using behaviour decreases the effectiveness of face masks where people touch it while using them, use it but hang it below their chin to breathe even when they are in public areas, disca
INTRODUCTION
Research rationale
The world has been devastated by a global pandemic known as the COVID-19 (WHO, 2020) It dramatically affected every life and imposed huge economic losses on people worldwide; from health issues to medical scarcity, from lockdowns to limited economic activities, from travel bans to degraded tourist economy, from closed schools to low online academic resources, and from shutdown of businesses to higher unemployment rate It presents tremendous medical, economic, and sociological difficulties that limit daily living in ways that were previously unthinkable for the majority of people The impact of the pandemic is more severe in developing countries where medical infrastructure and facilities are poor like the Philippines, Vietnam, and Indonesia Billions of debts continue to pile up in an attempt to contain the virus but to no avail
The rapid transmission of the COVID-19 virus has been prominent around the world even with the availability of the COVID-19 vaccines The WHO recommended preventive measures to subdue the COVID-19 outbreak by COVID-19 vaccination and medical declaration, disinfection, social distancing, limiting from going outside and avoiding crowded places, and mass masking Several governments recognized the threat of COVID-19 authorized lockdown, quarantine, and closed public buildings These policies have been able to control the spread of the virus; however, these restrictions negatively affect the daily lives of everyone and the country's economic status The maximum potential of one person to act for the benefit of oneself and the economy was traded-off to focus on limiting the spread of the virus Universal mask use is one preventive measure that has been shown to be the most successful strategy to stop the spread of COVID-19 and spare the nation from more economic hardships (Wrucke, et al., 2020) Medical experts recommended people who are vaccinated or not should properly wear their face mask when in a public place (CDC, 2021)
The spread of the COVID-19 is largely influenced by human behaviour It creates negative externalities on people since it has had and continues to have adverse effects on the economy, social life, and health care system At the moment, wearing a mask in public areas is required, and failure to comply carries a fine For many people, choosing whether or not to wear a mask means balancing their personal goals with the significant societal benefits of doing so Mandatory masking was implemented to trade- off individual freedom to address public health, economic prosperity, and social stability This opportunity cost contributes to a public good, namely public health and all its social and economic consequences, by limiting the spread of the virus Face masks are beneficial and effective, but not everyone uses them correctly, which reduces these qualities The general public's compliance with such measures is crucial to their success
The effectiveness of government measures to encourage mask-wearing relies heavily on social cooperation To optimize these measures, it is crucial to understand the factors influencing mask-using behavior.
Improper face mask usage significantly undermines their effectiveness Despite addressing mask-related issues, a lack of established policies has led to errors such as touching masks, hanging them below the chin, discarding them improperly, and wearing them for extended periods Rural areas exhibit lower mask compliance, contributing to the high COVID-19 case counts in countries like the Philippines, Vietnam, and Indonesia, where substantial populations reside in rural areas Understanding these factors is crucial for developing effective mask-wearing policies in diverse settings.
There is an abundance of documented evidence in other countries, but there is substantial limited information in the developing countries like the Philippines, Vietnam, and Indonesia Mandatory mask-wearing was implemented in these places as a preventive measure for the COVID-19 virus There is no policy governing the appropriate usage of masks, but people who are seen not wearing them are penalized Despite the fact that many people wear face masks, regardless of the present pandemic, the prevalence of using the proper mask precautions was insufficient (Machida et al., 2020)
This article synthesizes existing literature on the factors influencing mask-wearing behavior (Section II) and presents a study design and variable definitions (Section III) The results of the study are detailed in Section IV, while Section V concludes and offers practical recommendations regarding mask policies.
Research’s objectives
The study aimed to attain the following objectives:
1 The study aims toTo evaluate whether the household members in rural areas exhibit good mask-using behaviour and to examine its social and economic determinants
2 This study adds to the existing literature on the determinants of mask- wearing behaviour The spread of disease is highly associated with human behaviour Thus, it is essential to analyze and understand what drives people to engage and refrain from health-related behaviour during a pandemic Moreover, this study adds to the extensive literature on the economic behaviour during the COVID-19 pandemic The proper use of face masks does not just save lives but also saves the economy Finding strategies to encourage appropriate mask-using behaviours will require an understanding of how the general public utilizes face masks and what elements are linked to excellent compliance To provide effective nudges that can increase widespread adoption of the proper use of face masks
3 To the existing literature on the determinants of mask-wearing behaviour and to add to the extensive literature on the economic behaviour during the COVID-19 pandemic Additionally, policymakers and organizations will be able to locate risk populations and geographic areas in order to allocate limited medical or surveillance resources connected to the use of face masks and mask enforcement This will be helpful in controlling the
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1 What are the social and economic determinants of the mask-using behaviour in rural areas during the COVID-19 pandemic?
H1a: The socio-economic characteristics, economic preferences, social preferences, features of masks, law enforcement, and the severity of the pandemic have a significant impact on the mask-wearing behaviour of Filipinos, Vietnamese, and Indonesians
2 How do these determinants affect the mask-using behaviour in rural areas during the COVID-19 pandemic?
H1a: Mandatory mask-wearing increases mask-using compliance
3 How to encourage Filipinos, Vietnamese, and Indonesian’s to properly wear a mask in public places during the COVID 19?
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Due to resource limitations, the study cannot cover other countries or territories in ASEAN countries where the pandemic may also be severe Furthermore, the data that were collected are based on the subjective decision of the participants where policies in each countries are different Therefore, weWe recommend future researchers to conduct an observation study This is to have an objective set of data and to limit the participant’s bias In addition, statistical tests were limited to regression analysis due to insufficient time More and appropriate statistical tests were encourage to perform for future studies
Limitations
Researchers have extensively studied health-related behaviors during previous pandemics and the COVID-19 outbreak, focusing on precautionary measures While socioeconomic variables, economic preferences, social preferences, and mask characteristics are commonly analyzed, this study specifically investigates the determinants of mask use in rural households By filtering factors based on those used in COVID-19 pandemic studies, the researchers aim to identify key factors that influence mask-using behavior in this population.
Barceló and Sheen (2020) conducted a study to identify the barriers to wearing masks in Spain, a country with no mask-wearing culture The research was conducted at the early stage of COVID-19 when the use of face masks was not compulsory Ordinal logistic regression is the primary method used to examine the effect of the independent group on the behaviour before and after the control variable used This method was used because of the ordinal sequence of the measurement in the Likert
LITERATURE REVIEW
International Studies
Barceló and Sheen (2020) conducted a study to identify the barriers to wearing masks in Spain, a country with no mask-wearing culture The research was conducted at the early stage of COVID-19 when the use of face masks was not compulsory Ordinal logistic regression is the primary method used to examine the effect of the independent group on the behaviour before and after the control variable used This method was used because of the ordinal sequence of the measurement in the Likert scale They used the exposure time of the individuals outside their houses as the control variable The higher the exposure of an individual to a disease, the more reliable information can be collected from them The socio-economic characteristics and social acceptability were the determinants used to examine the dependent variable The mask- wearing behaviour of the individuals was assessed by the questionnaire with a four- level Likert scale The association between the socio-economic characteristics and the mask-wearing behaviour was analyzed in linear models Separated ordinal logistic analysis was performed to identify the differences of the individuals in places where wearing masks are common (60%) and in areas where it is uncommon (40%) Social acceptability of face masks allows them to locate the geographic location of the individuals and assess the social norm of the area Lastly, the interaction of all the predictors in their model posed a deficiency in examining the variations in coefficients that are statistically important because the model is not nested Ordinal regression tests showed that 48.9% of the Spanish wear masks and 41% never wear masks The analysis demonstrated a significant association between mask-wearing behaviour and the socio- economic characteristics age, education, and occupation Older people (OR: 1.77; 95% CI; 1.39-2.24) and educated individuals (OR: 0.71; CI: 0.56-0.90) are more likely to wear face masks at a 1% significance level, respectively As a person grows older, their immune system weakens which makes them more susceptible to illnesses than younger individuals Knowledgeable individuals are the most likely to comply with preventive measures that will protect themselves and others Non-frontliners who work from home are less likely to wear masks (OR: 1.13; CI: 0.75-1.72) at a 5% significance level These individuals are less cautious when going out to public places as they mostly spend their time inside their houses This carelessness is one way to get infected from the COVID-
Ordinal regression analysis on a split model revealed that age does not influence mask-wearing behaviors in areas where mask usage is uncommon However, in locations where face masks are prevalent, older individuals (OR: 2.13; CI: 1.32-3.42) are more likely to wear masks compared to younger individuals, with a significance level of 1% Educational level is not significantly associated with mask-wearing behavior regardless of mask usage prevalence Socioeconomic characteristics, on the other hand, significantly impact mask-wearing behavior.
An experimental study by Lee, Yip et al (2020) in Hong Kong examined the influential factors that affect the comfort of disposable face masks There is a global shortage of personal protective equipment, particularly face masks, as a result of panic buying and a significant increase in demand brought on by the COVID-19 pandemic Thus, the use of reusable cloth masks—which are less economical and environmentally friendly than medical masks—has become a common practice The investigation employed samples of seven various types of masks with various attributes The wear trial of the mask was experimented by a 25-year-old individual with a normal body mass index (BMI) The results of the trial demonstrated that surgical masks are thinner than washable masks with filters It's possible that thinner masks are frequently thought to be more breathable than thicker ones The investigation did show that there is a weak link between the breathability and the thickness of the masks, R2 = 0.45 The 3D masks, on the other hand, don't seem to fit the subject's facial features, which leads to seal leakage Because it regulates the size of the gap between the face and the mask, the fit of the face masks is the most crucial element that impacts breathability The fit of the masks correlates to comfort as tight masks may irritate the skin which coincides with the review of Bakhit, Krzyzaniak et al (2021) Overall, the study provided evidence that comfort in wearing masks affects whether individuals will have good or bad mask- wearing behaviour In the face of shortage in medical masks, cloth masks are highly advisable than no mask at all However, an individual is still expected to have good mask-wearing behaviour to increase the effectiveness of the policy and to reduce the risks of infection Discomfort in mask-wearing may reduce the compliance of the wearer which will greatly affect the economy which will result in the economic shutdowns
A systematic review by Bakhit, Krzyzaniak et al (2021) identified, appraised, and synthesized studies evaluating the downsides of wearing facemasks in any setting as well as the strategies on how to mitigate its downsides Thirty-seven studies were reviewed systematically and found out that discomfort, irritation, and misuse of masks are the downsides of wearing face masks Systematic reviews showed that misuse of face masks was less studied where it is largely seen in the essential workers and the members of households Essential workers are found to only cover their mouths and nose Additionally, they touched their eyes once an hour, their masks five times an hour, and their face two to three times an hour This is one of the objectives of the study where the factors that drive people to perform good or bad mask-wearing behaviour were evaluated Improper use of face masks could increase the risk of infection One reason for this behaviour is discomfort and it increases with the duration of mask- wearing The discomfort that wearing masks brings are warmth, irritation, and difficulty in breathing Shortness of breath is one of the major discomforts of wearing masks where essential workers working with masks on may have touch face and mask frequently which is bad mask-wearing behaviour A household member wearing masks for long hours brings unnecessary warmth to the face and irritation which can result in the bad behaviour of mask-wearing Overall, the review provided evidence on the significance of identifying the factors of mask-wearing behaviour which will be useful in controlling the COVID-19 pandemic Laws on using face masks were implemented but not how to properly use them Therefore, it is crucial to determine whether people wear masks in a positive or harmful way, especially household members who make up the foundation of the economy and who have been severely impacted by the COVID-
19 pandemic Moreover, the review offered data demonstrating the widespread abuse of face masks
A study conducted by Müller and Rau (2021) in Germany investigated whether economic preferences predict social compliance to policy regulations The study focuses on students' adherence to social norms during the COVID pandemic This sample selection could not necessarily represent the entire population and could be subject to the selection effect Ordinary least squares regression model is the primary method used to assess the effect of the independent variables to the dependent variable Cronbach’s alpha was used to analyze the reliability of health compliance The demographics age, gender, nationality, field of study/profession, and monthly income were used as control variables Economic preferences (risk and time) were used as the independent variables of social compliance Economic theories explained risk preferences as the tendency to choose an action with less or high risk It is characterized into three components: risk averse, risk neutral, and risk loving People who are afraid of taking chances are said to be risk-averse Even if the average outcome of the latter has a larger or comparable financial worth than the more definite outcome, they prefer outcomes with low uncertainty to those with high uncertainty Higher risk aversion lowers the frequency of harmful health behaviours, making people more likely to wear masks appropriately People who have no concern for dangers are said to be risk neutral People that are risk averse are more prone to engage in poor mask-wearing behaviour Finally, risk lovers are those who are eager to accept greater risk in exchange for a result with a relatively low additional expected benefit Risk loving individuals are more likely to have bad mask-wearing behaviour since these people enjoy taking risks On the other hand, time preference refers to a person’s willingness to wait for immediate or delayed financial rewards Time reference measures an individual’s patience thus, a person with high time preferences is considered to be patient and more likely to comply with the good mask-wearing behaviour Evaluating the preference of the individuals is essential to understand their behavioural response Studies on the link between economic preferences and health outcomes have traditionally been used to inform public policy, explain psychological decision-making, and elucidate the drivers of what might otherwise appear to be illogical health behaviour Individuals perceive health and preventative health interventions as investments, according to Grossman'swhich was seen similarly to basic economic model of individual demand for health from 1972 (Grossman, 2017) Data on risk preferences were collected through a qualitative question from the study of Falk, Becker et al (2018) which is measurable by 11-point Likert scale (0 = lowest degree;
10 = highest degree) Data on time preferences were elicited through a qualitative question asking the individuals to choose either a smaller amount of monetary compensation sooner or a larger amount in the future which are measured in the form of discount rates and represents the level of patience of the individuals Findings indicated that those with above-median risk tolerance are less likely to adhere to health standards, but those with greater patience and social responsibility are more likely to do so According to the results of the regression analysis, compliance behaviour is positively impacted by time and risk preferences At a 5% significance level, an increase of one standard deviation in risk tolerance and patience results in an increase of 0.195 standard deviation in health compliance Overall, economic preference showed a positive impact on compliance to health regulations Thus, it will be useful to examine the determinants of the good or bad mask-wearing behaviour using the factors used in this study
A study by Papageorge, Zahn et al (2021) in the USA examined the socio- economic factors that affect health behaviour They focused on the impact of socio- economic inequality on mask-wearing behaviour Linear probability models were used to investigate which socio-demographic traits are associated with self-protective behaviour Heteroskedastic robust standard errors were used to correlate income to other factors The socio-economic characteristics that were used as the determinants of the mask-wearing behaviour were income, gender, ethnicity, work status, housing quality, and location Work status describes the adjustments made to an individual's working situation during a pandemic, including those who had never worked before, had ceased working as a result of the pandemic, had started working online, or were still employed but without changing their work status People who are struggling financially might not practice healthy habits This might make high-risk groups more susceptible to infection and lengthen the pandemic Linear probability models showed that income is associated with a high possibility of engaging in self-protective behaviour However, the addition of the other variables only partially explains it This shows that while money is a significant predictor of behaviour change, the other factors considered only partially account for this association As a result, the relationship between income and other variables was used to explain how the COVID-19 pandemic and mask-wearing behaviour affected the economy Younger people have switched to working online, while older workers are more likely to have been unemployed before or during the epidemic, according to the findings Higher earners are more likely to work remotely, whereas lower earners are more likely to have either given up their jobs before the epidemic or to have stopped working altogether as a result of the pandemic This indicates that older people and lower income individuals are vulnerable to the effect of the COVID-19 pandemic Additionally, those with lower incomes who said they were still employed typically work as cashiers, packers, or packagers, among other occupations Lawyers, computer programmers, and managers with high incomes indicated continuing to work The lack of an income gradient for this particular category is explained by the fact that these occupations include persons who have been designated as "essential employees," despite the fact that their salaries vary significantly Income loss is one of the COVID-19 pandemic's economic effects Expected losses to labor income due to pandemic are largely seen in low income individuals Loss in household income is also affected People who belong to low income households reported nearly 20-25 percent losses and those who belong to high income households reported 10-15 percent household income losses On the other hand, the losses that already occurred due to the pandemic were specifically harmful to low income individuals People who work online increase as well as income People with low incomes are more inclined to quit their jobs Furthermore, those with low incomes had the least stable jobs and the largest chance of becoming temporarily unemployed While those with greater incomes were more likely to lose their employment permanently This could be due to selection; higher paying employment are typically more stable, so losing your job signals a significant and long-lasting change, like declaring bankruptcy Together, these numbers show how the pandemic has disproportionately affected people of lower socioeconomic status These are the individuals that have experienced comparatively greater loss of income and work, which may make it more difficult for them to act in a self-protective manner Full-time employees' working conditions and salary fluctuate, and as income rises, so does their capacity to work from home People with lower incomes said they either stopped working or had no change in their employment status While the same percentage of those with low incomes do not work, nearly 75% of those with high incomes work full- time Regression results showed that income has a positive impact on the mask-wearing behaviour An increase of 0.17-0.25 in income increases the probability of engaging in mask-wearing behaviour at a 1% significance level Higher income individuals are more likely to have positive mask-wearing behaviour People aged 56 and older have a positive impact on the mask-wearing behaviour where an increase in age increases the probability of engaging in mask-wearing behaviour of 0.14 at a 1% significance level This indicates that older people care more about their health than younger individuals Overall, the findings indicated that income had a favorable effect on mask- wearing behaviour and that people with higher incomes are more likely to engage in it Low income people are disproportionately hurt by the pandemic's economic effects Therefore, the pandemic's impact has a significant impact on how people wear masks
A cross-sectional study by Tan, Wang et al (2021) in China evaluated whether the public has good or bad mask-wearing compliance behaviour The prevalence of mask use among the general public was evaluated using descriptive statistics To determine the risk factors influencing the mask-wearing behaviour, a binary logistic regression analysis was carried out Each appropriate and inappropriate mask-wearing behaviour response received a score of 1 or 0, accordingly In the binary logistic regression analysis, the final score was classified as "good" or "bad" depending on whether a score of 10 or above (out of 13 points) was obtained The "good" rates between groups were compared using chi-squared tests, and variables with a significance level of less than 5% were included in the binary logistic regression analysis Data were gathered using a four-point Likert scale, multiple-choice questions, and forced choices The socioeconomic parameters (gender, age, city/province, level of education, work/living environment), the type of masks typically worn, exposure to correct face mask use, mask-wearing behaviours, mask disposal technique, and mask reuse were the determining factors The study reported that Chinese have a 99% mask-wearing compliance rate This is likely because of the mandatory use of face masks during the research process The majority of respondents (76.4%) reported learning how to apply face masks from social media 96.5% of the respondents knew the proper way of using face masks where the mouth, nose, and chin needed to be covered 81.5% of them make sure that there is no gap between the face and the mask Only 20.2% and 8.0% of users, however, never touched or adjusted their mask while using it, and more than half of those who did (55.3%) or did so only seldom (62.1%), did not wash their hands afterward A few participants said they occasionally or always hung their masks under their chins while wearing them (often 7.0%, always 9.4%), or occasionally or always covered their mouths or noses while using them (often 2.9%, always 1.3%) Nearly all of the Chinese respondents reported that they know how to use a face mask properly where they gathered the information mostly on social media However, only a few properly execute proper ways of using the masks This shows that social media is not an effective way to relay messages on how to properly use face masks 94% of the Chinese were aware of the proper way to remove used masks, but less were aware of the proper way to discard them; 7.6% of them disposed of their masks into trash cans without lids, while 22.5% disposed of them into any available trash can, lid or no lid The respondents shown nearly enough understanding of how to wear face masks properly The types of face masks used were disposable masks (93.8%), N95 respirators (26.2%), and cloth face masks (8.5%) Another issue that the general population faces is a wide variety of masks N95 respirators were worn by more than a quarter of the participants, even though they are not advised for the general public According to the Centers for Disease Control and Prevention (CDC), fit testing is necessary before using N95 respirators to ensure the best fit possible The dependability of N95 respirators depends on how well they fit the wearer The most dependable and advised face mask to utilize in this situation is a disposable medical mask Some participants admitted to wearing many masks at once (rarely 26.5%, frequently 2.1%, and always 1.5%) 58.8% of those surveyed said they had reused disposable masks More than one-third (37.6%) of the respondents did not replace the mask when used for more than 8 hours Due to the pandemic, many people lost their jobs, which resulted in lower to no monthly income Moreover, since the demand for face masks increases, the price also increases, which makes people resort to reuse a face mask Reusing a face mask is inevitable to lower-income households and especially when facing a shortage in the supply of face masks 73.3% of the subjects showed good compliance with the use of face masks, with a final score of 10 points or more being considered "good." Finally, binary logistic regression analysis revealed the variables that are specifically linked to high compliance, including gender, age, residence, educational background, present work/living situation, and familiarity with face mask usage guidelines Increased compliance was substantially less frequent in men than in women (OR=0.77, 95% CI
Mask-wearing compliance varied significantly among different demographics Women showed higher compliance than men, and younger individuals (14 years or younger) had better compliance than older age groups (15-34 and 35-65 years) Notably, North and South Chinese participants had lower compliance compared to those from Central China Urban dwellers exhibited better compliance than rural residents Educational attainment also influenced compliance, with individuals holding higher degrees showing better adherence Furthermore, awareness of proper mask usage instructions significantly increased compliance.
Studies in the Philippines, Vietnam, and Indonesia
On January 30, 2020, it was determined that COVID-19 had spread to the Philippines Since April 2020, the law requiring the wearing of face masks in public places has been in effect In addition to face masks, there is also a mandatory use of face shields which was implemented by the Philippine government as one of the precautionary measures against the COVID-19 A cross-sectional study in the Philippines by Lau, Hung et al 2020 investigated the behavioural response of the low- income households in some rural areas following the COVID-19 epidemic To determine how socioeconomic variables affected COVID-19 knowledge, attitude, and practices, logistic regression analysis was utilized Continuous variables having non- normal distributions were subjected to Kruskal-Wallis nonparametric testing Inflation factor and robust standard error were used to ensure that the results have no multicollinearity and heteroskedasticity The knowledge on the pandemic and the socio-economic characteristics were used as the determinants of the mask behaviour The results showed that only 28% of the low income households wear face masks This reflects that people who belong to the household with low monthly income have the least ability to buy and use face masks A total of 94% respondents heard of the COVID-19 pandemic; 85.5% of them heard of it from television and 56.1 in the radio The level of education is associated with knowledge at a 1% significance The association showed that for every unit increase in education, there is a 1.09 increase in the correlation to knowledge on how the COVID-19 is transmitted However, this connection is not related to the proper preventive measures against the virus This indicates that low income households do not have sufficient knowledge on the preventive measures to counter the virus which includes the good mask-wearing behaviour Overall, the study provides substantial support for the need to investigate the mask-wearing habits of households in rural parts of the Philippines, where the majority of those with low incomes dwell Moreover, there is a low spread of information in these areas which shows the importance of the information flow Furthermore, the laws on the proper use of face masks should be integrated especially in these areas to help alleviate economic loss
On the other hand, while the usage of face masks in public places became required in March 2020, the first confirmed COVID-19 incidence in Vietnam occurred on January 23, 2020 As a case study of effective epidemic containment, Vietnam had attracted the attention of epidemic health strategies (Falk, Becker et al 2018, and Huynh 2020) This is because of the successful interruptions of the previous pandemics
A study by Huynh (2020) examined the mask behaviour of the Vietnamese and provided related policy recommendations The knowledge of face mask properties and how to apply them properly was assessed Tobit regression model was utilized to determine the factors influencing the behaviour of the mask The socio-economic parameters (age, gender, and family size) were employed as the determinants of the mask behaviour, together with awareness of the usage of face masks, mask qualities, and these factors At a 1% level of significance, the results revealed that age positively predicts the right answers This indicates that as an individual ages, the number of correct answers on the mask behaviour were yielded It correlates that knowledge increases with age The characteristics of face masks were examined with the explanatory factor analysis (EFA) The research revealed that each variable might only represent a specific face mask component rather than a general trait, and that this could cause quasi-collinearity, which would raise the standard errors Therefore, the EFA must be used to address the problems The principle component factors approach and orthogonal varimax served as the foundation for the factor analysis (Kaiser on) According to the findings, one factor should be developed with an explanatory factor of variance up to 79.55%
Meanwhile, in Indonesia, the implementation of mandatory use of face masks in public places started on April 5; one month after the first COVID-19 case which happened on March 2, 2020 A study conducted by Chavarría, Diba et al (2021) in During the COVID-19 epidemic, Indonesia investigated the factors that influence illness knowledge and behaviour To evaluate the variables affecting knowledge and preventive behaviour during the pandemic, linear probability models were used The socio-economic characteristics (age, gender, education, and wealth), economic preferences, and knowledge on the pandemic were used as the determinants of the mask-wearing behaviour Questions were adapted from research on the 2009 H1N1 pandemic by Balkhy et al (2010) and Ibuka et al (2010) to assess the people' knowledge and behaviour (2010) Economic preferences were collected through validated surveys by Falk, Becker et al (2018) and were measured by self-reported questionnaires with a ten-point Likert scale Linear regression results showed that knowledge is the biggest driver of mask-wearing behaviour Individuals aged 50 years and above have a negative impact on mask-wearing behaviour For every increase in age, there is a decrease of 0.129 in the mask behaviour at 1% significance level It suggests that elderly persons are less adept at using face masks properly At a 1% significance level, higher education is linked to a 1.11 increase in the likelihood of knowing the appropriate mask behaviour It suggests that educated persons are better informed about how to utilize face masks The findings indicated that economic preferences and socioeconomic traits have no influence on mask-wearing behaviour People who reside in households with wealth above the median have a favorable effect on mask-wearing behaviour For every increase in household income, the probability of wearing a mask increases by 0.054 at a 5% significance level This indicates that in this economic recession, higher income individuals have the capability to use face masks properly At a 10% level of significance, there is a 0.009 increase in mask wearing likelihood when patience is positively correlated The findings revealed that people living in urban areas increase adaptation of wearing masks by 5-7% Overall, the study showed that knowledge affects how face masks should be worn Face mask usage must be marketed properly because it is prohibited in public areas Additionally, information about the proper usage of face masks should be made more widely available.
Summary
The COVID-19 has a negative influence on every individual and the economy Face mask use has been shown to reduce the spread of the virus, which is constantly evolving The proper usage, removal, disposal, and the appropriate time to change a face mask increases its effectiveness and avoids the surge of active cases Its determinants have been identified and explained to many countries, especially the developed countries Related policy recommendations were advocated in support of solidifying the mandatory use of face masks in public places However, information is limited to developing countries like the Philippines, Vietnam, and Indonesia where medical infrastructures are inferior Hence, the good mask-wearing behaviour of the community would be beneficial to these areas Moreover, the necessity to study the behaviour of the households in rural areas showed great significance as most of these developing countries are rural To eliminate the aforementioned gap in the literature review, this paper aims to address the insufficient data in rural developing countries.
OBJECTS AND METHODS
Objects
The target group of the study are the members of the households in the rural areas of Rizal Province in the Philippines, Thai Nguyen Province in Vietnam, and Java Island in Indonesia These countries are one of the developing countries where there is a poor medical infrastructure To fill this gap, understanding and practicing the proper way of using face masks is one way to reduce the social and economical impact of the pandemic Furthermore, the target groups are one of the most populated rural areas in their respective countries To limit the spread of the virus, these nations have made wearing face masks in public areas mandatory But because there aren't many rules governing how face masks should be worn, many people abuse them Moreover, people living in rural areas do not exhibit good mask-wearing compliance (Tan, Wang et al 2021) As a developing country, most of the population of the Philippines, Vietnam, and Indonesia are living in rural areas This may be one of the reasons why in contrast to Vietnam, the Philippines and Indonesia remain as one with the most number of COVID-
19 active cases Together, these traits will offer useful data on how people react to a pandemic in different policy situations and with varied family characteristics
Quantitative approach through an online cross-sectional survey was employed, which was deemed the most appropriate way to collect data without interference from the implemented restrictions from the government Questions were adapted from the study of Tan, Wang et al (2021) conducted in China Data collection was performed online using Google Forms, and the invitation to participate was shared on social media
Individuals living in rural areas aged 18 and above were asked to participate through a snowball sampling method The sample size of the target group consists of 397; 197 responses from the Philippines, and 100 responses from Vietnam and Indonesia Responses from people aged 17 and below were removed
The survey consists of five sections The first part assessed the mask-wearing behaviour of the respondents The next following parts examined the mask law enforcement, features of masks, economic and social preferences Lastly, the socio- economic characteristics of the respondents were evaluated The collection of data started from July 12 to August 5, 2021 when the COVID-19 active cases in the target group increased which made the collected data significant.
Methods
Data on the frequencies and percentages were used to present the results of the mask-using behaviour using excel The required use of face masks is severely enforced in the target area, which raises the compliance rate, therefore it is expected that the data will show good mask behaviour Moreover, the socio-economic characteristics, economic preferences, social preferences, features of masks, law enforcement, and the severity of the pandemic are expected to have a significant impact on the mask-using behaviour Furthermore, significant differences in the mask behaviour between the target group are expected to be identified
In order to evaluate the public's mask-using behaviours, descriptive data were used Four dependent variables were assessed to examine the determinants of the mask- using behaviour All of the information was presented as frequencies and percentages for categorical variables Correct behaviours from the Likert scale were recorded as 1 and wrong behaviours were recorded as 0 for the examination of mask-using behaviours (Tan, Wang et al 2021) The factors influencing the other mask behaviours were investigated using binary logistic regression analysis Stata was used to calculate every statistical analysis
To examine the determinants of mask-using behaviour, four types of linear probability regression specifications were used as:
1 Good/Bad mask-wearing behaviour
= outcome vector of the mask-wearing behaviour Questions on this variable were adapted from the study of Tan, Wang et al (2021) where the questionnaire was created based on the regulations of WHO A four-level Likert scale (never, sometimes, often, always), forced-choice, and multiple-choice answers are used to collect data For the analysis of the answers from the Likert scale, correct behaviours are recorded as 1 and incorrect behaviours were recorded as 0 The items 1, and 2, responses of “never” and
“sometimes” were defined as incorrect (0), while “often” and “always” were defined as correct (1) The opposite definitions were applied for items 3, 4, 5, 6, 7, and 8 “never” and “sometimes” were defined as correct (1) while “often” and “always” were defined as incorrect (0) Good behaviour was defined as a score of 5 or higher (out of a possible
8 points), and it served as the dependent variable in a binary logistic regression analysis
Individuals are expected to wear masks in public places as prescribed by the law and expected to have good mask-wearing behaviour
X1: personal characteristics (age, gender, education, marital status, occupation, work status, information channel, economic preferences, social preferences, and nationality)
= measured in years Individuals were categorized into young people (18-34), middle aged (35-50) and old people (>50) As a person grows, he/she pays more attention to their health Therefore, compliance to good mask-using behaviour is expected to be seen in older people
= dummy variable for gender Male is used as a dummy variable for gender recorded as 1 and 0 if female Women perceive themselves as more susceptible to viruses (Clark, Davila et al., 2020 & Tan, Wang et al., 2021) Thus, they are expected to comply with good mask-using behaviour
= categorical variable measured by the level of education Individuals who have a tertiary or post level of education are considered educated people thus, coded as 1 and
0 if otherwise As the educational level of an individual increases so does the knowledge An educated person is expected to have more knowledge on the proper way of using a mask thus, more likely to comply with good mask-using behaviour (Tan, Wang et al., 2021)
= dummy variable for marital status Married is used as a dummy variable for marital status recorded as 1 and 0 if otherwise Married individuals are more likely to pay more attention to mask-using behaviour to ensure personal and family safety Thus, they are expected to exhibit good mask-using behaviour
= categorical variable for occupation Occupation is self-reported and the
Individuals employed in occupations entailing frequent social interactions are more compliant with mask usage This is because those working with many people are more likely to exhibit responsible mask-wearing practices to protect both their health and the well-being of others The higher the proportion of individuals in an occupation who are socially engaged, the stronger the correlation with proper mask compliance.
= measured by work status Work status is measured by 1 if working and 0 if not Many people lose their job due to the pandemic thus, they are expected to have good mask-using behaviour to reduce health expenses
= a dummy variable indicating having learned about proper face mask usage from family members, TV, radio, social media, and local distribution Information gathered through word of mouth (family members/community) are coded as 1 and 0 if the information is gathered through technology
= measured by two proxies: risk and time preferences Risk preferences refers to the tendency to choose an action with less or high risk Risk preferences are characterized into three components: risk-averse, risk-neutral, and risk loving Risk- averse refers to people who are reluctant to take risks Risk neutral individuals do not care about the risks Lastly, risk-loving persons love to take risks regardless of the outcome Higher risk aversion is associated with better mask-using behaviour, while higher risk preferences are associated with worse mask-wearing behaviour (Campos-
Mercade, Meier et al 2021) On the other hand, time preference refers to a person’s willingness to wait for immediate or delayed financial rewards An individual with high time preferences is considered to be patient thus, willing to trade-off individual freedom to have higher health rewards in the future (Müller and Rau 2021)
= measured using two proxies: altruism and positive reciprocity The latter is the propensity for a person to respond to an action that provides a positive advantage with an action that provides at least an equal or complementary benefit Altruism, on the other hand, is the ability for unrestricted kindness Individuals who have high positive reciprocity and altruism care about the impact of their behaviour The data on the social preferences were collected through a self-assessed qualitative question measured in a scale of 0-10 by Falk, Becker et al., (2018) Individuals who have high positive reciprocity and altruism care about the impact of their behaviour High social preference individuals are expected to behave well when wearing masks as an act of kindness and for the benefit of others as well as themselves because they are seen as socially responsible and concerned about the effects of their behaviour (Campos-Mercade, Meier et al., 2021)
= categorical variable on the features of face masks Face masks have respective features that have different advantages and disadvantages The use of face masks has been proven effective by many researchers However, the fit, comfortability, warmth, irritation, and breathability are the features of masks that affect the mask- wearing behaviour (Bakhit, Krzyzaniak et al., 2021 & Lee, Yip et al., 2020) Therefore, the individuals are expected to have bad mask-using behaviour when the downsides of the masks are experienced The data on the features of masks were collected and measured in a scale of 0-10 self-made questionnaires
RESULTS
Face Masks in Rural Places
Figure 1 represents the percentage of the face masks used by the respondents; sixty-three percent of the participants use disposable medical masks, 26% use cloth masks, and 11% use N95 respirators when going out to public places The selection of the right type of face masks to use is one of the problems in the general community More than ten percent of them use N95 respirators, one-fifth of the Indonesians, 11% of the Filipinos, and 2% of the Vietnamese, which is not advisable and recommended for the public (Tan, Wang et al., 2021) It is uncommon knowledge among the general public that the efficiency of N95 respirators in preventing the COVID-19 airborne virus depends on how well the wearer's mask fits, necessitating fit testing before to use (CDC, 2020) More than one-fourth of the participants use cloth masks which were recommended rather than no mask at all Moreover, cloth masks are reusable and considered to be an option in the midst of mask shortage Therefore, it is necessary for the public to know the right type of face mask to use at the right time and place
Figure 1 Face masks used in rural places
Face masks used in rural places
Disposable medical masks, Cloth masks
4.1.1 Determinants of Mask-Wearing Behaviour
Table 1 provides an overview of the socio-economic characteristics of 397 respondents from rural households in the Philippines, Vietnam, and Indonesia The majority are male (36%) with a mean age of 29, indicating a younger population Education levels are high, with approximately 83% having a tertiary or higher level of education Household demographics include a significant number of married respondents (over one-third), living with an average of 5 family members The households earn an average monthly income of three thousand dollars In terms of employment, nearly one-fourth of the respondents are frontline employees, while other variables related to employment status are not specified in the provided context.
Table 1 Socio-economic characteristics of the participants and comparison of the frequencies of mask-wearing behaviours in variuos groups (N97)
More than one-third of the participants have the worst behaviour of adjusting a face mask while using them Additionally, more than one-fifth of the respondents do not check to make sure there are no gaps between their face and the face mask after donning it and frequently touch and hang the mask under their chin while using it in public These are the most common improper behaviours of using face masks Face masks shouldn’t be touched or adjusted when using them (CDC, 2020)
Table 2 Characteristics of Mask-Wearing Behaviours in Public (N97)
1 After wearing a mask, do you make sure that your mouth, nose, and chin were covered by the mask?
2 After wearing a mask, do you make sure that there are no gaps between your face and the mask?
3 Do you touch the mask while using it? 310(78%)/87(22%)
4 Do you adjust the mask while using it? 259(65%)/138(35%)
5 Do you hang the mask under the chin while using it? 302(76%)/95(24%)
6 Do you uncover your mouth or/and noses for a breath while using the mask?
7 Do you wear multiple masks at the same time? 321(81%)/76(19%)
8 Do you reuse disposable masks? 351(88%)/46(12%)
4.1.2 Determinants of Mask-Removing Behaviour
Figure 3 illustrates that a significant proportion of participants remove face masks correctly (by its laces), while others improperly remove them by touching the front or inside of the mask Table 3 further reveals that mask characteristics influence mask-removal behavior Notably, a well-fitting mask positively impacts proper removal, while poor breathability negatively affects it.
The variables warmth, time, and social preferences were removed from the model Indonesians were used in the regression analysis
Table 3 Determinants of Mask-Removing Behaviour
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Note: X1=information channel, X2=commonality of masks before COVID-19,
X3=level of commonality of masks before COVID-19, X4=punishment for not wearing mask, X5=strictness of mask law, X6=punishment for not wearing masks properly,
X7=strictness of law on proper mask-use, X8=comfortability, X9=fit,
X10=breathability, X11=warmth, X12e and ear irritation, X13=risk, X14=time,
X15=positive reciprocity, X16=altruism,X173=nationality, X18=gender, X19=age,
X20cation, X21=marital status, X22=household income, X23=household size,
4.1.3 Determinants of Mask-Changing Behaviour
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Figure 4 shows that almost half of the participants in each country do not change their face masks at the right time Table 4 presents the regression analysis of the determinants of the mask-changing behaviour The law plays a crucial role on the good mask-changing behavior However, it negatively affects the behavior In contrast, the strict law enforcement with regards to the behavior positively affects it This contradiction implies that a law without proper and strict enactment will not have any positive impact Moreover, belong to the high income household shows good mask- changing behavior The variables warmth, time, and social preferences were removed from the model
Indonesians were used in the regression analysis
Table 4 Determinants of Mask-Changing Behaviour
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Note: X1=information channel, X2=commonality of masks before COVID-19,
X3=level of commonality of masks before COVID-19, X4=punishment for not wearing mask, X5=strictness of mask law, X6=punishment for not wearing masks properly,
X7=strictness of law on proper mask-use, X8=comfortability, X9=fit,
X10=breathability, X11=warmth, X12e and ear irritation, X13=risk, X14=time,
X15=positive reciprocity, X16=altruism,X173=nationality, X18=gender, X19=age,
X20cation, X21=marital status, X22=household income, X23=household size,
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4.1.4 Determinants of Mask-Disposal Behaviour
Figure 5 indicates that 56% of participants disposed of used face masks responsibly in a trash bin with a lid or a designated receptacle Conversely, 44% disposed of masks improperly Table 5 provides regression analysis to identify factors influencing mask-changing behaviors.
Indonesians show a very good behavior when disposing of used face masks despite having a poor information channel and lack of knowledge on the proper mask-disposal behavior which negatively affect this behavior and lack of knowledge on the proper mask-disposal behavior Moreover, individuals who belong to higher income household show poor mask-disposal behavior
The variables warmth, time, and social preferences were removed from the model
Indonesians were used in the regression analysis
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Table 5 Determinants of Mask-Disposal Behaviour
Note: X1=information channel, X2=commonality of masks before COVID-19,
X3=level of commonality of masks before COVID-19, X4=punishment for not wearing mask, X5=strictness of mask law, X6=punishment for not wearing masks properly,
X7=strictness of law on proper mask-use, X8=comfortability, X9=fit,
X10=breathability, X11=warmth, X12e and ear irritation, X13=risk, X14=time,
X15=positive reciprocity, X16=altruism,X173=nationality, X18=gender, X19=age,
X20cation, X21=marital status, X22=household income, X23=household size,
Formatted: Superscript Formatted: English (United States)
Formatted: Font: (Default) Times New Roman, 13 pt
DISCUSSION AND CONCLUSION
Discussion
Eight questions related to the proper usage of face masks in public places were used to examine the mask-wearing behaviour of the respondents One point is given for every good behaviour and 0 if otherwise Participants with a score of 5 or higher were considered to have good mask-wearing behaviour Figure 2 showed the percentage of the respondents who comply with the proper use of face masks A small percentage of the public with poor mask-wearing behaviour may negatively affect the effectiveness of universal masking The success of the mask laws and policies depends on the compliance behaviour of the public Therefore, it is crucial to boost the rate of public mask compliance More details on the participants' socio-economic characteristics and comparison between the different groups are presented in Table 1 The result shows that men have better mask-wearing behaviour than women Educated people and households with less than 5 members have bad masks behaviour than their counterparts Poor mask behaviour can be seen on individuals aged 35-50 and non- frontliners despite not having the largest number of respondents It is worth noting the large gap between the participants who are not working and have less than 1,000$ monthly income Due to the epidemic, many households lost their jobs and earned the minimum monthly salary
Figure 3 demonstrates how the use of face masks was common before the COVID-19 incident, which has a negative impact on mask-removing behaviour A person living in an area where the use of a face mask is common decreases the compliance to good mask-wearing behaviour by 0.99 at a 5% significance level This indicates that the people living in an area where face masks have been common before the pandemic happened to have the least probability of complying with good mask- removing behaviour It demonstrates that how face masks were used prior to the pandemic does not correspond to how they ought to be used today This means that depending on the circumstance, different face masks should be used Different aspects of a mask's design have an effect on how it is worn The fit of face masks positively affects good mask-wearing behaviour For every one-unit increase in the good fit of the face mask, the probability to properly remove them increases by 0.21 at a 10% significance level This indicates that good compliance increases with a good fit of face masks It means that the mask must have a good fit to the wearer to properly remove them after use The breathability of face masks negatively affects good mask-wearing behaviour At a 5% significance level, the probability of successfully removing a face mask drops by 0.27 for every unit increase in breathability Obviously, the ability to breathe freely while wearing masks should provide a positive impact on the wearer However, the result showed the opposite This indicates that even if the masks have a good breathability feature, the wearer still finds it hard to comply with the good mask- wearing behaviour It means that further policies are needed to increase compliance while maintaining the positive features of face masks
Figure 4 depicts that the laws on the proper use of face masks negatively affect mask-changing behaviour For every one-unit increase in the law of proper use of a mask, the probability of compliance decreases by 0.49 at a 10% significance level In contrast, the strictness of this law positively affects compliance to good mask-changing behaviour For every increase in the level of strictness on the law of mask, the probability of good mask compliance decreases by 0.18 at a 1% significance level This contradiction implies that compliance to proper mask-changing behaviour heavily relies on the strictness of the law It means that the public is more likely to follow the regulations if strict laws were to be implemented since the frequency of changing masks can’t be monitored by the government This imposes a need to address the issue and to promote more information on the right time to replace a used face mask.The fit of face masks negatively affects good mask-wearing behaviour For every one-unit increase in the good fit of the face mask, the probability to properly change them decreases by 0.22 at a 5% significance level Obviously, the fit of a face mask should provide a positive impact on the wearer However, the result showed the opposite This indicates that even if the masks have a good fit, the wearer still finds it hard to comply with the good mask- wearing behaviour It means that further policies are needed to increase compliance while maintaining the positive features of face masks Lastly, household income has a positive effect on mask-wearing behaviour As income increases, the probability of having good mask-wearing behaviour increases by 0.09 at a 1% significance level This indicates that high-income households are more likely to comply with good mask behaviour than lower-income households It shows that a person that belongs to a high- income household has a higher capability to adapt to the precautionary behaviours than low-income people
Information channels negatively impact mask-disposal behavior With each increment in information dissemination through various channels, the probability of proper mask disposal decreases by 0.54 This suggests a decline in information credibility as it spreads through word of mouth and technology To maintain credibility, governments and medical authorities should directly provide information to the public.
19 happened positively affects the mask-disposal behaviour For every unit increase in the level of prevalence of face masks before the pandemic happened, the probability to comply with good mask behaviour increases by 0.09 at a 10% significance level This indicates that the higher an individual perceived the degree of prevalence of the use of face masks in their area increases the probability of complying with good mask behaviour It means that the public has sufficient knowledge on how to properly dispose of their used masks due to their history Risk preference has a positive impact on compliance to mask-disposal behaviour For every unit increase in the risk preference, the probability to comply with good mask behaviour increases by 0.06 at a 10% significance level This indicates that the higher an individual recognizes the risks of getting infected, the higher their compliance to dispose of their used masks A person’s nationality positively affects mask-disposal behaviour Being an Indonesian increases the probability of disposing of the used face masks in proper garbage by 0.90 at a 5% significance level This indicates that Indonesians are knowledgeable on how to properly dispose of their used mask It means that there is a need to increase awareness on how to remove face masks Finally, mask disposal behaviour is negatively impacted by household income and educational attainment The probability of adhering to proper mask-disposal behaviour drops by 0.50 for every level of education above the lowest at a 10% significance level It means that the participants possessed insufficient knowledge on the proper way to discard the used mask On the other hand, as income increases, the probability of complying with good mask-disposal behaviour decreases by 0.11 at a 5% significance level It means that high-income households are more likely to neglect good mask behaviour than lower-income households These results imply that a law on the proper disposal of used face masks should be focused on these groups.
Conclusion
People notoriously misuse face masks which may result to negative externalities The data was reliable at the time of writing because of the rise in COVID-19 active cases in the Philippines, Vietnam, and Indonesia The collection of data started where there are 5,036 new cases in the Philippines, 2,187 new cases in Vietnam, and 40,427 in Indonesia This shows that the severity of the virus continues to escalate; the virus evolves that creates new active cases and increases the number of deaths in which distress a country’s economic and social balance In this instance, limiting the virus's ability to spread is greatly aided by the usage of face masks
The researcher examined four different behaviours in using a face mask: (i) mask-wearing behaviour where we determined whether an individual follows the preventive measures instructed by the government and medical facilities, (ii) mask- removal where we determined whether an individual properly remove their face mask on its laces, (iii) mask-changing where we determined whether an individual change their used face mask when damped, torn, or used for no more than 8 hours, and (iv) mask-disposal where we determined whether an individual properly disposed of used face masks on trash bins with lids or special trash bins Results showed that the proper mask-changing and mask-disposing should be addressed primarily In rural areas, 88% of household members have good mask-wearing behaviour, with one-third adjusting their face mask while using it and one-fifth touching, hanging, or not making sure there is no space between their face and mask Medical facilities, especially the WHO advocates the proper way of handling a face mask, however these bad behaviours were one of the countermeasures that are tend to be unnoticed and some people not giving attention to wherein adjusting and touching their face mask while in public places is becoming a habit This implies that individuals tend to do these bad behaviours unconsciously and need to be addressed further by increasing public awareness through social media and news Although medical organizations have been running online instructional campaigns about how to properly wear face masks, there may not be much public knowledge of this (Machida et al., 2020) Furthermore, alcohol and hand sanitizers should be available in any public places so that people can have access to them whenever they touch their face masks
Nearly more than half of the respondents do not change their face mask on time and dispose of it in the right trash bins Among the influential factors, household income plays a crucial role in these behaviours wherein individuals with high household income are not guaranteed to have good mask-using behaviour For instance, individuals in a high-income household have a positive impact on the mask-changing behaviour while it has a negative impact on the mask-disposal behaviour Due to a lack of face masks, low income households have the lowest chances of changing their masks when they should This finding is in line with the study of Feng et al., (2020) Due to the epidemic, the price of face masks increases because of higher demands which individuals in low income households cannot afford Poor households are challenged to prioritize their basic needs over life supporting materials Researchers could look into ways to sanitize face masks as a compromise to help with the shortage issue (Li et al., 2021) On the other hand, it was discovered that high income homes had a low level of proper face mask disposal Therefore, it is important to actively promote correct face mask disposal methods and make trash cans available to the general population It is crucial to provide a steady supply of face masks and to give precise instructions on how to apply them when urging people to do so (Machida, et al., 2020) When establishing public face mask policies, the government should take into account regional features, necessary resources, viability, stability, hazards, and benefits-based methods Standardized face mask use and disposal will also need to be implemented due to policy and law
Public cooperation is crucial to the effectiveness of government efforts to tackle the COVID-19 outbreak and the severity of the economic crisis This study offers proof as to what motivates people to appropriately use face masks in public settings Findings showed that proper usage of face masks should be promoted effectively Whether a person is symptomatic or asymptomatic, wearing a mask is an efficient strategy to prevent the virus from spreading However, if worn improperly, this could potentially add to the virus' spread (WHO, 2020) Individuals with COVID-19 vaccines still have the probability of getting COVID-19 virus and transmitting it (Peiris & Leung, 2020), thus showing the importance of using face masks to protect oneself and others It would be shortsighted and naive to think that another virus, perhaps an even more damaging one, will not come about in the future Therefore, addressing this preventive measure now will be important not only as we move through the current crisis, but also as we begin to prepare for the next one Social scientists who study behaviour—and the policies that affect it—must play a critical role in these efforts One way is through the gathering and analysis of fresh survey data, which reveals what behaviour may be predicted for various population segments during a pandemic given the diversity of incentives, restrictions, and conditions people encounter These data could be used not only to describe behaviour but also in more specialized research projects, such as: assessing how the spread of information and attitudes toward the pandemic shape behaviour, evaluating the relative merits of localized policy responses, and calibrating epidemiologically grounded models linking variation in individual behaviour to the spread of illness, among many other things
To conclude, to mitigate the threat of the pandemic, the government should take immediate action to heighten public awareness and encourage behavioural change regarding the proper usage of face masks The impact of the factors on the mask-using behaviour varies in terms of magnitude and direction, according to the results of the logistic regressions It is possible to look into the impact of a few important influencing factors deeper.
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Figure 1 Face masks used in rural places
Figure 2 Usage of face masks Figure 3 Mask-removal
Figure 4 Mask changing frequency Figure 5 Mask disposal
PROPER USE OF FACE MASK
Face masks used in rural places
Disposable medical masks, Cloth masks
Table 1 Socio-economic characteristics of the participants and comparison of the frequencies of mask-wearing behaviours in different groups (N97)
Good rate/Poor rate (n/%) Gender (male) 0.355164 0.479167 141 (36%) 127(90%)/ 14(10%) Age (18-34) 29.98489 11.95931 282 (71%) 253(90%)/29(10%)
(Tertiary or higher) 0.828715 0.377233 329 (83%) 290(88%)/39(12%) Marital Status (Married) 0.360202 0.480665 143 (36%) 126(88%)/17(12%) Work Status (Working) 0.586902 0.493012 233 (59%) 205(88%)/28(12%) Occupation (Frontliners) 0.229219 0.420861 306 (77%) 273(89%)/33(11%)
Table 2 Characteristics of the public mask-wearing behaviours (N97)
1 After wearing a mask, do you make sure that your mouth, nose, and chin were covered by the mask?
2 After wearing a mask, do you make sure that there are no gaps between your face and the mask?
3 Do you touch the mask while using it? 310(78%)/87(22%)
4 Do you adjust the mask while using it? 259(65%)/138(35%)
5 Do you hang the mask under the chin while using it? 302(76%)/95(24%)
6 Do you uncover your mouth or/and noses for a breath while using the mask?
7 Do you wear multiple masks at the same time? 321(81%)/76(19%)
8 Do you reuse disposable masks? 351(88%)/46(12%)
Table 3 Determinants of Mask-Removing Behaviour
Table 4 Determinants of Mask-Changing Behaviour
Table 5 Determinants of Mask-Disposal Behaviour
APPENDICES QUESTIONNAIRE ON FACE MASKS FOR THE PUBLIC
1 After wearing a mask, do you make sure that your mouth, nose, and chin were covered by the mask?
2 After wearing a mask, do you make sure that there were no gaps between your face and the mask?
3 Do you touch the mask while using it?
4 Do you adjust the mask while using it?
5 Do you hang the mask under the chin while using it?
6 Do you uncover your mouth or/and noses for a breath while using the mask?
7 Do you wear multiple masks at the same time?
8 Do you reuse disposable masks?
9 How do you remove the used mask? (Select all that apply.)
□ Remove it by taking off the laces of the mask
□ Remove it by touching the front of the mask
□ Remove it by touching the inside of the mask
10 After you removed the mask, how do you dispose of it? (Select all that apply.)
□ Discard it into a garbage bin with a lid
□ Discard it into a garbage bin without a lid
□ Discard it into a special garbage bin
□ Discard it into a garbage bin in your reach whatever it has a lid or not
11 When do you replace the mask with a new one? (Select all that apply.)
□ Replace it as soon as it is damp
□ Replace it when it has been used for no more than 4 hours
□ Replace it when it has been used for a period between 4 hours and 8 hours
□ Replace it when it has been used for more than 8 hours
□ Replace it when it gets dirty
12 How did you get to know about the proper use of face masks? (Select all that apply.)
□ Informed by family members or friends
13 Which type of face masks do you use?
1 Is wearing masks in your area common since BEFORE the COVID-19 pandemic happened?
2 On a scale of 1-10, how common is mask-wearing in your area BEFORE the pandemic happened?
3 Is there a punishment for people who do not wear a mask in your area DURING the pandemic?
4 On a scale of 1-10, how strict is the law on wearing a mask in your area DURING the pandemic?
5 Is there a punishment for people who do not wear their face masks PROPERLY in your area DURING the pandemic?
6 On a scale of 1-10, how strict is the law on the PROPER use of masks in your area DURING the pandemic?
PART III Features of Masks
1 To which extent does the COMFORTABILITY of face masks apply to you when you use it? (1: less concern; 10: most concern)
2 To which extent does the FIT of face masks apply to you when you use it? (1: less concern; 10: most concern)
3 To which extent does the BREATHABILITY of face masks apply to you when you use it? (1: less concern; 10: most concern)
4 To which extent does the WARMTH of face masks apply to you when you use it? (1: less concern; 10: most concern)
5 To which extent does the FACE AND EAR IRRITATION caused by face masks apply to you when you use it? (1: less concern; 10: most concern)
1 How do you assess yourself: Please tell me, in general, are you a person who is prepared to take risks in general, or do you avoid taking risks? (0 = completely unwilling to take risks; 10 = very willing to take risks)
1 How willing are you to give up something that is beneficial for you today in order to benefit more from that in the future? (0 = completely unwilling to give up something today; 10 = very willing to give up something today)
When someone does me a favor, I am willing to return it (0 = does not describe me at all; 10 = describes me perfectly)
2 How willing are you to give to good causes without expecting anything in return? (0
= completely unwilling to do so; 10 = very willing to do so)
PART VII Socio-Economic Profile
□ High school or lower □ Tertiary or higher
5 How much is your HOUSEHOLD monthly income? Please specify
6 How many people are living in your house including you? Please specify
8 What is your current occupation?
□ Frontliners (Medical workers, Police Officers, Market vendors, Public workers, etc.)
□ Non-frontliners (Private workers, online sellers, student, etc.)