It may not be possible to change people’s behaviour just by telling them to wear a mask or telling them why wearing a mask is important. In such cases, it can be helpful to rely on behaviour change principles. Behaviour change principles can be applied alongside other measures to increase mask wearing behaviour, including mask legislation (e.g. requiring masks in public, and paying fines or facing penalties for noncompliance). The following general principles of behaviour change can strengthen promotion and communication about wearing face masks but should be adapted to suit the local context. Note that because wearing face masks in public is a relatively new behaviour, many of these ideas have not been evaluated, but they are based on behaviour change theories and community-level initiatives.
Target specific behaviours, audiences, and settings: Whenever communicating guidance for health behaviours, it is important to consider exactly what the target behaviour is, who should be practicing the behaviour, how the behaviour should be practiced, and when it should be practiced. It may be helpful to review this resource on population targeting when making these decisions. Recommendations should be as specific as possible to encourage appropriate adherence and wearing face masks. For example, the CDC provides very specific information on the key times a face mask should be worn, who should and should not wear face masks, and provides alternative suggestions (e.g. use of face shields, physical distancing) for circumstances when regular face mask use is not possible. Some individuals with health conditions may be exempt from wearing a mask and it can be useful to make sure that others in your community are aware of this. When designing programmes to promote face mask use, make sure to utilise behaviour change frameworks and formative research to better understand the behaviour within a particular context. It may also be helpful to target other mask-related behaviours, including handwashing, washing or disposing a face mask at the correct time, buying and wearing a clean mask, or remembering to have a face mask when leaving the house.
Communicate how masks can limit transmission: While some masks can offer the wearer some degree of protection against personal exposure to coronavirus, the primary function of using a face mask is to decrease the likelihood of an infected individual transmitting the virus to others (particularly if the person is asymptomatic). As such, it is important to emphasise that by wearing a face mask, you are acting out of a consideration for others. The act of wearing a mask can demonstrate that you have a concern for the health of people around you. This simulation provides a good visual explanation for how face masks can protect individuals and limit the transmission of coronavirus. These videos help to visualise how viruses transmit when we breathe, speak, cough or sneeze and shows the effect that masks can have in reducing this (Example 1, Example 2). It is also important to emphasize that masks are only effective if used correctly, this video can help explain this.
Source: Duke Health
Inspire people to act for the sake of others, not just themselves: In order for face masks to be effective in limiting the transmission of coronavirus, it is necessary that people wear them in public at the appropriate time. Similar to physical distancing, following public health recommendations and wearing a face mask protects others, especially those who are particularly vulnerable to COVID-19. By focusing on empathy and acting altruistically, it may be possible to change behaviours and increase the appropriate use of face masks. One study found that prosocial messaging, communication that highlighted how members of the community were at risk of getting sick and that individual efforts could keep others safe, was effective in getting people to practice COVID-19 preventive behaviours (i.e. washing hands, practicing physical distancing). The video below is from Pakistan and shows a famous artist and a chorus of others singing Pakistan’s national anthem for their independence day while wearing masks. It is an example of how to spread the message that people should be united in the effort to help protect the health of one another.
These public service announcements from the USA encourage people to #maskup to show others you care about them while also giving you an opportunity to express yourself by wearing a mask that has images, logos or phrases on them. A product of an ad contest in New York, this video emphasises that everyone needs to do their part and work together to protect themselves and everyone around them, and this can be done by wearing face masks.
Lastly the video below comes from Nepal. It emphasises that wearing masks, as well as other COVID-19 prevention behaviours are not easy to do, they require us to make short term social compromises to ensure that we can be together in the long term.
Build social norms around mask-wearing: Another strategy in increasing the uptake of appropriate mask use is to develop the social norms around the behaviour. Because wearing a mask in public is a very visible behaviour and benefits others, social influences and norms can play a role in practicing the behaviour. Even in areas where there may not be government mandates requiring masks to be worn in public, many businesses now require their employees and customers to wear face masks, which reinforces the expectation that masks should be worn to prevent the transmission of coronavirus. When strong social norms are in place, there may be pressure on others to behave in the same way to fit in. Formative research may be helpful in understanding how face coverings are perceived in your context, and those findings could be used to create norm-based messaging. Having important members of society, especially those in leadership positions, wear masks in public may also help establish norms around wearing masks. The media also plays an important role in creating social norms around mask-wearing because people can see others practicing the behaviour even if they are unable to see it in person due to physical isolation. This video does a nice job of showing that many people have different reasons for wearing a face mask and preventing the spread of coronavirus, which may be for a grandparent or their own health. The Pandemic Action Network also has a global #MaskingForAFriend campaign, for which they encourage people to share who they wear a mask for, and also use celebrities to normalise mask-wearing. A number of universities have created campaigns based on social norms to promote mask-wearing behaviours by showing that most of the students support and practice those behaviours themselves. In Northwest Syria, the NGO, Relief Experts Association, held a competition for people to make short videos about mask-wearing that targeted how the behaviour could fit with the local norm of doing right by others. This Social Norms Exploration Tool may be useful in better understanding norms in your setting and how to develop mask wearing programmes that are centered around these norms.
Image: A banner on display in Battery Park City, New York is part of a larger campaign to encourage the community to wear face masks
Image: Photos from the Pandemic Action Network’s #MaskingForAFriend campaign
The video above video was an entry in a video competition run by the Relief Experts Association in North West Syria and demonstrates how the decision to wear a mask can affect the people around you.
Encourage the behaviour through reminders: As more and more locations make rules about wearing face masks, reminders can prompt people to wear them appropriately in those spaces. Keeping a face mask with other items that are routinely taken when leaving the house (e.g. keys, wallet) can help remind individuals to take their mask with them. A study in Bangladesh found that having people who move around communities actively reminding people to wear masks can increase mask behaviour by about 30%.
Many businesses and indoor spaces have signs posted as cues both outside (to remind customers to put on a face mask before entering) and inside (to remind customers to keep their masks on so their nose and mouth are covered).
Images: Signs posted outside businesses to remind customers of face mask requirements
A multi-media campaign in Atlanta, Georgia called Big Fact, Small Acts, has been creating yard signs and adding masks to murals around the city to remind people to wear face masks when they are out in public. Murals painted by graffiti artists in Senegal show people practicing preventative behaviours, including wearing masks, and are useful in conveying health messaging in areas with lower literacy.
Image: A mural painted in Senegal tells people to “Wear a protective mask”
Twitter has been posting outdoor ads with user’s tweets which use humour as a way to encourage the public to wear face masks.
In Trabzon, Turkey, cameras have been installed at busy bus stops to show passengers video footage of themselves with their face covered by an image of a virus if they are not wearing a mask and to remind them to wear a mask. If the camera detects that they are wearing a mask, it displays a message thanking the individual.
It may be helpful to consider how to make disposable face masks available to people who do not have them but need them when out in public and how making them available can also act as a reminder to wear a face mask. For example, in some settings vending machines dispensing face masks are becoming popular and are often found in transit hubs (e.g. bus stations, train stations, metros).
Image: Mask vending machines allow people to purchase masks at a train station in Bangkok, Thailand.
Use trusted voices to model the behaviour: Leaders and influencers, especially at the community-level, can be key in encouraging the public to practice mask behaviours. They can also be helpful in establishing social norms around wearing masks. In Kerala, India, a campaign to bring public awareness to the importance of masks printed a magazine showing various prominent people from within the state all wearing face masks.
Image: The front page of a newspaper in Kerala, India, shows prominent people from the state wearing masks.
A media campaign called You Will See Me, targets communities of color that are disproportionately affected by COVID-19, and has messaging inspiring others to wear face masks. The Victorian government in Australia has created a series of humorous videos featuring well known athletes, comedians and actors emphasising the importance of engaging in preventative behaviours, such as wearing a face mask, to limit the spread of coronavirus. Religious leaders can also model mask wearing behaviours and have an influence on communities of faith.
Images: The Pope and an imam leading prayer while wearing face masks
Making wearing masks attractive and desirable: Fabric masks can be home-made and customised to reflect the identity of its wearer. One strategy in promoting mask wearing is to communicate how they can be worn as means of personal expression. Colorful masks, masks with animal print or faces, and adding their name on the mask can make wearing face masks more acceptable among children. Many retail stores are now stocking and marketing fabric masks as fashionable accessories for their customers. Some people have been matching their masks with their outfits or their head wraps. Face masks with designs on them for different holidays may also make wearing them more attractive and desirable. People can show their support for their favorite sports teams, schools, or brands by wearing fabric masks with logos, mascots and images. Fabric masks are also being used as a platform to bring awareness to social issues. For example, in Thailand, fabric face masks have been designed and sold to raise awareness and funds for cleft palate corrective surgery.
Images: These are some examples of how fabric masks can be made attractive and desirable for wearers: children’s masks with animal print, matching masks and outfits, matching masks with headwraps and using traditional fabrics, and masks with sports logos.
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Written by: Anika Jain
Last update: 07.11.2020