Predicting mask-wearing behavior intention among international students during COVID-19 based on the theory of planned behavior.

Background The global outbreak of the coronavirus disease 2019 (COVID-19) has emerged as a major public health threat. This study aimed to analyze the influencing factors of international students' intention to wear a mask based on the theory of planned behavior (TPB). The findings are important because they provide pertinent information in designing and implementing COVID-19 prevention programs. Methods Self-designed questionnaires were distributed to 477 international students. exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) was conducted to identify and confirm the factor structure, and the structural equation model (SEM) was applied to determine the predictors of masks wearing. Results The final structural model was well reflected by fit indices. The research model of international students' intention to wear a mask for protection against COVID-19 was acceptable. All of the hypotheses were supported. Attitude and perceived behavioral control (PBC) were positively related to behavior intention (BI), respectively. Subjective norm (SN) also had a direct effect on attitude, PBC, and BI. Conclusions Referring to TPB was useful in identifying determinants of mask-wearing. The strongest predictor was SN, which indicated it was deserving of increased attention. These findings are significant to strengthen international students' awareness regarding self-protection and enhance the effectiveness of COVID-19 prevention programs.