Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy

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In Indonesia there were 6,812,127 cases, which ranked 20th worldwide in the year 2024. In response, Indonesia issued a policy mandating mask use. This study aims to investigate the association between risk perception, sociodemographic factors, and knowledge of COVID-19 with consistent mask-wearing outside the home. Methods This was an online study conducted from November 2020 to February 2021, during the first wave of COVID-19. Participants were provided written informed consent prior to agreeing or declining to voluntarily participate in the questionnaire-based study. A total of 1,153 respondents were selected. The dependent variable was consistent mask-wearing outside the home, while the independent variables were risk perception regarding COVID-19, sociodemographic factors (location, age, gender, education, occupation, family income, family members, social health scheme), and knowledge of COVID-19. Data were analyzed using logistic regression analysis. Results The risk perception of COVID-19 as a viral disease that can cause death (aOR: 2.502; 95% CI: 1.601-3.912) was positively associated with consistent mask-wearing outside the home. Regarding sociodemographic factor, individuals aged between 25 to 44 years (aOR: 0.486; 95% CI: 0.254-0.932) were 49% less likely to consistently use masks. Knowledge of the need to change cloth masks every 4-6 hours (aOR: 1.697; 95% CI: 1.118-2.576); the transmission (aOR: 1.974; 95%CI: 1.040-3.746), knowledge of severe symptoms of COVID-19 (aOR: 1.981; 95%CI: 1.175-3.342); and awareness of the confirmed diagnosis by PCR (aOR: 2.238; 95%CI: 1.215-4.120) were positively associated with consistent mask-wearing outside the home. Conclusions The risk perception of COVID-19 as potentially fatal and knowledge regarding proper mask-changing intervals, the transmission, severe symptoms, and PCR-based diagnosis were positively associated with mask-wearing outside the home. However, individuals aged between 25 to 44 years were less likely to wear mask consistently. These findings underscore the importance of targeted public health interventions that address risk perception and enhance knowledge to promote mask use as effective COVID-19 prevention measures. " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/14-179/v2", "name": "Risk perception, sociodemographic factors, and knowledge of COVID-19..." } } ] } Home Browse Risk perception, sociodemographic factors, and knowledge of COVID-19... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Roosihermiatie B, Yunitaningtyas K, Siahaan SAS et al. Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy [version 2; peer review: 4 not approved] . F1000Research 2025, 14 :179 ( https://doi.org/10.12688/f1000research.157369.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article Revised Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy [version 2; peer review: 4 not approved] Betty Roosihermiatie https://orcid.org/0000-0002-7080-4640 1 , Kristiana Yunitaningtyas 2 , Selma Arsit Selto Siahaan 1 , [...] Siti Isfandari 1 , Pramita Andarwati 3 , Zainul Khaqiqi Nantabah 4 , Rukmini Rukmini https://orcid.org/0000-0002-4831-4901 1,5 , Tjipto Wibowo 6 Betty Roosihermiatie https://orcid.org/0000-0002-7080-4640 1 , Kristiana Yunitaningtyas 2 , [...] Selma Arsit Selto Siahaan 1 , Siti Isfandari 1 , Pramita Andarwati 3 , Zainul Khaqiqi Nantabah 4 , Rukmini Rukmini https://orcid.org/0000-0002-4831-4901 1,5 , Tjipto Wibowo 6 PUBLISHED 20 Jun 2025 Author details Author details 1 Research Center for Public Health and Nutrition, National Research and Innovation Agency Republic of Indonesia, Bogor Regency, West Java, 16911, Indonesia 2 Center for Health Financing and Decentralization Policy, Ministry of Health the Republic of Indonesia, Jakarta, DKI Jakarta, 10560, Indonesia 3 Research Center for Preclinical and Clinical Medicine, National Research and Innovation Agency Indonesia, Bogor Regency, West Java, 16911, Indonesia 4 Directorate of Laboratory Management, Research Facilities, and Science and Technology Park, Central Jakarta, Jakarta, 10340, Indonesia 5 East Java Province National Research and Innovation Agency, Surabaya, Indonesia 6 Department Pulmonology, PHC Hospital Surabaya, Surabaya, East Java, 60165, Indonesia Betty Roosihermiatie Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Kristiana Yunitaningtyas Roles: Formal Analysis, Investigation, Resources, Software, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Selma Arsit Selto Siahaan Roles: Conceptualization, Data Curation, Methodology, Resources, Writing – Original Draft Preparation, Writing – Review & Editing Siti Isfandari Roles: Conceptualization, Data Curation, Investigation, Project Administration, Writing – Original Draft Preparation, Writing – Review & Editing Pramita Andarwati Roles: Formal Analysis, Writing – Original Draft Preparation, Writing – Review & Editing Zainul Khaqiqi Nantabah Roles: Formal Analysis, Writing – Original Draft Preparation, Writing – Review & Editing Rukmini Rukmini Roles: Data Curation, Formal Analysis, Investigation, Project Administration, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Tjipto Wibowo Roles: Conceptualization, Investigation, Supervision, Writing – Original Draft Preparation, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS This article is included in the Human resilience, growth and well-being during COVID19 collection. This article is included in the Coronavirus (COVID-19) collection. Abstract Background: After the onset of the COVID-19 pandemic, it spread to 213 countries in 2020. In Indonesia there were 6,812,127 cases, which ranked 20 th worldwide in the year 2024. In response, Indonesia issued a policy mandating mask use. This study aims to investigate the association between risk perception, sociodemographic factors, and knowledge of COVID-19 with consistent mask-wearing outside the home. Methods This was an online study conducted from November 2020 to February 2021, during the first wave of COVID-19. Participants were provided written informed consent prior to agreeing or declining to voluntarily participate in the questionnaire-based study. A total of 1,153 respondents were selected. The dependent variable was consistent mask-wearing outside the home, while the independent variables were risk perception regarding COVID-19, sociodemographic factors (location, age, gender, education, occupation, family income, family members, social health scheme), and knowledge of COVID-19. Data were analyzed using logistic regression analysis. Results The risk perception of COVID-19 as a viral disease that can cause death (aOR: 2.502; 95% CI: 1.601-3.912) was positively associated with consistent mask-wearing outside the home. Regarding sociodemographic factor, individuals aged between 25 to 44 years (aOR: 0.486; 95% CI: 0.254-0.932) were 49% less likely to consistently use masks. Knowledge of the need to change cloth masks every 4-6 hours (aOR: 1.697; 95% CI: 1.118-2.576); the transmission (aOR: 1.974; 95%CI: 1.040-3.746), knowledge of severe symptoms of COVID-19 (aOR: 1.981; 95%CI: 1.175-3.342); and awareness of the confirmed diagnosis by PCR (aOR: 2.238; 95%CI: 1.215-4.120) were positively associated with consistent mask-wearing outside the home. Conclusions The risk perception of COVID-19 as potentially fatal and knowledge regarding proper mask-changing intervals, the transmission, severe symptoms, and PCR-based diagnosis were positively associated with mask-wearing outside the home. However, individuals aged between 25 to 44 years were less likely to wear mask consistently. These findings underscore the importance of targeted public health interventions that address risk perception and enhance knowledge to promote mask use as effective COVID-19 prevention measures. READ ALL READ LESS Keywords risk perception, sociodemographic factors, knowledge, COVID-19, mask-wearing outside the home Corresponding Author(s) Betty Roosihermiatie ( [email protected] ) Close Corresponding author: Betty Roosihermiatie Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2025 Roosihermiatie B et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Roosihermiatie B, Yunitaningtyas K, Siahaan SAS et al. Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy [version 2; peer review: 4 not approved] . F1000Research 2025, 14 :179 ( https://doi.org/10.12688/f1000research.157369.2 ) First published: 10 Feb 2025, 14 :179 ( https://doi.org/10.12688/f1000research.157369.1 ) Latest published: 20 Jun 2025, 14 :179 ( https://doi.org/10.12688/f1000research.157369.2 ) Revised Amendments from Version 1 We edited the english language of the article. Background: We added reference of systematic review and metaanalysis of case control study on effectiveness of mask use. We deleted COVID-19 mortality in Indonesia, not be compared to global mortality. We changed ‘strickness’ of the policy (mandatory mask policy) to the strick enforment of the policy. Methods: We added references in developing questionaires, and the link directly of the questionnaires after pretested. In this questionnaire, questions for risk perception were changed to multiple choice answers. After the time of the study, it follows by ‘the google form link was shared to contact persons of WA groups’ with various educational and occupational backgrounds. Interacting variables are deleted to estimate each of risk perception, sociodemographic factors, and knowledge of Covid-19 variables; for focus public health interventions. Results: We added descriptive of variables; explanation the crude Odds of Ratio of variables; and check for knowledge of ‘activities after going out to do’, with the word ‘except’ as the questionnaire, and corrected results of the multivariate analysis. Discussion: It did not include policy index in the analysis since there was restriction of the study period (during the mandatory policy). Besides, Indonesia people less accustomed to wearing mask, even in the early phase of COVID-19 pandemic so they were social sanction and fines. We deleted discussion bivariate analysis results, and duplicate paragraph. Older ages were negatively associated with mask use. It was similar to a study in South Africa, in contrast to a study in United States. We added time of providing COVID-19 vaccination in Indonesia. Underlying Data : For download underlying data, choose the dat (SPSS) file, as the original. The description of variables is available in the second sheet ‘variable view’. References: We added references for background, methods, discussion and questionnaire after pre-tested (the extended data). We edited the english language of the article. Background: We added reference of systematic review and metaanalysis of case control study on effectiveness of mask use. We deleted COVID-19 mortality in Indonesia, not be compared to global mortality. We changed ‘strickness’ of the policy (mandatory mask policy) to the strick enforment of the policy. Methods: We added references in developing questionaires, and the link directly of the questionnaires after pretested. In this questionnaire, questions for risk perception were changed to multiple choice answers. After the time of the study, it follows by ‘the google form link was shared to contact persons of WA groups’ with various educational and occupational backgrounds. Interacting variables are deleted to estimate each of risk perception, sociodemographic factors, and knowledge of Covid-19 variables; for focus public health interventions. Results: We added descriptive of variables; explanation the crude Odds of Ratio of variables; and check for knowledge of ‘activities after going out to do’, with the word ‘except’ as the questionnaire, and corrected results of the multivariate analysis. Discussion: It did not include policy index in the analysis since there was restriction of the study period (during the mandatory policy). Besides, Indonesia people less accustomed to wearing mask, even in the early phase of COVID-19 pandemic so they were social sanction and fines. We deleted discussion bivariate analysis results, and duplicate paragraph. Older ages were negatively associated with mask use. It was similar to a study in South Africa, in contrast to a study in United States. We added time of providing COVID-19 vaccination in Indonesia. Underlying Data : For download underlying data, choose the dat (SPSS) file, as the original. The description of variables is available in the second sheet ‘variable view’. References: We added references for background, methods, discussion and questionnaire after pre-tested (the extended data). See the authors' detailed response to the review by Atle Fretheim See the authors' detailed response to the review by Neilshan Loedy READ REVIEWER RESPONSES Background The COVID-19 pandemic, which began in late 2019, was marked by an incidence of symptoms such as severe tightness in the chest, similar to those observed in Middle East Respiratory Syndrome (MERS). The initial laboratory examinations of the coronavirus occurred in Wuhan City, China, leading to its identification as SARS-CoV-2. The World Health Organization (WHO) reported the outbreak and officially labeled the disease as COVID-19. By March 2020, due to its rapid global spread, the WHO declared COVID-19 a pandemic ( World Health Organization (WHO), 2020a ). As of September 17, 2020, the pandemic had affected 213 countries, with approximately 30,340,825 reported cases worldwide. Of these, 22,031,183 individuals had recovered, while about 950,000 had succumbed to the virus, resulting in a relative mortality rate of 0.3%. By July 21, 2023, global cases had surged to 768,237,788, with Europe, the Western Pacific, and the Americas reporting the highest numbers. Total deaths reached around 6.9 million, with a relative mortality rate of 1.1%. In Indonesia there were 6,812,127 cases, which ranked 20th worldwide with 161,879 deaths in the year 2024 ( COVID-19 Statistic Team, 2024 ). COVID-19 is primarily transmitted through respiratory droplets, with an incubation period of 1 to 2 weeks. The Indonesian Ministry of Health has issued guidelines emphasizing preventive measures such as mask-wearing, regular hand hygiene with soap, maintaining physical distance, and avoiding crowded places ( The Ministry of Health of The Republic of Indonesia, 2020 ; World Health Organization (WHO), 2021 ). Recommendations also included minimizing contact with the face, mouth, nose, or eyes in order to prevent droplet transmission, and disinfecting surfaces potentially exposed to respiratory droplets ( World Health Organization (WHO), 2021 ). Numerous studies have established the effectiveness of mask-wearing in preventing COVID-19 transmission ( Wang et al., 2021 ; Hajmohammadi, Saki Malehi, and Maraghi, 2023 ). For instance, compliance was notably high in East Asian countries like Japan and Korea, with Hong Kong reporting a compliance rate of 96.6% ( Fischer et al., 2021 ). This high adherence was linked to a marked reduction in COVID-19 cases compared to regions with lower compliance ( Cheng et al., 2020 ). Moreover, a study in Singapore found a mask compliance rate of 84.5%, where factors such as gender and crowd density influenced behaviour ( Xiang Ong et al., 2023 ). In contrast, European countries displayed more varied compliance rates, which did not consistently correlate with health outcomes ( Spira, 2022 ). Germany’s mandatory mask policy improved compliance ( Betsch et al., 2020 ), whereas other countries like France and Spain showed significant variation. In Eastern Europe, mask use was more evenly distributed, but higher compliance did not necessarily lead to better health outcomes. Studies in Poland highlighted that despite regulations, compliance remained influenced by cultural and social factors ( Matulewska et al., 2022 ). In the United States, compliance rates varied widely, with some regions experiencing low adherence alongside higher transmission rates. Risk perception significantly influences mask usage in combating COVID-19 ( World Health Organization (WHO), 2019 , UNICEF, 2020 ). The Health Belief Model suggests that individual perceptions of risk, along with sociodemographic factors and knowledge, play crucial roles in determining mask use ( Roth et al., 2024 ; Li et al., 2022 ; White et al., 2022 ). During the COVID-19 pandemic, Indonesia implemented a mandatory mask policy for all residents ( The Ministry of Health of The Republic of Indonesia, 2020 ), which led to increased compliance ( Kar et al., 2023 ). However, following the WHO’s declaration of COVID-19 as endemic in early May 2023, and similarly in Indonesia, the strict enforcement of this policy was relaxed, even as transmission persisted. Given this context, this study aims to investigate the association between risk perception, sociodemographic factors, and knowledge of COVID-19 with mask-wearing behavior outside the home in Indonesia. By understanding these dynamics, this research aims to contribute valuable insights for future public health strategies. Methods The study was observational and employed a cross-sectional design. Data collection was performed online using Google Forms. The recruitment targeted individuals with various educational and occupational backgrounds through online community groups. The questionnaire was distributed to the participants via WhatsApp (WA) to the following groups: 1) government offices, 2) private offices, 3) companies, 4) self-employed individuals, 5) professionals, 6) neighborhood association (RT), 7) university students, 8) other students, and 9) informal groups with their various ages and genders https://hdl.handle.net/20.500.12690/RIN/87OSKQ ( Roosihermiatie 2025 ). The informal groups included fishermen, farmers, traditional market sellers, group of neighborhood associations, including private sector workers. This approach aimed to assess mask use within the broader community during the COVID-19 pandemic. Children were excluded because their preventive behavior, such as mask-wearing, is primarily influenced by their parents. Children were excluded because their preventive behavior, such as mask-wearing, is primarily influenced by their parents. The sample size was calculated based on the estimated population proportion with relative precision of confidence interval (α) = 0.05, proportion (P) = ranges 0.25–0.50, and relative precision (ε) = 0.1. The sample size calculation was: n = z 2 = ( z 1 − α / ε 1 − 2 ) 2 ( 1 − P = ) ε 2 . P = 1153 . The sample size was 1153 people ( Lwanga et al., 1991 ). Data collection took place during the period from November 2020 to February 2021. The Google Form link was shared with contact persons of the above groups, who then distributed it to their WhatsApp (WA) groups. Prior to completing the questionnaire, participants were presented with a written informed consent form outlining the study’s objectives: “This online study aims to identify factors associated with preventive behaviors against COVID-19 within the community as part of efforts to mitigate the virus’s spread. I acknowledge that I have read and understood the purpose of the study. I voluntarily consent to participate without coercion. I understand I may withdraw at any time without penalties.” Participants who agreed selected the “Agree” button and were directed to the questionnaire. Those who declined selected “Reject” and were exited from the platform. A total of 1,317 people accessed the questionnaire. Of these individuals, 22 declined to participate and 142 provided incomplete responses. As a result, 164 respondents (12.4%) were excluded, and 1,153 participants were included in the study. The study applied the Health Belief Model, comprising risk perception and the modifying factors of sociodemographic factors and knowledge of COVID-19, as determinants of mask use. The dependent variable was consistency of wearing mask outside the home, referring strictly to usage in outdoor or public spaces. The question was ‘Bagaimana kebiasaan Bapak/Ibu/Sdr menggunakan masker bila berada luar rumah?’ What is your habit of wearing a mask when you are outside the home? The answer choices were: never, seldom, sometimes, and always. Responses of “never”, “seldom”, and “sometimes” were categorized as inconsistent mask-wearing, while “always” was categorized as consistent mask-wearing outside the home. The independent variables included risk perception, such as personal understanding of COVID-19, knowing someone who had the virus, ever having tested PCR positive, or recent close contact with a COVID-19-positive individual; the sociodemographic factors included location, age, gender, education, occupation, family income, number of family members, and ownership of a social health insurance scheme; and knowledge of COVID-19 included including knowledge of its causes, transmission, prevention (such as mask replacement frequency), post-outing hygiene practices, symptoms and severe symptoms, screening, confirmed diagnosis, management of mild and severe cases, comorbid conditions, and immune-boosting activities. Age groups were categorized based on social activity levels. The questionnaire was developed based on the guidelines by the World Health Organization (2020b) , Harvard Medical School (2020) , and the Indonesian Ministry of Health (2020) . It was pre-tested with individuals from various occupational groups to evaluate the clarity, relevance, and understanding of items related to sociodemographic factors, perception, and knowledge. In the pre-test, perception-related questions were open-ended questions and time-consuming to answer. These items were revised into close-ended questions with predefined response options based on the pre-test feedback. Data were analyzed both using bivariate and multivariate logistic regression. Variables with a p-value ≤ 0.2 in the bivariate analysis were included in the multivariate model. Variables such as having tested PCR-positive (p = 0.804), close contact within two weeks (p = 0.580), and number of family members (p = 0.611) were excluded from the multivariate analysis. The multivariate analysis used backward likelihood ratio (LR) to identify independent associations among risk perception, where by interacting variables are deleted. It was to estimate each of risk perception, sociodemographic factors, and knowledge of Covid-19 variables, allowing for targeted public health interventions. Analyses were conducted using SPSS version 21 (Code 4-1EA96), with the significance was p < 0.05. Results Regarding mask usage, 2 (0.2%) respondents reported never using them, 37 (3.2%) seldom used them, 257 (22.3%) sometimes used masks, and 857 (74.3%) always used them. In terms of mask-wearing outside the home, 3 (0.3%) never used, 24 (2.1%) seldom used, 88 (7.6%) sometimes used, and 1038 (90.0%) always used. Univariate analysis of determinants showed that, regarding perception of COVID-19, about a half of the respondents (585 or 50.1%) identified COVID-19 as a viral disease that can cause death, while other 554 (48.0%) individuals answered as viral disease with flu-like symptoms. There were 10 persons who answered “do not know” and 4 persons who described COVID-19 as non-communicable disease, with the total of only 14 (1.2%) respondents. Due to low frequencies and equal distribution across mask usage categories, these respondents were grouped into “common disease” category for the analysis, and not to COVID-19 was viral disease which could cause death. In terms of the feeling when neighbors were ill with COVID-19, most respondents (818 or 70.9%) reported anxiety, followed by 267 (23.2%) people who felt indifferent. Only 45 (3.9%) respondents had tested positive for COVID-19 by PCR, and 63 (5.5%) reported close contact with infected individuals in the previous two weeks. Regarding the geographic areas, respondents were mostly from Greater Surabaya (502 or 43.5%), followed by areas outside Java, Sumatra, or Sulawesi (244 or 21.2%), and Greater Jakarta (191 or 16.6%). In terms of age distribution, 428 (37.1%) aged 15-24 (young adults), 438 (38.0%) aged 25-44 (adults), and 287 (24.9%) aged >44 years old (old adults). In terms of gender distribution, slightly above a half 603 (52.3%) were females. In terms of education background, the majority (517 or 44.8%) were academy/university graduates, followed by 288 (24.9%) with high school education. Regarding occupation, 348 (30.2%) were civil servants/police/soldier/government workers, followed by university/academic students of 198 (17.2%) and private employees of 193 (16.7%). In terms of family income, mostly 304 (26.4%) earned Rp >2,000,000-4,000,000, followed by Rp >4,000,000-7,000,000 (269 or 23.2%), and people up to Rp 2,000,000 244 (21.2%). Mostly respondents (796 or 69.0%) had ≤ 4 family members, and 961 (83.3%) were covered under National Health Scheme. Regarding knowledge of COVID-19, most respondents (1,127 or 94.3%) mentioned the disease was caused by a virus; 1,087 (97.7%) understood the transmission was by droplets; 1,091 (94.6%) said the transmission can be from goods/surfaces; additionally, 787 (68.3%) said cloth mask should be replaced every 4-6 hours. Most respondents (1,017 or 88.2%) said the preventive measures of the disease were by all of wearing a mask, frequent hand washing with soap (using hand sanitizer), maintaining a minimum physical distance of 1 meter; 891 (77.3%) knew they should not directly take a rest immediately after going out. For COVID-19 symptoms, 794 (68.9%) mentioned all four major symptoms (fever, flu, cough, and shortness of breath), while only 62 (5.4%) individuals knew just one symptom. Most respondents (1,032 or 89.5%) recognize that shortness of breath was a severe symptom. For screening, 1,018 (88.3%) mentioned the rapid test; similarly, 1,018 (88.3%) cited the swab test as a method for confirmed diagnosis. For mild cases, almost all (1,080 or 93.7%) people mentioned self-isolation at home was the management, while 1,082 (93.8%) recognized that severe cases should be managed at referral hospitals. Regarding comorbid conditions, 769 (66.7%) respondents identified conditions that exacerbate COVID-19, excluding bone disease. In terms of immunity-boosting activities, 945 (82.0%) respondents identified all four recommended practices (light exercise, balanced nutrition, sufficient rest, and sun exposure between 09:00–11:00 for 30 minutes). Only 25 (2.2%) respondents mentioned just two of the activities. Table 1 shows the bivariate analysis that where the risk perception of COVID-19 as a viral disease that can cause death was positively associated with consistent mask-wearing outside the home (crude Odds Ratio: 3.102; 95% CI: 2.018–4.766). In contrast, perceiving a neighbor’s illness with COVID-19 as causing stress or depression was negatively associated (crude Odds Ratio: 0.478; 95% CI: 0.316–0.723), and feelings of fear were also negatively associated (crude Odds Ratio: 0.357; 95% CI: 0.039–3.238). However, feelings of anxiety or worry were positively associated (crude Odds Ratio: 1.035; 95% CI: 0.401–2.668) with consistent mask use, compared to those who felt indifferent. The risk perceptions of having ever PCR-tested positive for COVID-19 (crude Odds Ratio: 1.141; 95% CI: 0.401–3.246) and having had close contact (in the same room) with an infected person during the past two weeks (crude Odds Ratio: 1.302; 95% CI: 0.511–3.315) were not significantly associated with consistent mask-wearing outside the home. Table 1. Risk perception and always use of mask outside the home. Risk perceptions of Covid-19 Not always use mask in outside Always use mask in outside Crude Odds Ratio 95% CI p Perception about Covid-19 Common disease/Viral disease with flu, cough symptoms 84 (14.8%) 584 (85.2%) Viral disease which could cause death 31 (5.3%) 554 (94.7%) 3.102 2.018-4.766 0.000 Feeling if neighbor’s sick of Covid-19 Usual 42 (15.7%) 225 (84.3%) Depressed 1 (20.0%) 4 (80.0%) 0.478 0.316-0.723 0.000 Afraid 5 (7.9%) 58 (92.1%) 0.357 0.039-3.238 0.360 Anxious 67 (8.2%) 751 (91.8%) 1.035 0.401-2.668 0.943 Ever having PCR positive Covid-19 No 111 (10.0%) 997 (90.0%) Yes 4 (8.9%) 41 (91.1%) 1.141 0.401-3.246 0.804 Close contact with Covid-19 persons during the past 2 weeks No 110 (10.1%) 980 (89.9%) Yes 5 (7.9%) 58 (92.1%) 1.302 0.511-3.315 0.580 Total 115 (10.0%) 1038 (90.0%) Table 2 presents the bivariate analysis which illustrates the association between various sociodemographic factors (i.e. age, gender, education, occupation, family income, family member and insurance ownership) and consistent mask-wearing outside the home. Among these factors, the number of family members was not significantly associated with consistent mask use (p = 0.611). In terms of geographic location, it showed varying correlations. Residents of outer Surabaya were positively associated with consistent mask use compared to those living in municipalities or districts outside Java, Sumatra, or Sulawesi (crude Odds Ratio: 2.235; 95% CI: 1.120–4.459; p = 0.023). In contrast, other geographic areas (Java, Sumatra, Sulawesi, outer Jakarta) did not show statistically significant associations. Table 2. Sociodemographics and always use of mask outside the home. Sociodemographics Not always use mask in outside Always use mask in outside Crude Odds Ratio 95% CI p Geographic areas Municipalities/districts outside Java/Sumatra/Sulawesi 20 (8.2%) 224 (91.8%) Municipalities/districts in Java 8 (16.0%) 42 (84.0%) 1.383 0.814 – 2.350 0.231 Sumatra island 3 (9.7%) 28 (90.3%) 0.648 0.291 – 1.446 0.286 Sulawesi island 14 (15.4%) 77 (84.6%) 1.152 0.340 – 3.905 0.820 Outer Jakarta 10 (5.2%) 181 (94.8%) 0.679 0.362 – 1.274 0.228 Outer Surabaya 60 (11.0%) 486 (89.0%) 2.235 1.120 – 4.459 0.023 Ages (years) 15-24 63 (14.7%) 365 (85.3%) 25-44 39 (8.9%) 399 (91.1%) 0.275 0.148 – 0.510 0.000 >44 13 (4.5%) 274 (95.5%) 0.485 0.254 – 0.926 0.028 Sex Males 69 (12.5%) 481 (87.5%) Females 46 (7.6%) 557 (92.4%) 1.285 1.173-2.572 0.006 Education Below High School 26 (18.4%) 115 (81.6%) High School 41 (14.2%) 247 (85.8%) 0.225 0.105-0.482 0.000 Academy/University 38 (7.4%) 479 (92.6%) 0.306 0.149-0.626 0.001 Post Graduate 10 (4.8%) 197 (95.2%) 0.640 0.313-1.309 0.222 Occupation Civil servants/police/soldiers/government workers 20 (5.7%) 328 (94.3%) Students 24 (17.9%) 110 (82.1%) 2.253 1.155 – 4.396 0.017 Academy/University students 25 (12.2%) 173 (87.8%) 0.618 0.319 – 1.199 0.155 Professionals 6 (4.7%) 121 (95.3%) 1.002 0.522 – 1.923 0.995 Private employees 23 (11.9%) 170 (88.1%) 2.840 1.092 – 7.387 0.032 Others 17 (11.1%) 136 (88.9%) 1.028 0.533 – 1.983 0.935 Family income (Rp) - 2,000,000 39 (16.0%) 205 (84.0%) >2,000,000 – 4,000,000 40 (13.2%) 264 (86.8%) 0.253 0.088 – 0.731 0.011 >4,000,000 – 7,000,000 23 (8.6%) 246 (91.4%) 0.318 0.111 – 0.915 0.034 >7,000,000 – 10,000,000 5 (3.4%) 144 (96.6%) 0.515 0.173 – 1.534 0.234 >10,000,000 – 15,000,000 4 (4.0%) 96 (96.0%) 1.388 0.363 – 5.313 0.632 >15,000,000 4 (4.6%) 83 (95.4%) 1.157 0.280 – 4.769 0.840 Family members ≤ 4 members 77 (9.7%) 719 (90.3%) > 4 members 38 (10.6%) 319 (89.4%) 1.112 0.738 – 1.677 0.611 Ownership of National Health Scheme None 31 (16.1%) 161 (83.9%) National Health Scheme/insurance 84 (8.7%) 877 (91.3%) 2.010 1.288 – 3.137 0.002 Total 115 (10.0%) 1038 (90.0%) Age was a significant factor. Individuals aged 25–44 years (crude Odds Ratio: 0.275; 95% CI: 0.148–0.510; p < 0.000) and over 44 years (crude Odds Ratio: 0.485; 95% CI: 0.254–0.926; p = 0.028) were less likely to consistently wear masks outside compared to those aged 15–24 years. Regarding gender, female respondents were more likely to consistently wear masks outside the home compared to males with the crude Odds Ratio 1.285 (95% CI: 1.173–2.572; p = 0.006). Education levels were negatively correlated with consistent mask use outside the home. Compared to those with less than high school education, respondents with high school education and university/academy degrees, were significantly more likely to consistently wear masks. In terms of occupational status, it revealed varying trends. Compared to civil servants/police/soldier/government workers, students and private employees were less likely to consistently wear masks. Regarding family income, families with higher income (Rp >10,000,000-15,000,000 and Rp >15,000,000) were positively correlated with consistent mask use outside the home. respondents earning: Rp >2,000,000–4,000,000 and Rp >4,000,000–7,000,000 were less likely to wear masks consistently compared to those earning Rp ≤2,000,000. More than 4 family members were correlated with consistent mask use outside the home (crude Odds Ratio: 1.112; 95% CI: 0.738–1.677). Finally, ownership of National Health Scheme was significantly associated with consistent mask use outside the home (crude Odds Ratio: 2.010; 95% CI: 1.288–3.137), indicating individuals with health insurance were more likely to adhere to mask-wearing guidelines. Table 3 shows the knowledge about COVID-19, specifically regarding its causation, transmission, recommended time to change cloth mask, post-outing hygiene practices, symptoms, case management, comorbidities that cause severe COVID-19, screening procedures, confirmed diagnosis, and activities to boost immunity, was positively associated with consistent use of mask outside the home. However, in some cases, greater knowledge about prevention methods, recognition of symptoms, and immunity-enhancing activities was negatively associated with lower levels of mask-wearing outside the home. Table 3. Knowledge of Covid-19 and always use of mask outside the home. Knowledge Not always use mask in outside Always use mask in outside Crude Odds Ratio 95% CI p Cause of Covid-19 Others than virus 8 (30.8%) 18 (69.2%) Virus 107 (9.5%) 1020 (90.5%) 4.237 1.799 – 9.975 0.001 Transmission of Covid-19 Others than droplet infection 18 (27.3%) 48 (72.7%) Droplet infection 97 (8.9%) 990 (91.1%) 3.827 2.142 – 6.839 0.000 Transmission of Covid-19 could by Others than goods 11 (17.7%) 51 (82.3%) Goods 104 (9.5%) 987 (90.5%) 2.047 1.035 – 4.049 0.040 Prevention of Covid-19 One of prevention methods 4 (13.8%) 25 (86.2%) Two of prevention methods 11 (14.7%) 64 (85.3%) 0.629 0.214 – 1.846 0.399 Three of prevention methods 7 (21.9%) 25 (78.1%) 0.586 0.298 – 1.149 0.120 All four of prevention methods 93 (9.1%) 924 (90.9%) 0.359 0.151 – 0.854 0.020 Changing cloth mask Other than every 4-6 hours 56 (15.3%) 310 (84.7%) Every 4-6 hours 59 (7.5%) 728 (92.5%) 2.229 1.511 – 3.289 0.000 After going out to do, except Clean goods, take a bath 43 (16.4%) 219 (83.6%) Directly take a rest 72 (8.1%) 819 (91.9%) 2.233 1.488 – 3.352 0.000 Symptoms of Covid-19 One 13 (21.0%) 49 (79.0%) Two symptoms 8 (23.5%) 26 (76.5%) 0.347 0.179 – 0.673 0.002 Three symptoms 27 (10.3%) 236 (89.7%) 0.300 0.130 – 0.688 0.004 All four symptoms 67 (8.4%) 727 (91.6%) 0.806 0.503 – 1.289 0.367 Severe symptom of Covid-19 Others than dyspnea 29 (24.0%) 92 (76.0%) Dyspnea 86 (8.3%) 946 (91.7%) 3.467 2.162 – 5.560 0.000 Screening of Covid-19 Others than Rapid Diagnostic Test 28 (20.7%) 107 (79.3%) Rapid Diagnostic Test 87 (8.5%) 931 (91.5%) 2.800 1.749 – 4.483 0.000 Confirmed diagnostic of Covid-19 Others than PCR 22 (30.6%) 50 (69.4%) PCR 93 (8.6%) 988 (91.4%) 4.674 2.711 – 8.059 0.000 Management of mild Covid-19 Others than home isolation 15 (20.5%) 58 (79.5%) Home isolation 100 (9.3%) 980 (90.7%) 2.534 1.386 – 4.636 0.003 Management of severe Covid-19 Others than hospital isolation 14 (19.7%) 57 (80.3%) Hospital isolation 101 (9.3%) 981 (90.7%) 2.386 1.284 – 4.432 0.006 Diseases causing severe Covid-19 except of DM, CVD 58 (15.1%) 326 (84.9%) Orthopedic diseases 57 (7.4%) 712 (92.6%) 2.222 1.507 – 3.277 0.000 Activities enhancing immunity One of 4 answer choices 18 (23.4%) 59 (76.6%) Two of 4 answer choices 7 (2.0%) 18 (72.0%) 0.303 0.171 – 0.539 0.000 Three of 4 answer choices 10 (9.4%) 96 (90.6%) 0.238 0.096 – 0.586 0.002 All of 4 answer choices 80 (8.5%) 865 (91.5%) 0.888 0.445 – 1.771 0.736 Total 115 (10.0%) 1,038 (90.0%) Table 4 shows that being aged 25 to 44 years was negatively associated with consistent mask-wearing outside the home (aOR: 0.486; 95% CI: 0.254–0.932), while perceiving COVID-19 as a viral disease that could cause death was positively associated (aOR: 2.502 (95% CI: 1.601-3.912). In addition, specific knowledge factors were significantly associated with consistent mask-wearing, including awareness of PCR testing as the method for COVID-19 confirmation (aOR: 2.238; 95% CI: 1.215–4.120), recognition of severe symptoms such as dyspnea (aOR: 1.981; 95% CI: 1.175–3.342), understanding of transmission modes (aOR: 1.974; 95% CI: 1.040–3.746), and knowledge of the recommended cloth mask replacement interval (aOR: 1.697; 95% CI: 1.118–2.576). In contrast, post-outing activities such as bathing and cleaning were not significantly associated with mask use outside the home. Table 4. The logistic regression of factors associated with always use of mask outside the home. Variables β SE Exp (B) 95% CI P Age (years) 15-24 25-44 -0.721 0.332 0.486 0.254 – 0.932 0.030 >44 -0.593 0.337 0.552 0.285 – 1.070 0.079 Perception about Covid-10 Common disease/Viral disease with flu, cough symptoms Viral disease which could cause death 0.917 0.228 2.502 1.601 – 3.912 0.000 Transmission of Covid-19 Others than droplet infection Droplet infection 0.680 0.327 1.974 1.040 – 3.746 0.038 Changing cloth mask Other than every 4-6 hours Every 4-6 hours 0.529 0.213 1.697 1.118 – 2.576 0.013 After going out doing, except Clean goods take a bath Directly take a rest -0.414 0.224 1.513 0.4976 – 2.346 0.064 Severe symptom of Covid-19 Others than dyspnea Dyspnea 0.684 0.267 1.981 1.175 – 3.342 0.010 Confirmed diagnostic of Covid-19 Others than PCR PCR 0.805 0.311 2.238 1.215 – 4.120 0.010 Constant 0.115 0.518 Discussions This online study investigated mask use during the COVID-19 pandemic under Indonesia’s mandatory mask policy. The rate of consistent mask-wearing outside the home was high (90.0%). Among mask types used, the majority reported using surgical masks (60%), followed by cloth masks (36.4%), N-19 masks (3.0%), and other types. Meanwhile, mask-wearing during the pandemic varied by region: 83% in the Western Pacific, 82% in Southeast Asia, 73% in the Eastern Mediterranean, 62% in Africa, 33% in Europe, and 32% in the Americas ( Li et al., 2022 ). Initially, Indonesian people were less accustomed to wearing masks than other countries such as Japan, where mask-use has been culturally embedded ( Ryall, 2020 ). Even in the early phase of the pandemic, many Indonesians did not adhere to mask use and they were met with social sanctions at the first wave of COVID-19, such as such as picking up trash, returning home to get a mask, buying one immediately, or doing push-ups. In several provinces like Jakarta and West Java, regional regulations even imposed fines for not wearing masks in public places. Our study revealed a positive association between risk perception and consistent mask-wearing outside the home. In line with previous studies, viewing COVID-19 as a life-threatening viral disease was significantly associated with mask use (aOR: 2.502; 95% CI: 1.601–3.746) ( Lo Moro et al., 2023 ; Shahnazi et al., 2020 ). However, feeling responses such as depression, fear, or anxiety when neighbors contracted COVID-19 were not significantly associated in the multivariate analysis ( Yang et al., 2024 ). Additionally, personal experiences, such as having previous contracted COVID-19 or being in close contact with infected COVID-19 individuals during the two weeks prior to the study were not associated with the consistent mask use outside the home ( White et al., 2022 ). These findings suggest that perceived risk of fatality, rather than direct exposure or feeling response, plays a stronger role in shaping mask-wearing behavior during a public health crisis. According to the Health Belief Model, social behaviours are influenced by perceived risks, sociodemographic characteristics, and knowledge. In line with this model, the feelings of anxiety and fear, along with knowledge of disease significantly influence the risk perception ( Sinicrope et al., 2021 ). Additionally, the anxiety and fear can shape social awareness ( Xia et al., 2023 ), further impacting the adoption of preventive measures like mask-wearing. Previous studies indicated sociodemographic factors such as older individuals, women, and government workers tend to adhere to mask use due to higher awareness of risks. Additionally, in urban areas, individuals with health insurance and larger households have also shown higher compliance and awareness of COVID-19 and subsequent mask use ( Chu et al., 2020 ). This study found no multivariate association between consistent mask use outside the home and geographic areas, sex, education, occupation, family income, as well as ownership of social health scheme. Similarly, these findings align with a study conducted in South Africa, where age was negatively associated with consistent mask use during the early stages of the pandemic ( Burger et al., 2022 ). Moreover, research in the United States showed younger individuals and those from lower socioeconomics were not associated with mask use ( Willis et al., 2021 ). However, older individuals in the United States demonstrated a higher likelihood of mask-wearing, likely due to their greater awareness of personal health in relation to comorbid conditions ( Liu & Arledge, 2022 ), The lack of association with other sociodemographic factors may be attributed to the mandatory mask policy implemented by the Indonesian government, which required all citizens to wear masks, particularly in public spaces. Additionally, the nationwide distribution of free masks, extended even to neighborhood levels, likely played a significant role in promoting widespread compliance across various demographic groups. This study identified key areas of COVID-19 knowledge that were positively associated with consistent mask-wearing: correct replacement intervals for cloth masks, awareness of severe symptoms, understanding of transmission, and confirmation through PCR testing. These results are consistent with studies showing that specific knowledge contributes to protective behavior ( Duong et al., 2021 ; Lo Moro et al., 2023 ). Furthermore, high global prevalence of perceived effectiveness of mask use in public settings ( Li et al., 2022 ), support the potential influence of Indonesia’s mask mandate ( Kar et al., 2023 ; The Ministry of Health of the Republic of Indonesia, 2020 ; Wismans et al., 2022 ). These insights underscore the importance of risk communication and targeted health education in promoting effective public health and preventive behaviors. While sociodemographic factor s such as age is amenable to change, this study highlights risk perception and knowledge are modifiable as key components for intervention aimed at promoting mask-wearing behavior. Despite high initial vaccination rates in Indonesia (86.88% for the first dose and for 74.55% for the second dose), booster uptake has significantly declined (38.11% for the first booster and 1.92% for the second booster as of July 31, 2023), highlighting a critical gap that must be addressed ( https://vaksin.kemkes.go.id/#/vaccines ). COVID-19 vaccination in Indonesia began on January 14, 2021, was implemented in four stages. Stages 1 and 2 on January to April 2021 targeted prioritized groups. Stage 1 focused on for health workers and their assistants, supporting staffs and students who were undergoing professional medical education in health services. Stage 2 targeted public service officers, including military personnel and police, law enforcement officers, and other public service officers including officers at airports, ports, stations, and terminals. This stage also included workers in the banking sector, state electricity companies, regional drinking water providers, and other frontline officers directly engaged in community service delivery. Additionally, individuals aged 60 years and above were included in Stage 2. Meanwhile, Stages 3 and 4, conducted from April 2021 to March 2022, extended vaccination to broader populations. Stage 3 targeted vulnerable communities, particularly those affected by geospatial, social, and economic disadvantages. Stage 4 focused on the general public and economic actors, following a cluster-based approach aligned with vaccine availability. While COVID-19 vaccination offers protection and immunity and reduces disease severity ( Havard Medical School, 2020 ), risk perception and knowledge about the virus remains essential motivators of preventing behaviour, including mask use. Our findings underscore the need for strategic interventions (communication and education) that address risk perception and knowledge gaps, encouraging consistent mask-wearing, especially with the declining vaccination rates ( Wismans et al., 2022 ). Additionally, mask use can help prevent other respiratory infections ( Liang et al., 2020 ; Wismans et al., 2022 ). Integrating these insights into ongoing public health strategies will be essential for improving health outcomes and pandemic preparedness. Conclusions In conclusion, this study demonstrates that the risk perception of COVID-19 as a viral disease that can cause death was positively associated with consistent mask-wearing outside the home. Meanwhile, specific sociodemographic factor of being aged 25 to 44 years was found to be negatively influence mask-wearing behavior. In addition, possessing knowledge, such as proper intervals for changing mask clothes, severe symptoms, COVID-19 transmission, and the confirmed diagnosis of COVID-19 by PCR was positively associated with consistent mask-wearing. These findings underscore the importance of targeted public health interventions that address risk perception and enhance knowledge to promote mask use as effective COVID-19 prevention measures. Future research could explore additional behavioral and contextual factors influencing mask use, as well as the long-term public health impacts of these preventive practices. Ethics and consent Ethical clearance for this study was granted by the Ethics Committee of the National Institute of Health Research and Development, Ministry of Health of the Republic of Indonesia (Number LB.02.01/2/KE.415/2020), dated on November 5, 2020. The committee confirmed that the study protocol, titled Factors Related to Preventive Behaviors of COVID-19 in Society, Indonesia”, involving human participants, had been thoroughly reviewed and found to be in accordance with the principles of the Helsinki Declaration. The principal investigator, Betty Roosihermiatie, declared that the approved protocol was ready for implementation. The ethical approval is valid from November 5, 2020, to November 4, 2021. Any modifications (amendments) or requests to extend the study period would require re-submission of the revised protocol for further ethical review and approval. Data availability statement Underlying data Dataverse: Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy, https://hdl.handle.net/20.500.12690/RIN/SV5YWF ( Roosihermiatie B., 2024 ). This project contains the following underlying data: • Covid-19_Indonesia_in_2000 F1000 research - deposit_translated.tab Data of this study is licensed under CC0 1.0 from the National Scientific Repository (Repositori Ilmiah Nasional/RIN) of the National Research and Innovation Agency Indonesia, by Communicable Disease, Non-Communicable Diseases, and Mental Health Laboratory. For download underlying data, choose the dat (SPSS) file, as the original. The description of variables is available in the second sheet ‘variable view’. Extended data Dataverse: Replication Data for Questionnaires on Factors Related to Preventive Behaviors Covid-19 in Society Indonesia, https://hdl.handle.net/20.500.12690/RIN/87OSKQ ( Roosihermiatie, 2025 ). This project contains the following underlying data: • Questionnaires on Factors Related to Preventive Behaviors Covid-19 in Society Indonesia_After pretest_Bahasa and EN.pdf Questionnaires of this study is licensed under CC0 1.0 from the National Scientific Repository (Repositori Ilmiah Nasional/RIN) of the National Research and Innovation Agency Indonesia, by Communicable Disease, Non-Communicable Diseases, and Mental Health Laboratory. Acknowledgement The authors would like to express their sincere thanks to Professor M. Sudomo and Dr. Idawaty Abbas, DMD, of the Indonesia Association of Health Researchers, for their constructive feedback and insightful comments throughout the development of this study. 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PubMed Abstract | Publisher Full Text | Free Full Text Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 10 Feb 2025 ADD YOUR COMMENT Comment Author details Author details 1 Research Center for Public Health and Nutrition, National Research and Innovation Agency Republic of Indonesia, Bogor Regency, West Java, 16911, Indonesia 2 Center for Health Financing and Decentralization Policy, Ministry of Health the Republic of Indonesia, Jakarta, DKI Jakarta, 10560, Indonesia 3 Research Center for Preclinical and Clinical Medicine, National Research and Innovation Agency Indonesia, Bogor Regency, West Java, 16911, Indonesia 4 Directorate of Laboratory Management, Research Facilities, and Science and Technology Park, Central Jakarta, Jakarta, 10340, Indonesia 5 East Java Province National Research and Innovation Agency, Surabaya, Indonesia 6 Department Pulmonology, PHC Hospital Surabaya, Surabaya, East Java, 60165, Indonesia Betty Roosihermiatie Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Kristiana Yunitaningtyas Roles: Formal Analysis, Investigation, Resources, Software, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Selma Arsit Selto Siahaan Roles: Conceptualization, Data Curation, Methodology, Resources, Writing – Original Draft Preparation, Writing – Review & Editing Siti Isfandari Roles: Conceptualization, Data Curation, Investigation, Project Administration, Writing – Original Draft Preparation, Writing – Review & Editing Pramita Andarwati Roles: Formal Analysis, Writing – Original Draft Preparation, Writing – Review & Editing Zainul Khaqiqi Nantabah Roles: Formal Analysis, Writing – Original Draft Preparation, Writing – Review & Editing Rukmini Rukmini Roles: Data Curation, Formal Analysis, Investigation, Project Administration, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Tjipto Wibowo Roles: Conceptualization, Investigation, Supervision, Writing – Original Draft Preparation, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (2) version 2 Revised Published: 20 Jun 2025, 14:179 https://doi.org/10.12688/f1000research.157369.2 version 1 Published: 10 Feb 2025, 14:179 https://doi.org/10.12688/f1000research.157369.1 Copyright © 2025 Roosihermiatie B et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Roosihermiatie B, Yunitaningtyas K, Siahaan SAS et al. Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy [version 2; peer review: 4 not approved] . F1000Research 2025, 14 :179 ( https://doi.org/10.12688/f1000research.157369.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 2 VERSION 2 PUBLISHED 20 Jun 2025 Revised Views 0 Cite How to cite this report: Zewotir T. Reviewer Report For: Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy [version 2; peer review: 4 not approved] . F1000Research 2025, 14 :179 ( https://doi.org/10.5256/f1000research.183333.r419295 ) The direct URL for this report is: https://f1000research.com/articles/14-179/v2#referee-response-419295 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 09 Oct 2025 Temesgen Zewotir , University of KwaZulu Natal, KwaZulu-Natal, South Africa Not Approved VIEWS 0 https://doi.org/10.5256/f1000research.183333.r419295 This study examined the factors influencing consistent mask-wearing outside the home in Indonesia during the pandemic. An online survey was conducted between November 2020 and February 2021 via Google Forms, shared through various WhatsApp community groups. Logistic regression was used as ... Continue reading READ ALL This study examined the factors influencing consistent mask-wearing outside the home in Indonesia during the pandemic. An online survey was conducted between November 2020 and February 2021 via Google Forms, shared through various WhatsApp community groups. Logistic regression was used as the method of analysis. The study reported nothing from the data analysis but high mask compliance because Indonesia’s strict mask mandate and extensive public education campaigns. Besides the low sample size by putting very modest P value, the method of analysis is not appropriate to establish causal relationships between risk perception, knowledge, and mask-wearing behavior.. Proper causal analysis should have been used. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? No Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Not applicable Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? No Competing Interests: No competing interests were disclosed. Reviewer Expertise: Applied Statistics and Data Science particularly interested in the abundance of data that could accelerate the development and refinement of basic research and theories. I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Zewotir T. Reviewer Report For: Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy [version 2; peer review: 4 not approved] . F1000Research 2025, 14 :179 ( https://doi.org/10.5256/f1000research.183333.r419295 ) The direct URL for this report is: https://f1000research.com/articles/14-179/v2#referee-response-419295 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Loedy N. Reviewer Report For: Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy [version 2; peer review: 4 not approved] . F1000Research 2025, 14 :179 ( https://doi.org/10.5256/f1000research.183333.r393493 ) The direct URL for this report is: https://f1000research.com/articles/14-179/v2#referee-response-393493 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 13 Aug 2025 Neilshan Loedy , Hasselt University, Hasselt, Belgium Not Approved VIEWS 0 https://doi.org/10.5256/f1000research.183333.r393493 I appreciate the authors’ efforts in revising the manuscript and providing a detailed point-by-point response. However, after carefully reviewing the revised version and the responses, I find that several major concerns raised in my initial review remain insufficiently addressed. ... Continue reading READ ALL I appreciate the authors’ efforts in revising the manuscript and providing a detailed point-by-point response. However, after carefully reviewing the revised version and the responses, I find that several major concerns raised in my initial review remain insufficiently addressed. For example, the descriptive results do not appear to be calculated carefully in some cases. There are instances where percentages do not sum to 100% without clear explanation (e.g., “According to sex, slightly above half 496 (55.2%) were females and nearly half 550 (47.7%) were males”). Greater care is needed to ensure accuracy in these basic summaries. Additionally, the issue regarding the age group divisions has not received sufficient attention or justification, despite earlier feedback that this could introduce inaccuracies in the conclusions. I also remain concerned that the analysis does not adequately consider the stringency index or related measures. Although the authors note that mask use was uncommon before COVID-19, the study period (November 2020 to February 2021) falls well within the pandemic, and varying public health measures could have influenced the findings. At the very least, a careful literature review and a discussion of the potential implications of differing public health policies should be added to strengthen the interpretation of the results. Moreover, while the authors have made revisions, it is unclear where these changes were made in the manuscript. I strongly recommend that any future revision clearly indicate the locations of all changes, ideally by specifying line numbers or highlighting the modified sections. These points are critical for the validity and robustness of the study’s conclusions. Addressing them would require substantial additional work beyond the scope of a minor revision. For these reasons, I do not think the manuscript is suitable for publication in its current form. I thank the authors again for their efforts and encourage them to consider a more substantial revision of their methods and analyses if they choose to submit the work to another journal. Competing Interests: No competing interests were disclosed. Reviewer Expertise: Statistics, Epidemiology, Social contact data. I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Loedy N. Reviewer Report For: Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy [version 2; peer review: 4 not approved] . F1000Research 2025, 14 :179 ( https://doi.org/10.5256/f1000research.183333.r393493 ) The direct URL for this report is: https://f1000research.com/articles/14-179/v2#referee-response-393493 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Conduah AK. Reviewer Report For: Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy [version 2; peer review: 4 not approved] . F1000Research 2025, 14 :179 ( https://doi.org/10.5256/f1000research.183333.r395660 ) The direct URL for this report is: https://f1000research.com/articles/14-179/v2#referee-response-395660 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 13 Aug 2025 Andrew Kweku Conduah , University of Professional Studies, Madina, Ghana Not Approved VIEWS 0 https://doi.org/10.5256/f1000research.183333.r395660 Manuscript Title: Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy. Phase 1: Title and Abstract Strengths: Clear, focused, and ... Continue reading READ ALL Manuscript Title: Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy. Phase 1: Title and Abstract Strengths: Clear, focused, and informative title. Abstract outlines the background, methodology, and key findings succinctly. Areas for Improvement: The abstract should explicitly state the study design (“cross-sectional online survey”). Include at least one statistical outcome (e.g., OR or CI) for scientific precision. Recommendation: Minor Revision – Add study design and one or two statistical results for clarity. Phase 2: Introduction / Background Strengths: Strong rationale for the study. Mentions Health Belief Model (HBM) and relevant literature. Areas for Improvement: (“strickness”) requires correction. Weak transition from global to Indonesian context. Lacks clarity on why specific demographic groups behave differently. Recommendation: Minor Revision – Improve grammar and contextual alignment with HBM and Indonesia’s socio-cultural setting. Phase 3: Methods Strengths: Methodology is generally well-structured. Ethical clearance is clearly stated. Concerns & Suggestions: Sampling bias due to online-only survey not sufficiently flagged. COVID-19 knowledge scoring lacks detail: cut-offs, reliability testing (e.g., Cronbach’s alpha). Sociodemographic variables (e.g., occupation) are undefined in terms of categorization. Statistical transparency is inadequate: No collinearity checks No model fit statistics (e.g., Hosmer–Lemeshow test) No logit linearity test for continuous variables Recommendation: Moderate Revision – Improve transparency on variable construction, scoring, and regression diagnostics. Phase 4: Results Strengths: Comprehensive presentation of both bivariate and multivariate outcomes. Use of AOR (Adjusted Odds Ratio) enhances interpretability. Areas for Improvement: Weak integration of results into narrative. No interpretation of non-significant variables (e.g., gender, income). Tables need better formatting and use of footnotes for clarity. Recommendation: Moderate Revision – Improve narrative integration, discuss non-significant findings, and enhance table readability. Phase 5: Discussion Strengths: Attempts to link findings to HBM. Recognizes policy implications and limitations. Critical Gaps: Superficial interpretation – key patterns (e.g., age-related behavior) not critically unpacked. No comparative literature from Southeast Asia or beyond. Weak policy implications, which are generic and not tailored to findings. Non-significant results are ignored, which limits analytical balance. Recommendation: Major Revision – Deepen interpretation, engage comparative literature, and derive specific policy applications. Phase 6: Conclusion Strengths: Summarizes key points. Reaffirms public health relevance. Limitations: Repetitive phrasing. Misses opportunity to suggest future research or broader implications. Recommendation: Minor Revision – Reframe for conciseness and include forward-looking recommendations. Phase 7: Final Evaluation Summary Scientific Soundness: Yes, the method is appropriate, but underreported Data & Methods Clarity: Partial – needs more transparency Language and Accessibility: Needs Improvement – professional editing required Originality & Contribution: Moderate – contextually useful, but interpretively weak Phase 8: Final Recommendation Recommendation: Not Approved Justification: While this manuscript explores an important area of public health behavior, it requires substantial revision in order to meet the standards of scholarly publication: Theoretical framing is shallow, with limited application of the Health Belief Model beyond introductory mentions. Literature is outdated and lacks a comparative perspective, missing recent findings from 2023–2024 and key regional studies. Methodological reporting is incomplete, especially regarding statistical diagnostics and operationalization of key variables. Discussion is underdeveloped, lacking both interpretive depth and actionable policy insights. Language quality is poor, with numerous grammatical errors and inconsistent phrasing throughout the manuscript. Given these significant weaknesses, I cannot recommend indexing in its current form. I encourage the authors to undertake a major revision, rebuilding the theoretical, methodological, and interpretive components, before resubmission. Is the work clearly and accurately presented and does it cite the current literature? No Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Partly Competing Interests: No competing interests were disclosed. Reviewer Expertise: Public health, ageing and health equity, population studies, health-related quality of life (HRQoL), social determinants of health, health behavior and risk perception, survey methodology, and mixed methods research. I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Conduah AK. Reviewer Report For: Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy [version 2; peer review: 4 not approved] . F1000Research 2025, 14 :179 ( https://doi.org/10.5256/f1000research.183333.r395660 ) The direct URL for this report is: https://f1000research.com/articles/14-179/v2#referee-response-395660 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Fretheim A. Reviewer Report For: Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy [version 2; peer review: 4 not approved] . F1000Research 2025, 14 :179 ( https://doi.org/10.5256/f1000research.183333.r393492 ) The direct URL for this report is: https://f1000research.com/articles/14-179/v2#referee-response-393492 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 21 Jul 2025 Atle Fretheim , Oslo Metropolitan University, Oslo, Norway Not Approved VIEWS 0 https://doi.org/10.5256/f1000research.183333.r393492 The authors have responded satisfactory to some of my concerns, and some not. 1. My main concern was that I was not able to make full sense of the calculated crude ORs, and I suggested that the ... Continue reading READ ALL The authors have responded satisfactory to some of my concerns, and some not. 1. My main concern was that I was not able to make full sense of the calculated crude ORs, and I suggested that the authors should provide a somewhat more detailed explanation of what the ORs represent. In my view, the authors have not responded sufficiently to this. I realise that the interpretation of the results in e.g. Table 1 may be perceived as obvious to some, but a table footnote with some key information should be provided since there are several valid ways of presenting results in such tables, and the reader should not have to make assumptions or guess. Information in a footnote should e.g. include i) what the percentages represent, ii) a statement saying that some results (e.g. marked with a *) cannot be calculated directly from the due to non-responses which changes the denominator (which I assume is the case), iii) explain why some rows do not report ORs, iv) what the reference groups are, v) spelling out absolutely all abbreviations etc. 2. I also commented in the previous round that it is not clear how the respondents were recruited, and the authors have not added much to understand the recruitment process. Their latest description is this: “The recruitment targeted individuals with various educational and occupational backgrounds through online community groups. The questionnaire was distributed to the participants via WhatsApp (WA) to the following groups: 1) government offices, 2) private offices, 3) companies, 4) self-employed individuals, 5) professionals, 6) neighborhood association (RT), 7) university students, 8) other students, and 9) informal groups with their various ages and genders”, This is not clear to me. I assume there are hundreds or thousands of online community groups on WhatsApp, and some sort of process was carried out to select groups to invite? Or did the authors identify as many such groups as they could, and invite all? 3. There is still no reference to a protocol, except under “Ethics and consent”. I take that as an indication that all analyses were decided upon post hoc. If not, the protocol should be included as an attachment file. The post hoc nature of the study (if this is the case) is a weakness the authors should reflect on – as I suggested in the previous round. 4. The authors have decided to drop their comparison of mortality rates across countries, as I suggested. 5. The authors maintain that the incubation period of COVID-19 is 14 days. Since they have disregarded my suggestion to change this to a much shorter period, which I believe is more in line with the broad consensus, I would insist that they provide a reference for their claim that the incubation period is 14 days. 6. I commented earlier that the authors should refer to systematic review(s) of effectiveness studies than a (random?) selection of observational studies. They have responded by adding two references: a systematic review of case-control studies (which is an odd choice when the question at hand is to determine the effectiveness of face masks – case-control studies are generally not seen as strong evidence in support of claims of effectiveness of interventions, and there are several available systematic reviews that have assessed the available evidence from effect studies such as randomize trials) and an unsystematic review or commentary from very early on in the COVID-19 pandemic. I don’t find this to be a convincing response. 7. I believe the authors have misunderstood my problem with the word “strickness», since they have simply rephrased and are using the word “strick”. My comment concerned the spelling of the word: it should strictness (or “strict”). 8. The authors have included a link directly from the text to the questionnaire, as I suggested. 9. It is still not clear to me HOW the open-ended questions on perceptions were converted to variables that could be included in regressions analyses. This should be pretty straightforward to give an account of. 10. When I commented that “cOR” and “RDT” needs to be spelled out, I did not mean that this had to be done throughout the manuscript, but that it be done at least the first time the abbreviations were used (the abbreviations were not explained anywhere in the first version of the manuscript). I realise that I could have been clearer about that. Competing Interests: No competing interests were disclosed. I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Fretheim A. Reviewer Report For: Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy [version 2; peer review: 4 not approved] . F1000Research 2025, 14 :179 ( https://doi.org/10.5256/f1000research.183333.r393492 ) The direct URL for this report is: https://f1000research.com/articles/14-179/v2#referee-response-393492 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Version 1 VERSION 1 PUBLISHED 10 Feb 2025 Views 0 Cite How to cite this report: Fretheim A. Reviewer Report For: Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy [version 2; peer review: 4 not approved] . F1000Research 2025, 14 :179 ( https://doi.org/10.5256/f1000research.172805.r373692 ) The direct URL for this report is: https://f1000research.com/articles/14-179/v1#referee-response-373692 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 15 Apr 2025 Atle Fretheim , Oslo Metropolitan University, Oslo, Norway Not Approved VIEWS 0 https://doi.org/10.5256/f1000research.172805.r373692 Peer review report on F1000 research article “Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy“ The authors have explored the association between various ... Continue reading READ ALL Peer review report on F1000 research article “Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy“ The authors have explored the association between various factors and use of face masks, based on a survey conducted in Indonesia. My main concern with the manuscript is that I could not make full sense of the calculated crude ORs, i.e. to me some of them seem to be incorrect, so the calculations need to be checked. Of course, if the results from the univariate analyses are wrong, this will likely mean that the multivariate analyses are wrong too, and consequently the conclusions will probably change. If I have misunderstood something, or the error is on my side, I apologise. Anyhow, if the calculations are indeed correct, perhaps a more detailed explanation of the approach may be needed (the current description is very short). It is not very clear how the respondents were recruited, although there is a brief description of the recruitment process. There is not reference to a protocol. I assume that this means that all analyses were decided upon post hoc, which would be a weakness the authors should reflect on – and they should argue carefully for every analytical choice they have made, and describe these in detail. The 1 st paragraph of the Background includes a repetition of a sentence. The 2 nd paragraph discusses mortality rates across countries. I think it’s better to skip this, since such comparisons are difficult to make, mainly due to variation in reporting of cases. Incubation period is not 14 days, but much shorter. The paragraph starting with “Numerous studies have established the effectiveness of mask-wearing» does not read will, and the line of argument is weak. The authors should rather refer to systematic review(s) of effectiveness studies than a (random?) selection of observational studies. Error in spelling: “strickness» When referring to the questionnaire in the text, I suggest linking directly to the questionnaire. In the paragraph starting with “Data collection took place during the period from November 2020 to February 2021”, there is an “s” missing in a “follows”, and there is a quotation mark missing. It is not explained how the open-ended questions on perceptions were converted to variables that could be included in regressions analyses. The first sentence in Results, “use” should be “used”. Error in spelling: “Tabel 1” “RDT” needs to be spelled out. cOR needs to be spelled out. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? No If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Partly Competing Interests: No competing interests were disclosed. Reviewer Expertise: Effectiveness studies. I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Fretheim A. Reviewer Report For: Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy [version 2; peer review: 4 not approved] . F1000Research 2025, 14 :179 ( https://doi.org/10.5256/f1000research.172805.r373692 ) The direct URL for this report is: https://f1000research.com/articles/14-179/v1#referee-response-373692 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 11 Aug 2025 Betty Roosihermiatie , Research Center for Public Health and Nutrition, National Research and Innovation Agency Republic of Indonesia, Bogor Regency, 16911, Indonesia 11 Aug 2025 Author Response My main concern with the manuscript is that I could not make full sense of the calculated crude ORs, i.e. to me some of them seem to be incorrect, so ... Continue reading My main concern with the manuscript is that I could not make full sense of the calculated crude ORs, i.e. to me some of them seem to be incorrect, so the calculations need to be checked. Of course, if the results from the univariate analyses are wrong, this will likely mean that the multivariate analyses are wrong too, and consequently the conclusions will probably change. If I have misunderstood something, or the error is on my side, I apologise. Anyhow, if the calculations are indeed correct, perhaps a more detailed explanation of the approach may be needed (the current description is very short). Thank you for the comment. There is an incorrect calculation from knowledge in which the actual question was ‘activities after going out, EXCEPT’; we have revised as the questionnaire and make correction for the results (in bivariate and multivariate analysis). More detailed explanation of univariate and bivariate analysis was added. It is not very clear how the respondents were recruited, although there is a brief description of the recruitment process. Response: Thank you for the comment. We added ‘The recruitment was for people with various of studying or working backrounds on online community in the society’. There is not reference to a protocol. I assume that this means that all analyses were decided upon post hoc, which would be a weakness the authors should reflect on – and they should argue carefully for every analytical choice they have made, and describe these in detail. Response: Thank you for the comment, we added the references in the developing of the questionnaires. The 1 st paragraph of the Background includes a repetition of a sentence. Response: ​​​​​​​Thank you for the comment, we deleted the repetition of a paragraph in the background. The 2 nd paragraph discusses mortality rates across countries. I think it’s better to skip this, since such comparisons are difficult to make, mainly due to variation in reporting of cases. Thank you for the comment, we deleted the mortality rate in Indonesia. Incubation period is not 14 days, but much shorter. Response: ​​​​​​​Thank you for the comment, we changed the incubation period of COVID-19 is 1 to 2 weeks. The paragraph starting with “Numerous studies have established the effectiveness of mask-wearing» does not read will, and the line of argument is weak. The authors should rather refer to systematic review(s) of effectiveness studies than a (random?) selection of observational studies. Response: ​​​​​​​Thank you for the comment. We added a reference of metaanalysis on effectiveness of mask use. Error in spelling: “strickness» Response: ​​​​​​​Thank you for the comment, we changed to ‘mandatory’. When referring to the questionnaire in the text, I suggest linking directly to the questionnaire. Response: ​​​​​​​Thank you for the comment, we added the link of questionnaire. In the paragraph starting with “Data collection took place during the period from November 2020 to February 2021”, there is an “s” missing in a “follows”, and there is a quotation mark missing. Response: ​​​​​​​Thank you for the comment , we added as follows ‘The link of questionnaire in google form was distributed to contact persons of online community from the aboved groups. Then, the link was shared to the WhatsApp (WA) groups.Prior to completing the questionnaire, participants were presented with a written informed consent statement to determine their willingness to voluntarily participate in the study’. It is not explained how the open-ended questions on perceptions were converted to variables that could be included in regressions analyses. Response: ​​​​​​​Thank you for the comment, we added ‘The questionnaire after pre-test as the question for perception was changed as to answer of answer choices’ The first sentence in Results, “use” should be “used”. Error in spelling: “Tabel 1” Response: ​​​​​​​Thank you for the comment, it changed to used. “RDT” needs to be spelled out. Response: ​​​​​​​Thank you for the comment, the RDT had been spelled out cOR needs to be spelled out. Response: ​​​​​​​Thank you for the comment, the cOR had been spelled out We have added the information for download data, the original file 'dat' (SPSS) that The description of variables is available in the second sheet ‘variable view’. The link of questionnaire - after pretesting had been directly added. The underlying data and extended data of questionnaire had been in CC0.1.0 version (open access). My main concern with the manuscript is that I could not make full sense of the calculated crude ORs, i.e. to me some of them seem to be incorrect, so the calculations need to be checked. Of course, if the results from the univariate analyses are wrong, this will likely mean that the multivariate analyses are wrong too, and consequently the conclusions will probably change. If I have misunderstood something, or the error is on my side, I apologise. Anyhow, if the calculations are indeed correct, perhaps a more detailed explanation of the approach may be needed (the current description is very short). Thank you for the comment. There is an incorrect calculation from knowledge in which the actual question was ‘activities after going out, EXCEPT’; we have revised as the questionnaire and make correction for the results (in bivariate and multivariate analysis). More detailed explanation of univariate and bivariate analysis was added. It is not very clear how the respondents were recruited, although there is a brief description of the recruitment process. Response: Thank you for the comment. We added ‘The recruitment was for people with various of studying or working backrounds on online community in the society’. There is not reference to a protocol. I assume that this means that all analyses were decided upon post hoc, which would be a weakness the authors should reflect on – and they should argue carefully for every analytical choice they have made, and describe these in detail. Response: Thank you for the comment, we added the references in the developing of the questionnaires. The 1 st paragraph of the Background includes a repetition of a sentence. Response: ​​​​​​​Thank you for the comment, we deleted the repetition of a paragraph in the background. The 2 nd paragraph discusses mortality rates across countries. I think it’s better to skip this, since such comparisons are difficult to make, mainly due to variation in reporting of cases. Thank you for the comment, we deleted the mortality rate in Indonesia. Incubation period is not 14 days, but much shorter. Response: ​​​​​​​Thank you for the comment, we changed the incubation period of COVID-19 is 1 to 2 weeks. The paragraph starting with “Numerous studies have established the effectiveness of mask-wearing» does not read will, and the line of argument is weak. The authors should rather refer to systematic review(s) of effectiveness studies than a (random?) selection of observational studies. Response: ​​​​​​​Thank you for the comment. We added a reference of metaanalysis on effectiveness of mask use. Error in spelling: “strickness» Response: ​​​​​​​Thank you for the comment, we changed to ‘mandatory’. When referring to the questionnaire in the text, I suggest linking directly to the questionnaire. Response: ​​​​​​​Thank you for the comment, we added the link of questionnaire. In the paragraph starting with “Data collection took place during the period from November 2020 to February 2021”, there is an “s” missing in a “follows”, and there is a quotation mark missing. Response: ​​​​​​​Thank you for the comment , we added as follows ‘The link of questionnaire in google form was distributed to contact persons of online community from the aboved groups. Then, the link was shared to the WhatsApp (WA) groups.Prior to completing the questionnaire, participants were presented with a written informed consent statement to determine their willingness to voluntarily participate in the study’. It is not explained how the open-ended questions on perceptions were converted to variables that could be included in regressions analyses. Response: ​​​​​​​Thank you for the comment, we added ‘The questionnaire after pre-test as the question for perception was changed as to answer of answer choices’ The first sentence in Results, “use” should be “used”. Error in spelling: “Tabel 1” Response: ​​​​​​​Thank you for the comment, it changed to used. “RDT” needs to be spelled out. Response: ​​​​​​​Thank you for the comment, the RDT had been spelled out cOR needs to be spelled out. Response: ​​​​​​​Thank you for the comment, the cOR had been spelled out We have added the information for download data, the original file 'dat' (SPSS) that The description of variables is available in the second sheet ‘variable view’. The link of questionnaire - after pretesting had been directly added. The underlying data and extended data of questionnaire had been in CC0.1.0 version (open access). Competing Interests: All authors declare no competing of interest. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 11 Aug 2025 Betty Roosihermiatie , Research Center for Public Health and Nutrition, National Research and Innovation Agency Republic of Indonesia, Bogor Regency, 16911, Indonesia 11 Aug 2025 Author Response My main concern with the manuscript is that I could not make full sense of the calculated crude ORs, i.e. to me some of them seem to be incorrect, so ... Continue reading My main concern with the manuscript is that I could not make full sense of the calculated crude ORs, i.e. to me some of them seem to be incorrect, so the calculations need to be checked. Of course, if the results from the univariate analyses are wrong, this will likely mean that the multivariate analyses are wrong too, and consequently the conclusions will probably change. If I have misunderstood something, or the error is on my side, I apologise. Anyhow, if the calculations are indeed correct, perhaps a more detailed explanation of the approach may be needed (the current description is very short). Thank you for the comment. There is an incorrect calculation from knowledge in which the actual question was ‘activities after going out, EXCEPT’; we have revised as the questionnaire and make correction for the results (in bivariate and multivariate analysis). More detailed explanation of univariate and bivariate analysis was added. It is not very clear how the respondents were recruited, although there is a brief description of the recruitment process. Response: Thank you for the comment. We added ‘The recruitment was for people with various of studying or working backrounds on online community in the society’. There is not reference to a protocol. I assume that this means that all analyses were decided upon post hoc, which would be a weakness the authors should reflect on – and they should argue carefully for every analytical choice they have made, and describe these in detail. Response: Thank you for the comment, we added the references in the developing of the questionnaires. The 1 st paragraph of the Background includes a repetition of a sentence. Response: ​​​​​​​Thank you for the comment, we deleted the repetition of a paragraph in the background. The 2 nd paragraph discusses mortality rates across countries. I think it’s better to skip this, since such comparisons are difficult to make, mainly due to variation in reporting of cases. Thank you for the comment, we deleted the mortality rate in Indonesia. Incubation period is not 14 days, but much shorter. Response: ​​​​​​​Thank you for the comment, we changed the incubation period of COVID-19 is 1 to 2 weeks. The paragraph starting with “Numerous studies have established the effectiveness of mask-wearing» does not read will, and the line of argument is weak. The authors should rather refer to systematic review(s) of effectiveness studies than a (random?) selection of observational studies. Response: ​​​​​​​Thank you for the comment. We added a reference of metaanalysis on effectiveness of mask use. Error in spelling: “strickness» Response: ​​​​​​​Thank you for the comment, we changed to ‘mandatory’. When referring to the questionnaire in the text, I suggest linking directly to the questionnaire. Response: ​​​​​​​Thank you for the comment, we added the link of questionnaire. In the paragraph starting with “Data collection took place during the period from November 2020 to February 2021”, there is an “s” missing in a “follows”, and there is a quotation mark missing. Response: ​​​​​​​Thank you for the comment , we added as follows ‘The link of questionnaire in google form was distributed to contact persons of online community from the aboved groups. Then, the link was shared to the WhatsApp (WA) groups.Prior to completing the questionnaire, participants were presented with a written informed consent statement to determine their willingness to voluntarily participate in the study’. It is not explained how the open-ended questions on perceptions were converted to variables that could be included in regressions analyses. Response: ​​​​​​​Thank you for the comment, we added ‘The questionnaire after pre-test as the question for perception was changed as to answer of answer choices’ The first sentence in Results, “use” should be “used”. Error in spelling: “Tabel 1” Response: ​​​​​​​Thank you for the comment, it changed to used. “RDT” needs to be spelled out. Response: ​​​​​​​Thank you for the comment, the RDT had been spelled out cOR needs to be spelled out. Response: ​​​​​​​Thank you for the comment, the cOR had been spelled out We have added the information for download data, the original file 'dat' (SPSS) that The description of variables is available in the second sheet ‘variable view’. The link of questionnaire - after pretesting had been directly added. The underlying data and extended data of questionnaire had been in CC0.1.0 version (open access). My main concern with the manuscript is that I could not make full sense of the calculated crude ORs, i.e. to me some of them seem to be incorrect, so the calculations need to be checked. Of course, if the results from the univariate analyses are wrong, this will likely mean that the multivariate analyses are wrong too, and consequently the conclusions will probably change. If I have misunderstood something, or the error is on my side, I apologise. Anyhow, if the calculations are indeed correct, perhaps a more detailed explanation of the approach may be needed (the current description is very short). Thank you for the comment. There is an incorrect calculation from knowledge in which the actual question was ‘activities after going out, EXCEPT’; we have revised as the questionnaire and make correction for the results (in bivariate and multivariate analysis). More detailed explanation of univariate and bivariate analysis was added. It is not very clear how the respondents were recruited, although there is a brief description of the recruitment process. Response: Thank you for the comment. We added ‘The recruitment was for people with various of studying or working backrounds on online community in the society’. There is not reference to a protocol. I assume that this means that all analyses were decided upon post hoc, which would be a weakness the authors should reflect on – and they should argue carefully for every analytical choice they have made, and describe these in detail. Response: Thank you for the comment, we added the references in the developing of the questionnaires. The 1 st paragraph of the Background includes a repetition of a sentence. Response: ​​​​​​​Thank you for the comment, we deleted the repetition of a paragraph in the background. The 2 nd paragraph discusses mortality rates across countries. I think it’s better to skip this, since such comparisons are difficult to make, mainly due to variation in reporting of cases. Thank you for the comment, we deleted the mortality rate in Indonesia. Incubation period is not 14 days, but much shorter. Response: ​​​​​​​Thank you for the comment, we changed the incubation period of COVID-19 is 1 to 2 weeks. The paragraph starting with “Numerous studies have established the effectiveness of mask-wearing» does not read will, and the line of argument is weak. The authors should rather refer to systematic review(s) of effectiveness studies than a (random?) selection of observational studies. Response: ​​​​​​​Thank you for the comment. We added a reference of metaanalysis on effectiveness of mask use. Error in spelling: “strickness» Response: ​​​​​​​Thank you for the comment, we changed to ‘mandatory’. When referring to the questionnaire in the text, I suggest linking directly to the questionnaire. Response: ​​​​​​​Thank you for the comment, we added the link of questionnaire. In the paragraph starting with “Data collection took place during the period from November 2020 to February 2021”, there is an “s” missing in a “follows”, and there is a quotation mark missing. Response: ​​​​​​​Thank you for the comment , we added as follows ‘The link of questionnaire in google form was distributed to contact persons of online community from the aboved groups. Then, the link was shared to the WhatsApp (WA) groups.Prior to completing the questionnaire, participants were presented with a written informed consent statement to determine their willingness to voluntarily participate in the study’. It is not explained how the open-ended questions on perceptions were converted to variables that could be included in regressions analyses. Response: ​​​​​​​Thank you for the comment, we added ‘The questionnaire after pre-test as the question for perception was changed as to answer of answer choices’ The first sentence in Results, “use” should be “used”. Error in spelling: “Tabel 1” Response: ​​​​​​​Thank you for the comment, it changed to used. “RDT” needs to be spelled out. Response: ​​​​​​​Thank you for the comment, the RDT had been spelled out cOR needs to be spelled out. Response: ​​​​​​​Thank you for the comment, the cOR had been spelled out We have added the information for download data, the original file 'dat' (SPSS) that The description of variables is available in the second sheet ‘variable view’. The link of questionnaire - after pretesting had been directly added. The underlying data and extended data of questionnaire had been in CC0.1.0 version (open access). Competing Interests: All authors declare no competing of interest. Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Loedy N. Reviewer Report For: Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy [version 2; peer review: 4 not approved] . F1000Research 2025, 14 :179 ( https://doi.org/10.5256/f1000research.172805.r369443 ) The direct URL for this report is: https://f1000research.com/articles/14-179/v1#referee-response-369443 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 17 Mar 2025 Neilshan Loedy , Hasselt University, Hasselt, Belgium Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.172805.r369443 I am pleased to read and evaluate the manuscript prepared by Roosihermiatie and colleagues. In this manuscript, the author collected data associated with mask use during the COVID-19 pandemic in Indonesia. The data collection spanned from November 2020 to February ... Continue reading READ ALL I am pleased to read and evaluate the manuscript prepared by Roosihermiatie and colleagues. In this manuscript, the author collected data associated with mask use during the COVID-19 pandemic in Indonesia. The data collection spanned from November 2020 to February 2021, resulting data from 1,153 participants to be analyzed. The data collected has been made publicly available, which is a commendable outcome as it supports open science and provides a valuable resource for the scientific community. The study examined the association between risk perception, sociodemographic, knowledge of COVID-19 and face mask adherence using a multivariate logistic regression. The results indicate positive association between the use of facemask outside the home and the risk perception, COVID-19 knowledge, and age. The topic of this manuscript is highly relevant, and I wish that more studies would collect similar valuable information. However, I would like to raise several questions and possible improvements to ensure the interpretability of the results. Moreover, authors need to thoroughly proofread and update the manuscript as the overall writing quality, including formatting and language, was rather poor. Major comments I understand that values can be seen from the tables, but I suggest expanding the results to include some of the obtained quantitative estimates. Right now, it just appears to be rather generic. The manuscript mentions that the questionnaire was distributed to different public groups via WhatsApp. However, it would be helpful to discuss the rationale behind selecting these groups and provide details on their distribution. Additionally, could the authors clarify how representative this sample is in terms of key demographics, such as age and gender? Figures showing the distributions of key sociodemographic factors would be a very nice addition in this case. Furthermore, a discussion on potential biases introduced by these chosen groups would strengthen the study's validity. It would be helpful to clarify the purpose of the pre-testing in the manuscript. Specifically, could you explain why the questionnaires were pre-tested on individuals with varying occupations and how the feedback influenced the revisions? Could the authors clarify the rationale behind the chosen age groups in the analysis? Specifically, the category of “older than 44 years” covers a broad range, which may obscure potential variations in mask-wearing behavior among different age subgroups. Given that previous studies have reported higher face mask usage among older individuals due to increased susceptibility to COVID-19 (e.g., Haischer et al, 2020 [Ref 2]), a more granular age categorization might provide additional insights. In the discussion section it is written that “This online study investigated mask use during the COVID-19 pandemic in the Indonesia’s mask mandatory policy”. The study period spanned from November 2020 to February 2021, during which the use of face masks is strongly influenced by government policies (as shown in other studies, e.g., Gimma et al., 2022 [Ref 3]). Not accounting for policy changes (e.g., by using stringency index or other relevant measures) in the analysis is likely affect the model’s results. It would be logical to explore the effect of a stringency/policy index variable in the model, which would ultimately increase the validity of the findings and support the statement written in the Discussion section. In addition to my previous comment (No. 3), I noticed that the first public COVID-19 vaccinations in Indonesia began on January 14, 2021. While the questionnaire does not include a question about vaccination status, the discussion section touches on vaccination rates and their relevance to mask-wearing adherence. To avoid confusion, I suggest clarifying this timeline in the discussion and addressing its potential impact on the analysis. The arguments in the discussion section are too generic and vague, making it unclear what message the authors are trying to convey. For instance, the statement: “This study revealed that among the sociodemographic factors, only individuals of productive age (25 to 44 years) are negatively associated with consistent mask-wearing outside the home” is somewhat confusing. Another paragraph states, “Previous studies identified that older individuals were associated with adherence to mask use...” which seems to contrast with the earlier finding. While there is an attempt to explain this, the paragraph could be more clearly structured to enhance clarity and coherence. I noticed that the idea of “Our study revealed/highlights a relationship between risk perception of COVID-19 and the (consistent) use of masks outside the home” appears multiple times throughout the discussion. To improve clarity and avoid redundancy, it might be helpful to restructure the discussion to consolidate these points and present them more cohesively. In the discussion section, it is stated that “In contrast, this study found that younger and older age groups, women, … living in outer Surabaya as well as … failed to be associated with consistent mask-wearing outside the home in the multivariate analysis.” However, I do not see any results in Table 4 that reflect these findings. If these results were obtained from bivariate analysis rather than multivariate analysis, it would be important to clarify this distinction, as interpreting bivariate results in this context may not be appropriate. It would also interesting to add to the manuscript a discussion on Peltz man effect (individuals might alter their risk perceptions after access to preventive measures, leading to greater engagement in riskier behaviour (e.g., making more contacts with people outside)). This has been shown after participants in other study received vaccination (Wambua et al, 2023 [Ref 1]). Exploring its impact on disease spread and identifying suitable interventions could provide valuable insights for the readers. Minor comments In the abstract, the statement “Regarding sociodemographic factors, individuals aged between 25 to 44 years aOR: 0.486” is unclear. Could you clarify (or put more context) what this refers to? I would recommend including confidence intervals for all estimates in the manuscript, to improve the comprehensiveness of the results. The sentence “By March 2020, due to its rapid global spread, the WHO declared COVID-19 a pandemic.” is repeated twice. The fourth paragraph “Risk perception significantly … determining mask adherence.”, looks a little bit out of place. The sentence “During the COVID-19 pandemic, Indonesia enforced a mandatory mask policy (The Ministry of Health of The Republic of Indonesia, 2020), which led to increased usage (Kar et al., 2023).”, can be phrased better. Please check the clarity of each sentence in the manuscript. I am not sure with the use of the word “strickness”, in the last paragraph of the Introduction. What is the definition of “outside the home”? Does it refer strictly to areas outside the house, or does it include spaces like the backyard, terrace, or a small park? It would be useful to make this clear in the manuscript. How do you define “Informal groups?” It might be helpful to rephrase the third paragraph of the Methodology section (“Data collection took place…”) to enhance clarity, as the current wording is a bit unclear. I would expect that the number of participants who never (or always) use a mask in general would be fewer than those who never (or always) use a mask outside the home, as the latter seems like a subset of the former. However, this does not seem to be the case. Could you please clarify the difference between these two questions and provide an explanation for this discrepancy? Could the authors explain the rationale behind excluding interaction effects from the analysis? It would be helpful to understand the reasoning for this decision. I do not think the statement “In this study, consistent mask-wearing outside the home was higher (90.0%), with the types of masks were mostly surgical masks (60%), followed by cloth masks (36.4%), N-19 masks (3.0%), and others.”, belong in the discussion section. I do not see any clear connection between the statement “Moreover, the Indonesian government distributed free masks down to neighborhood levels, further supporting compliance” with its preceeding statements. The statement that “sociodemographic factors are challenging to modify” feels somewhat unclear. While it is true that factors like age cannot be changed, their significance in the analysis somehow suggests the need for age-specific targeted interventions. It might be helpful to clarify this point to better align with the study's implications. A reference for Indonesia’s vaccination rate in the discussion section is needed It would also be beneficial to put all the codes used to produce the results in an open access repository to ensure open science to the general community Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Partly References 1. Wambua J, Loedy N, Jarvis CI, Wong KLM, et al.: The influence of COVID-19 risk perception and vaccination status on the number of social contacts across Europe: insights from the CoMix study. BMC Public Health . 2023; 23 (1): 1350 PubMed Abstract | Publisher Full Text 2. Haischer MH, Beilfuss R, Hart MR, Opielinski L, et al.: Who is wearing a mask? Gender-, age-, and location-related differences during the COVID-19 pandemic. PLoS One . 2020; 15 (10): e0240785 PubMed Abstract | Publisher Full Text 3. Gimma A, Munday JD, Wong KLM, Coletti P, et al.: Changes in social contacts in England during the COVID-19 pandemic between March 2020 and March 2021 as measured by the CoMix survey: A repeated cross-sectional study. PLoS Med . 2022; 19 (3): e1003907 PubMed Abstract | Publisher Full Text Competing Interests: No competing interests were disclosed. Reviewer Expertise: Statistics, Epidemiology, Social contact data. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Loedy N. Reviewer Report For: Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy [version 2; peer review: 4 not approved] . F1000Research 2025, 14 :179 ( https://doi.org/10.5256/f1000research.172805.r369443 ) The direct URL for this report is: https://f1000research.com/articles/14-179/v1#referee-response-369443 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 20 Mar 2025 Betty Roosihermiatie , Research Center for Public Health and Nutrition, National Research and Innovation Agency Republic of Indonesia, Bogor Regency, 16911, Indonesia 20 Mar 2025 Author Response Major Comments Responses Thank you for the comment. We, would add the descriptive estimate at first of Results as follows. The perception about Covid-19, about a ... Continue reading Major Comments Responses Thank you for the comment. We, would add the descriptive estimate at first of Results as follows. The perception about Covid-19, about a half 585 (50.1%) people answered as viral disease which could cause death and nearly a half 554 (48.0%) people answered as viral disease with flu, cough symptoms. For the feeling if neighbour’s sick of Covid-19, the majority 818 (70.9%) people answered feeling of anxiety, followed by 267 (23.2%) people answered feeling of usual. Meanwhile, for experiencing PCR positive Covid-19 and close contact with Covid-19 persons during the past 2 weeks before the study, just 45 (3.9%) people answered ever having PCR positive Covid-19 and 63 (5.5%) people having close contact with Covid-19 persons during the past 2 weeks before the study, respectively. For the sociodemographic factors of geographic areas it consisted of municipalities/districts outside Java/Sumatra/Sulawesi, municipalities/districts in Java (excluding greater Jakarta and greater Surabaya), Sumatra island, Sulawesi island, greater Jakarta, and greater Surabaya. The geographic areas of people who responded the study were mostly 502 (43.5%) people from greater Surabaya, 244 (21.2%) people from municipalities/districts outside Java/Sumatra/Sulawesi, and 191 (16.6%) people from greater Jakarta. For age, it composed of ed of 428 (37.1%) people aged 15-24 years old (young adults), 438 (38.0%) people aged 25-44 years old (adults), and 287 (24.9%) people aged >44 years old (old adults). According to sex, slightly above a half 496 (55.2%) were females and nearly a half 550 (47.7%) were males. While according to education, mostly were 517 (44.8%) academy/university graduate, followed by 288 (24.9%) high school education. According to occupation, mostly 346 (30.0%) people were Civil servants/police/soldiers/government workers; followed by almost the same of Academy/University students and private employees of 198 (17.2%) and 193 (16.7%) people, respectively. The family income, mostly 304 (26.4%) were Rp. >2,000,000 – 4,000,000,-, followed by 269 (23.2%) people with Rp. >4,000,000 – 7,000,000,- and 244 (21.2%) people up to Rp. 2,000,000,-, respectively. Mostly, 796 (69.0%) people had ≤ 4 family members and 961 (83.3%) people owned of National Health Scheme. 2. The questionnaire was distributed to different public groups that it could describe the use of mask in the society. It will be added in the methods. About age and gender, it would be as aboved description that the categories are as social activities that their distribution among categories were equal as possible of bias. Moreover, if there were biases - they had been controlled in the analysis. 3. The purpose of pre-testing the questionnaire to varying occupation was to get information on how to provide answers, namely sociodemografic factors, perception and knowledge of COVID-19 in the community. In the pre-test questionnaire, the questions about the perception were asked with open questions in which required times to answer. So, the questions about the perception of COVID-19 were changed into close questions with answer choices and in which included responses from the pre-test. These would be added. 4. The categories of age used the division as for social activity in which the the percentages (estimates) showed trend that use of mask in old adults is less. 5. Before Covid-19 pandemic, mask use was uncommon in Indonesia. Even in the early of pandemic, there were still many people who did not comply with wearing mask use even though there was policy to prevent Covid-19 with mask use. The statement was the last sentence of the first paragraph of Discussion. As the study, it was conducted during the first wave of COVID-19 pandemic in Indonesia when there was a mandatory of mask use policy. 6.The vaccination of Covid-19 began on January 14 2021 in 4 stages which priority stage 1 and 2 on January to April 2021 were given to stage 1. Target for health workers and their asistants, supporting staffs and students who are undergoing professional medical education in health services. Stage 2. Target for public service officers, namely soldiers/Police, law enforcement officers, and other public service officers including officers at airports/ports/stations/terminals. Then, workers in the banking sector, state electricity companies, and regional drinking water companies, as well as other officers who are directly involved provide services to the community. In addition, the elderly age group (60 years old and above). Meanwhile, stage 3 and 4 were given April 2021 to March 2022. Link questionnaires of the study were given to WA groups for community and not to health workers or public officers, including WA groups on target 2 for soldiers/police (although there were 3 soldiers and 1 police who were not public officers that responded the questionnaires included in the study). 7. ‘Productive age’ would be changed to adult as active individuals and whom may feel healthy, so they still need a process to change their behavior of wearing mask. 8. Thank you for the comment, we would avoid redundant. 9. The bivariate analysis as sex, gender, geographic area (greater Surabaya) with p<0.2 were included in the logistic regression analysis, with backward LR but the variables were (out) not in the final model. 10. The participants were not target (stage 1&2) of vaccination at the time of study. Minor comments Responses Thank you, would be added “49% likely for consistent mask use”. Thank you, would be added 95% CI. Thank you, the sentence would be deleted. Thank you, mask adherence would be changed to “mask use”. Thank you, would be changed to increase compliance with mask use. Thank you, would be changed to about the mandatory use of mask from the policy. Thank you, the question was “what are your habits of using a mask when you are outside the house”. It would be added in methods Thank you, informal groups as group of fisherman/farmer, group of traditional market seller, group of neighborhood associations (private sector workers) Thank you, would be rephrased Thank you, during the wave of Covid-19 there was social sanction if not using mask outside such as cleaning trash around the place where he was not wearing the mask, take mask in home, buy mask, push up. Even in few provinces such as Jakarta, west Java provinces there were governor regulation that if not wearing mask in public places would be fined. Thank you, it is for having estimate on each of risk perception, sociodemographic factors, and knowledge of Covid-19, respectively. So, if intervention is needed, the target variable can be focused on. Thank you, they were actually 2 sentences of mask use and type of mask; would be changed to 2 sentences. Thank you, I mean “the Government was distributing masks down to neighbourhood levels for free” Thank you, I mean that sociodemographic factors are characteristics and are somewhat difficult to change such as education level, income or can’t be changed as age (in this study was significantly associated); so, it needs intervention as health education The reference of Covid-19 vaccination is “ https://vaksin.kemkes.go.id/#/vaccines ” Thank you, actually the file deposited was in SPSS software and that have been with codes in the variable view sheet. Major Comments Responses Thank you for the comment. We, would add the descriptive estimate at first of Results as follows. The perception about Covid-19, about a half 585 (50.1%) people answered as viral disease which could cause death and nearly a half 554 (48.0%) people answered as viral disease with flu, cough symptoms. For the feeling if neighbour’s sick of Covid-19, the majority 818 (70.9%) people answered feeling of anxiety, followed by 267 (23.2%) people answered feeling of usual. Meanwhile, for experiencing PCR positive Covid-19 and close contact with Covid-19 persons during the past 2 weeks before the study, just 45 (3.9%) people answered ever having PCR positive Covid-19 and 63 (5.5%) people having close contact with Covid-19 persons during the past 2 weeks before the study, respectively. For the sociodemographic factors of geographic areas it consisted of municipalities/districts outside Java/Sumatra/Sulawesi, municipalities/districts in Java (excluding greater Jakarta and greater Surabaya), Sumatra island, Sulawesi island, greater Jakarta, and greater Surabaya. The geographic areas of people who responded the study were mostly 502 (43.5%) people from greater Surabaya, 244 (21.2%) people from municipalities/districts outside Java/Sumatra/Sulawesi, and 191 (16.6%) people from greater Jakarta. For age, it composed of ed of 428 (37.1%) people aged 15-24 years old (young adults), 438 (38.0%) people aged 25-44 years old (adults), and 287 (24.9%) people aged >44 years old (old adults). According to sex, slightly above a half 496 (55.2%) were females and nearly a half 550 (47.7%) were males. While according to education, mostly were 517 (44.8%) academy/university graduate, followed by 288 (24.9%) high school education. According to occupation, mostly 346 (30.0%) people were Civil servants/police/soldiers/government workers; followed by almost the same of Academy/University students and private employees of 198 (17.2%) and 193 (16.7%) people, respectively. The family income, mostly 304 (26.4%) were Rp. >2,000,000 – 4,000,000,-, followed by 269 (23.2%) people with Rp. >4,000,000 – 7,000,000,- and 244 (21.2%) people up to Rp. 2,000,000,-, respectively. Mostly, 796 (69.0%) people had ≤ 4 family members and 961 (83.3%) people owned of National Health Scheme. 2. The questionnaire was distributed to different public groups that it could describe the use of mask in the society. It will be added in the methods. About age and gender, it would be as aboved description that the categories are as social activities that their distribution among categories were equal as possible of bias. Moreover, if there were biases - they had been controlled in the analysis. 3. The purpose of pre-testing the questionnaire to varying occupation was to get information on how to provide answers, namely sociodemografic factors, perception and knowledge of COVID-19 in the community. In the pre-test questionnaire, the questions about the perception were asked with open questions in which required times to answer. So, the questions about the perception of COVID-19 were changed into close questions with answer choices and in which included responses from the pre-test. These would be added. 4. The categories of age used the division as for social activity in which the the percentages (estimates) showed trend that use of mask in old adults is less. 5. Before Covid-19 pandemic, mask use was uncommon in Indonesia. Even in the early of pandemic, there were still many people who did not comply with wearing mask use even though there was policy to prevent Covid-19 with mask use. The statement was the last sentence of the first paragraph of Discussion. As the study, it was conducted during the first wave of COVID-19 pandemic in Indonesia when there was a mandatory of mask use policy. 6.The vaccination of Covid-19 began on January 14 2021 in 4 stages which priority stage 1 and 2 on January to April 2021 were given to stage 1. Target for health workers and their asistants, supporting staffs and students who are undergoing professional medical education in health services. Stage 2. Target for public service officers, namely soldiers/Police, law enforcement officers, and other public service officers including officers at airports/ports/stations/terminals. Then, workers in the banking sector, state electricity companies, and regional drinking water companies, as well as other officers who are directly involved provide services to the community. In addition, the elderly age group (60 years old and above). Meanwhile, stage 3 and 4 were given April 2021 to March 2022. Link questionnaires of the study were given to WA groups for community and not to health workers or public officers, including WA groups on target 2 for soldiers/police (although there were 3 soldiers and 1 police who were not public officers that responded the questionnaires included in the study). 7. ‘Productive age’ would be changed to adult as active individuals and whom may feel healthy, so they still need a process to change their behavior of wearing mask. 8. Thank you for the comment, we would avoid redundant. 9. The bivariate analysis as sex, gender, geographic area (greater Surabaya) with p<0.2 were included in the logistic regression analysis, with backward LR but the variables were (out) not in the final model. 10. The participants were not target (stage 1&2) of vaccination at the time of study. Minor comments Responses Thank you, would be added “49% likely for consistent mask use”. Thank you, would be added 95% CI. Thank you, the sentence would be deleted. Thank you, mask adherence would be changed to “mask use”. Thank you, would be changed to increase compliance with mask use. Thank you, would be changed to about the mandatory use of mask from the policy. Thank you, the question was “what are your habits of using a mask when you are outside the house”. It would be added in methods Thank you, informal groups as group of fisherman/farmer, group of traditional market seller, group of neighborhood associations (private sector workers) Thank you, would be rephrased Thank you, during the wave of Covid-19 there was social sanction if not using mask outside such as cleaning trash around the place where he was not wearing the mask, take mask in home, buy mask, push up. Even in few provinces such as Jakarta, west Java provinces there were governor regulation that if not wearing mask in public places would be fined. Thank you, it is for having estimate on each of risk perception, sociodemographic factors, and knowledge of Covid-19, respectively. So, if intervention is needed, the target variable can be focused on. Thank you, they were actually 2 sentences of mask use and type of mask; would be changed to 2 sentences. Thank you, I mean “the Government was distributing masks down to neighbourhood levels for free” Thank you, I mean that sociodemographic factors are characteristics and are somewhat difficult to change such as education level, income or can’t be changed as age (in this study was significantly associated); so, it needs intervention as health education The reference of Covid-19 vaccination is “ https://vaksin.kemkes.go.id/#/vaccines ” Thank you, actually the file deposited was in SPSS software and that have been with codes in the variable view sheet. Competing Interests: No competing of interest Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 20 Mar 2025 Betty Roosihermiatie , Research Center for Public Health and Nutrition, National Research and Innovation Agency Republic of Indonesia, Bogor Regency, 16911, Indonesia 20 Mar 2025 Author Response Major Comments Responses Thank you for the comment. We, would add the descriptive estimate at first of Results as follows. The perception about Covid-19, about a ... Continue reading Major Comments Responses Thank you for the comment. We, would add the descriptive estimate at first of Results as follows. The perception about Covid-19, about a half 585 (50.1%) people answered as viral disease which could cause death and nearly a half 554 (48.0%) people answered as viral disease with flu, cough symptoms. For the feeling if neighbour’s sick of Covid-19, the majority 818 (70.9%) people answered feeling of anxiety, followed by 267 (23.2%) people answered feeling of usual. Meanwhile, for experiencing PCR positive Covid-19 and close contact with Covid-19 persons during the past 2 weeks before the study, just 45 (3.9%) people answered ever having PCR positive Covid-19 and 63 (5.5%) people having close contact with Covid-19 persons during the past 2 weeks before the study, respectively. For the sociodemographic factors of geographic areas it consisted of municipalities/districts outside Java/Sumatra/Sulawesi, municipalities/districts in Java (excluding greater Jakarta and greater Surabaya), Sumatra island, Sulawesi island, greater Jakarta, and greater Surabaya. The geographic areas of people who responded the study were mostly 502 (43.5%) people from greater Surabaya, 244 (21.2%) people from municipalities/districts outside Java/Sumatra/Sulawesi, and 191 (16.6%) people from greater Jakarta. For age, it composed of ed of 428 (37.1%) people aged 15-24 years old (young adults), 438 (38.0%) people aged 25-44 years old (adults), and 287 (24.9%) people aged >44 years old (old adults). According to sex, slightly above a half 496 (55.2%) were females and nearly a half 550 (47.7%) were males. While according to education, mostly were 517 (44.8%) academy/university graduate, followed by 288 (24.9%) high school education. According to occupation, mostly 346 (30.0%) people were Civil servants/police/soldiers/government workers; followed by almost the same of Academy/University students and private employees of 198 (17.2%) and 193 (16.7%) people, respectively. The family income, mostly 304 (26.4%) were Rp. >2,000,000 – 4,000,000,-, followed by 269 (23.2%) people with Rp. >4,000,000 – 7,000,000,- and 244 (21.2%) people up to Rp. 2,000,000,-, respectively. Mostly, 796 (69.0%) people had ≤ 4 family members and 961 (83.3%) people owned of National Health Scheme. 2. The questionnaire was distributed to different public groups that it could describe the use of mask in the society. It will be added in the methods. About age and gender, it would be as aboved description that the categories are as social activities that their distribution among categories were equal as possible of bias. Moreover, if there were biases - they had been controlled in the analysis. 3. The purpose of pre-testing the questionnaire to varying occupation was to get information on how to provide answers, namely sociodemografic factors, perception and knowledge of COVID-19 in the community. In the pre-test questionnaire, the questions about the perception were asked with open questions in which required times to answer. So, the questions about the perception of COVID-19 were changed into close questions with answer choices and in which included responses from the pre-test. These would be added. 4. The categories of age used the division as for social activity in which the the percentages (estimates) showed trend that use of mask in old adults is less. 5. Before Covid-19 pandemic, mask use was uncommon in Indonesia. Even in the early of pandemic, there were still many people who did not comply with wearing mask use even though there was policy to prevent Covid-19 with mask use. The statement was the last sentence of the first paragraph of Discussion. As the study, it was conducted during the first wave of COVID-19 pandemic in Indonesia when there was a mandatory of mask use policy. 6.The vaccination of Covid-19 began on January 14 2021 in 4 stages which priority stage 1 and 2 on January to April 2021 were given to stage 1. Target for health workers and their asistants, supporting staffs and students who are undergoing professional medical education in health services. Stage 2. Target for public service officers, namely soldiers/Police, law enforcement officers, and other public service officers including officers at airports/ports/stations/terminals. Then, workers in the banking sector, state electricity companies, and regional drinking water companies, as well as other officers who are directly involved provide services to the community. In addition, the elderly age group (60 years old and above). Meanwhile, stage 3 and 4 were given April 2021 to March 2022. Link questionnaires of the study were given to WA groups for community and not to health workers or public officers, including WA groups on target 2 for soldiers/police (although there were 3 soldiers and 1 police who were not public officers that responded the questionnaires included in the study). 7. ‘Productive age’ would be changed to adult as active individuals and whom may feel healthy, so they still need a process to change their behavior of wearing mask. 8. Thank you for the comment, we would avoid redundant. 9. The bivariate analysis as sex, gender, geographic area (greater Surabaya) with p<0.2 were included in the logistic regression analysis, with backward LR but the variables were (out) not in the final model. 10. The participants were not target (stage 1&2) of vaccination at the time of study. Minor comments Responses Thank you, would be added “49% likely for consistent mask use”. Thank you, would be added 95% CI. Thank you, the sentence would be deleted. Thank you, mask adherence would be changed to “mask use”. Thank you, would be changed to increase compliance with mask use. Thank you, would be changed to about the mandatory use of mask from the policy. Thank you, the question was “what are your habits of using a mask when you are outside the house”. It would be added in methods Thank you, informal groups as group of fisherman/farmer, group of traditional market seller, group of neighborhood associations (private sector workers) Thank you, would be rephrased Thank you, during the wave of Covid-19 there was social sanction if not using mask outside such as cleaning trash around the place where he was not wearing the mask, take mask in home, buy mask, push up. Even in few provinces such as Jakarta, west Java provinces there were governor regulation that if not wearing mask in public places would be fined. Thank you, it is for having estimate on each of risk perception, sociodemographic factors, and knowledge of Covid-19, respectively. So, if intervention is needed, the target variable can be focused on. Thank you, they were actually 2 sentences of mask use and type of mask; would be changed to 2 sentences. Thank you, I mean “the Government was distributing masks down to neighbourhood levels for free” Thank you, I mean that sociodemographic factors are characteristics and are somewhat difficult to change such as education level, income or can’t be changed as age (in this study was significantly associated); so, it needs intervention as health education The reference of Covid-19 vaccination is “ https://vaksin.kemkes.go.id/#/vaccines ” Thank you, actually the file deposited was in SPSS software and that have been with codes in the variable view sheet. Major Comments Responses Thank you for the comment. We, would add the descriptive estimate at first of Results as follows. The perception about Covid-19, about a half 585 (50.1%) people answered as viral disease which could cause death and nearly a half 554 (48.0%) people answered as viral disease with flu, cough symptoms. For the feeling if neighbour’s sick of Covid-19, the majority 818 (70.9%) people answered feeling of anxiety, followed by 267 (23.2%) people answered feeling of usual. Meanwhile, for experiencing PCR positive Covid-19 and close contact with Covid-19 persons during the past 2 weeks before the study, just 45 (3.9%) people answered ever having PCR positive Covid-19 and 63 (5.5%) people having close contact with Covid-19 persons during the past 2 weeks before the study, respectively. For the sociodemographic factors of geographic areas it consisted of municipalities/districts outside Java/Sumatra/Sulawesi, municipalities/districts in Java (excluding greater Jakarta and greater Surabaya), Sumatra island, Sulawesi island, greater Jakarta, and greater Surabaya. The geographic areas of people who responded the study were mostly 502 (43.5%) people from greater Surabaya, 244 (21.2%) people from municipalities/districts outside Java/Sumatra/Sulawesi, and 191 (16.6%) people from greater Jakarta. For age, it composed of ed of 428 (37.1%) people aged 15-24 years old (young adults), 438 (38.0%) people aged 25-44 years old (adults), and 287 (24.9%) people aged >44 years old (old adults). According to sex, slightly above a half 496 (55.2%) were females and nearly a half 550 (47.7%) were males. While according to education, mostly were 517 (44.8%) academy/university graduate, followed by 288 (24.9%) high school education. According to occupation, mostly 346 (30.0%) people were Civil servants/police/soldiers/government workers; followed by almost the same of Academy/University students and private employees of 198 (17.2%) and 193 (16.7%) people, respectively. The family income, mostly 304 (26.4%) were Rp. >2,000,000 – 4,000,000,-, followed by 269 (23.2%) people with Rp. >4,000,000 – 7,000,000,- and 244 (21.2%) people up to Rp. 2,000,000,-, respectively. Mostly, 796 (69.0%) people had ≤ 4 family members and 961 (83.3%) people owned of National Health Scheme. 2. The questionnaire was distributed to different public groups that it could describe the use of mask in the society. It will be added in the methods. About age and gender, it would be as aboved description that the categories are as social activities that their distribution among categories were equal as possible of bias. Moreover, if there were biases - they had been controlled in the analysis. 3. The purpose of pre-testing the questionnaire to varying occupation was to get information on how to provide answers, namely sociodemografic factors, perception and knowledge of COVID-19 in the community. In the pre-test questionnaire, the questions about the perception were asked with open questions in which required times to answer. So, the questions about the perception of COVID-19 were changed into close questions with answer choices and in which included responses from the pre-test. These would be added. 4. The categories of age used the division as for social activity in which the the percentages (estimates) showed trend that use of mask in old adults is less. 5. Before Covid-19 pandemic, mask use was uncommon in Indonesia. Even in the early of pandemic, there were still many people who did not comply with wearing mask use even though there was policy to prevent Covid-19 with mask use. The statement was the last sentence of the first paragraph of Discussion. As the study, it was conducted during the first wave of COVID-19 pandemic in Indonesia when there was a mandatory of mask use policy. 6.The vaccination of Covid-19 began on January 14 2021 in 4 stages which priority stage 1 and 2 on January to April 2021 were given to stage 1. Target for health workers and their asistants, supporting staffs and students who are undergoing professional medical education in health services. Stage 2. Target for public service officers, namely soldiers/Police, law enforcement officers, and other public service officers including officers at airports/ports/stations/terminals. Then, workers in the banking sector, state electricity companies, and regional drinking water companies, as well as other officers who are directly involved provide services to the community. In addition, the elderly age group (60 years old and above). Meanwhile, stage 3 and 4 were given April 2021 to March 2022. Link questionnaires of the study were given to WA groups for community and not to health workers or public officers, including WA groups on target 2 for soldiers/police (although there were 3 soldiers and 1 police who were not public officers that responded the questionnaires included in the study). 7. ‘Productive age’ would be changed to adult as active individuals and whom may feel healthy, so they still need a process to change their behavior of wearing mask. 8. Thank you for the comment, we would avoid redundant. 9. The bivariate analysis as sex, gender, geographic area (greater Surabaya) with p<0.2 were included in the logistic regression analysis, with backward LR but the variables were (out) not in the final model. 10. The participants were not target (stage 1&2) of vaccination at the time of study. Minor comments Responses Thank you, would be added “49% likely for consistent mask use”. Thank you, would be added 95% CI. Thank you, the sentence would be deleted. Thank you, mask adherence would be changed to “mask use”. Thank you, would be changed to increase compliance with mask use. Thank you, would be changed to about the mandatory use of mask from the policy. Thank you, the question was “what are your habits of using a mask when you are outside the house”. It would be added in methods Thank you, informal groups as group of fisherman/farmer, group of traditional market seller, group of neighborhood associations (private sector workers) Thank you, would be rephrased Thank you, during the wave of Covid-19 there was social sanction if not using mask outside such as cleaning trash around the place where he was not wearing the mask, take mask in home, buy mask, push up. Even in few provinces such as Jakarta, west Java provinces there were governor regulation that if not wearing mask in public places would be fined. Thank you, it is for having estimate on each of risk perception, sociodemographic factors, and knowledge of Covid-19, respectively. So, if intervention is needed, the target variable can be focused on. Thank you, they were actually 2 sentences of mask use and type of mask; would be changed to 2 sentences. Thank you, I mean “the Government was distributing masks down to neighbourhood levels for free” Thank you, I mean that sociodemographic factors are characteristics and are somewhat difficult to change such as education level, income or can’t be changed as age (in this study was significantly associated); so, it needs intervention as health education The reference of Covid-19 vaccination is “ https://vaksin.kemkes.go.id/#/vaccines ” Thank you, actually the file deposited was in SPSS software and that have been with codes in the variable view sheet. Competing Interests: No competing of interest Close Report a concern COMMENT ON THIS REPORT Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 10 Feb 2025 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 3 4 Version 2 (revision) 20 Jun 25 read read read read Version 1 10 Feb 25 read read Neilshan Loedy , Hasselt University, Hasselt, Belgium Atle Fretheim , Oslo Metropolitan University, Oslo, Norway Andrew Kweku Conduah , University of Professional Studies, Madina, Ghana Temesgen Zewotir , University of KwaZulu Natal, KwaZulu-Natal, South Africa Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Zewotir T. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 09 Oct 2025 | for Version 2 Temesgen Zewotir , University of KwaZulu Natal, KwaZulu-Natal, South Africa 0 Views copyright © 2025 Zewotir T. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Not Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions This study examined the factors influencing consistent mask-wearing outside the home in Indonesia during the pandemic. An online survey was conducted between November 2020 and February 2021 via Google Forms, shared through various WhatsApp community groups. Logistic regression was used as the method of analysis. The study reported nothing from the data analysis but high mask compliance because Indonesia’s strict mask mandate and extensive public education campaigns. Besides the low sample size by putting very modest P value, the method of analysis is not appropriate to establish causal relationships between risk perception, knowledge, and mask-wearing behavior.. Proper causal analysis should have been used. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? No Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Not applicable Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? No Competing Interests No competing interests were disclosed. Reviewer Expertise Applied Statistics and Data Science particularly interested in the abundance of data that could accelerate the development and refinement of basic research and theories. I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. reply Respond to this report Responses (0) Zewotir T. Peer Review Report For: Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy [version 2; peer review: 4 not approved] . F1000Research 2025, 14 :179 ( https://doi.org/10.5256/f1000research.183333.r419295) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-179/v2#referee-response-419295 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Loedy N. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 13 Aug 2025 | for Version 2 Neilshan Loedy , Hasselt University, Hasselt, Belgium 0 Views copyright © 2025 Loedy N. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Not Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions I appreciate the authors’ efforts in revising the manuscript and providing a detailed point-by-point response. However, after carefully reviewing the revised version and the responses, I find that several major concerns raised in my initial review remain insufficiently addressed. For example, the descriptive results do not appear to be calculated carefully in some cases. There are instances where percentages do not sum to 100% without clear explanation (e.g., “According to sex, slightly above half 496 (55.2%) were females and nearly half 550 (47.7%) were males”). Greater care is needed to ensure accuracy in these basic summaries. Additionally, the issue regarding the age group divisions has not received sufficient attention or justification, despite earlier feedback that this could introduce inaccuracies in the conclusions. I also remain concerned that the analysis does not adequately consider the stringency index or related measures. Although the authors note that mask use was uncommon before COVID-19, the study period (November 2020 to February 2021) falls well within the pandemic, and varying public health measures could have influenced the findings. At the very least, a careful literature review and a discussion of the potential implications of differing public health policies should be added to strengthen the interpretation of the results. Moreover, while the authors have made revisions, it is unclear where these changes were made in the manuscript. I strongly recommend that any future revision clearly indicate the locations of all changes, ideally by specifying line numbers or highlighting the modified sections. These points are critical for the validity and robustness of the study’s conclusions. Addressing them would require substantial additional work beyond the scope of a minor revision. For these reasons, I do not think the manuscript is suitable for publication in its current form. I thank the authors again for their efforts and encourage them to consider a more substantial revision of their methods and analyses if they choose to submit the work to another journal. Competing Interests No competing interests were disclosed. Reviewer Expertise Statistics, Epidemiology, Social contact data. I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. reply Respond to this report Responses (0) Loedy N. Peer Review Report For: Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy [version 2; peer review: 4 not approved] . F1000Research 2025, 14 :179 ( https://doi.org/10.5256/f1000research.183333.r393493) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-179/v2#referee-response-393493 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Conduah A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 13 Aug 2025 | for Version 2 Andrew Kweku Conduah , University of Professional Studies, Madina, Ghana 0 Views copyright © 2025 Conduah A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Not Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Manuscript Title: Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy. Phase 1: Title and Abstract Strengths: Clear, focused, and informative title. Abstract outlines the background, methodology, and key findings succinctly. Areas for Improvement: The abstract should explicitly state the study design (“cross-sectional online survey”). Include at least one statistical outcome (e.g., OR or CI) for scientific precision. Recommendation: Minor Revision – Add study design and one or two statistical results for clarity. Phase 2: Introduction / Background Strengths: Strong rationale for the study. Mentions Health Belief Model (HBM) and relevant literature. Areas for Improvement: (“strickness”) requires correction. Weak transition from global to Indonesian context. Lacks clarity on why specific demographic groups behave differently. Recommendation: Minor Revision – Improve grammar and contextual alignment with HBM and Indonesia’s socio-cultural setting. Phase 3: Methods Strengths: Methodology is generally well-structured. Ethical clearance is clearly stated. Concerns & Suggestions: Sampling bias due to online-only survey not sufficiently flagged. COVID-19 knowledge scoring lacks detail: cut-offs, reliability testing (e.g., Cronbach’s alpha). Sociodemographic variables (e.g., occupation) are undefined in terms of categorization. Statistical transparency is inadequate: No collinearity checks No model fit statistics (e.g., Hosmer–Lemeshow test) No logit linearity test for continuous variables Recommendation: Moderate Revision – Improve transparency on variable construction, scoring, and regression diagnostics. Phase 4: Results Strengths: Comprehensive presentation of both bivariate and multivariate outcomes. Use of AOR (Adjusted Odds Ratio) enhances interpretability. Areas for Improvement: Weak integration of results into narrative. No interpretation of non-significant variables (e.g., gender, income). Tables need better formatting and use of footnotes for clarity. Recommendation: Moderate Revision – Improve narrative integration, discuss non-significant findings, and enhance table readability. Phase 5: Discussion Strengths: Attempts to link findings to HBM. Recognizes policy implications and limitations. Critical Gaps: Superficial interpretation – key patterns (e.g., age-related behavior) not critically unpacked. No comparative literature from Southeast Asia or beyond. Weak policy implications, which are generic and not tailored to findings. Non-significant results are ignored, which limits analytical balance. Recommendation: Major Revision – Deepen interpretation, engage comparative literature, and derive specific policy applications. Phase 6: Conclusion Strengths: Summarizes key points. Reaffirms public health relevance. Limitations: Repetitive phrasing. Misses opportunity to suggest future research or broader implications. Recommendation: Minor Revision – Reframe for conciseness and include forward-looking recommendations. Phase 7: Final Evaluation Summary Scientific Soundness: Yes, the method is appropriate, but underreported Data & Methods Clarity: Partial – needs more transparency Language and Accessibility: Needs Improvement – professional editing required Originality & Contribution: Moderate – contextually useful, but interpretively weak Phase 8: Final Recommendation Recommendation: Not Approved Justification: While this manuscript explores an important area of public health behavior, it requires substantial revision in order to meet the standards of scholarly publication: Theoretical framing is shallow, with limited application of the Health Belief Model beyond introductory mentions. Literature is outdated and lacks a comparative perspective, missing recent findings from 2023–2024 and key regional studies. Methodological reporting is incomplete, especially regarding statistical diagnostics and operationalization of key variables. Discussion is underdeveloped, lacking both interpretive depth and actionable policy insights. Language quality is poor, with numerous grammatical errors and inconsistent phrasing throughout the manuscript. Given these significant weaknesses, I cannot recommend indexing in its current form. I encourage the authors to undertake a major revision, rebuilding the theoretical, methodological, and interpretive components, before resubmission. Is the work clearly and accurately presented and does it cite the current literature? No Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Partly Competing Interests No competing interests were disclosed. Reviewer Expertise Public health, ageing and health equity, population studies, health-related quality of life (HRQoL), social determinants of health, health behavior and risk perception, survey methodology, and mixed methods research. I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. reply Respond to this report Responses (0) Conduah AK. Peer Review Report For: Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy [version 2; peer review: 4 not approved] . F1000Research 2025, 14 :179 ( https://doi.org/10.5256/f1000research.183333.r395660) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-179/v2#referee-response-395660 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Fretheim A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 21 Jul 2025 | for Version 2 Atle Fretheim , Oslo Metropolitan University, Oslo, Norway 0 Views copyright © 2025 Fretheim A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Not Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The authors have responded satisfactory to some of my concerns, and some not. 1. My main concern was that I was not able to make full sense of the calculated crude ORs, and I suggested that the authors should provide a somewhat more detailed explanation of what the ORs represent. In my view, the authors have not responded sufficiently to this. I realise that the interpretation of the results in e.g. Table 1 may be perceived as obvious to some, but a table footnote with some key information should be provided since there are several valid ways of presenting results in such tables, and the reader should not have to make assumptions or guess. Information in a footnote should e.g. include i) what the percentages represent, ii) a statement saying that some results (e.g. marked with a *) cannot be calculated directly from the due to non-responses which changes the denominator (which I assume is the case), iii) explain why some rows do not report ORs, iv) what the reference groups are, v) spelling out absolutely all abbreviations etc. 2. I also commented in the previous round that it is not clear how the respondents were recruited, and the authors have not added much to understand the recruitment process. Their latest description is this: “The recruitment targeted individuals with various educational and occupational backgrounds through online community groups. The questionnaire was distributed to the participants via WhatsApp (WA) to the following groups: 1) government offices, 2) private offices, 3) companies, 4) self-employed individuals, 5) professionals, 6) neighborhood association (RT), 7) university students, 8) other students, and 9) informal groups with their various ages and genders”, This is not clear to me. I assume there are hundreds or thousands of online community groups on WhatsApp, and some sort of process was carried out to select groups to invite? Or did the authors identify as many such groups as they could, and invite all? 3. There is still no reference to a protocol, except under “Ethics and consent”. I take that as an indication that all analyses were decided upon post hoc. If not, the protocol should be included as an attachment file. The post hoc nature of the study (if this is the case) is a weakness the authors should reflect on – as I suggested in the previous round. 4. The authors have decided to drop their comparison of mortality rates across countries, as I suggested. 5. The authors maintain that the incubation period of COVID-19 is 14 days. Since they have disregarded my suggestion to change this to a much shorter period, which I believe is more in line with the broad consensus, I would insist that they provide a reference for their claim that the incubation period is 14 days. 6. I commented earlier that the authors should refer to systematic review(s) of effectiveness studies than a (random?) selection of observational studies. They have responded by adding two references: a systematic review of case-control studies (which is an odd choice when the question at hand is to determine the effectiveness of face masks – case-control studies are generally not seen as strong evidence in support of claims of effectiveness of interventions, and there are several available systematic reviews that have assessed the available evidence from effect studies such as randomize trials) and an unsystematic review or commentary from very early on in the COVID-19 pandemic. I don’t find this to be a convincing response. 7. I believe the authors have misunderstood my problem with the word “strickness», since they have simply rephrased and are using the word “strick”. My comment concerned the spelling of the word: it should strictness (or “strict”). 8. The authors have included a link directly from the text to the questionnaire, as I suggested. 9. It is still not clear to me HOW the open-ended questions on perceptions were converted to variables that could be included in regressions analyses. This should be pretty straightforward to give an account of. 10. When I commented that “cOR” and “RDT” needs to be spelled out, I did not mean that this had to be done throughout the manuscript, but that it be done at least the first time the abbreviations were used (the abbreviations were not explained anywhere in the first version of the manuscript). I realise that I could have been clearer about that. Competing Interests No competing interests were disclosed. I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. reply Respond to this report Responses (0) Fretheim A. Peer Review Report For: Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy [version 2; peer review: 4 not approved] . F1000Research 2025, 14 :179 ( https://doi.org/10.5256/f1000research.183333.r393492) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-179/v2#referee-response-393492 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Fretheim A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 15 Apr 2025 | for Version 1 Atle Fretheim , Oslo Metropolitan University, Oslo, Norway 0 Views copyright © 2025 Fretheim A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Not Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Peer review report on F1000 research article “Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy“ The authors have explored the association between various factors and use of face masks, based on a survey conducted in Indonesia. My main concern with the manuscript is that I could not make full sense of the calculated crude ORs, i.e. to me some of them seem to be incorrect, so the calculations need to be checked. Of course, if the results from the univariate analyses are wrong, this will likely mean that the multivariate analyses are wrong too, and consequently the conclusions will probably change. If I have misunderstood something, or the error is on my side, I apologise. Anyhow, if the calculations are indeed correct, perhaps a more detailed explanation of the approach may be needed (the current description is very short). It is not very clear how the respondents were recruited, although there is a brief description of the recruitment process. There is not reference to a protocol. I assume that this means that all analyses were decided upon post hoc, which would be a weakness the authors should reflect on – and they should argue carefully for every analytical choice they have made, and describe these in detail. The 1 st paragraph of the Background includes a repetition of a sentence. The 2 nd paragraph discusses mortality rates across countries. I think it’s better to skip this, since such comparisons are difficult to make, mainly due to variation in reporting of cases. Incubation period is not 14 days, but much shorter. The paragraph starting with “Numerous studies have established the effectiveness of mask-wearing» does not read will, and the line of argument is weak. The authors should rather refer to systematic review(s) of effectiveness studies than a (random?) selection of observational studies. Error in spelling: “strickness» When referring to the questionnaire in the text, I suggest linking directly to the questionnaire. In the paragraph starting with “Data collection took place during the period from November 2020 to February 2021”, there is an “s” missing in a “follows”, and there is a quotation mark missing. It is not explained how the open-ended questions on perceptions were converted to variables that could be included in regressions analyses. The first sentence in Results, “use” should be “used”. Error in spelling: “Tabel 1” “RDT” needs to be spelled out. cOR needs to be spelled out. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? No If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Partly Competing Interests No competing interests were disclosed. Reviewer Expertise Effectiveness studies. I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. reply Respond to this report Responses (1) Author Response 11 Aug 2025 Betty Roosihermiatie, Research Center for Public Health and Nutrition, National Research and Innovation Agency Republic of Indonesia, Bogor Regency, 16911, Indonesia My main concern with the manuscript is that I could not make full sense of the calculated crude ORs, i.e. to me some of them seem to be incorrect, so the calculations need to be checked. Of course, if the results from the univariate analyses are wrong, this will likely mean that the multivariate analyses are wrong too, and consequently the conclusions will probably change. If I have misunderstood something, or the error is on my side, I apologise. Anyhow, if the calculations are indeed correct, perhaps a more detailed explanation of the approach may be needed (the current description is very short). Thank you for the comment. There is an incorrect calculation from knowledge in which the actual question was ‘activities after going out, EXCEPT’; we have revised as the questionnaire and make correction for the results (in bivariate and multivariate analysis). More detailed explanation of univariate and bivariate analysis was added. It is not very clear how the respondents were recruited, although there is a brief description of the recruitment process. Response: Thank you for the comment. We added ‘The recruitment was for people with various of studying or working backrounds on online community in the society’. There is not reference to a protocol. I assume that this means that all analyses were decided upon post hoc, which would be a weakness the authors should reflect on – and they should argue carefully for every analytical choice they have made, and describe these in detail. Response: Thank you for the comment, we added the references in the developing of the questionnaires. The 1 st paragraph of the Background includes a repetition of a sentence. Response: ​​​​​​​Thank you for the comment, we deleted the repetition of a paragraph in the background. The 2 nd paragraph discusses mortality rates across countries. I think it’s better to skip this, since such comparisons are difficult to make, mainly due to variation in reporting of cases. Thank you for the comment, we deleted the mortality rate in Indonesia. Incubation period is not 14 days, but much shorter. Response: ​​​​​​​Thank you for the comment, we changed the incubation period of COVID-19 is 1 to 2 weeks. The paragraph starting with “Numerous studies have established the effectiveness of mask-wearing» does not read will, and the line of argument is weak. The authors should rather refer to systematic review(s) of effectiveness studies than a (random?) selection of observational studies. Response: ​​​​​​​Thank you for the comment. We added a reference of metaanalysis on effectiveness of mask use. Error in spelling: “strickness» Response: ​​​​​​​Thank you for the comment, we changed to ‘mandatory’. When referring to the questionnaire in the text, I suggest linking directly to the questionnaire. Response: ​​​​​​​Thank you for the comment, we added the link of questionnaire. In the paragraph starting with “Data collection took place during the period from November 2020 to February 2021”, there is an “s” missing in a “follows”, and there is a quotation mark missing. Response: ​​​​​​​Thank you for the comment , we added as follows ‘The link of questionnaire in google form was distributed to contact persons of online community from the aboved groups. Then, the link was shared to the WhatsApp (WA) groups.Prior to completing the questionnaire, participants were presented with a written informed consent statement to determine their willingness to voluntarily participate in the study’. It is not explained how the open-ended questions on perceptions were converted to variables that could be included in regressions analyses. Response: ​​​​​​​Thank you for the comment, we added ‘The questionnaire after pre-test as the question for perception was changed as to answer of answer choices’ The first sentence in Results, “use” should be “used”. Error in spelling: “Tabel 1” Response: ​​​​​​​Thank you for the comment, it changed to used. “RDT” needs to be spelled out. Response: ​​​​​​​Thank you for the comment, the RDT had been spelled out cOR needs to be spelled out. Response: ​​​​​​​Thank you for the comment, the cOR had been spelled out We have added the information for download data, the original file 'dat' (SPSS) that The description of variables is available in the second sheet ‘variable view’. The link of questionnaire - after pretesting had been directly added. The underlying data and extended data of questionnaire had been in CC0.1.0 version (open access). View more View less Competing Interests All authors declare no competing of interest. reply Respond Report a concern Fretheim A. Peer Review Report For: Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy [version 2; peer review: 4 not approved] . F1000Research 2025, 14 :179 ( https://doi.org/10.5256/f1000research.172805.r373692) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-179/v1#referee-response-373692 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Loedy N. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 17 Mar 2025 | for Version 1 Neilshan Loedy , Hasselt University, Hasselt, Belgium 0 Views copyright © 2025 Loedy N. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions I am pleased to read and evaluate the manuscript prepared by Roosihermiatie and colleagues. In this manuscript, the author collected data associated with mask use during the COVID-19 pandemic in Indonesia. The data collection spanned from November 2020 to February 2021, resulting data from 1,153 participants to be analyzed. The data collected has been made publicly available, which is a commendable outcome as it supports open science and provides a valuable resource for the scientific community. The study examined the association between risk perception, sociodemographic, knowledge of COVID-19 and face mask adherence using a multivariate logistic regression. The results indicate positive association between the use of facemask outside the home and the risk perception, COVID-19 knowledge, and age. The topic of this manuscript is highly relevant, and I wish that more studies would collect similar valuable information. However, I would like to raise several questions and possible improvements to ensure the interpretability of the results. Moreover, authors need to thoroughly proofread and update the manuscript as the overall writing quality, including formatting and language, was rather poor. Major comments I understand that values can be seen from the tables, but I suggest expanding the results to include some of the obtained quantitative estimates. Right now, it just appears to be rather generic. The manuscript mentions that the questionnaire was distributed to different public groups via WhatsApp. However, it would be helpful to discuss the rationale behind selecting these groups and provide details on their distribution. Additionally, could the authors clarify how representative this sample is in terms of key demographics, such as age and gender? Figures showing the distributions of key sociodemographic factors would be a very nice addition in this case. Furthermore, a discussion on potential biases introduced by these chosen groups would strengthen the study's validity. It would be helpful to clarify the purpose of the pre-testing in the manuscript. Specifically, could you explain why the questionnaires were pre-tested on individuals with varying occupations and how the feedback influenced the revisions? Could the authors clarify the rationale behind the chosen age groups in the analysis? Specifically, the category of “older than 44 years” covers a broad range, which may obscure potential variations in mask-wearing behavior among different age subgroups. Given that previous studies have reported higher face mask usage among older individuals due to increased susceptibility to COVID-19 (e.g., Haischer et al, 2020 [Ref 2]), a more granular age categorization might provide additional insights. In the discussion section it is written that “This online study investigated mask use during the COVID-19 pandemic in the Indonesia’s mask mandatory policy”. The study period spanned from November 2020 to February 2021, during which the use of face masks is strongly influenced by government policies (as shown in other studies, e.g., Gimma et al., 2022 [Ref 3]). Not accounting for policy changes (e.g., by using stringency index or other relevant measures) in the analysis is likely affect the model’s results. It would be logical to explore the effect of a stringency/policy index variable in the model, which would ultimately increase the validity of the findings and support the statement written in the Discussion section. In addition to my previous comment (No. 3), I noticed that the first public COVID-19 vaccinations in Indonesia began on January 14, 2021. While the questionnaire does not include a question about vaccination status, the discussion section touches on vaccination rates and their relevance to mask-wearing adherence. To avoid confusion, I suggest clarifying this timeline in the discussion and addressing its potential impact on the analysis. The arguments in the discussion section are too generic and vague, making it unclear what message the authors are trying to convey. For instance, the statement: “This study revealed that among the sociodemographic factors, only individuals of productive age (25 to 44 years) are negatively associated with consistent mask-wearing outside the home” is somewhat confusing. Another paragraph states, “Previous studies identified that older individuals were associated with adherence to mask use...” which seems to contrast with the earlier finding. While there is an attempt to explain this, the paragraph could be more clearly structured to enhance clarity and coherence. I noticed that the idea of “Our study revealed/highlights a relationship between risk perception of COVID-19 and the (consistent) use of masks outside the home” appears multiple times throughout the discussion. To improve clarity and avoid redundancy, it might be helpful to restructure the discussion to consolidate these points and present them more cohesively. In the discussion section, it is stated that “In contrast, this study found that younger and older age groups, women, … living in outer Surabaya as well as … failed to be associated with consistent mask-wearing outside the home in the multivariate analysis.” However, I do not see any results in Table 4 that reflect these findings. If these results were obtained from bivariate analysis rather than multivariate analysis, it would be important to clarify this distinction, as interpreting bivariate results in this context may not be appropriate. It would also interesting to add to the manuscript a discussion on Peltz man effect (individuals might alter their risk perceptions after access to preventive measures, leading to greater engagement in riskier behaviour (e.g., making more contacts with people outside)). This has been shown after participants in other study received vaccination (Wambua et al, 2023 [Ref 1]). Exploring its impact on disease spread and identifying suitable interventions could provide valuable insights for the readers. Minor comments In the abstract, the statement “Regarding sociodemographic factors, individuals aged between 25 to 44 years aOR: 0.486” is unclear. Could you clarify (or put more context) what this refers to? I would recommend including confidence intervals for all estimates in the manuscript, to improve the comprehensiveness of the results. The sentence “By March 2020, due to its rapid global spread, the WHO declared COVID-19 a pandemic.” is repeated twice. The fourth paragraph “Risk perception significantly … determining mask adherence.”, looks a little bit out of place. The sentence “During the COVID-19 pandemic, Indonesia enforced a mandatory mask policy (The Ministry of Health of The Republic of Indonesia, 2020), which led to increased usage (Kar et al., 2023).”, can be phrased better. Please check the clarity of each sentence in the manuscript. I am not sure with the use of the word “strickness”, in the last paragraph of the Introduction. What is the definition of “outside the home”? Does it refer strictly to areas outside the house, or does it include spaces like the backyard, terrace, or a small park? It would be useful to make this clear in the manuscript. How do you define “Informal groups?” It might be helpful to rephrase the third paragraph of the Methodology section (“Data collection took place…”) to enhance clarity, as the current wording is a bit unclear. I would expect that the number of participants who never (or always) use a mask in general would be fewer than those who never (or always) use a mask outside the home, as the latter seems like a subset of the former. However, this does not seem to be the case. Could you please clarify the difference between these two questions and provide an explanation for this discrepancy? Could the authors explain the rationale behind excluding interaction effects from the analysis? It would be helpful to understand the reasoning for this decision. I do not think the statement “In this study, consistent mask-wearing outside the home was higher (90.0%), with the types of masks were mostly surgical masks (60%), followed by cloth masks (36.4%), N-19 masks (3.0%), and others.”, belong in the discussion section. I do not see any clear connection between the statement “Moreover, the Indonesian government distributed free masks down to neighborhood levels, further supporting compliance” with its preceeding statements. The statement that “sociodemographic factors are challenging to modify” feels somewhat unclear. While it is true that factors like age cannot be changed, their significance in the analysis somehow suggests the need for age-specific targeted interventions. It might be helpful to clarify this point to better align with the study's implications. A reference for Indonesia’s vaccination rate in the discussion section is needed It would also be beneficial to put all the codes used to produce the results in an open access repository to ensure open science to the general community Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Partly References 1. Wambua J, Loedy N, Jarvis CI, Wong KLM, et al.: The influence of COVID-19 risk perception and vaccination status on the number of social contacts across Europe: insights from the CoMix study. BMC Public Health . 2023; 23 (1): 1350 PubMed Abstract | Publisher Full Text 2. Haischer MH, Beilfuss R, Hart MR, Opielinski L, et al.: Who is wearing a mask? Gender-, age-, and location-related differences during the COVID-19 pandemic. PLoS One . 2020; 15 (10): e0240785 PubMed Abstract | Publisher Full Text 3. Gimma A, Munday JD, Wong KLM, Coletti P, et al.: Changes in social contacts in England during the COVID-19 pandemic between March 2020 and March 2021 as measured by the CoMix survey: A repeated cross-sectional study. PLoS Med . 2022; 19 (3): e1003907 PubMed Abstract | Publisher Full Text Competing Interests No competing interests were disclosed. Reviewer Expertise Statistics, Epidemiology, Social contact data. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 20 Mar 2025 Betty Roosihermiatie, Research Center for Public Health and Nutrition, National Research and Innovation Agency Republic of Indonesia, Bogor Regency, 16911, Indonesia Major Comments Responses Thank you for the comment. We, would add the descriptive estimate at first of Results as follows. The perception about Covid-19, about a half 585 (50.1%) people answered as viral disease which could cause death and nearly a half 554 (48.0%) people answered as viral disease with flu, cough symptoms. For the feeling if neighbour’s sick of Covid-19, the majority 818 (70.9%) people answered feeling of anxiety, followed by 267 (23.2%) people answered feeling of usual. Meanwhile, for experiencing PCR positive Covid-19 and close contact with Covid-19 persons during the past 2 weeks before the study, just 45 (3.9%) people answered ever having PCR positive Covid-19 and 63 (5.5%) people having close contact with Covid-19 persons during the past 2 weeks before the study, respectively. For the sociodemographic factors of geographic areas it consisted of municipalities/districts outside Java/Sumatra/Sulawesi, municipalities/districts in Java (excluding greater Jakarta and greater Surabaya), Sumatra island, Sulawesi island, greater Jakarta, and greater Surabaya. The geographic areas of people who responded the study were mostly 502 (43.5%) people from greater Surabaya, 244 (21.2%) people from municipalities/districts outside Java/Sumatra/Sulawesi, and 191 (16.6%) people from greater Jakarta. For age, it composed of ed of 428 (37.1%) people aged 15-24 years old (young adults), 438 (38.0%) people aged 25-44 years old (adults), and 287 (24.9%) people aged >44 years old (old adults). According to sex, slightly above a half 496 (55.2%) were females and nearly a half 550 (47.7%) were males. While according to education, mostly were 517 (44.8%) academy/university graduate, followed by 288 (24.9%) high school education. According to occupation, mostly 346 (30.0%) people were Civil servants/police/soldiers/government workers; followed by almost the same of Academy/University students and private employees of 198 (17.2%) and 193 (16.7%) people, respectively. The family income, mostly 304 (26.4%) were Rp. >2,000,000 – 4,000,000,-, followed by 269 (23.2%) people with Rp. >4,000,000 – 7,000,000,- and 244 (21.2%) people up to Rp. 2,000,000,-, respectively. Mostly, 796 (69.0%) people had ≤ 4 family members and 961 (83.3%) people owned of National Health Scheme. 2. The questionnaire was distributed to different public groups that it could describe the use of mask in the society. It will be added in the methods. About age and gender, it would be as aboved description that the categories are as social activities that their distribution among categories were equal as possible of bias. Moreover, if there were biases - they had been controlled in the analysis. 3. The purpose of pre-testing the questionnaire to varying occupation was to get information on how to provide answers, namely sociodemografic factors, perception and knowledge of COVID-19 in the community. In the pre-test questionnaire, the questions about the perception were asked with open questions in which required times to answer. So, the questions about the perception of COVID-19 were changed into close questions with answer choices and in which included responses from the pre-test. These would be added. 4. The categories of age used the division as for social activity in which the the percentages (estimates) showed trend that use of mask in old adults is less. 5. Before Covid-19 pandemic, mask use was uncommon in Indonesia. Even in the early of pandemic, there were still many people who did not comply with wearing mask use even though there was policy to prevent Covid-19 with mask use. The statement was the last sentence of the first paragraph of Discussion. As the study, it was conducted during the first wave of COVID-19 pandemic in Indonesia when there was a mandatory of mask use policy. 6.The vaccination of Covid-19 began on January 14 2021 in 4 stages which priority stage 1 and 2 on January to April 2021 were given to stage 1. Target for health workers and their asistants, supporting staffs and students who are undergoing professional medical education in health services. Stage 2. Target for public service officers, namely soldiers/Police, law enforcement officers, and other public service officers including officers at airports/ports/stations/terminals. Then, workers in the banking sector, state electricity companies, and regional drinking water companies, as well as other officers who are directly involved provide services to the community. In addition, the elderly age group (60 years old and above). Meanwhile, stage 3 and 4 were given April 2021 to March 2022. Link questionnaires of the study were given to WA groups for community and not to health workers or public officers, including WA groups on target 2 for soldiers/police (although there were 3 soldiers and 1 police who were not public officers that responded the questionnaires included in the study). 7. ‘Productive age’ would be changed to adult as active individuals and whom may feel healthy, so they still need a process to change their behavior of wearing mask. 8. Thank you for the comment, we would avoid redundant. 9. The bivariate analysis as sex, gender, geographic area (greater Surabaya) with p<0.2 were included in the logistic regression analysis, with backward LR but the variables were (out) not in the final model. 10. The participants were not target (stage 1&2) of vaccination at the time of study. Minor comments Responses Thank you, would be added “49% likely for consistent mask use”. Thank you, would be added 95% CI. Thank you, the sentence would be deleted. Thank you, mask adherence would be changed to “mask use”. Thank you, would be changed to increase compliance with mask use. Thank you, would be changed to about the mandatory use of mask from the policy. Thank you, the question was “what are your habits of using a mask when you are outside the house”. It would be added in methods Thank you, informal groups as group of fisherman/farmer, group of traditional market seller, group of neighborhood associations (private sector workers) Thank you, would be rephrased Thank you, during the wave of Covid-19 there was social sanction if not using mask outside such as cleaning trash around the place where he was not wearing the mask, take mask in home, buy mask, push up. Even in few provinces such as Jakarta, west Java provinces there were governor regulation that if not wearing mask in public places would be fined. Thank you, it is for having estimate on each of risk perception, sociodemographic factors, and knowledge of Covid-19, respectively. So, if intervention is needed, the target variable can be focused on. Thank you, they were actually 2 sentences of mask use and type of mask; would be changed to 2 sentences. Thank you, I mean “the Government was distributing masks down to neighbourhood levels for free” Thank you, I mean that sociodemographic factors are characteristics and are somewhat difficult to change such as education level, income or can’t be changed as age (in this study was significantly associated); so, it needs intervention as health education The reference of Covid-19 vaccination is “ https://vaksin.kemkes.go.id/#/vaccines ” Thank you, actually the file deposited was in SPSS software and that have been with codes in the variable view sheet. View more View less Competing Interests No competing of interest reply Respond Report a concern Loedy N. Peer Review Report For: Risk perception, sociodemographic factors, and knowledge of COVID-19 associated with mask use outside the home in Indonesia during the mandatory policy [version 2; peer review: 4 not approved] . F1000Research 2025, 14 :179 ( https://doi.org/10.5256/f1000research.172805.r369443) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-179/v1#referee-response-369443 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. 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last seen: 2026-05-20T01:45:00.602351+00:00