Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Department of Population, Family, and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States.
Front Public Health. 2023 Jul 31;11:1217638. doi: 10.3389/fpubh.2023.1217638. eCollection 2023.
Although factors such as urbanicity, population demographics, and political affiliation have been linked with COVID-19 masking behavior and policy in community settings, little work has investigated factors associated with school mask policies. We sought to characterize United States state and school district student COVID-19 masking policies during the 2021-22 school year and determine predictors of these mandates at four time points, including before and after federal guidance relaxed school mask recommendations in February 2022.
Student mask policies for US states and the District of Columbia, as well as a sample of 56 districts were categorized as prohibited, recommended, or required in September 2021, November 2021, January 2022, and March 2022 based on the Johns Hopkins eSchool+ Initiative School Reopening Tracker. Changes in policies over time were characterized. Generalized estimating equations and logistic regression were used to evaluate whether political affiliation of governor, urbanicity, economic disadvantage, and race/ethnic composition of district students, and county-level COVID-19 incidence predicted the presence of a district mask mandate at any time point and at all four time points.
State and district policies changed over time. Districts that implemented student mandates at any point were more likely to be in states with Democratic governors (AOR: 5.52; 95% CI: 2.23, 13.64) or in non-rural areas (AOR: 8.20; 95% CI: 2.63, 25.51). Districts that retained mask mandates at all four time points were more likely to have Democratic governors (AOR: 5.39; 95% CI: 2.69, 10.82) and serve a smaller proportion of economically disadvantaged students (AOR: 0.97; 95% CI: 0.95, 0.99). Districts serving a larger proportion of students from minoritized racial/ethnic groups were more likely to have mask mandates at any or all timepoints. Notably, county-level COVID-19 prevalence was not related to the presence of a mask mandate at any or all time points. By March 2022, no factors were significantly associated with district mask policy.
Political, geographic, and demographic characteristics predicted the likelihood of student mask mandates in the 2021-22 school year. Public health promotion messages and policy must account for variation in these factors, potentially through centralized and consistent messaging and unbiased, trustworthy communication.
尽管城市化程度、人口统计数据和政治派别等因素与社区环境中的 COVID-19 口罩行为和政策有关，但很少有研究调查与学校口罩政策相关的因素。我们旨在描述 2021-22 学年美国各州和学区学生的 COVID-19 口罩政策，并在四个时间点确定这些规定的预测因素，包括 2022 年 2 月联邦政府放宽学校口罩建议前后。
根据约翰霍普金斯大学 eSchool+倡议学校重新开放跟踪器，将美国各州和哥伦比亚特区的学生口罩政策以及 56 个学区的样本分为禁止、建议或要求，分别在 2021 年 9 月、2021 年 11 月、2022 年 1 月和 2022 年 3 月。描述了随时间变化的政策。使用广义估计方程和逻辑回归来评估州长的政治派别、城市化程度、经济劣势以及地区学生的种族/族裔构成，以及县一级的 COVID-19 发病率是否预测了任何时间点以及所有四个时间点的地区口罩强制令的存在。
州和地区的政策随时间发生变化。在任何时候实施学生强制令的地区更有可能位于民主党州长的州（AOR：5.52；95%CI：2.23，13.64）或非农村地区（AOR：8.20；95%CI：2.63，25.51）。在所有四个时间点都保留口罩强制令的地区更有可能有民主党州长（AOR：5.39；95%CI：2.69，10.82），并且服务的经济弱势群体比例较小（AOR：0.97；95%CI：0.95，0.99）。服务于少数族裔学生比例较大的地区更有可能在任何或所有时间点都有口罩强制令。值得注意的是，县一级的 COVID-19 患病率与任何或所有时间点的口罩强制令无关。到 2022 年 3 月，没有任何因素与地区口罩政策显著相关。
政治、地理和人口统计学特征预测了 2021-22 学年学生口罩强制令的可能性。公共卫生促进信息和政策必须考虑到这些因素的变化，可能需要通过集中和一致的信息传递以及公正、值得信赖的沟通来实现。
