Mask Up: Exploring Cross-Cultural Influences on Mask-Making Behavior During the COVID-19 Pandemic

Abstract

At the beginning of the COVID-19 pandemic, people from around the world made numerous homemade masks for themselves and their community due to shortage of medical masks as well as to stop the spread of COVID-19. The purpose of the current study was to conduct cross cultural exploration of the reasons for making masks, self-construal and wellbeing associated with masks making by collecting data from residents across US, India, and China. The finding of this study presented different reasons for making masks as well as self-construal, and wellbeing in people who made masks versus those who did not. Differences were also observed among three different cultural groups. This study offers a unique contribution to the public health research engaging in craft making related activities to gain a better perspective of the state of health of a population and the understanding of cross-cultural study of craft making behavior during the pandemic.

Keywords

homemade mask pandemic self-construal wellbeing

During the COVID-19 pandemic, US health officials urged people around the world to start making their own homemade cloth masks in order to protect themselves and others (Barth, 2020). In the early days of the coronavirus pandemic, the US Centers for Disease Control (CDC) and World Health Organization (WHO) did not encourage people to wear masks unless they were sick or were a medical professional (Eyal, 2020). With COVID-19 cases soaring and severe shortage of masks for medical professionals at that time, both CDC and WHO’s intentions were to prevent non-frontline workers from buying masks (Eyal, 2020). However, countries around the world including parts of Asia encouraged their citizens to wear masks, including homemade ones, in public (Servick, 2020). In China, with a population of over 1.4 billion, making DIY masks quickly provided additional masks to make up for the shortage of commercial masks (Pinghui, 2020).

With increased numbers of COVID-19 positive cases and deaths recorded daily in April 2020, the Indian government recommended their people to wear homemade masks in densely populated areas across the country. The government also put out detailed instructions for DIY face masks that can be made from available fabric at home (Gunasekar & Baruah, 2020). Similarly, starting March 2020, volunteers around the United States stepped up to make homemade masks for medical professionals and heath care workers due to a national shortage of Personal Protective Equipment (PPE) (Kaur & Luhby, 2020). Hospitals, sewing groups, and fabric craft stores across the country released video tutorials and instructions on how to make face masks. Although mask use in public were controversial at beginning of the pandemic, starting April 2020, the US CDC recommended the public to wear cloth masks rather than the N95 masks and reserve the latter for frontline workers (Eikenberry et al., 2020). Eventually, detailed instructions on making homemade masks were also available through the US CDC website (“How to Make,” 2020).

Globally, at the beginning of the COVID-19 pandemic, homemade masks became popular among crafters, sewers, or anyone who had time and enjoyed hands-on activities. People stepped up and made numerous homemade masks for themselves and their community. Universal reasons for making homemade masks among people from different countries seemed clear and understandable: shortage of surgical and N95 masks as well as stopping the spread of COVID-19. Despite the global need for homemade masks during the pandemic, no studies explored and compared ones’ personal reasons and self-construal, namely, their beliefs about self particularly with respect to their relation to others, as well as their wellbeing associated with mask-making across different countries. Three countries, India, China, and the United States were chosen for this study because these countries exhibit different cultural values (US representing an individualistic culture and China and India representing collectivistic cultures) (Hofstede, 2001). Between these two Asian countries, China faced the pandemic at a much earlier stage than India did. In addition, these three countries represent some of the world’s highest number of positive cases of COVID-19 (COVID-19 Map, 2020).

Previous studies have examined the psychological benefits of “making” behavior and identified that “crafting can provide satisfaction, optimism, social support, and a way to effectively cope with negative feelings (S. H. Pöllänen, 2015b) as well as to improve wellbeing (S. Pöllänen, 2015a) and reduce stress (Adams-Price & Steinman, 2007)” (as cited in Collier & Wayment, 2018, p. 2017). In addition, previous studies have suggested that making something enables people to cope with everyday emotional worries and concerns by discovering the joy, pride, and achievement associated with hands-on activities (Collier, 2011; S. H. Pöllänen, 2015b). Although previous studies have shown that there are significant psychological benefits and positive wellbeing associated with makers’ behavior and textile making behaviors (Collier & Von Károlyi, 2014; Collier & Wayment, 2018), no studies have identified how mask-making behavior influences people’s wellbeing, namely affect and anxiety, and how different cultural values such as self-construal influence cross-cultural mask-making behaviors during the pandemic. Therefore, the purpose of this study was to conduct cross-cultural exploration of personal reasons for making masks, self-construal, and wellbeing associated with mask-makers and non-mask-makers by collecting data from residents across US, India, and China.

Literature Review

Self-Construal

Self-construal refers to a collection of thoughts, feelings, and actions regarding one’s relationship to others (Singelis, 1994). Individuals can view themselves as valuing independent self-construal or interdependent self-construal depending on their roles and positions in the society (Singelis, 1994). People from individualistic cultures are more concerned with individuals’ needs, and mainly focus on oneself and one’s immediate family or group. In contrast, people from collectivistic cultures are more concerned with “others” and emphasize group goals rather than one’s individual goal (Hofstede, 2001). People with an independent self-construal are more likely to emphasize intrinsically oriented goals (i.e., personally oriented values), whereas people with an interdependent self-construal are more likely to emphasize extrinsically oriented goals (i.e., socially oriented values) (Y. Kim et al., 2003). Self-construal varies across cultures and within cultures. Before digital technologies advanced our world with connectivity, inclusion, and accessibility, people in Western and individualistic cultures used to mostly value independent self-construal more, whereas people in Eastern and collectivistic cultures valued interdependent self-construal more (Markus & Kitayama, 1991).

However, recent studies demonstrated that within a given culture, people might value either independent or interdependent self-construal to various degrees in different situations and that no distinct differences exist between Eastern and Western cultures in terms of self-construal measures (Harb & Smith, 2008; Krishna et al., 2008; H. S. Park & Ahn, 2008). When Hahn et al. (2013) explored different patterns and reasons for textile-making between three generations in the Korean culture (non-Western and traditionally a collectivistic culture), they found that contemporary younger Korean adults presented more independent self-construal compared to middle- and older-aged Korean women. Although self-construal can vary by situation, which determines how a person behaves and experiences an event or activity (Kwang, 2005), people with higher independent self-construal tend to be more sensitive and responsive to events that emphasize their personal roles, feelings, and thoughts and such sensitivity can sometimes have a positive influence on creative behavior (H. S. Kim & Markus, 1999; Kwang, 2005). On the other hand, people with higher interdependent self-construal are more accustomed to events revolving around social interactions and collective activities (Marian & Kaushanskaya, 2004; Wang & Ross, 2005).

Although researchers have not specifically examined the relation between self-construal and mask-making, Schofield-Tomschin and Littrell (2001) identified that craft-making enables makers to gain self-actualization and achieve personal goals and needs. Their study also found that craft-making processes provide identity, therapy, and creativity to individual crafters and that their association with a craft social group such as sewing guild provide them with learning, sharing, motivation, and identity formation opportunities. In the absence of research related to mask-making, it would be interesting to find out how mask-making relates to self-construal in different countries. By exploring independent and interdependent self-construal in the current study, we hope to gain valuable information about why individuals engage in mask-making behavior during the pandemic among those in the United States, India, and China.

Reasons for Making Masks

At the beginning of the coronavirus pandemic, the major impetus behind making masks at home was shortage of surgical and N95 masks as well as preventing the spread of the virus. While in-depth studies regarding specific reasons for making masks during the pandemic are hard to find, a few studies on textile handcrafters and sewing guilds demonstrated that the main reasons for textile handcrafters to engage in making are self-fulfillment, aesthetics, and enjoyment. Financial impetus was the least likely reason and most of textile handcrafters made things to give away or for personal collection/use (Collier, 2011; Schofield-Tomschin & Littrell, 2001). Other reasons for engaging in craft-making included therapy, creativity, and intellectual stimulation (Collier, 2011; Schofield-Tomschin & Littrell, 2001). However, little is known about personal reasons behind making masks during COVID-19. Thus, this study will explore these reasons from people across the three different countries.

Wellbeing and Craft-Making Activities

Craft-making refers to making practical and/or decorative items by hand or using hand-controlled machines or tools (Gardner, 1990), and thus can include mask-making at home. Previous studies have demonstrated that craft-making activities increase one’s wellbeing and potentially reduces psychological discomfort, depression, and anxiety especially during the periods of significant stress (Bailey & Fernando, 2012; Collier, 2011). According to S. Pöllänen (2015a), craft-making activities enhance one’s wellbeing by providing a sense of achievement, feeling of success, personal growth as well as development of physical and cognitive skills. Furthermore, craft-making activities enable makers to feel grounded, cope with different emotions, and solve problems especially during difficult times such as illness, depression, divorce, unemployment, and illness or death of a loved one (Collier, 2011; Johnson & Wilson, 2005; S. Pöllänen, 2015a). Under stressful times and situations, makers use craft as a means of self-protection to escape from their everyday lives and push away negative feelings by engaging in the physical activity and gaining a sense of control (Collier, 2011; Johnson & Wilson, 2005; S. Pöllänen, 2015a; S. H. Pöllänen, 2015b). It provides makers with a sense of pride in their skills and self-achievement as well as the feeling of psychological empowerment while enjoying a self-imposed activity (S. H. Pöllänen, 2015b).

These findings related to crafting and wellbeing are particularly applicable to mask-making during COVID-19. Since COVID-19 was declared a pandemic on March 11, 2020 (Bao et al., 2020), many countries around the world instructed their citizens to quarantine themselves at home and to practice “physical or social distancing,” which caused significant stress to some people (Bao et al., 2020). A recent survey study from China showed that 8.1% (∼112 million) people living in China reported moderate-to-severe stress levels during the COVID-19 pandemic (Ahmed et al., 2020). Another nationwide survey among Italians reported 27.2% participants experienced high-to-very high levels of psychological distress during the pandemic (Mazza et al., 2020). The authors found that higher levels of depression, anxiety, and stress were associated with females, negative affect, and feelings of detachment. As shown in previous research, craft-making activities such as mask-making could have been used as a means to manage and reduce stress during the COVID-19 pandemic. Therefore, it would be interesting to explore if citizens engaged in mask-making activities during the stressful COVID-19 pandemic reported more positive indicators of mental wellbeing compared to those who did not make masks. Two indicators of mental wellbeing were used in this study: affect and anxiety.

Affect

Affect refers to the emotions or feelings that people experience and display and how such emotions influence them to act and make decisions. Positive affect refers to positive emotions and expression, including cheerfulness, pride, enthusiasm, energy, and joy. Negative affect refers to negative emotions and expression, which include sadness, disgust, lethargy, fear, and distress (Lopes et al., 2020). According to Lopes et al. (2020), people with a positive state of mind are less likely to get sick compared to those with a negative state of mind. By the same token, a positive state of mind not only affects physical health but also helps cope with stressful events (Su et al., 2014). Positive and Negative Affect Scales (PANAS) (Watson et al., 1988) have been used extensively in the field of psychological wellbeing research.

Anxiety

Anxiety, another measure of mental well-being, is defined as “an unpleasant feeling of fear and apprehension, characterized by discomfort derived from anticipating danger” (Allen et al., 1995, p. 976). Anxiety becomes recognized when it reaches an extreme level, which interferes with one’s quality of life, and may negatively influence one’s ability to function on a daily basis (Su et al., 2014). Anxiety can also be a symptom of depression and the second leading cause of death by suicide among young people aged 15–19 according to the World Health Organization (WHO) (Su et al., 2014). In relation to the COVID-19 pandemic, a study done by the Chinese Psychology Society in February 2020 found that 42.6% of people screened tested positive for symptoms of anxiety (Wiederhold, 2020). Even in the United States, there has been a spike in phone calls to the National Alliance on Mental Illness. Also, Mental Health America reported that the rate of completion of its online anxiety self-screening tests has increased significantly (19%) between the beginning and end of February of 2020 (Bao et al., 2020).

Based on previous research on how craft-making helps individuals cope with difficult emotions and situations, examining affect and anxiety level of those individuals who made or did not make masks is a good indicator to measure the wellbeing of individuals. It is also clear during this global pandemic, people from all over the world have been engaged in similar activities of making masks for various reasons. Thus, the current study was designed to answer the following research questions: (1) Are personal reasons of mask-making different among individuals in three countries, the United States, India, and China? (2) Does self-construal of mask-makers versus non-mask-makers differ among those in the three countries? and (3) Does the wellbeing (affect and anxiety) of mask-makers versus non-mask-makers differ among those in the three countries?

Method

Study Design and Participant Selection

An online survey was designed for the study. Adult participants were recruited by a market-based research firm (Qualtrics) and the survey was distributed to their chosen sample using their own online platform during June 2020. Participants were residents of one of the three countries: the United States (n = 320), China (n = 296), and India (n = 312). The three countries were selected based on two reasons. First, traditionally the United States represents an individualist culture, while China and India represent collectivist cultures (Hofstede, 2001). Although self-construal can vary within a culture (Harb & Smith, 2008), culture influences individuals’ perceptions of self-construal (DeAndrea et al., 2010), and thus it was imperative to identify countries that portray different cultures. Second, these three countries represent major outbreaks for COVID-19 with some of the world’s highest number of cases (COVID-19 Map, 2020), with China having started the outbreak much earlier than India and the United States. Although previous researchers have reported that sewers across the world have been primarily women (Collier, 2011), this study employed both male and female participants for two major reasons. First, COVID-19 pandemic impacted all genders and as a result, everyone was encouraged to make/wear masks for personal protection. Second, although women were traditionally involved in home sewing, social media and other channels provided abundant examples of how to make “no-sew” masks, such as using bandanas, old t-shirts, etc. to enable and mobilize every individual into making and wearing masks.

Within each country, a quota was imposed to get equal numbers of mask-makers and non-mask-makers. Mask-makers were those who made any mask for use as a personal protective equipment during COVID-19 pandemic. No other restriction was placed on participant recruitment criteria because people from all backgrounds in these countries were affected by COVID-19. This was purposefully done to allow for variation in the sample characteristics, which contributes to external validity and generalizability of the study findings.

The surveys were administered in English for the United States and India. For China, the survey was translated into Mandarin by one native Chinese speaker conversant in both English and Mandarin and cross-checked for accuracy by one additional Chinese speaker conversant in both languages. Finally, the survey was proofread by one of the researchers who has intermediate knowledge of Mandarin and proficiency in English.

Measures

Reasons for making masks were measured using 23 items, on a 5-point rating scale (1: Not at all important, 5: Extremely important), adapted from Collier’s (2011) study on reasons for making textile handcrafts. Positive and negative affect were measured using 20 items from the Positive and Negative Affect Schedule Short Form (PANAS-SF) on a 5-point rating scale (1: very slightly/not at all, 5: extremely). This survey tool has excellent validity, stability, reliability, and cross-cultural factorial invariance (Thompson, 2007). Ten of the items were for positive affect, while the remaining 10 were for negative affect. Self-construal was measured using 23 items (Singelis, 1994) on a 7-point Likert type scale (1: Strongly Disagree, 7: Strongly Agree). Twelve of the items measured interdependent self-construal, while the remaining 11 items measured independent self-construal. Finally, anxiety was measured using 7-items from the Generalized Anxiety Disorder (GAD-7) (Spitzer et al., 2006) on a 4-point rating scale (0: Not at all sure to 3: Nearly every day). See Table 1 for scale items.

Table 1.

Measures Used for the Study.

Reasons for Making Masks (Collier, 2011 )

Having a sense of community. ^D

Puts me in a better mood. [S]

I like to reuse and recycle. [S]

I want to take a more active role in my life. [S]

Allows me to make what I need or what I want. [S]

Economic necessity. [F]

It allows me to live a simpler life. [S]

Frugality [F]

Anti-consumption mentality. [S]

I like to make things for others. [S]

I just enjoy the process. ^D

It keeps my hands busy. [S]

It helps my physical health. [S]

Need for customization. [A]

It is a good distraction from problems. ^D

Lack of product quality available in the market. [A]

Fulfillment of craftsmanship/craftswomanship. [A]

Empowerment ^D

Need for uniqueness. [A]

Lack of product availability. [A]

I have time. [A]

I enjoy the sensations, such as the feel, touch, visuals, etc. ^D

It is a historical marker, it creates memories. [A]

Self-Construal (Singelis, 1994)

I have respect for the authority figures with whom I interact. [T]

It is important for me to maintain harmony within my group(s). [T]

My happiness depends on the happiness of those around me. [T]

I will sacrifice my self-interest for the benefit of my group(s). [T]

I would offer my seat in a bus to an older person. ^D

I respect people who are modest about themselves. [T]

I often have the feeling that my relationships with others are more important than my own accomplishments. [T]

It is important to me to respect decisions made by my group(s). [T]

I will stay in group(s) if they need me, even when I’m not happy with the group(s). [T]

If my brother, sister, or child fails at something, I feel responsible. [T]

I should take into consideration my groups’ advice when making decisions about my future. [T]

Even when I strongly disagree with my group(‘s) members, I avoid an argument. [T]

I’d rather say “No” directly, than risk being misunderstood. [I]

I feel comfortable using someone’s first name soon after I meet them, even when they are much older than I am. [I]

I prefer to be direct and forthright when dealing with people I’ve just met. [I]

I enjoy being unique and different from others in many respects. [I]

My personal identity independent of others is very important to me. [I]

Speaking up during a class or a public setting is not a problem for me. [I]

Having a lively imagination is important to me. [I]

I am comfortable with being singled out for praise or rewards. [I]

I act the same way no matter who I am with. [I]

I am the same person at home that I am at work. [I]

Being able to take care of myself is a primary concern for me. [I]

Positive and Negative Affect Scale (Watson et al., 1988 )

Indicate the extent you have felt this way over the past week:

1. Interested

2. Distressed

3. Excited

4. Upset

5. Strong

6. Guilty

7. Scared

8. Hostile

9. Enthusiastic

10. Proud

11.Irritable

12. Alert

13. Ashamed

14. Inspired

15. Nervous

16. Determined

17. Attentive

18. Jittery

19. Active

20. Afraid

Anxiety (Generalized Anxiety Disorder 7-item (GAD-7) scale)

Over the last 2 weeks, how often have you been bothered by the following problems?

1. Feeling nervous, anxious, or on edge.

2. Not being able to stop or control worrying.

3. Worrying too much about different things.

4. Trouble relaxing.

5. Being so restless that it’s hard to sit still.

6. Becoming easily annoyed or irritable.

7. Feeling afraid as if something awful might happen

Note. ^D Represents items deleted from final analyses. [S] represents items loaded on to self-fulfillment reason, [A] on to aesthetic, [F] on to financial. For self-construal, [T] represents items loaded on to interdependent self-construal and [I] on independent self-construal.

Data Analyses

Descriptive analyses of the study data were conducted to examine respondent demographics. Principal component analysis (PCA) was conducted to determine the underlying dimensions of participants’ reasons for making masks, affect, self-construal and anxiety. To answer our research questions, three-group MANOVA followed by multiple one-way ANOVAs was conducted to understand the differences (if any) in reasons for mask-making among mask-makers across the three countries (US/India/China). Next, 2 (mask-making: mask-makers/ non-maskers) × 3 (country: US/India/ China) MANOVA followed by multiple one-way ANOVAs was conducted to test the difference (if any) between mask-makers and non-mask-makers in affect, self-construal and anxiety across the three countries.

Results

Respondent Characteristics

Among all respondents, 160 U.S. respondents (50%, out of 320), 161 Chinese respondents (51.6%, out of 312), and 163 Indian participants (50.9%, out of 320) indicated that they made masks for protection of themselves or their family members during COVID-19 outbreak. See Table 2 for detailed demographic information of the respondents from the three countries.

Table 2.

Demographic Characteristics of Participants (USA: n = 320; China: n = 312; India: n = 320).

		USA	China	India
Variable	Levels	Frequency (%)	Frequency (%)	Frequency (%)
Age	18–20	10 (3.1)	23 (7.4)	23 (7.2)
	21–30	78 (2.4)	101 (32.4)	101 (31.6)
	31–40	98 (30.6)	76 (24.4)	76 (23.8)
	41–50	56 (17.5)	50 (16.0)	50 (15.6)
	51–60	33 (10.3)	45 (14.4)	45 (14.1)
	61 and over	45 (14)	25 (8.0)	17 (5.3)
Gender	Male	126 (39.4)	217 (69.6)	223 (69.7)
	Female	193 (60.3)	95 (30.4)	97 (30.3)
	Other	1 (0.3)
Ethnicity*	Caucasian	222 (69.4)	—	—
	Hispanic	29 (9.1)	—	—
	African-American	44 (13.8)	—	—
	Asian	19 (5.9)	—	—
	Other	4 (1.3)	—	—
Education	Some high school	10 (3.1)	2 (0.6)	2 (0.6)
	High school degree	86 (26.9)	17 (5.4)	18 (5.6)
	Some college	80 (25.0)	27 (8.7)	27 (8.4)
	College degree	107 (33.4)	120 (38.4)	126 (39.4)
	Graduate degree	34 (10.6)	123 (39.4)	124 (38.8)
	Other	3 (0.9)	23 (7.4)	23 (7.2)

Note. * Ethnic information was not collected for Chinese and Indian participants as both countries are relatively ethnically homogeneous

Principal Component Analyses and Scale Reliability Tests

Principal component analyses (PCA) were conducted to determine the underlying dimensions of participants’ reasons for mask-making, self-construal, affect and anxiety. PCA with oblique rotation using eigenvalue larger than 1 revealed three principal components for reasons for mask-making (81.73% of total variance explained). Five items were removed due to low factor loadings or cross-loadings. Of the remaining items, 11 loaded on self-fulfillment (factor loadings: 1.03–0.51), six on aesthetic need (factor loadings: 0.96–0.92), and two items on financial need (factor loadings: 0.92, 0.81). For self-construal, PCA revealed two factors (42.3% of total variance explained). One item was deleted due to low factor loading (factor loading: 0.37). Of the remaining items, 12 loaded on interdependent self-construal (factor loadings: 0.76–0.42), and 10 items loaded on independent self-construal (factor loadings: 0.76–0.45). The deleted item asked participants if they would offer their seat on a bus to an older person, which may not have resonated with the U.S. participants, many of whom do not frequently use public transport. For affect, PCA revealed two factors (58.36% of total variance explained). Ten items loaded on one factor for positive affect (factor loadings: 0.74–0.52), and 10 items loaded on another factor for negative affect (factor loadings: 0.85–0.70). Finally, all seven items for anxiety loaded on one factor (68.77% of total variance explained; factor loadings: 0.86–0.80). Reliabilities (Cronbach’s α) of the scales were as follows: reasons for mask-making (self-satisfaction = 0.97, aesthetic need = 0.97, financial need = 0.86), self-construal (interdependent = 0.86; independent = 0.84), affect (positive = 0.88, negative = 0.97), and anxiety = 0.93. See Table 1 for measures used in this study and specific items that loaded on each factor.

Reasons for Mask-Making: Cultural Differences

To answer research question 1 (whether personal reasons of mask-making are different among individuals in the three countries, the United States, India, and China), three-group MANOVA testing the effect of country on reasons for mask-making was conducted. Box’s M test was significant, indicating violation of the assumption (Box’s M = 30.01, p < .001). However, because of the large total sample size (n = 484) and high observed power (1.0), Pillai’s Trace (a more robust measure than Wilks’ Lambda) was used for MANOVA. Results indicated that reasons for mask-making differed significantly across the three countries (F [6, 956] = 149.34, p < .001, partial eta sq. = 0.48). To probe statistically significant multivariate effects, three one-way ANOVAs were conducted. Results indicated significant direct effects of country on all three reasons for mask-making: self-fulfillment (F [2,479] = 263.79, p < .001), aesthetic (F [2,479] = 871.19, p < .001), and financial (F [2,479] = 131.17, p < .001). The reason of self-fulfillment was highest for the Chinese (mean = 5.80, S.D. = 1.00), followed by Indians (mean = 4.06, S.D. = 0.76) and U.S. participants (mean = 3.63, S.D. = 0.92). The aesthetic reason was highest for Indians (mean = 3.96, S.D. = 0.79), followed by U.S. participants (mean = 3.64, S.D. = 0.91) and the Chinese (mean = 3.30, S.D. = 0.77). Finally, the financial reason was highest for the Chinese (mean = 5.53, S.D. = 1.61), followed by Indians (mean = 3.72, S.D. = 0.99) and U.S. participants (mean = 3.50, S.D. = 1.01).

Self-construal and Wellbeing: Cultural Differences Between Mask Makers and Non-Mask Makers

To answer research questions 2 and 3, that is, whether self-construal (RQ2) and wellbeing (RQ3) of mask-makers versus non-mask-makers differed among three different countries, 2 (mask-making: mask-makers/non-mask-makers) × 3 (country: US/India/ China) MANOVA was conducted to test the difference (if any) between mask-makers and non-mask-makers in affect, self-construal, and anxiety across the three cultures. Box’s M test was significant, indicating violation of the assumption (Box’s M = 698.09, p < .001). However, because of the large total sample size (n = 952) and high observed power (1.0), further analyses for MANOVA were conducted using Pillai’s Trace (a more robust measure than Wilks’ Lambda). MANOVA results indicated that participants’ self-construal, affect, and anxiety differed significantly between mask-makers and non-mask-makers in general [F (5, 943) = 12.34, p < .001, partial eta sq. = 0.06]. In addition, the variables also differed among the three countries, irrespective of the mask-making group [F (10, 1888) = 146.07, p < .001, partial eta sq. = 0.44]. Further, there was an interaction effect between country and mask-making group [F (10, 1888) = 0.57, p < .001, partial eta sq. = 0.29].

Self-construal

To probe statistically significant multivariate effects, multiple two-way ANOVAs were conducted. First, there were significant differences in both interdependent (F [1,947] = 20.22, p < .001) and independent (F [1,947] = 9.44, p < .001) self-construal between mask-makers and non-mask-makers for all three countries combined. Interdependent self-construal was higher for participants who made masks (mean = 5.51, S.D. = 1.16) compared to non-mask-makers (mean = 5.22, S.D. = 1.03). Independent self-construal was also higher for participants who made masks (mean = 5.28, S.D. = 1.07) compared to non-mask-makers (mean = 5.05, S.D. = 0.95). Both interdependent (F [1,947] = 118.40, p < .001) and independent self-construal (F [1,947] = 16.49, p < .001) were also significantly different among participants across the three countries. Interdependent self-construal was highest for participants from China (mean = 5.92, S.D. = 0.79), followed by those from India (mean = 5.43, S.D. = 1.03), and least for U.S. participants (mean = 4.74, S.D. = 1.14). Similarly, independent self-construal was highest for participants from China (mean = 5.37, S.D. = 0.67), followed by those from India (mean = 5.21, S.D. = 1.14), and least for U.S. participants (mean = 4.92, S.D. = 1.14). There were also interaction effects of mask-making group and country on both interdependent (F [2,947] = 3.05, p = .05) and independent (F [2,947] = 9.60, p < .001) self-construal. Interdependent self-construal was highest for mask-makers in China (mean = 5.95, S.D. = 0.91), and lowest for non-mask-makers in the United States (mean = 4.53, S.D. = 0.97). Independent self-construal was highest for mask-makers in India (mean = 5.47, S.D. = 1.17), with a similar mean for non-mask-makers in China (mean = 5.44, S.D. = 0.58), and lowest for non-mask-makers in the United States (mean = 4.78, S.D. = 1.03).

Positive and negative affect

There were significant differences in both positive (F [1,947] = 27.00, p < .001) and negative (F [1,947] = 35.87, p < .001) affect between mask-makers and non-mask-makers. Positive affect was higher for participants who made masks (mean = 4.23, S.D. = 1.11) compared to non-mask-makers (mean = 3.98, S.D. = 1.23). Negative affect was also higher for participants who made masks (mean = 3.44, S.D. = 1.42) compared to non-mask-makers (mean = 3.15, S.D. = 1.44). Further, both positive (F [2,947] = 652.53, p < .001) and negative affect (F [2,947] = 1138.91, p < .001) were also significantly different among participants across the three countries. Positive affect was highest for participants from China (mean = 5.23, S.D. = 0.65), followed by those from India (mean = 3.85, S.D. = 0.73), and least for U.S. participants (mean = 3.17, S.D. = 0.92). Similarly, negative affect was highest for participants from China (mean = 4.98, S.D. = 0.54), followed by those from India (mean = 2.54, S.D. = 0.93), and least for U.S. participants (mean = 2.35, S.D. = 0.86). There were also interaction effects of mask-making group and country on both positive (F [2,947] = 6.55, p = .001) and negative (F [2,947] = 4.46, p = .012) affect. Positive affect was highest for mask-makers (mean = 5.30, S.D. = 0.73) in China, and lowest for non-mask-makers in the United States (mean = 2.94, S.D. = 0.93). Negative affect was highest for mask-makers in China (mean = 5.02, S.D. = 0.58) and lowest for non-mask-makers in the United States (mean = 2.16, S.D. = 0.77).

Anxiety

There was no significant difference in anxiety (F [1,947] = 3.13, p = .077) between mask-makers and non-mask-makers. Anxiety was only slightly higher for participants who made masks (mean = 2.56, S.D. = 0.84) compared to non-mask-makers (mean = 2.48, S.D. = 0.95). However, anxiety (F [2,947] = 246.90, p < .001) was significantly different among participants across the three countries. Anxiety was highest for participants from China (mean = 3.25, S.D. = 0.51), followed by those from India (mean = 2.18, S.D. = 0.72), and least for U.S. participants (mean = 2.13, S.D. = 0.91). There was also an interaction effect of mask-making group and country on anxiety (F [2,947] = 10.41, p = .001). Anxiety was highest for non-mask-makers (mean = 3.36, S.D. = 0.43) in China, and lowest for non-mask-makers in U.S. participants (mean = 1.97, S.D. = 0.92). Interestingly, while anxiety was lower for non-mask-makers compared to mask-makers in the United States and India, it was the reverse in China. See Figure 1 for other detailed mean differences.

Figure 1.

ANOVA group means for self-construal, affect, and anxiety for Mask-Making × Country.

Post-Hoc Analyses Using Gender

Given that this is one of the few studies to incorporate both genders, post-hoc tests were conducted to test gender-based differences (if any) on participant responses. Two group (male/female) independent sample t-tests were conducted for each country. There were no mean differences on any of the dependent variables for India (p: 0.27–0.73) or China (p: 0.27–0.90). However, for participants in the United States, significant mean differences existed between mask-makers and non-mask-makers in the aesthetic reason for mask-making (p = 008). The aesthetic reason for mask-making was higher for males (mean = 3.86, S.D. = 0.86) than for females (mean = 3.47, S.D. = 0.92). Further, there were significant differences in positive affect (p < .001), interdependent self-construal (p = .005), and independent self-construal (p < .001). Male participants, compared to female participants, had higher positive affect (male: mean = 3.45, S.D. = 0.96; female: mean = 2.99, S.D. = 0.83), higher interdependent self-construal (male: mean = 4.96, S.D. = 1.21; female: mean = 4.61, S.D. = 1.03), and higher independent self-construal (male: mean = 5.25, S.D. = 1.16, female: mean = 4.73, S.D. = 1.04).

Discussions

This research investigated reasons for civilians to make masks for themselves and/or their friends and family during the COVID-19 outbreak. It also looked at how mask-makers and non-mask-makers differed in terms of their self-construal and their wellbeing, namely affect and anxiety. Analyses were conducted across three different countries: the United States, India, and China. The results on gender indicated that for China and India, there were no differences based on gender. For the United States, although there were gender differences, the relationships between dependent and independent variables were still in the same direction, which indicates overall general support for the relations investigated in this study.

It is worth noting that participants across the three countries differed in their reasons for mask-making during COVID-19 outbreak, and financial reasons were ranked the lowest among three countries despite the shortage of face masks for purchase. It is possible that many crafters around the world have made masks for themselves or to donate to others rather than for financial reasons (Haggerty, 2020). In addition, fabric masks were not available for sale commercially, and hence financial motivation behind making such masks may have been weak. It is also interesting to note that for all three countries, self-fulfillment was the most important reason for making masks. This is consistent with previous research findings (Collier, 2011; Schofield-Tomschin & Littrell, 2001) that craft makers engage in making activities to gain self-actualization, achieve psychological fulfillment, and express oneself. Self-fulfillment reason was ranked the highest for both Chinese and Indian mask makers, but the second highest ranked reason was different between two countries. U.S. mask-makers did not portray much difference in three reasons of making masks (i.e., self-fulfillment, aesthetic, and financial reasons) but their overall means were lower than other countries. It is possible that these different responses were due to notably different perceptions of mask wearing and behavior. In China and India, mask wearing behavior has been a common recommendation to prevent viruses even before COVID-19 since the SARS outbreak in 2003 and the bird flu epidemic in 2004 (Cheung, 2020).

Second, the results showed that mask-makers versus non-mask-makers differed in their self-construal, and such differences were also observed across the three countries. This is consistent with recent studies that within a given culture, people might value either independent or interdependent self-construal to varying degrees under different situations and there are no distinct differences between Eastern and Western cultures in terms of self-construal measures (Harb & Smith, 2008; Krishna et al., 2008; H. S. Park & Ahn, 2008). This was particularly interesting to note as the COVID-19 pandemic provided a unique situation related to social/physical interactions. Literature suggests that people with higher independent self-construal tend to be more sensitive and responsive to an event that emphasizes their personal roles, feelings, and thoughts and such sensitivity can sometimes have a positive influence on creative behavior (H. S. Kim & Markus, 1999; Kwang, 2005). On the other hand, people with higher interdependent self-construal are more accustomed to events revolving around social interactions and collective activities (Marian & Kaushanskaya, 2004; Wang & Ross, 2005). Given that the spread of COVID-19 is largely attributed to social/physical interactions, making masks as a personal protective gear not only allowed participants to protect them during social interactions (thereby catering to interdependent self-construal) but also as a way to express their personal self and creativity (thereby catering to independent self-construal). The study results found that self-construal for mask-makers versus non-mask-makers differed across countries. Interdependent self-construal was highest for mask-makers in China and lowest for non-mask-makers in the United States. This is consistent with the previous cross-cultural studies where people from non-Western cultures expressed higher interdependent self-construal, compared to people from Western cultures (Markus & Kitayama, 1991). However, independent self-construal was highest for mask-makers in India and much lower for non-mask-makers in the United States. This result could be explained by recent studies demonstrating people might present either independent or interdependent self-construal within one culture based on different situations and no distinct differences exist between Eastern and Western cultures in terms of self-construal measures (Harb & Smith, 2008; Krishna et al., 2008; H. S. Park & Ahn, 2008).

Third, differences were observed in both positive and negative affect between mask-makers and non-mask-makers. Both affects were higher for mask-makers compared to non-mask-makers. It is possible that when people feel overwhelmed and emotionally charged, they might react both strongly positively or negatively to certain situations and engage in mask-making behaviors as a way to release their emotions and to distract themselves from stress or reality (Luckman, 2018). Although it was beyond the scope of this study, it is possible that Chinese participants might have higher levels of affect as they have experienced the pandemic longer and struggled to deal with emotions more, compared to other countries. In this light, Ahmed et al.’s study (2020) found much higher rates of anxiety, depression, alcohol consumptions and lower mental well-being than usual among Chinese people due to the COVID-19 outbreak. Thus, it can be assumed that the prolonged lockdown might have some impact on both positive and negative psychological status of Chinese people compared to other two countries.

Unlike affect, there was no significant difference in anxiety between mask-makers and non-mask-makers. It was expected, based on wellbeing and craft-making behavior from previous research (Bailey & Fernando, 2012: Collier, 2011), that mask-makers present lower anxiety levels; however, our study presented contradicting results. Although Chinese mask-makers presented lower anxiety levels compared to non-mask-makers, mask-makers from the United States and India did not necessarily portray lower anxiety levels as we anticipated. Therefore, future studies may explore underlying factors affecting anxiety during COVID-19 outbreak, other than mask-making.

Implications

Two distinctive findings from our study are: (1) U.S. mask-makers’ overall ratings of reasons were lower than those of other two groups, and (2) the higher levels of both independent and interdependent self-construal were observed among mask-makers. These two findings reflect how mask-making behavior is intertwined with the nature of COVID-19 pandemic revolving around social interactions and expression of personal self and creativity. It also highlighted differences in people’s perception around making and wearing masks and how their behavior differed across countries. The different reasons of mask-making as well as different self-construal levels observed across three different countries also exhibited both social/psychological status of society in the world and people’s perceptions of mask-wearing during the pandemic. Before the digital technology revolution, people in Western and individualistic cultures tended to value independent self-construal more, whereas people in non-Western and collectivistic cultures tended to value the interdependent self-construal more (Markus & Kitayama, 1991). With the current digital revolution, people from individualist culture are transitioning to valuing interdependent self-construal due to rampant use of social media that enhances connectivity, inclusion, and accessibility with others. The result of our study reflects that current trend.

Lastly, our study did not show that mask-making behavior necessarily improved one’s wellbeing, unlike the findings of previous research on craft-making and wellbeing (e.g., Bailey & Fernando, 2012; Collier, 2011). Higher levels of both positive and negative affect as well as anxiety were found among people who made masks. It is possible that people were inclined to engage in mask-making behavior during the pandemic due to already high levels of psychological status (both negative and positive) and thus mask-making was a way to feel grounded and to cope with different emotions (S. Pöllänen, 2015a). Although this study was not able to find direct relationships between mask-making behavior and positive psychological benefits, some of the significant differences found among the three countries warrant further investigation on the impact of mask-making behavior on one’s wellbeing. In line with previous studies, our research found that craft-making activities were associated with one’s mental wellbeing. Craft-making, including mask-making, not only provides a sense of fulfillment and enjoyment, but also serves as an outlet for releasing makers’ negative emotions (Collier, 2011). This study contributes to public health research to explore whether engaging in craft-making related activities helps citizens to improve their health.

This study not only reflected on the current social status and trend across different countries that have been impacted by the pandemic but also on how mask-making behavior is closely associated with personal expression/self-fulfillment and wellbeing. Public health departments in these countries can utilize this information to promote public involvement in mask-making to help individuals learn to cope with stress in a healthy manner. From a business perspective, the findings of the study indicate promising opportunities for craft, fabric, and sewing supplies retailers to grow and adapt during or even after the pandemic. Such was evidenced by JOANN Fabrics (U.S. leading craft and fabric retailer) which had 300%–400% increase in demand for mask-making supplies in 2020 alone (S. Park, 2020).

Limitations and Suggestions for Future Research

As with any other study, this study is not free from limitations, which in turn provide opportunities for future research. First, data were collected during late May of 2020, when the three countries were at various stages of the pandemic. While COVID-19 was already reported to be well contained in China at that time, the United States saw a major surge in cases, and the outbreak started to show a growing trend in India. Further, while some countries such as China and India mandated the use of face masks during the onset of pandemic, there were mixed messages from health officials related to the effectiveness of facial mask use and there was no nationwide mandate in the United States during that time. This may have impacted participants’ responses. Therefore, for future studies, it may be worthwhile to gather data from countries who are at the same stage of disease outbreak in order to reduce the impact of this extraneous variable (i.e., outbreak stage). Second, although the majority of people who sew at home tend to be women (Collier, 2011), the majority of respondents from China and India were males, which might be non-representative of the population and might limit the generalizability. Therefore, future studies may involve an equal proportion of genders. Further, the sample from India may have been skewed toward higher income respondents because participating in online survey required basic education in English as well as access to a computer. This might have impacted responses, particularly the financial reason behind mask-making. Future studies may ensure recruiting participants with varying economic backgrounds to better represent the population.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iDs

Kim H. Y. Hahn

Gargi Bhaduri

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