The ongoing pandemic marks a period of immense uncertainty worldwide. This has seen states deploying all means in their playbooks to ensure that people follow the rules and norms that would prevent spread. However, one issue, which for months was hotly debated but is now more or less unanimously agreed upon is the usage of face masks.
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Despite the many studies and guidelines recommending usage of face masks or coverings, their usage is far from universal. And, where it is used, we have seen them dangling in various ways over the face, without covering the nose and mouth in the way it should.
But is it just a question of not following the ‘right technique’? The seemingly simple action is guided by several underlying behavioural nuances. Imposing fines may not always be the best way to ensure compliance.
An individual’s decision to wear a mask or not, like any behaviour, is subject to several ‘internal’ and ‘external’ factors. Some individuals may intrinsically adopt wearing them while others might not. This decision is governed by many factors, including the information available about the risks or benefits and prevailing social norms.
The issue of wearing of masks has received widespread international coverage. After several states in the USA mandated mask use, we saw people linking it with muzzling of their individual freedom. In India, local administrations tasked with fighting COVID-19, have managed to collect substantial amounts in fines from people for not wearing masks. For instance, the Chennai traffic police is said to have collected upto Rs 3.2 crores in fines between May and June from motorists not wearing masks.
Proper mask usage still remains low in India. The use of ‘fines’ can be classified as a ‘policing’ approach, where compliance is ensured by strict enforcement by authorities.
However, not all citizens may be able to ‘comply’ due to various constraints. This person could be a sanitation worker who, during her break time, would want to remove the mask to clear off sweat and relax. Or it could be resistance from people who ‘question’ what the rules or authorities say, something known as ‘reactive devaluation’, similar to that of a rebel child going against the wishes of its parents.
The emphasis on wearing masks is not new. It has been recommended in the past, like during the SARS outbreak or in cities which witness a high level of air pollution. However, despite air pollution killing more people than COVID-19, people failed to wear masks. People act on the perceived harm based on the information they get. In behavioural terms, this is also linked to aspects of ‘loss aversion’ or even ‘overconfidence’.
Loss aversion is when people choose to avoid immediate losses over long term gains while overconfidence is when people may irrationally overestimate their abilities. In the case of wearing masks, people may see the discomfort of wearing masks loom larger than its benefits. Additionally, they may also think they do not necessarily require to wear a mask altogether due to misplaced beliefs in their ability to avoid infection.
Why communication matters
What did not help was the flip-flop of decision making bodies on mask use. The WHO, along with many countries, for a long time did not mandate the use of masks. There seemed to be contradictory statements on the effectiveness of masks.
However, over the last few weeks, there has been an almost universal acceptance of the importance of wearing masks. In situations such as this deadly pandemic, policy response becomes critical in assisting the population to rapidly assess, trust and adapt to such preventive behaviours. Once the behaviour becomes a ‘norm’, the common man would automatically feel out-of-place without a mask.
At an individual level, everyone tries to do a cost-benefit analysis on the use or non-use of masks. On the ‘cost’ side, people rationalize not wearing a mask for a lot of reasons. This can range from a feeling that they will be perceived as ‘weak’ if they wear a mask, or the discomfort felt by wearing a mask.
This may also be accompanied by arguments like, ‘there are many who don’t wear a mask, why should I wear one?’ People are more likely to take a decision only if they see others around them performing the same action.
In the theory of social norms, people often follow what others do. What would this imply? For people to adopt such behaviours, positive reinforcement may work. This would mean conveying the message that people have now ‘increasingly started wearing masks’. Eventually, the objective must be to enable mask-wearing become a ‘social norm’.
There are a few ways in which the benefits of following a particular behaviour can be highlighted. An approach opposite to fines can be rewarding those who practice mask wearing. This could mean, at random, rewarding people who wear masks at traffic lights.
Rewards could be through messages like, ‘Thank you for wearing a mask’ or by sharing these positive stories on social media, highlighting ‘good behaviour’. Behaviour change communication should focus on reducing the ‘costs’ of mask usage and instead highlight the ‘benefits’.
Lastly, normalizing correct mask usage can go a long way to increase acceptance. This would imply depictions of people wearing masks everywhere. Perhaps even in signages!
The right information, through the right influencers
One key component of any such communication is to simplify information. In a recent study done by the Behavioural Insights Team, UK, it was found that communications with easy to understand and ‘vivid’ information helps people retain information easily.
In India, earlier in June, such a behaviour change campaign called, ‘Navigating the New Normal’, was launched which targets several such behavioural biases in the context of COVID-19.
Other ways to communicate the importance of masks could be to ensure that local government officials always wear masks and in the right way, especially during media briefings and public appearances. The role of local celebrities can also be important, where their advocacy can lead to an increase in mask acceptance.
Ensuring clear and consistent communication on use of masks can help increase compliance. To that end, it is important to identify and highlight authentic and verifiable sources of information. With COVID-19 here to stay, and reports suggesting that the country is set to witness ‘uneven peaks’ and new hotbeds, the playbook of policymakers must remain agile.
It must take into account behavioural components and not rely solely on conventional enforcement methods. Targeting behavioural barriers and incorrect beliefs about the use of masks can be a powerful way to protect our population, till the arrival of a vaccine.