Abstract
BackgroundSeveral countries have implemented mobile apps in an attempt to trace close contacts of patients with COVID-19 and, in turn, reduce the spread of SARS-CoV-2. However, the effectiveness of this approach depends on the adherence of a large segment of the population.ObjectiveThe aims of this study were to evaluate the acceptability of a COVID-19 contact tracing mobile app among the French population and to investigate the barriers to its use.MethodsThe Health Literacy Survey 2019 questioned 1003 people in France during the COVID-19 pandemic on the basis of quota sampling. The survey collected sociodemographic characteristics and health literacy data, as well as information on participants’ communication with caregivers, trust in institutions, and COVID-19 knowledge and preventive behaviors. The acceptability of a mobile app for contact tracing was measured by a single question, the responses to which were grouped into three modalities: app-supporting, app-willing, and app-reluctant. Multinomial logistic regression analysis was performed to identify the factors associated with the acceptability of a mobile app during the COVID-19 pandemic.ResultsOnly 19.2% (193/1003) of all participants were app-supporting, whereas half of them (504/1003, 50.3%) were reluctant. The factors associated with willingness or support toward the contact tracing app included lower financial deprivation (app-willing: adjusted odds ratio [aOR] 0.8, 95% CI 0.69-0.93; app-supporting: aOR 0.7, 95% CI 0.58-0.84) and higher perceived usefulness of using a mobile app to send completed health questionnaires to doctors (app-willing: aOR 2.3, 95% CI 1.70-3.26; app-supporting: aOR 3.1, 95% CI 2.04-4.82). Furthermore, the likelihood of supporting the mobile app increased with age over 60 years (aOR 1.9, 95% CI 1.13-3.22), trust in political representatives (aOR 2.7, 95% CI 1.72-4.23), feeling concerned about the pandemic situation (aOR 2.2, 95% CI 1.47-3.32), and knowledge about the transmission of COVID-19 (aOR 2.0, 95% CI 1.39-2.96).ConclusionsThe most socioeconomically precarious people, who are at a higher risk of SARS-CoV-2 infection, are also the most reluctant to using a contact tracing mobile app. Therefore, optimal adherence can only be effective with a targeted discourse on public health benefits to adopt such an app, which should be combined with a reduction in inequalities by acting on structural determinants.
Highlights
MethodsMonitoring contacts of patients with COVID-19 is a key issue for long-term control of the pandemic
The likelihood of supporting the mobile app increased with age over 60 years, trust in political representatives, feeling concerned about the pandemic situation, and knowledge about the transmission of COVID-19
The most socioeconomically precarious people, who are at a higher risk of SARS-CoV-2 infection, are the most reluctant to using a contact tracing mobile app
Summary
MethodsMonitoring contacts of patients with COVID-19 is a key issue for long-term control of the pandemic. Contact tracing apps have been designed to identify and inform people of likely exposure [2]. Since March, such contact tracing apps were installed by approximately 9.3% of the population around the world [3] and adopted by many countries, including China, South Korea, Australia, Turkey, Germany, Israel, and Singapore [3], with mandatory or voluntary setups. Because downloading and using the TousAntiCovid app is voluntary in France, its effectiveness is dependent on acceptability and adoption among users. Several countries have implemented mobile apps in an attempt to trace close contacts of patients with COVID-19 and, in turn, reduce the spread of SARS-CoV-2. The effectiveness of this approach depends on the adherence of a large segment of the population
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