Mask Use Experiences, COVID-19, and Adults with Asthma: A Mixed Methods Approach

Abstract Background While masks are recommended for those with asthma in the era of COVID-19, there is limited research exploring the extent of and problems related to mask use in adults with asthma. Objective We sought to describe in adults with asthma: 1) the extent masks are worn and attitudes and beliefs about wearing masks; (2) participant characteristics associated with problems experienced while wearing a mask, and (3) participant experiences and recommendations regarding masks. Methods The Mask Use in Adults with Asthma online survey was conducted with 501 adults with asthma primarily (96.6%) from the United States. A Mask Effects Scale (MES) was compiled from items addressing problems experienced wearing a mask with higher total scores indicating more problems. Open-ended questions explored factors considered when choosing a mask, problems experienced while wearing a mask, and recommendations to others with asthma. Survey data were analyzed descriptively and via multiple regression. Themes were generated from open-ended items. Results Almost all participants (98.4%) indicated wearing a mask in public and most (67.4%) wore a mask ≤3 hours per day. Poorer asthma control and wearing a mask longer were significantly associated with higher MES scores (P≤.001 & .005, respectively). Participant recommendations included “Just wear it”, use a comfortable, well-fitting mask, take mask breaks, and carry your inhaler. Conclusions Wearing a mask in public was almost uniformly adhered to by participants, despite reporting problematic effects. Implementing recommendations, such as planned mask breaks, can support and enhance the experience of wearing a mask for adults with asthma.