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Monitoring and Evaluation Action Guide: Wearing Masks as a COVID-19 Community Mitigation Strategy

Monitoring and Evaluation Action Guide: Wearing Masks as a COVID-19 Community Mitigation Strategy
Updated June 22, 2021
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This action guide is developed to help evaluators, program implementers, and policy makers monitor and evaluate wearing masks as a community mitigation strategy. This is not meant for healthcare settings. This guide provides practical considerations and examples of evaluation questions, indicators, and data sources.

Approach for the Monitoring and Evaluation of Wearing Masks

flowchart: governments, organizations, and individuals -- Implement wearing masks as a community mitigation strategy that prevents spread, and maintain healty environments and operations -- reduce exposure among individuals -- reduce transmission -- reduce burden on the health care system -- minimize COVID-19 morbidity and associated mortality -- Thrive socially, emotionally, and economically -- Strengthen, focus, or relax mitigation strategies based on local context. Critical considerations: Assure individual and community ability to adopt and sustain wearing masks. Mitigate adverse effects and impacts on health disparities and social determinants of health. Foster mental and emotional health and resilience. Minimize negative physical, mental, and emotional challenges related to wearing masks.

Governments, organizations, and individuals support and promote community mitigation across settings and sectors with special attention to disproportionately affected populations

[Illustration Approach for the Monitoring and Evaluation of Wearing Masks decision tree flow chart first box on top; text]

Strategy

Implement wearing masks as a community mitigation strategy that prevents spread of COVID-19, and maintain healthy environments and operations

[Illustration of arrows the go in circular motion; text]

Strengthen, focus, or relax mitigation strategies based on local context

[Illustration of arrow on right that goes to box; text]

Outcomes

Reduce exposure among individuals

[Illustration of arrow pointing down that goes to box; text]

Reduce transmission

[Illustration of arrow pointing down and to right that goes to box; text]

Reduce burden to the health care system

Impact

Minimize COVID-19 morbidity & associated mortality

[Illustration of arrow pointing down that goes to box; text]

Thrive socially, emotionally, and economically

[Illustration of box; text]

Critical considerations:

  • Assure individual and community ability to adopt and sustain wearing masks
  • Mitigate adverse effects and impacts on health disparities and social determinants of health
  • Foster mental and emotional health and resilience
  • Minimize negative physical, mental, and emotional challenges related to wearing masks

Wearing masks can help communities slow the spread of COVID-19 when worn consistently and correctly by a majority of people in public settings and when masks are used along with other preventive measures, including social distancing, frequent handwashing, and cleaning and disinfecting.

Please see CDC’s Considerations for Wearing Masks for information about how wearing masks can help reduce spread of COVID-19, for whom wearing a mask is or is not recommended, and considerations regarding implementation of mask-wearing as a COVID-19 community mitigation strategy.

This action guide tailors the logic model (depicted) for mask-wearing and the  CDC’s Approach for Monitoring and Evaluating Community Mitigation Strategies for COVID-19 for monitoring and evaluating mask-wearing.

Monitoring and evaluation enable stakeholders to examine their unique circumstances and make proactive decisions about what is best for their needs and context.

Monitoring and Evaluation Action Steps

To evaluate mask wearing as a community mitigation strategy, consider performing the following activities:

  • Prioritize and focus the evaluation on what is feasible, useful, and applicable to the jurisdiction (e.g., state, county, city, organization) and to a community’s needs and context.
  • Collect new data or review existing data on mask-wearing appropriate for the focus and align with other activities that monitor and evaluate COVID-19 community mitigation strategies.
  • Conduct analyses that compare changes over time and geographic and socio-demographic variations to assess how mask-wearing can reduce COVID-19 transmission, morbidity, and related mortality.
  • Consider each community’s cultural context when interpreting findings and making conclusions.
  • Use evaluation findings to
    • Inform decisions about strengthening, focusing, and relaxing guidance for mask-wearing.
    • Monitor disparities and social determinants of health to understand how different populations participate in, and are affected by, wearing masks, including stigma associated with mask-wearing in specific populations.
    • Share lessons learned, along with tools and resources needed to effectively implement mask-wearing as a COVID-19 community mitigation strategy.
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Example evaluation questions

To what extent do individuals and organizations participate in mask-wearing in community settings?

Example Indicators [ 1 ]

  • Description and timeframe of implementation of workplace policies to mandate masks
  • Number/proportion of:
    • The population that report using masks outside the home
    • K-12 school-aged children using masks outside the home or while attending school and school-sanctioned events
    • People wearing a mask properly (e.g., over the nose) in highly trafficked settings (e.g., airport, grocery store)

Example Data Sources

To what extent do individuals’ knowledge, attitudes, and perceptions facilitate or hinder mask-wearing?

Example Indicators [ 1 ]

  • Number/proportion of the population that report:
    • They know that CDC recommends wearing a mask in public settings for some people
    • That wearing a mask in public settings is a good idea
    • That wearing a mask in public settings is easy
    • They intend to wear a mask in public settings
    • Knowing how to wear masks correctly and who report wearing masks correctly
    • They do not think they need to wear a mask in public settings
    • Wearing a mask in public settings is hard
    • They won’t wear a mask every time they go out in a public space
  • Perception of mask-wearing as a community mitigation strategy by K-12 school-aged children
  • Perceived or actual stigma and discriminations against wearing mask, especially among specific groups (e.g., people of color)

Example Data Sources

  • Survey data
  • Interviews or focus groups
  • Observational data
  • Social media data
To what extent do individuals’ access to a mask hinder mask-wearing as a community mitigation strategy?

Example Indicators [ 1 ]

  • Number/proportion of population that report:
    • They do not currently have a mask
    • They do not have access to masks
    • They do not know where to get a mask or how to make one​

Example Data Sources

  • Survey data
  • Interviews
  • Focus groups
  • Business consumption data
What is the relationship between implementation of policies for mask-wearing and COVID-19 transmission, morbidity, and mortality?

Example Indicators [ 1 ]

  • Description and timeframe of implementation of workplace/business policies to mandate masks
  • State and local mandates of wearing masks
  • Total and incident COVID-19 cases, hospitalizations, deaths

Example Data Sources

How does mask-wearing and COVID-19 related outcomes differ among disproportionately affected population or groups who experience health disparities?

Example Indicators [ 1 ]

  • Number/proportion of people wearing masks by socioeconomic status, race, ethnicity, age, urban-rural status, essential worker status, and other groups.
  • Trends in COVID-19 cases, hospitalizations, and mortality among disproportionately affected populations

Example Data Sources

  • COVID-19 Epidemiology, Community Characteristics, Healthcare Capacity, and Public Healthcare Capacity [ 2 ]

1 Indicators and data sources can be tailored to align with the context of the intended evaluation

2 Data sources related to COVID-19 Epidemiology, Community Characteristics, Healthcare Capacity, and Public Healthcare Capacity should refer to existing indicators: CDC COVID Data Tracker or CDC’s COVID Surveillance and Data Analytics page as well those being monitoring in your state/local jurisdiction.

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