Prevalence of COVID-19 Mitigation Behaviors in US Adults (August-December 2020): Nationwide Household Probability Survey

• Type of Material: Article
• Authors: Travis Sanchez, Emory University; Eric Hall, Emory University; Aaron J Siegler, Emory University; Radhika Prakash Asrani, Emory University; Heather Bradley, Georgia State University; Mansour Fahimi, Marketing Systems Group; Ben Lopman, Emory University; Nicole Luisi, Emory University; Kristin Nelson, Emory University; Charles Sailey, Molecular Testing Labs; Kayoko Mori, Emory University; Mariah Valentine-Graves, Emory University; Patrick S Sullivan, Emory University
• Language: English
• Date: 2023-12-06
• Publisher: JMIR Publications
• Publication Version: Final Published Version
• Copyright Statement: ©Travis Sanchez, Eric Hall, Aaron J Siegler, Radhika Prakash-Asrani, Heather Bradley, Mansour Fahimi, Benjamin Lopman, Nicole Luisi, Kristin N Nelson, Charles Sailey, Kayoko Shioda, Mariah Valentine-Graves, Patrick S Sullivan.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): https://doi.org/10.2196/37102
• Title of Journal or Parent Work: JMIR Public Health and Surveillance
• Volume: 9
• Start Page: e37102
• Grant/Funding Information: The study was funded by a grant from the National Institutes of Health (3R01AI143875-02S1).
• Keywords: pandemic; public health; COVID-19; mitigation behavior; social distancing; hygiene; disease prevention; risk factor; health policy; mask; handwashing; hand sanitizer; latent class analysis
• Research Categories: Health Sciences, Public Health; Health Sciences, Epidemiology

Abstract

Background COVID-19 mitigation behaviors, such as wearing masks, maintaining social distancing, and practicing hand hygiene, have been and will remain vital to slowing the pandemic. Objective This study aims to describe the period prevalence of consistent mask-wearing, social distancing, and hand hygiene practices during the peak of COVID-19 incidence (August-December 2020) and just before COVID-19 vaccine availability, overall and in demographic subgroups. Methods We used baseline survey data from a nationwide household probability sample to generate weighted estimates of mitigation behaviors: wearing masks, maintaining social distancing, and practicing hand hygiene. Weighted logistic regression explored differences in mitigation behaviors by demographics. Latent class analysis (LCA) identified patterns in mitigation behaviors. Results Among 4654 participants, most (n=2727, 58.6%) were female, were non-Hispanic White (n=3063, 65.8%), were aged 55 years or older (n=2099, 45.1%), lived in the South (n=2275, 48.9%), lived in metropolitan areas (n=4186, 89.9%), had at least a bachelor’s degree (n=2547, 54.7%), had an income of US $50,000-$99,000 (n=1445, 31%), and were privately insured (n=2734, 58.7%). The period prevalence of consistent mask wearing was 71.1% (sample-weighted 95% CI 68.8-73.3); consistent social distancing, 42.9% (95% CI 40.5-45.3); frequent handwashing, 55.0% (95% CI 52.3-57.7); and frequent hand sanitizing, 21.5% (95% CI 19.4-23.8). Mitigation behaviors were more prevalent among women, older persons, Black or Hispanic persons, those who were not college graduates, and service-oriented workers. LCA identified an optimal-mitigation class that consistently practiced all behaviors (n=2656, 67% of US adults), a low-mitigation class that inconsistently practiced all behaviors (n=771, 20.6%), and a class that had optimal masking and social distancing but a high frequency of hand hygiene (n=463, 12.4%). Conclusions Despite a high prevalence of COVID-19 mitigation behaviors, there were likely millions who did not consistently practice these behaviors during the time of the highest COVID-19 incidence. In future infectious disease outbreak responses, public health authorities should also consider addressing disparities in mitigation practices through more targeted prevention messaging.