%0 Journal Article
%@ 2369-2960
%I JMIR Publications
%V 9
%N 
%P e37102
%T Prevalence of COVID-19 Mitigation Behaviors in US Adults (August-December 2020): Nationwide Household Probability Survey
%A Sanchez,Travis
%A Hall,Eric
%A Siegler,Aaron J
%A Prakash-Asrani,Radhika
%A Bradley,Heather
%A Fahimi,Mansour
%A Lopman,Benjamin
%A Luisi,Nicole
%A Nelson,Kristin N
%A Sailey,Charles
%A Shioda,Kayoko
%A Valentine-Graves,Mariah
%A Sullivan,Patrick S
%+ Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, United States, 1 404 727 8403, Travis.Sanchez@emory.edu
%K COVID-19
%K mask
%K social distancing
%K handwashing
%K hand sanitizer
%K public health
%K pandemic
%K mitigation behavior
%K risk factor
%K disease prevention
%K health policy
%K latent class analysis
%K hygiene
%D 2023
%7 6.12.2023
%9 Original Paper
%J JMIR Public Health Surveill
%G English
%X 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. 
%M 38055314
%R 10.2196/37102
%U https://publichealth.jmir.org/2023/1/e37102
%U https://doi.org/10.2196/37102
%U http://www.ncbi.nlm.nih.gov/pubmed/38055314