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COVID-19 Mitigation Behaviors by Age Group – United States, April-June 2020

Our take —

A survey of U.S. adults conducted over three waves (April, May, and June 2020) found increasing self-reported mask use but declining prevalence of other behaviors that have been recommended by the CDC to reduce SARS-CoV-2 transmission, such as avoiding crowded places and keeping six feet of distance from others. Age was consistently associated with these self-reported behaviors: older adults reported that they engaged in each behavior more often than younger adults. These results support other evidence that younger adults are less likely to adhere to transmission mitigation behaviors; this age group represents a target for public information campaigns. Potential biases such as non response, social desirability and recall bias should be considered in the interpretation of these findings.

Study design

Cross-Sectional

Study population and setting

This study reported on an online and telephone survey of 6,475 U.S. adults at least 18 years old, conducted over three waves from April 20 to June 8, 2020, that focused on personal measures taken to mitigate SARS-CoV-2 transmission. The study population was drawn from a national probability sample, and results were weighted to adjust for nonresponse and over- and under-representation. The survey asked “Which of the following measures, if any, are you taking in response to the coronavirus?” and provided 19 possible responses. These possible responses included six that were aligned with CDC recommendations and White House guidelines (mask use, hand washing/sanitizing, six feet of distance from those outside the household, avoiding public or crowded places, canceling/postponing social/recreational activities, avoiding some or all restaurants).

Summary of Main Findings

Across survey waves, 50% of respondents from the weighted sample identified as female, and the majority of respondents (62-65%) identified as non-Hispanic/Latino white. More than 40% of respondents reported all six of the government-recommended behaviors in each survey wave. Self-reported mask use increased from 78% in April to 83% in May and 89% in June. Each of the other five recommended measures declined (except avoiding restaurants, which did not change) from April to June. In each survey wave, respondents 60 years and older reported the highest prevalence of each of the six government-recommended mitigation behaviors, and those aged 18-29 reported the lowest prevalence. Older adults also reported more cumulative mitigation behaviors than younger adults at all time points. Those who reported not using masks also reported low prevalence of the other five mitigation measures, and their overall engagement in mitigation measures decreased over time.

Study Strengths

The survey was conducted over three waves, allowing for assessment of temporal trends in self-reported behaviors.

Limitations

Survey response rates were low (19.7-26.1%) and biases in participation cannot be ruled out. Respondents might have overreported mitigation behaviors for reasons of social acceptability. Answers are also subject to recall error, which could bias results in either direction. Survey questions did not ask about frequency or duration of mitigation behaviors, and were not specific with regard to the circumstances in which the behaviors applied: for example, “wore a face mask” did not specify the type of mask worn, how often it was worn, or where it was worn. This may have resulted in an overestimate of mitigation behavior prevalence.

Value added

This paper adds to evidence from other U.S. surveys that younger adults are less likely to adhere to behaviors recommended to reduce the risk of SARS-CoV-2 transmission.

This review was posted on: 5 December 2020