Mask-wearing intention after the removal of the mandatory mask-wearing requirement in Hong Kong: application of the protection motivation theory and the theory of planned behaviour

Introduction: The mandatory mask-wearing requirement, which had been in place for nearly 1000 days in Hong Kong, was lifted on 1 March 2023. Little is known about the intention to continue wearing a mask after the removal of the mandate in the city. This study aimed to examine predictors of mask-wearing intention after the mandate was lifted, using the protection motivation theory (PMT) and the theory of planned behaviour (TPB). Methods: A conceptual model was developed to depict the relationships between the constructs of PMT and TPB in predicting continued mask-wearing intention after the removal of the mandate. A cross-sectional study was conducted using an online questionnaire from 8 to 20 March 2023. Partial least squares structural equation modelling was utilised to examine relationships between the constructs. Results: In total, 483 responses were included in the data analysis. Perceived severity (β=0.089; P=0.017), perceived self-efficacy (β=0.253; P<0.001), subjective norms (β=0.289; P<0.001), and attitude (β=0.325; P<0.001) had significant positive effects on the intention to continue wearing a mask. In contrast, the perceived reward of maladaptive behaviours had a significant negative effect on mask-wearing intention (β=-0.071; P=0.012). Perceived vulnerability, perceived response efficacy, perceived response cost, and perceived behavioural control were not significantly associated with mask-wearing intention. Conclusion: The findings indicate that attitude towards continued mask-wearing was the strongest predictor of mask-wearing intention, followed by subjective norms and perceived self-efficacy. Insights from this study may inform public health policymaking regarding mask-wearing practices in future health crises.