By Alan Mozes
MONDAY, July 27, 2020 (HealthDay News) -- In the midst of a pandemic, many Americans still view face mask mandates as an assault on their personal freedoms, rather than a means of protecting themselves and others from COVID-19.
But a group of researchers out of Duke University say the mask backlash can be turned around -- as long as efforts to do so are grounded in empathy, not judgment.
As coronavirus cases in the United States soar, face mask mandates have been issued by a growing number of cities, states and national retailers. The mandates make sense, health experts say.
"I think face masking is a very important part [of curbing the spread of COVID-19] and ought to be done in this epidemic," Dr. Robert Brook, distinguished chair of RAND Corporation's health care services program, said in a HD Live! interview. "It's one of the few things we can do that will slow the pandemic."
But there's been no national public health campaign to tell Americans why face masks work, and how to use them properly, Brook added.
May Chu, a clinical professor of epidemiology at the University of Colorado's School of Public Health, concurred.
"We have to teach people how to wear it, how to take care of them and when to use them," she said in the same HD Live! interview.
In the meantime, some Americans balk at wearing a mask. When that happens, the best approaches to change minds are based in understanding and empathy, according to Gavan Fitzsimons. He's professor of marketing and psychology at Duke University's Fuqua School of Business, in Durham, N.C.
"Many people perceive that some of the public health guidelines are direct threats to their freedoms," Fitzsimons noted. Roughly one-third of the population has "an extremely strong 'reactive response' when their freedom is threatened," he said.
And those who do feel threatened will go "to great lengths to try to restore their freedom," Fitzsimons added, and efforts to change their minds won't work if those efforts are also viewed as threatening.
"The way we communicate is going to be very critical here," Fitzsimons said during a Duke University telebriefing this week. For example, he questioned the value of characterizing those who refuse to wear masks as "selfish," a term used recently by North Carolina Gov. Roy Cooper.
"Obviously the governor is well-intentioned. But using a term like 'selfish', I think, is going to lead people who are already digging in to dig in even harder," Fitzsimons said.
His suggestion: Help those resistant to masks "feel they have the freedom to make a choice."
That approach could be a game-changer when concerned store managers confront mask-less customers, he said.
"If you want to minimize resistance, you want to try to give some agency to that shopper," Fitzsimons said. "Rather than approach and say, 'Ma'am, you must wear a facemask,' you might say, 'Ma'am, the local law says you must wear a facemask. We have three different types, all of which are comfortable. Which of these might you like to use today?'"
That tactic may not always work, he acknowledged, "but it helps. If the person who feels their freedom is threatened feels like part of the solution, they're more likely to comply. Giving them a choice helps a lot."
Speaking at the same briefing, Lavanya Vasudevan, an assistant professor of community and family medicine at Duke, offered similar advice when tackling the misgivings some Americans have already expressed about getting a COVID-19 vaccine when it becomes available.
"There are many people out there who are either not convinced there is a pandemic or don't think COVID is a threat to them either because of their age or other circumstance," she noted. "We really need to start communicating about why the vaccine is important to them in terms of benefits rather than threats."
The focus, she said, needs to be on building community confidence in vaccine safety and effectiveness. And Vasudevan echoed Fitzsimons central point: "It's always good to communicate in terms of benefits rather than threats. Talking to folks about the benefits of mask-wearing, the benefits of vaccinations, is always better."
Another key to success: enlisting trusted local leaders to deliver the message.
"If it's on the national level, it feels more distant," Vasudevan cautioned, adding that "people want facts, but more importantly they want facts from people they trust."
Enlisting "trusted voices within the community" is helpful, agreed Benjamin Anderson, an assistant professor of science and global health at Duke Kunshan University in China. "It could be religious institutions, it could be service organizations. Having that message that goes all the way down on the local and personal level makes for a more impactful message."
Why? Because while "people don't want to be told what to do, they want to be told what their peers and community members are doing," Vasudevan explained. "If something is a norm in a community, it is more likely to be accepted."
Of course, national figures can either reinforce acceptance or foster confusion, Anderson and Fitzsimons both noted.
For example, said Anderson, China's "very centralized approach" to coronavirus included "a very consistent message in terms of how the response was going to be rolled out, what measures were going to be put in place."
In contrast, the U.S. government largely chose to defer to the states on these decisions. That created "a lot of confusion, as people are seeing different things presented to the communities in terms of what's effective, what's not effective," he added.
The result was an unhelpful politicization of masks, Fitzsimons said. "The trouble, of course, is that once there was the link between the political and the wearing of a mask, that's where that feeling that the freedom to not wear a mask became important to a lot of folks," he noted.
Still, "we've seen some movement in the last couple of days across the political spectrum to unify behind a mask/face covering strategy," Fitzsimons added.
It may be working: A new Associated Press-NORC Center for Public Affairs Research poll shows that three in four Americans now believe face masks should be worn by people when they leave home.