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Current COVID-19 messaging efforts by public health departments are primarily informational in nature and assume that audiences will make rational choices in compliance, contradicting extensive research indicating that individuals make lifestyle choices based on emotional, social, and impulsive factors. To complement the current model, audience barriers to prevention need to be better understood. A content analysis of news source comments in response to daily COVID-19 reports was conducted in Montana, one of the states expressing resistance to routine prevention efforts. A total of 615 Facebook comments drawn from Montana news sources were analyzed using the Persuasive Health Message Framework to identify perceived barriers and benefits of mask-wearing. A majority (63%) of comments expressed barriers, the most common of which were categorized as either misinformation about the virus or conspiracy theories. Benefits (46%) of mask-wearing were articulated as benefits to loved ones or people in one's community or saving hospital space. This paper analyzes the implications of low perceived threat accompanied by low perceived efficacy of mask-wearing to make recommendations for future prevention efforts.

How Social Media Comments Inform the Promotion of Mask-Wearing and Other COVID-19 Prevention Strategies