What Face Masks Teach Us About Behaviour Change

How do new ideas and practices take hold? And why do some practices that require behaviour change get adopted more quickly than others?

COVID-19 has meant we have all had to embark on some very significant changes to our lives:

  • Queuing to get into supermarkets.
  • More regular handwashing.
  • Not hugging or shaking hands with people we know or love.
  • Wearing masks in public.

Some of these have been adopted easily whilst others are more problematic and have faced resistance. Understanding how and why some get adopted without question and others don’t is crucial if you’re involved in innovation or change management.

Many of the very best innovations in history took a long time to catch on. The train, the personal computer, the mobile phone – things that have truly changed the world but were not accepted immediately, and faced huge resistance from doubters.

Some of the behaviour change required by COVID-19 has been adopted more easily than others because they build upon clear pre-existing norms.

Queuing to get into a supermarket was easily adopted in the UK – because the British are particularly good at queuing. Even to the extent of being obsessive about other countries not being good at it. Queuing seems to have become an established social norm in the early 19th Century, a product of more urbanised, industrial societies which brought masses of people together. But it wasn’t until World War II and rationing that Britain’s reputation as civilised queuers was established.

Handwashing as you enter a shop or bar builds upon an established norm common in medical environments.

Like most norms though – handwashing in hospitals wasn’t adopted quickly. Although washing with soap and water has been considered a measure of personal hygiene for centuries the link between handwashing and the spread of disease was established only a couple of hundred years ago. The physician Ignaz Semmelweis advanced the idea of “hand hygiene” in medical settings by observing that when students and doctors washed their hands with an antiseptic solution before examining women during childbirth, infection and maternal death fell by 90%.

A discovery like that would spread like wildfire surely?

Not so – Semmelweis attempted to spread these hand hygiene practices, even confirming his findings in a different hospital. But he was largely ignored, even derided, and died at the age of 47 in an asylum.

Whatever your transformation roadmap says some of the best and most sustainable change takes decades, not months, to achieve.

Some health workers have struggled to adopt consistent approaches to hand washing even up to the last few years. One of the most effective ways adoption was boosted was simply by making hand dispensers much more prevalent and available. People will change their behaviour if the effort involved is minimal. Taking this from medical settings and applying it in pubs and restaurants is a significant leap forward but one that is understandable to the public at large.

As Chris Bolton has written, COVID-19 will have all sorts of long term effects on behaviour change, and some unintended consequences. Will ritualistic hand washing as we enter shops and other establishments continue long after the virus has gone? We won’t know for a long time.

With any change our resistance is usually not overt, just passive. With passive innovation resistance we don’t resist a product but rather the change that the innovation requires us to make. By making the right thing to do much easier we can boost adoption and spread the change.

Which brings us to face masking.

Why is facemasking so controversial that people will organise rallies against wearing them or feel so passionately about them that they will change their Twitter profile picture to include one? One of the reasons masking is divisive is that it doesn’t build on any established norm. In the West at least, it flies in the face of them.

                                                                                 Masked up in Phnom Penh 2015

Back in 2015 I was travelling in a Tuk Tuk across a traffic clogged city in Cambodia. The driver pulled over , ran into a roadside shop and promptly presented us with two masks, saying we’d have a better journey wearing one. It was a simple act of kindness, of great customer service , rather than an enforced change. Little did we know that five years later we’d be wearing them in Sainsbury’s.

In parts of the East, face masking builds upon a long standing tradition. For instance, in Japan the custom of facemask-wearing began in the early 20th century, during the Spanish Flu epidemic. A few years later, the Great Kanto Earthquake of 1923, triggered an inferno that filled the air with smoke and ash for weeks, and air quality suffered for months afterward. A second global flu epidemic in 1934 cemented Japan’s love affair with the facemask, which then began to be worn with regularity during the winter months to prevent coughs and colds. Today masks are even worn by some young people as a fashion statement.

However as Jeff Yang writes, the predilection for face masks in public in Asia builds upon a tradition that goes much further back in time, into Taoism and the health precepts of Traditional Chinese Medicine, in which breath and breathing are seen as a central element in good health. The 2002 SARS outbreak and the 2006 bird flu panic, have seen face masking increase exponentially and without controversy, because it builds upon deep cultural beliefs.

In the West, no such cultural beliefs exist. Covering parts of your face is viewed as a suspicious act and has links with anti social behaviour and criminality. Additionally the adoption of face masking has been further complicated by the lack of something all change needs to succeed: a good story behind it.

The story of masking is inconsistent: first we were told they were of no use, then we were told they were good. The application of the story is also confusing: in England they are mandatory in shops, but at the weekend I popped over the border into Wales where they are not and people are free to do as they wish.

Queuing to get into shops is a simple leap for us to make.

You can argue about actual evidence all day long but inconsistent application and poor storytelling are hugely damaging to the adoption of new practice.

Washing hands as you enter a building is asking a bit more from us – but we kind of get it.

Wearing masks is a completely alien concept and therefore resistance is guaranteed.

And that’s the lesson to take back into our organisations and communities when we want to make change:

  • Try to build on existing cultural norms where possible.
  • Make it something that the community can adapt to without much effort.
  • Be consistent with your story telling about why change is needed in the first place.

Change only sticks when we understand the modern information ecosystem and have trusted communications with colleagues and communities.

Ultimately the innovation and change process begins and ends with one basic premise – listen first.

Related: COVID Accelerates Everything: Including Change Fatigue