In the United States, seasonal influenza is responsible for enormous medical costs and lost earnings as well as thousands of deaths. Medical masks are effective non-pharmaceutical preventions for minimizing the spread of illness in the event of an influenza outbreak. However, people in the United States rarely wear face masks the way many people in Asian countries do.

In a previous study of public response to the 2009 influenza A H1N1 pandemic, 71% of United States respondents supported the recommendation to wear a mask during the flu outbreak, while only 8% of respondents reported they wore a mask in public to protect themselves from getting sick. What are the factors that cause this gap? The purpose of this exploratory study is to identify barriers to the wearing of masks among adults in the United States.

The research was conducted through an online survey of 84 American residents via the Survey Monkey Audience service to collect their opinions on influenza, mask-wearing, and the perceived barriers to wearing face masks for flu prevention. The results are presented in the descriptive analysis and the non-parametric analysis.

The results showed a barrier against social interaction is a significant factor (p=0.003) regarding the impact between flu experience and the perceived barriers. The participants believed mask-wearing may lead other people difficult to perceiving their feelings. Regarding the relationship between mask-wearing experience and the perceived barriers, there were significant differences in perceived benefits (p=0.028), perceived risks (p= 0.003), and social value (p=0.021). Participants who have had worn masks had perceived higher benefits of mask-wearing, higher risks of catching the flu, and a higher agreement of importance to protect other people from getting the flu from them. The most common perceived barrier among the participants is product satisfaction. 85.71% of the participants agreed that wearing face masks is uncomfortable. 80.95% of the participants agreed with the importance to wear face masks as it protects other people from getting the flu from them, but only 37.5% of the participants with flu history had worn face masks.

By examining barriers to the wearing of masks for influenza prevention, this study can assess public willingness to adopt personal prevention behaviors and provide information for related policies in the future.