@Article{info:doi/10.2196/37102,
author="Sanchez, Travis
and Hall, Eric
and Siegler, Aaron J
and Prakash-Asrani, Radhika
and Bradley, Heather
and Fahimi, Mansour
and Lopman, Benjamin
and Luisi, Nicole
and Nelson, Kristin N
and Sailey, Charles
and Shioda, Kayoko
and Valentine-Graves, Mariah
and Sullivan, Patrick S",
title="Prevalence of COVID-19 Mitigation Behaviors in US Adults (August-December 2020): Nationwide Household Probability Survey",
journal="JMIR Public Health Surveill",
year="2023",
month="Dec",
day="6",
volume="9",
pages="e37102",
keywords="COVID-19; mask; social distancing; handwashing; hand sanitizer; public health; pandemic; mitigation behavior; risk factor; disease prevention; health policy; latent class analysis; hygiene",
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. ",
issn="2369-2960",
doi="10.2196/37102",
url="https://publichealth.jmir.org/2023/1/e37102",
url="https://doi.org/10.2196/37102",
url="http://www.ncbi.nlm.nih.gov/pubmed/38055314"
}