COVID-19 transmission based on the theory of planned behavior is tested using a sample of 904 individuals by adding two relevant variables in the COVID-19 context: skepticism and responsibility toward COVID-19 transmission. Responsibility and the intention to behave in a protective way act as mediators in predicting protective behaviors. The model is invariant between younger and older people, although some path differences were found: the perception that individuals have about the extent to which their reference group adopts protective behaviors directly influences individual protective behavior for younger but not older people, for whom subjective social norms were only indirect predictors of such behavior. Additionally, the rates in all the variables showed that the group under 35 took more risks in the context of protective behaviors against COVID-19: they exhibited more skepticism, lower behavioral control, perceived fewer positive social norms regarding protective behaviors, felt less responsible for spreading the disease, had less intention to behave in a protective way, and finally adopted fewer protective behaviors. Developers of intervention strategies and campaigns should contemplate such variables and focus on differences according to age.

It Matters to Whom You Compare Yourself: The Case of Unrealistic Optimism and Gender-Specific Comparisons

Unrealistic Optimism (UO) appears when comparing participants' risk estimates for themselves with an average peer, which typically results in lower risk estimates for the self. This article reports nuanced effects when comparison varies in terms of the gender of the peer. In three studies (total N = 2,468, representative sample), we assessed people's risk estimates for COVID-19 infections for peers with the same or other gender. If a peer's gender is not taken into account, previous studies were replicated: Compared with others, participants perceived themselves as less likely to get infected with COVID-19. Interestingly, this effect was qualified by gender: Respondents perceived women as less threatened than men because women are perceived as more cautious and compliant with medical guidelines.

The influence of face mask on social spaces depends on the behavioral immune system

Interacting with objects and people requires specifying localized spaces where these interactions can take place. Previous studies suggest that the space for interacting with objects (i.e., the peripersonal space) contributes to defining the space for interacting with people (i.e., personal and interpersonal spaces). Furthermore, situational factors, such as wearing a face mask, have been shown to influence social spaces, but how they influence the relation between action and social spaces and are modulated by individual factors is still not well understood. In this context, the present study investigated the relationship between action peripersonal and social personal and interpersonal spaces in participants approached by male and female virtual characters wearing or not wearing a face mask. We also measured individual factors related to the behavioral immune system, namely willingness to take risks, perceived infectability and germ aversion. The results showed that compared to peripersonal space, personal space was smaller and interpersonal space was larger, but the three spaces were positively correlated. All spaces were altered by gender, being shorter when participants faced female characters. Personal and interpersonal spaces were reduced with virtual characters wearing a face mask, especially in participants highly aversive to risks and germs. Altogether, these findings suggest that the regulation of the social spaces depends on the representation of action peripersonal space, but with an extra margin that is modulated by situational and personal factors in relation to the behavioral immune system.

No evidence that mask-wearing in public places elicits risk compensation behavior during the COVID-19 pandemic

Face masks have been widely employed as a personal protective measure during the COVID-19 pandemic. However, concerns remain that masks create a false sense of security that reduces adherence to other public health measures, including social distancing. This paper tested whether mask-wearing was negatively associated with social distancing compliance. In two studies, we combined video-observational records of public mask-wearing in two Dutch cities with a natural-experimental approach to evaluate the effect of an area-based mask mandate. We found no observational evidence of an association between mask-wearing and social distancing but found a positive link between crowding and social distancing violations. Our natural-experimental analysis showed that an area-based mask mandate did not significantly affect social distancing or crowding levels. Our results alleviate the concern that mask use reduces social distancing compliance or increases crowding levels. On the other hand, crowding reduction may be a viable strategy to mitigate social distancing violations.

Promoting physical distancing during COVID-19: a systematic approach to compare behavioral interventions

In the wake of the COVID-19 pandemic, physical distancing behavior turned out to be key to mitigating the virus spread. Therefore, it is crucial that we understand how we can successfully alter our behavior and promote physical distancing. We present a framework to systematically assess the effectiveness of behavioral interventions to stimulate physical distancing. In addition, we demonstrate the feasibility of this framework in a large-scale natural experiment (N = 639) conducted during an art fair. In an experimental design, we varied interventions to evaluate the effect of face masks, walking directions, and immediate feedback on visitors' contacts. We represent visitors as nodes, and their contacts as links in a contact network. Subsequently, we used network modelling to test for differences in these contact networks. We find no evidence that face masks influence physical distancing, while unidirectional walking directions and buzzer feedback do positively impact physical distancing. This study offers a feasible way to optimize physical distancing interventions through scientific research. As such, the presented framework provides society with the means to directly evaluate interventions, so that policy can be based on evidence rather than conjecture.