Do you take off your mask correctly? A survey during COVID-19 pandemic in Ningbo, China

Guidelines and recommendations from public health authorities related to face masks have been essential for containing the COVID-19 pandemic. A cross-sectional survey was conducted in Ningbo City, China, from April 8 to 12, 2022. We assessed the behavioral differences and correlates of mask usage, primarily mask-removal. We examined public mask-wearing behavior during on-site COVID-19 nucleic acid detection. The survey instrument was developed based on the guidelines issued by the World Health Organization and consisted of demographics, mask-wearing knowledge, and behavior. We analyzed data from 1180 participants; 73.2% demonstrated good mask-wearing knowledge. However, regarding mask-wearing behavior, only 53.7% knew the correct way to remove a mask; 70.3% maintained hand hygiene after touching the outside. Binary logistic regression analyses revealed that health prevention knowledge and free mask distribution were positively associated with two types of mask-wearing behaviors. Most participants used masks during the COVID-19 pandemic; however, mask-removal and hand hygiene were neglected when touching the outside of the mask. More attention must be paid to mask-removal and hand hygiene details. Local health authorities should consider introducing the free distribution of masks.