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Facemasks: Perceptions and use in an ED population during COVID-19

Cite this dataset

Eswaran, Vidya et al. (2022). Facemasks: Perceptions and use in an ED population during COVID-19 [Dataset]. Dryad.


Study Objective: Facemask use is associated with reduced transmission of SARS-CoV-2. Most surveys assessing perceptions and practices of mask use miss the most vulnerable racial, ethnic, and socio-economic populations. These same populations have suffered disproportionate impacts from the pandemic. The purpose of this study was to assess beliefs, access, and practices of mask wearing across 15 urban emergency department (ED) populations. 

Methods: This was a secondary analysis of a cross-sectional study of ED patients from December 2020 to March 2021 at 15 geographically diverse, safety net EDs across the US. The primary outcome was frequency of mask use outside the home and around others. Other outcome measures included having enough masks and difficulty obtaining them.

Results: Of 2,575 patients approached, 2,301 (89%) agreed to participate; nine had missing data pertaining to the primary outcome, leaving 2,292 included in the final analysis. A total of 79% of respondents reported wearing masks “all of the time” and 96% reported wearing masks over half the time. Subjects with PCPs were more likely to report wearing masks over half the time compared to those without PCPs (97% vs 92%). Individuals experiencing homelessness were less likely to wear a mask over half the time compared to those who were housed (81% vs 96%).

Conclusions: Study participants reported high rates of facemask use. Respondents who did not have PCPs and those who were homeless were less likely to report wearing a mask over half the time and more likely to report barriers in obtaining masks. The ED may serve a critical role in education regarding, and provision of, masks for vulnerable populations. 


Study Design and Setting

We conducted this secondary analysis of a previously published study regarding ED patients perceptions’ of COVID-19 vaccination.[13] The parent study was a prospective, cross-sectional survey of ED patients at 15 safety net EDs in 14 US cities. The University of California Institutional Review Board approved this study. Verbal consent was obtained. 

Data Processing

Participant ethnicity (Latinx/non-Latinx) and race were self-reported. We categorized those who self-identified as any race other than Latinx as ‘reported race’, non-Latinx (i.e. Black, non-Latinx and White, non-Latinx). If the patient identified themselves as Latinx, they were placed in that category and not in that of any other race. If an individual identified as more than one non-Latinx race, they were categorized as multiracial.

Individuals who reported that they were currently applying for health insurance, were unsure if they were insured, or if their response to the question was missing (18 respondents) were categorized as uninsured in a binary variable, and separate analysis was done based on type of insurance reported. The survey submitted in our supplement (S1) is the version used at the lead site. Each of the remaining sites revised their survey to include wording applicable to their community (i.e., the site in Los Angeles changed Healthy San Francisco to Healthy Los Angeles), and these local community health plans were coded together.

We identified individuals who reported English and Spanish as their primary language, and grouped those who reported Arabic, Bengali, Cantonese, Tagalog, or Other as “Other” primary language. With regards to gender, we categorized those who identified as gender queer, nonbinary, trans man and trans woman as “other”.

Study Outcomes and Key Variables

Our primary outcome was subjects’ response to the question, “Do you wear a mask when you are outside of your home when you are around other people?” with answer choices a) always, b) most of the time (more than 50%), c) sometimes, but less than half of the time (less than 50%), and d) I never wear a mask. Respondents were provided with these percentages to help quantify their responses. We stratified respondents into two groups: those who responded always or most of the time as “wears masks over half the time” and those who responded sometimes or never as “wears masks less than half the time.

We sorted each of the 15 sites into four geographic regions within the United States. There were 3 sites located in New Jersey, Massachusetts, and Pennsylvania which we categorized in the Northeast region. We categorized 3 sites in Michigan and Iowa as Midwest, and 3 sites in North Carolina, Louisiana, and Maryland as the South. There were 6 sites located on the West Coast from California and Washington State.