# Face mask mandates alter major determinants of adherence to protective health behaviours in Australia

## TL;DR

This study shows how face mask mandates in Australia changed the factors influencing mask wearing and other protective health behaviors during the pandemic.

## Contribution

The study reveals how mandates altered key predictors of mask adherence, offering insights for future public health strategies.

## Key findings

- Ensemble and tree-based models best predicted mask wearing before and after mandates.
- Age, survey week, contacts, wellbeing, and illness threat perception were consistent predictors.
- Trust in government and willingness to isolate emerged as unique predictors before and after mandates, respectively.

## Abstract

Face mask wearing is a protective health behaviour that helps mitigate the spread of infectious diseases such as influenza and COVID-19. Understanding predictors of face mask wearing can help refine public health messaging and policy in future pandemics. Government mandates influence face mask wearing, but how mandates change predictors of face mask wearing has not been explored. We investigate how mandates changed predictors of face mask wearing and general protective behaviours within Australia during the COVID-19 pandemic using cross-sectional survey data. We compared four machine learning models to predict face mask wearing and general protective behaviours before and after mandates started in Australia; ensemble, tree-based models (XGBoost and random forests) performed best. Other than state, common predictors before and after mandates included age, survey week, average number of contacts, wellbeing, and perception of illness threat. Predictors that only appeared in the top ten before mandates included trust in government, and employment status; and after mandates were willingness to isolate. These distinct predictors are possible targets for future public health messaging at different stages of a new pandemic.