{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T04:29:42Z","timestamp":1789705782366,"version":"4.0.1"},"reference-count":12,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T00:00:00Z","timestamp":1612224000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Promotion Practice"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>To limit the spread of coronavirus disease 2019 (COVID-19), the Centers for Disease Control and Prevention issued recommendations that individuals wear face masks in public. Despite these recommendations, the individual decision to adhere and wear a mask may not be a simple decision. In this article, we examine the decision to wear a mask from a social-ecological perspective. Through critical analysis of societal, interpersonal and community, and intrapersonal influences, it is clear that the decision to wear a mask is multifaceted and influenced by constructs including public health recommendations and government mandates, racism and cultural norms, geography, household income, age, and personal attitudes. Understanding the multifactorial influences on mask wearing during COVID-19 is crucial for informing the creation and distribution of inclusive public health messaging regarding mask wearing now in the midst of an unprecedented health crisis, and in future unforeseen public health emergencies.<\/jats:p>","DOI":"10.1177\/1524839920983922","type":"journal-article","created":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T14:59:21Z","timestamp":1612277961000},"page":"152-155","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":27,"title":["Mask Use During COVID-19: A Social-Ecological Analysis"],"prefix":"10.1177","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7836-3774","authenticated-orcid":false,"given":"Allison R.","family":"Casola","sequence":"first","affiliation":[{"name":"Thomas Jefferson University, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brianna","family":"Kunes","sequence":"additional","affiliation":[{"name":"Thomas Jefferson University, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Cunningham","sequence":"additional","affiliation":[{"name":"Thomas Jefferson University, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Motley","sequence":"additional","affiliation":[{"name":"Thomas Jefferson University, Philadelphia, PA, USA"},{"name":"Thomas Jefferson University Hospital, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,2,2]]},"reference":[{"key":"bibr1-1524839920983922","unstructured":"Armus T. (2020, September 9). A GOP county chair asked Trump to wear a mask to his rally. Instead, Trump mocked pandemic restrictions. The Washington Post. https:\/\/www.washingtonpost.com\/nation\/2020\/09\/09\/trump-rally-masks-nc\/"},{"key":"bibr2-1524839920983922","unstructured":"Aviles G. (2020, April 9). Black men fear homemade coronavirus masks could exacerbate racial profiling. NBC News. https:\/\/www.nbcnews.com\/news\/nbcblk\/black-men-fear-homemade-masks-could-exacerbate-racial-profiling-n1179236"},{"key":"bibr3-1524839920983922","unstructured":"Boskovich B. (2020, May 15). Masks, men, and the exhausting pursuit of desperate masculinity. Esquire. https:\/\/www.esquire.com\/news-politics\/a32478465\/covid-19-men-not-wearing-face-masks-coronavirus\/"},{"key":"bibr4-1524839920983922","unstructured":"Centers for Disease Control and Prevention. (2020a). Considerations for wearing masks. https:\/\/www.cdc.gov\/coronavirus\/2019ncov\/prevent-getting-sick\/cloth-face-cover.html"},{"key":"bibr5-1524839920983922","unstructured":"Centers for Disease Control and Prevention. (2020b). The social-ecological model: A framework for prevention. https:\/\/www.cdc.gov\/violenceprevention\/publichealthissue\/social-ecologicalmodel.html"},{"key":"bibr6-1524839920983922","doi-asserted-by":"crossref","unstructured":"Fan Yi., Orhun A. Y., Turjeman D. (2020). Heterogeneous actions, beliefs, constraints and risk tolerance during the covid-19 pandemic (National Bureau of Economic Research Working Paper No. 27211, p. 41). National Bureau of Economic Research.","DOI":"10.3386\/w27211"},{"key":"bibr7-1524839920983922","unstructured":"Fisher M., Williams C., Rozsa L. (2020, April 18). Will Americans wear masks? Politics, history, race and crime factor into tough decision. The Washington Post. https:\/\/www.washingtonpost.com\/national\/coronavirus-masks-america\/2020\/04\/18\/bdb16bf2-7a85-11ea-a130-df573469f094_story.html"},{"key":"bibr8-1524839920983922","doi-asserted-by":"publisher","DOI":"10.3201\/eid2607.201595"},{"key":"bibr9-1524839920983922","unstructured":"Haelle T. (2020, February 29). Masks prevent you from infecting others with coronavirus, but may not protect you from being infected. Forbes. https:\/\/www.forbes.com\/sites\/tarahaelle\/2020\/02\/29\/no-you-do-not-need-face-masks-for-coronavirus-they-might-increase-your-infection-risk\/#4d0ec558676c"},{"key":"bibr10-1524839920983922","unstructured":"Liptak K. (2020, April 29). Pence flouts Mayo Clinic policy on masks\u2014which is to wear one. CNN Politics. Retrieved from https:\/\/www.cnn.com\/2020\/04\/28\/politics\/mike-pence-mayo-clinic-mask\/index.html"},{"key":"bibr11-1524839920983922","unstructured":"Markowitz A. (2020, October 12). State-by-state guide to face mask requirements. https:\/\/www.aarp.org\/health\/healthy-living\/info-2020\/states-mask-mandates-coronavirus.html"},{"key":"bibr12-1524839920983922","volume-title":"Individualism & collectivism","author":"Triandis H.","year":"1995"}],"container-title":["Health Promotion Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1524839920983922","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1524839920983922","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1524839920983922","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T08:26:16Z","timestamp":1777451176000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1524839920983922"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,2]]},"references-count":12,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,3]]}},"alternative-id":["10.1177\/1524839920983922"],"URL":"https:\/\/doi.org\/10.1177\/1524839920983922","relation":{},"ISSN":["1524-8399","1552-6372"],"issn-type":[{"value":"1524-8399","type":"print"},{"value":"1552-6372","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,2]]}}}