Study: Most high-school age youth are willing to wear masks to prevent COVID-19 spread

A new study from Indiana University researchers finds that most high-school age youth are willing to wear masks to help prevent the spread of the COVID-19 virus, but that more education is needed on how to wear masks properly and on the importance of consistent commitment to public health guidelines.

The study, published today in the Journal of Adolescent Health looked at 1,152 youth's mask wearing and social distancing behaviors during five, in-person live-streamed high school graduations from one U.S. public school district in early July 2020. These broadcasts allowed the researchers to systematically document social-distancing behaviors throughout the ceremonies and mask-wearing as students crossed the graduation stage to receive their diplomas and as they posed for photos with the school principal.

Each graduation ceremony, which took place outdoors, included safety protocols approved by the local public health department. The district also provided students with free masks bearing their school's logo and had students seated in socially-distanced chairs.

The key to preventing the spread of the COVID-19 virus relies on scientifically-backed best practices and buy-in from the public to engage in these safety protocols. As schools navigate how to keep students safe, young people's participation in these protocols is vital. And the good news is that teens seem willing."

Anna Mueller, the Luther Dana Waterman Associate Professor in Sociology, IU Bloomington and Study's Co-Lead Author

The study had several key findings:

• Nearly 70 percent of students wore their masks properly while receiving their diploma
• Almost 10 percent wore no mask
• Nearly 20 percent struggled with mask fit - the masks kept slipping low on their nose, requiring students to repeatedly pull it back up
• Mask wearing varied significantly across schools, with some doing better than others
• All schools struggled with social distancing, except when students were seated in socially-distanced chairs
• Student graduation speakers at all schools expressed altruistic concern for the safety and well-being of their community during the pandemic

The high rate of student mask wearing is particularly interesting since the school district is in a community with low rates of community mask-wearing and no local or state mask mandate at the time of these graduations. With additional public health interventions - in schools and in the community at large - it is likely that conformity would be even higher.

"We did find evidence that adults can influence youth's mask-wearing behaviors," said Sarah Diefendorf, the other co-lead author. "This was particularly evident during the graduation pictures. When teens approached their principal for their picture, all but one student took off their mask after an adult suggested they could. Most of these students [80 percent] were wearing their mask properly just seconds before."

The study also found that how stringently school staff role modeled or facilitated public health behaviors mattered. Schools with adults who consistently wore their own masks or where adults verbally encouraging students to keep their mask on had greater youth adherence to COVID-19 guidelines.

Visible differences in schools' conformity to COVID-19 guidelines also aligned with differences in how student graduation speakers discussed the pandemic and their senior year. At the three high schools with higher rates of mask-wearing, students talked about COVID-19 alongside broader social justice issues, including the Black Lives Matter protests of 2020. However, across all five schools, students noted the seriousness of the pandemic and expressed concern for their communities.

"Students clearly cared about the health and wellbeing of their peers and their broader community, suggesting that they can be important allies in keeping schools open and as safe as possible given our circumstances," Mueller said. "But youth also learn from adults, in schools and out. So it's crucial that we make sure that parents, teachers, and other community adults get the message that masks and social-distancing are crucial to getting life back to normal and keeping schools open."