Posted in COVID19publichealthresearch

Face mask compliance: A simple study design

This face mask compliance observational study attracted my attention because of its simplistic nature and reader-friendly presentation. I must thank Assistant Professor Susan Parham and Dr. Matthew Hardy for publishing the study on The Centre for Evidence-Based Medicine website.

About the location

Researchers have chosen a small tourist city in Paris for this face mask compliance study. Their reason for choosing this place is because of its popularity among both tourists and the local population. Wearing of face coverings became mandatory in this place by the time they conducted the observation.

Location selection

Professor Susan Parham and Dr. Matthew Hardy have chosen their place for observation off the main street. They cite two reasons for the selection: 1) It was a busy place so that they can count people and observe accurately gather more information; 2) They expected people to behave more naturally due to less expectation of official surveillance of face covering.

The observation method

They have observed the people for 30 minutes at lunchtime on two separate days at the same place: One weekday and one weekend day. On the first day, they have observed adults and children and on the second day, they have observed adult men and women separately.

Day 1mask wearing behavior of adults and children
Day 2mask-wearing behavior of male and female

Data collection tool

What attracted me about their presentation of this study was that they have pictured their actual data documentation tool as follows;

Source: The Center for Evidence-based Medicine, University of Oxford

How they tabulated findings:

Data tabulations

I created two blank tables that mimic their actual tables. Those interested can read their actual data through the link I have cited at the end of this post.

Day 1 data tabulation table

maskedunmaskedsemi-maskedmasked childunmasked child
total (273)
%
% of adults
Adapted from The Center for Evidence-based Medicine, University of Oxford

Data 2 data tabulation table

masked male masked femaleunmasked maleunmasked male semi-masked malesemi-asked female
Total
%of all adults
% of each sex

Findings

Day 1:
  • Of the total of 272 adults observed, 82 percent were adhering to face mask compliance as recommended.
  • Of the rest who were not complying, 12.5 percent were unmasked 8.5 percent were semi-masked (mask-wearing under the nose).
Day 2:
  • Of the 218 adults observed, 74.3 percent were wearing masks with 26.7 percent were either unmasked (16 percent) or semi-masked (9.7 percent).
  • Of them, 76.9 percent of women and 71.3 percent of men were wearing masks.

The authors of this face mask compliance observational study bring forward an interesting discussion about social norms conformity using the findings that were really critical in creating messages and social marketing campaigns.

Those interested can read the full paper through this link; https://www.cebm.net/2020/10/face-coverings-self-surveillance-and-social-conformity-in-a-time-of-covid-19/?unapproved=319632&moderation-hash=ea7fb58dd08238c803648b8afee163c2#comment-319632

Posted in #covid-19 Risk communication

How to frame messages in an epidemic – I

Tell the truth; be transparent

source: the US CDC CERC (CRISIS + EMERGENCY RISK COMMUNICATION WALLET CARD: https://emergency.cdc.gov/cerc/resources/pdf/cerc_wallet-card_english.pdf

The world is now grappling with another global epidemic: the coronavirus, COVID-19.

The risk communication is very critical during epidemics. Its importance is apparent now more than ever.

Providing factually correct messages is necessary but not adequate; the messages need to be framed in ways relevant to the intended audience and persuasive enough to change into the recommended behaviors.

Based on recent past experience with the SARS and Ebola virus types, the World Health Organization (WHO), US CDC, European Union, and almost all countries have developed comprehensive evidence-based guidelines, manuals, training modules, etc.

This post summarizes the relevant sections of these documents while citing those references where relevant.

Steps in framing messages in an epidemic

The US CDC recommends to include the following components when formulating messages with regard to the epidemic irrespective of its mode of delivery, either orally, in writing, or in any other media.

Begin with empathy

  • Acknowledge the target audience’s concerns by saying/writing.
  • Either write or say something similar to this: “we are aware that you are anxious and worried and we care and working to understand their perspective more”.
  • In fact, we need to include contact methods to demonstrate to them that we really care and should promote asking questions.

Identify and explain the threat

  • Mention “what is causing the threat, who is at risk, and what causes someone to be at risk”;
  • “What to do to prevent the harm and to get help if needed”;
  • “Acknowledge uncertainties”;
  • “Do not over-reassure or over-promise”

Explain what is currently known and unknown

  • Provide exact details and timelines
  • Admit what is unknown at the moment saying, “we do not have sufficient information yet and we will inform you as soon as we obtain those details without holding back.
  • Explain what is being done to minimize harm

Explain what actions are being taken and why as well as the actions that are not being taken and why

  • Explain the agencies involved, their roles and responsibilities
  • Share dilemmas, be open with making decisions on imperfect and incomplete information
  • Explain possible undesired consequences, if anticipated
  • Let the media know the assumptions and the possibility of changing recommendations in the future based on new information

Crisis + Emergency Risk Communication (CERC) Wallet Card

The US CDC CERC had produced an extremely useful wallet card that, I believe every professional responsible should carry. Anyone can access to it through this link:https://emergency.cdc.gov/cerc/resources/pdf/cerc_wallet-card_english.pdf