{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T17:47:40Z","timestamp":1790185660118,"version":"4.1.0"},"reference-count":105,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T00:00:00Z","timestamp":1760918400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100027475","name":"The Conrad Prebys Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100027475","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100032765","name":"SDSU HealthLINK Endowment","doi-asserted-by":"crossref","award":["S21 MD010690"],"award-info":[{"award-number":["S21 MD010690"]}],"id":[{"id":"10.13039\/100032765","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Objectives: Prevention of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease COVID-19 is a public health priority. The efficacy of non-pharmaceutical interventions such as wearing face masks to prevent SARS-CoV-2 infection has been well established in controlled settings. However, evidence for the effectiveness of face masks in preventing SARS-CoV-2 transmission within real-world settings is limited and mixed. The present systematic review evaluated the effectiveness of face mask policies and mask wearing to prevent SARS-CoV-2 transmission and COVID-19 in real-world settings. Methods: Following PRISMA guidelines, scientific databases, and gray literature, were searched through June 2023. Inclusion criteria were as follows: (1) studies\/reports written in or translated to English; (2) prospectively assessed incidence of SARS-CoV-2 or COVID-19; (3) assessed the behavior and\/or policy of mask-wearing; and (4) conducted in community\/public settings (i.e., not laboratory). Studies were excluded if they did not parse out data specific to the effect of mask wearing (behavior and\/or policy) and subsequent SARS-CoV-2 transmission or COVID-19 disease or if they relied solely on statistical models to estimate the effects of mask wearing on transmission. A total of 2616 studies were initially identified, and 470 met inclusion and exclusion criteria for full-text review. The vote counting method was used to evaluate effectiveness, and risk of bias was assessed using JBI critical appraisal tools. Results: A total of 79 unique studies met the final inclusion criteria, and their data were abstracted and evaluated. Study settings included community\/neighborhood settings (n = 34, 43%), healthcare settings (n = 30, 38%), and school\/universities (n = 15, 19%). A majority of studies (n = 61, 77%) provided evidence to support the effectiveness of wearing face masks and\/or face mask policies to reduce the transmission of SARS-CoV-2 and\/or prevention of COVID-19. Effectiveness of mask wearing did not vary substantially by study design (67\u2013100%), type of mask (77\u2013100%), or setting (80\u201391%), while 85% of masking policies specifically reported a benefit. Conclusions: This systematic literature review supports public health recommendations and policies that encourage the public to wear face masks to reduce the risk of SARS-CoV-2 infection and COVID-19 in multiple real-world settings. Effective communication strategies are needed to encourage and support the use of face masks by the general public, particularly during peak infection cycles.<\/jats:p>","DOI":"10.3390\/ijerph22101590","type":"journal-article","created":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:44:10Z","timestamp":1760957050000},"page":"1590","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evidence of Face Masks and Masking Policies for the Prevention of SARS-CoV-2 Transmission and COVID-19 in Real-World Settings: A Systematic Literature Review"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2302-5257","authenticated-orcid":false,"given":"Noe C.","family":"Crespo","sequence":"first","affiliation":[{"name":"School of Public Health, San Diego State University, San Diego, CA 92123, USA"},{"name":"Institute for Behavioral and Community Health (IBACH), San Diego, CA 92123, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Savannah","family":"Shifflett","sequence":"additional","affiliation":[{"name":"School of Public Health, San Diego State University, San Diego, CA 92123, USA"},{"name":"Institute for Behavioral and Community Health (IBACH), San Diego, CA 92123, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayla","family":"Kosta","sequence":"additional","affiliation":[{"name":"School of Public Health, San Diego State University, San Diego, CA 92123, USA"},{"name":"Institute for Behavioral and Community Health (IBACH), San Diego, CA 92123, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joelle M.","family":"Fornasier","sequence":"additional","affiliation":[{"name":"School of Public Health, San Diego State University, San Diego, CA 92123, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9661-0617","authenticated-orcid":false,"given":"Patricia","family":"Dionicio","sequence":"additional","affiliation":[{"name":"School of Public Health, San Diego State University, San Diego, CA 92123, USA"},{"name":"Institute for Behavioral and Community Health (IBACH), San Diego, CA 92123, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5896-0894","authenticated-orcid":false,"given":"Eric T.","family":"Hyde","sequence":"additional","affiliation":[{"name":"School of Public Health, San Diego State University, San Diego, CA 92123, USA"},{"name":"Institute for Behavioral and Community Health (IBACH), San Diego, CA 92123, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4852-6277","authenticated-orcid":false,"given":"Job G.","family":"Godino","sequence":"additional","affiliation":[{"name":"Laura Rodriguez Research Institute, Family Health Centers of San Diego, San Diego, CA 92101, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2419-2054","authenticated-orcid":false,"given":"Christian B.","family":"Ramers","sequence":"additional","affiliation":[{"name":"Laura Rodriguez Research Institute, Family Health Centers of San Diego, San Diego, CA 92101, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P.","family":"Elder","sequence":"additional","affiliation":[{"name":"School of Public Health, San Diego State University, San Diego, CA 92123, USA"},{"name":"Institute for Behavioral and Community Health (IBACH), San Diego, CA 92123, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4062-7532","authenticated-orcid":false,"given":"Corinne","family":"McDaniels-Davidson","sequence":"additional","affiliation":[{"name":"School of Public Health, San Diego State University, San Diego, CA 92123, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Scheid, J.L., Lupien, S.P., Ford, G.S., and West, S.L. 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