To Mask or Not to Mask

face mask

What does it take to change a behavior?

What prompts some people to recognize the critical importance of wearing face protection during these virus-laden days, while others do not? What would it take to convince someone to be receptive to masking up when they have not been inclined in the past?

Mandating cooperation is certainly one approach, but maybe there are other ways. We all have thoughts and theories about this issue. Here are mine.

If you were to read “The End of October” by Lawrence Wright, I suspect even the most oppositional person would entertain said behavior change. The just-published novel is described as “a cautionary tale that comes too late” and “eerily prescient about a devastating virus that begins in Asia before going global.” Describing this book as “riveting” is an understatement. I was already persuaded that we are dealing with a significant public health crisis, and have a wardrobe of masks, but if I were disinclined to adhere, this powerfully researched book would convince me.

Sometimes a specific encounter prompts immediate behavior change. Learning a family member has been diagnosed with COVID-19 or hearing that a loved one will be hospitalized and immediately placed on a ventilator would be other examples.

But behavior usually modifies more gradually. Making a behavior change that reduces the risk of death and disease is best understood if we think about it in stages.

First, there is the Pre-Contemplative Stage. You recognize that something big is happening in the world, but that’s about it. You may feel inconvenienced by the circumstances and grumble a bit.

Then comes the Contemplative Stage. You listen to a newscaster you trust, or see a lot more people wearing masks in public and you take note. You know your spouse is immune-compromised and at greater risk of getting the virus. You start to gather information. Politics aside, you seriously think about doing this.

Next comes the Preparation Stage. If this were a behavior change that involved quitting smoking or losing weight you would be exploring things like a nicotine patch, the Zone diet, an exercise regimen. This stage is where you actually acquire a mask option — or are given one by a caring friend.

In the Action Stage, you actively engage in the new approach. You wear that patch, i.e. the mask. And finally, you enter the Maintenance Stage, which means you sustain the behavior for over six months. When it comes to mask wearing, you maintain that new behavior as long as necessary. And you do not grumble.

Researchers tell us we have the most success with a decision like this if we see ourselves as a “mover” and “someone who takes personal responsibility.” Positive reinforcement helps. Removing negative reinforcement does as well. Social supports, surrounding yourself with people who acknowledge your adherence and comment affirmatively, is important. Research confirms that.

If you have already embraced mask-wearing — bravo! If you know someone who has not, be persuasive. Your life — and his or her life — may depend on it.

Sharon Johnson is a retired health educator. 

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