Background: Mask-wearing shows a reduced spread of SARS-COV-2, yet accurate recommendations were not effectively communicated early in the pandemic. Lower health literacy, depression, and anxiety symptoms may play a role in the uptake and utilization of mask-wearing. Additionally, health beliefs regarding perceptions of the severity of and susceptibility to COVID-19, and benefits and barriers to mask-wearing, may also contribute to mask-wearing behaviors. Objective: This study aimed to investigate correlations between health beliefs as defined by the Health Belief Model (HBM), depression, anxiety, health literacy, and mask-wearing during the COVID-19 pandemic. Methods: We conducted a secondary analysis from the Behavioral Outcomes During Social Distancing cohort study. Data were collected at 2 timepoints between March and August 2020 in 346 adults in the United States and analyzed through bivariate Pearson and Spearman correlations. Results: Participants perceived COVID-19 as somewhat severe, felt somewhat susceptible to infection, saw more benefits than barriers to mask-wearing, reported moderate depression and anxiety symptoms, and had high electronic health literacy. Adherence to mask-wearing was positively associated with perceived severity, susceptibility, and benefits of mask-wearing, and negatively associated with perceived barriers. Depression, anxiety, and health literacy were not significantly associated with mask-wearing. Conclusions: These findings suggest that health beliefs play a crucial role in mask-wearing behaviors. Further research is needed to explore how health beliefs influence other mitigation measures, such as immunizations, social distancing, and hand hygiene. Interventions targeting HBM concepts could potentially improve mask-wearing and other health actions, reducing the spread of viral illnesses.
Wierenga et al. (Sat,) studied this question.