title: Barriers to mask wearing for influenza-like illnesses among urban Hispanic households.
abstract: OBJECTIVE
  To identify barriers to mask wearing and to examine the factors associated with the willingness to wear masks among households.
  
  
  METHODS
  We used data sources from a study assessing the impact of 3 nonpharmaceutical interventions on the rates of influenza: exit interviews; home visits with a subset of the mask group; and a focus group.
  
  
  METHODS
  Risk perception score, univariate analysis, and logistic regression were conducted to identify the characteristics and predictors of mask use. Thematic barriers to mask wearing were identified from qualitative data obtained at home visits and focus group.
  
  
  RESULTS
  Respondents from the mask group, when compared with the nonmask group, demonstrated higher risk perception scores concerning influenza (maximum score: 60, means: 37.6 and 30.2, p<.001) and increased perception of effectiveness of mask wearing (maximum score: 10, means: 7.8 and 7.3, p=.043). There was no significant association between demographic, attitudinal, or knowledge variables and adherence to wearing masks. Thematic barriers were identified such as social acceptability of mask use, comfort and fit, and perception of the risk/need for masks.
  
  
  CONCLUSIONS
  Face masks may not be an effective intervention for seasonal or pandemic influenza unless the risk perception of influenza is high. Dissemination of culturally appropriate mask use information by health authorities and providers must be emphasized when educating the public.
authors.affiliation: Columbia University School of Nursing, New York, New York, USA. yf2182@columbia.edu
authors.forename: Yu-hui
authors.initials: YH
authors.lastname: Ferng
authors.forename: Jennifer
authors.initials: J
authors.lastname: Wong-McLoughlin
authors.forename: Angela
authors.initials: A
authors.lastname: Barrett
authors.forename: Leanne
authors.initials: L
authors.lastname: Currie
authors.forename: Elaine
authors.initials: E
authors.lastname: Larson
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D017144:Focus Groups; D015438:Health Behavior; D006266:Health Education / Q000379:methods; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006630:Hispanic or Latino / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D007251:Influenza, Human / Q000208:ethnology / Q000517:prevention & control*; D016015:Logistic Models; D008297:Male; D008397:Masks / Q000706:statistics & numerical data*; D009519:New York City; D012111:Residence Characteristics / Q000706:statistics & numerical data; D018570:Risk Assessment / Q000379:methods; D013637:Tape Recording; D014481:United States; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult