Masking Behaviors in the Absence of Local Mandate-An Observational Study from Hillsborough County, Florida.

The purpose of this study was to understand the predictors of masking-especially age, race/ethnicity and gender-in Hillsborough County Florida, a region without mask mandates. Masking and social distancing behaviors of individuals were observed in Hillsborough County during one-week intervals in July 2021, August 2021 and Late September-early October 2021. Demographic and behavioral observations were recorded and logistic regression was utilized to determine the odds ratio of wearing a mask amongst various groups. Overall, masking ranged from 36.80% to 48.64%, peaking during the second observation period. Masking rates were highest amongst people of color, women and seniors. Establishments posting mask-negative language, such as "masks NOT required," saw a 46% decrease in the odds of masking compared to establishments without mask-related signage (thereby defaulting to no mandate). Understanding who engaged in masking and social distancing behaviors will provide local public health officials with a deeper understanding of the effectiveness of previously used strategies, which can be leveraged in future surges of COVID-19 and other emergencies to create maximum impact. Lessons learned regarding policy implementation and understanding patterns of uptake of health guidelines are important for the continuous improvement of public health practice.