P-ISSN: 2808-0467
E-ISSN: 2808-5051
Homepage: https://iss.internationaljournallabs.com/index.php/iss
1651
COMPLIANCE WITH THE USE OF MASK IN YOUNG ADULT
COMMUNITY GROUP IN KUPANG CITY
Angel Yulied Basy, Anderias Umbu Roga
*
, Pius Weraman, Jacob M. Ratu, Christina
Olly Lada
Postgraduate Program of Public Health, Nusa Cendana University, Kupang, East Nusa Tenggara, Indonesia
*
anderias_umburoga@staf.undana.ac.id
PAPER INFO ABSTRACT
Received:
October 2022
Revised:
November 2022
Approved:
November 2022
Background: COVID-19 is a deadly disease transmitted by the SARS-CoV-
2 virus that spreads quickly and widely through droplets and the air.
Prevention behavior through the 3M, namely maintaining distance, washing
hands with soap, maintaining distance, and always using a mask when doing
activities outside the home, is important for every individual. Community
compliance with Government appeals is very important in controlling the
increasing number of cases.
Aim: This study aims to analyze the simultaneous influence of knowledge,
attitudes, social support, income, education, employment, and history of the
COVID-19 vaccine to obtain a model of factors that influence adherence to
the use of masks during the COVID-19 pandemic in adolescent in Kupang
City.
Method: This study is an analytic observational study with a cross-sectional
design. The research sample was young adults with an age range of 20-40
years as many as 395 people. Data were collected using a list of questions
and observations. Data analysis using multiple logistic regression.
Findings: The results of statistical analysis show that there is a significant
effect between attitudes, social support, employment, and history of
administering the COVID-19 vaccine with adherence to the use of masks.
With the regression equation model g(x)=2.582+-2.521 (social support) +-
3.222 (occupation) +-6.136 (vaccine history) with adherence to the use of
masks. Occupation is the dominant variable, with a magnitude of 25,082
times its effect on compliance with the use of masks. Immediate actions taken
by the government and relevant stakeholders are firstly increasing public
knowledge through continuous health promotion about the dangers of
COVID-19 and secondly increasing vaccination, and tightening community
mobilization’s supervision.
KEYWORDS
COVID-19, compliance, use of masks
© The author(s). This work is distributed under the terms of the Creative
Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0)
INTRODUCTION
The number of COVID-19 cases is increasing rapidly every day, worldwide as of 13 May
2021, there were 159,329,011 confirmed cases, with 3,311,998 deaths and as of 13 June 2021,
174,918,667 confirmed cases with 3,782,490 deaths (KemenKes_RI, 2021; WHO, 2021). The
distribution of COVID-19 case data in Indonesia as of May 13, 2021, there were 1,728,204
confirmed cases with 47,617 deaths, as of June 13, 2021 there were 1,901,490 confirmed cases
with 52,730 deaths spread across 510 regencies/cities including East Nusa Tenggara. Data on
the distribution of COVID-19 cases in East Nusa Tenggara Province was recorded as of May
13, 2021, there were 15,577 confirmed cases with 409 deaths and as of June 13, 2021, there
were 17,104 confirmed cases with 443 deaths. The highest distribution of COVID-19 cases in
Compliance with the Use of Mask in Young Adult Community Group in Kupang City
1652 Interdisciplinary Social Studies, 2(2), Nov 2022
Kupang City occurred in Maulafa District in 2020 as many as 198 cases with 48
(covid19.nttprov.com, 2021).
According to the COVID-19 Handling Committee, the highest number of positive cases
as of June 13 in Indonesia occurred in the 31-45-year-old group (29%) followed by the 19-30-
year-old group (24%). The second-highest percentage of deaths also occurred in the 31-45 age
group (11.1%) followed by the 19-30 group (2.5%). In East Nusa Tenggara Province, the
highest percentage of positive cases as of June 13 was in the 31-45-year age group (29.8%)
followed by the 19-30-year group (27.2%), and the percentage of deaths occurred in the 31-45
age group (10.9%) (KemenKes_RI, 2021). The highest number of confirmed cases in Kupang
City occurred in the 30-39 age group as many as 1,712, followed by the 19-29 age group with
1,585 (covid19.nttprov.com, 2021; KemenKes_RI, 2021).
The trend of positive cases of COVID-19 occurs in the young adult age group
(KemenKes_RI, 2021). The young adult age group is the age group from 20-40 years WHO
have a high level of productivity and mobility because they have to work to meet the needs of
themselves and their families (Papalia, D. E., Feldman, R. D., Martorel, 2014)
Their high mobility allows them to come into contact with other people who may be
infected with the Coronavirus, this situation has the potential to be the beginning of the spread
of the virus in the family (Yanti et al., 2020). For the Prevention of Transmission of Infection
(PTI) COVID-19, the Government issued regulations to implement the 4M health protocol,
namely, maintaining distance, washing hands with soap, and using masks every time they do
activities outside the home, but there are still many people who have not implemented COVID-
19 prevention behavior (Kemenkes_RI, 2021).
As part of a comprehensive series of measures to prevent transmission of COVID-19,
masks can protect healthy people (used to protect themselves when in contact with infected
people) or to control sources (worn by infected people to prevent further transmission(Garcia,
2020; WHO, 2020). Although it has a very important role, the use of masks is considered
uncomfortable, inconvenient, and interferes with activities, so this is also the reason people do
not wear masks when doing activities outside the home (Scheid et al., 2020). Community
compliance with government advice is very important to reduce the increase in the number of
cases (Wu & McGoogan, 2020).
METHOD
The type of research used is analytic observational with a cross-sectional study approach.
The research location is in the Maulafa District, Kupang City, and carried out from February
to June 2021. The population of this research is all young adults (20-40 years old) in the
Maulafa District, Kupang City as many as 32,342 people. The sample in this study were young
adults living in the Maulafa District, Kupang City with a total of 395 people. The instrument
used to collect data is a questionnaire. The ethical feasibility has been reviewed and approved
by KEPK Faculty of Medicine, Nusa Cendana University with the number: UN 02210541-
KEPK. Bivariate analysis techniques to determine the influence between attitudes, knowledge,
attitudes, social support, education, knowledge, income, work history of the Covid-19 vaccine
with mask compliance using chi-square statistical tests and multivariate analysis techniques to
analyze how much simultaneous influence between independent variables on independent
variables simultaneously using multiple logistic regression analyst tests.
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1653 Interdisciplinary Social Studies, 2(2), Nov 2022
RESULTS AND DISCUSSION
The study was conducted in May 2021 with a total sample of 395.
Table 1. Characteristics of Respondents
Table 1 shows that the characteristics of respondents based on gender are known to be the
most female respondents (53.1%), the most age group is the 20-30 group (74.6%), most
respondents are unmarried (78.9%).
Table 2. Relationship Between Knowledge, Attitude, Social Support, Income, Education,
Employment, Profession, and COVID-19 Vaccine History and Compliance with the Use of
Masks as an Effort to Prevent COVID-19 Disease in Maulafa District, Kupang City
Category
Amount (n)
Precentage (%)
Gender
Female
Male
Age (year)
20-30
31-40
Status
Married
Single
210
185
297
98
83
312
53.1%
46.9%
75%
25%
21%
79%
Variable
Obedience
Amount
%
p-
value
Not
Obey
%
Obey
%
Knowledge
Less
Good
Attitude
Negative
Positive
Social Support
Does not support
Support
Income
Low
High
Education
Low
High
Profession
Student / Housewife
17
187
29
175
94
110
156
48
91
113
93
4.3%
47.3
7.3%
44.3%
23.8%
27.9%
39.4%
12.1%
23.0%
28.6%
23.5%
7
184
5
186
28
163
134
57
74
117
184
1.8%
46.5%
1.2%
47.0%
7.0%
41.2%
34 %
14.5%
18.8%
29.6%
46.5%
24
371
34
361
122
273
290
105
165
230
277
6.1%
93.9%
8.6%
91.4%
30.9%
69.1%
73.4%
26.6%
41.8%
58.2%
70,1%
0.040
0.000
0.000
0.096
0.175
0.000
Compliance with the Use of Mask in Young Adult Community Group in Kupang City
1654 Interdisciplinary Social Studies, 2(2), Nov 2022
Table 2 shows that some respondents with good knowledge (47.3%) are not obedient to
using masks and some (46.5%) are obedient to using masks, respondents with less knowledge
(1.8%) are obedient to using masks. Some of the positive respondents (47.0%) obeyed using
masks and some did not comply with using masks (44.3%). Respondents with a negative
attitude did not comply with using masks (7.3%) and a small proportion was obedient in using
masks (1.2%). Some of the respondents with the support of social support, obeyed using masks
(41.2%) and some did not comply with using masks (27.9%), a small proportion of respondents
were not supported but complied with using masks (7.0%). Some respondents with low income
do not comply with using masks (39.4%) and some comply with using masks (34%), a small
proportion of respondents with high incomes do not comply with wearing masks (12.1%).
Some respondents with higher education comply with wearing masks (29.6%) and some do not
comply with wearing masks (28.6%). Most respondents with low education are not compliant
with wearing masks (23.0%) and some are obedient in using masks (18.8%). Most respondents
do not or have not worked/students/IRT obediently using masks (46.5%), most of them are not
compliant (23.5%). Most of the respondents working as civil servants/non-civil servants did
not comply with wearing masks (28.1%) and some complied (1.8%). Most respondents have
not been vaccinated against COVID-19 are not compliant with wearing masks (50.9%), a small
proportion is compliant with wearing masks (10.6%). In contrast to respondents who have been
vaccinated, they are more obedient to masks (37.8%). The results of the bivariate test using the
Chi-Square test show that there is a significant influence between attitudes, social support,
work, and history of the COVID-19 vaccine on adherence to the use of masks as an effort to
prevent COVID-19 disease in Maulafa District, Kupang City.
Table 3. Simultaneous Relationship Between Knowledge, Attitude, Social Support, Income,
Education, Employment and History of the COVID-19 Vaccine Factors Affecting
Compliance with the Use of Masks During the COVID-19 Pandemic in Young Adults in
Maulafa District, Kupang City
Variabel
B
S.E.
Wald
Df
Sig.
Exp(B)
95% C.I. for
EXP(B)
Lower
Upper
Social Support(1)
-2,521
,633
15,840
1
,000
,080
,023
,278
Profession(1)
3,222
,684
22,168
1
,000
25,082
6,559
95,919
COVID-19 Vaccine
History (1)
-6,136
,847
52,462
1
,000
,002
,000
,011
Constant
2,582
,892
8,374
1
,004
13,225
Civil servants/Non civil
servants
COVID-19 Vaccine
History
Not yet
Already
111
201
3
28.1%
50.9%
0.7%
7
42
149
1.8%
10.6%
37.8%
118
243
152
29.9%
61.5%
38.5%
0.000
Compliance with the Use of Mask in Young Adult Community Group in Kupang City
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The results of the multivariate test showed that the variables of social support, occupation,
and history of the COVID-19 vaccine were simultaneously associated with compliance with
the use of masks as an effort to prevent COVID-19 disease in Maulafa District, Kupang City.
The logistic regression model can be formed is:
g (x)= 2.582+-2.521 X3(1) +3.222 X 6(1) +-6.136 X7(1)
g(x)=2.582+-2.521 X (social support_support) +-3.222 X (profession_work)+-6.136
X_(vaccine history_already) g (x)= 2.853 p= 0.55
Thus the probability of young adults complying with wearing a mask is 55%. Based on the
test results above, there is a simultaneous influence between social support variables with a
large effect of 0.080, occupation with a large effect of 25.082 times, and a history of the COVD-
19 vaccine with a large effect of 0.002 times on adherence to the use of masks. Occupation is
the most dominant variable, with a large effect of 25,082 times on compliance with the use of
masks. From the results of the logistic regression model formed, it has a negelkerke R square
value of 0.812 and a cox & Snell R square of 0.609 meaning that the ability of the independent
variables of social support, occupation, and history of the COVID-19 vaccine can explain the
dependent variable of adherence to the use of masks by 81% and 29% factors. other outside
the model.
Discussion
The results of the bivariate selection analysis between the independent variables, namely,
knowledge, attitudes, social support, education, income, occupation, and history of the
COVID-19 vaccine on adherence to the use of masks using the chi-square test showed a
significant relationship between the variables of attitude, social support, occupation, and
history. COVID-19 vaccine. While the variables of knowledge, education, and income there is
no significant relationship. Furthermore, the results of the multivariate analysis obtained in step
1 (a), obtained that the variables of knowledge, attitude, social support, occupation, and history
of the COVID-19 vaccine were eligible to be retested. After simultaneously testing these
variables in step 2 (a), the variables of knowledge, social support, and history of vaccines
passed the test were obtained. Then the test was carried out again in step 3 (a), 3 who passed,
namely social support (p-value 0.000), employment (p-value 0.000), and history of COVID-19
vaccine (p-value 0.000), with the probability that young adults adhere to wearing masks is 55%.
The results of this study are in line with research conducted by Fairus (2021) which states
that there is an influence between the attitudes and behavior of Generation Z and adherence to
wearing masks with a p-value <0.05. Attitude is one of the underlying causes for the occurrence
of behavior where attitudes have 3 components, namely cognitive, affective and conative.
People who have good attitudes and beliefs will also have the intention to take good actions
(Manurung, 2020). This can be seen from the results of this study where people with positive
attitudes will tend to create compliance and negative attitudes will tend to disobey wearing
masks. So it can be concluded that attitude influences adherence to wearing masks.
Based on the results of this study, it is known that most of the respondents have good social
support. This can be seen in the results of the study which showed that respondents received
good emotional support and appreciation where the family always conveyed information,
reminded, and motivated to always implement preventive behavior.
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In line with Setiyaningsih and Ningsih (2019), subjects WHO have a high level of family
support have a greater chance of carrying out hypertension control behavior (p-value = 0.000)
(Setiyaningsih & Ningsih, 2019). Another study conducted by Susanti showed that family
support can improve dietary adherence in patients with diabetes mellitus (p-value = 0.00). But
it is not in line with the research of Paykan et al (2021) with the title Perceived social support
and compliance with stay-at-home orders during the COVID-19 outbreak: evidence from Iran
where there is no relationship of social support from family, friends, and others to stay-at-home
compliance at home (Paykani et al., 2020). Respondents WHO felt more support from their
family members were more likely to adhere to stay-at-home advice. In contrast, those who felt
more support from friends were less likely to comply. It appears that immediate family
members may have helped reinforce social distancing directives and promote compliance. In
contrast, individuals who rely heavily on peer support may feel greater pressure to leave their
homes to socialize, pressures that may have been reinforced as a social norm by some peer
groups. Research has shown that different sources of support may have different effects on
behavior and health outcomes (Paykani et al., 2020).
In addition to social support, work also affects compliance with the use of masks.
Respondents WHO work more have higher activities outside the home which affects
compliance with the use of masks. Based on a survey conducted by the Central Statistics
Agency (2020), the reasons civil servants and non-civil servants do not comply with wearing
masks are that there are no sanctions if they do not apply health protocols (59%/53%), there
are no cases of COVID-19 sufferers in the surrounding environment (40%) /30%), work
becomes difficult if you have to apply health protocols (34%/32%), and the prices for masks,
face-shields, hand sanitizers or other protective equipment tend to be expensive (23%/24%)
and others (Tim BPS Covid-19 Statistical Task Force, 2020).
In addition to the income factor, the history of the COVID-19 vaccine also affects
compliance with the use of masks. The results of this study show that most respondents WHO
have not been fully vaccinated against COVID-19 tend to be less compliant with wearing
masks than those WHO have been vaccinated. This could be due to a lack of information
regarding COVID-19 and the vaccine itself. In addition, the information received is invalid or
a hoax. This is explained in the study of Nani Rahayu and Sensusiyati (2021) on the COVID-
19 vaccine in Indonesia.
This affects people's desire to be vaccinated (Rahayu, 2021). It was emphasized in the
survey of recipients of the COVID-19 vaccine in Indonesia by the Ministry of Health,
respondents expressed concerns about the safety and effectiveness of vaccines, expressed
distrust of vaccines, and questioned the halalness of vaccines. The most common reasons for
refusing the COVID-19 vaccine were related to vaccine safety (30%), doubts about the
effectiveness of the vaccine (22%), distrust of the vaccine (13%), concerns about side effects
such as fever and pain (12%), and reasons religious (8%). A small part of the community lowers
their awareness because they feel they have been protected by the COVID-19 vaccine and most
do not believe in vaccines (Kementerian Kesehatan RI, 2021)
Until now, 14.19% of people WHO have been fully vaccinated in Indonesia or 5,725,348
people, of the National targets for stages 1 and 2 are 40,349051. In NTT Province, there are
877,852 vaccine targets for stages 1 and 2, as many as 73,087 people WHO have been
Compliance with the Use of Mask in Young Adult Community Group in Kupang City
1657 Interdisciplinary Social Studies, 2(2), Nov 2022
vaccinated with dose 2 or complete vaccines (Kementerian Kesehatan RI, 2021). In this study,
243 people, or 61.5% of the 395 respondents were vaccinated in Maulafa District.
Until now, 14.19% of people WHO have been fully vaccinated in Indonesia or 5,725,348
people, of the National targets for stages 1 and 2 are 40,349051. In NTT Province, there are
877,852 vaccine targets for stages 1 and 2, as many as 73,087 people WHO have been
vaccinated with dose 2 or complete vaccines (Ministry of Health of the Republic of Indonesia,
2021). In this study, 243 people, or 61.5% of the 395 respondents were vaccinated in Maulafa
District.
In immunization, it is known as herd immunity or group (community) immunity. Herd
immunity is a situation where the majority of the community is protected/immune to certain
diseases, resulting in an indirect effect, namely the protection of community groups that are
not the target of immunization from the disease in question. So, if vulnerable groups such as
infants and toddlers are protected through immunization, then disease transmission in the
community will be controlled so that older age groups are also protected because of low disease
transmission (Kementerian Kesehatan RI, 2021). This condition can only be achieved with high
and even immunization coverage. Herd immunity is a situation where a large part of the
community is protected against certain diseases. Through herd immunity, there will be an
indirect impact, namely the protection of vulnerable groups of people who are not the target of
vaccination. This condition can only be achieved with high and equitable vaccination coverage
(Kementerian Kesehatan RI et al., 2020).
CONCLUSION
There is a simultaneous influence of social support variables, work, and history of COVID-
19 vaccine on adherence to the use of masks in young adults in Maulafa District, Kupang City.
g (x)=2.582+-2.521 X (supportive social support) +-3.222 X (Profession work) +-6.136
X_(vaccine history already) g (x)= 2.853, p= 0.55 Thus the probability of young adults to
compliance with wearing a mask is 55%. Based on the test results above, there is a simultaneous
influence between social support variables with a large effect of 0.080, occupation with a large
effect of 25,082 times, and a history of the COVD-19 vaccine with a large effect of 0.002 times
on adherence to the use of masks. Occupation is the most dominant variable, with a large effect
of 25,082 times on compliance with the use of masks. It is necessary to increase the provision
of media with counseling and promotion of COVID-19 disease, health protocols and the
importance of counseling about the COVID-19 vaccine in every health service facility that is
easily accessible to the public such as posters, leaflets, flipcharts or billboards in collaboration
with stakeholders to increase knowledge able to change people's views and behavior.Seeing
herd immunity that has not been achieved and the low level of community compliance, the
implementation of health protocols must be under stricter supervision, due to the large number
of young adults receiving the COVID-19 vaccine, so extra supervision is needed to maintain
health protocols, one of which is to continue to use masks when traveling or be outside the
house.
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