Contact Tracing Apps Research Articles

Older Adults’ Perceptions of Smart City Initiatives to Age in Community

This project explores older American adults’ perceptions of smart city initiatives for them to “age in community” particularly in the northeast region. As the U.S. population is aging, it is imperative that the American cities can support their citizens to live in their preferred community environments for as long as they want. While there are many definitions of a smart city, some exemplary smarty city initiatives can be characterized as actively utilizing information and sensor technologies to promote efficiency and sustainability of city-wide systems, ultimately enhancing the quality of citizens' life. This project examines, in particular, seven smart city initiatives that are implemented globally: smart streetlights, health and fall monitoring system, community ridesharing, enhanced CCTVs, "age-friendly map," contact tracing app, and smart traffic system. By surveying those age 55 and older, with a representative sampling from the nine states in the northeast region, this project found that the vast majority of older Americans in this region would prefer to age in rural and suburban communities, and depending on where they prefer to age in (rural-exurban-suburban communities vs. urban-urban center communities) and gender (female vs. male), they perceive particular sets of smart city initiatives as more important for them to age in community. Furthermore, regardless of the community/location preference and demographic (gender, income level, and age) differences, 40% of the respondents expressed no concern of data or information privacy issues from these initiatives, opening some doors for the municipalities that plan to adopt some of these initiatives in the near future.

COVID-19 Tracing Apps as a Legal Problem: An Investigation of the Norwegian ‘Smittestopp’ App

In their efforts to curb the COVID-19 pandemic, many countries have introduced contact tracing apps installed on mobile phones with the aim of breaking chains of infection. This raises ethical and legal questions, as these apps have the potential to be used for surveillance of the population. There is pressure to set privacy and data protection aside to allow extensive collection and processing of personal data, while their benefits remain uncertain. The two versions of the Norwegian COVID-19 tracing app are used as a case study to explore how law and legal norms are made and implemented – or not – in the context of a public emergency. In Norway, the legal question of contact tracing apps has largely been limited to a question of compliance with the GDPR and has excluded a meaningful conversation about the use of apps as pandemic response tools and their impact on rights and freedoms. The normative argument of the article is that to combine a robust form of privacy and data protection with the use of digital tools in a crisis, we need to carefully scrutinize the effects technology choices have on human rights and the rule of law.

Data Quality and Network Considerations for Mobile Contact Tracing and Health Monitoring.

Machine Learning (ML) has been a useful tool for scientific advancement during the COVID-19 pandemic. Contact tracing apps are just one area reaping the benefits, as ML can use location and health data from these apps to forecast virus spread, predict “hotspots,” and identify vulnerable groups. However, to do so, it is first important to ensure that the dataset these apps yield is accurate, free of biases, and reliable, as any flaw can directly influence ML predictions. Given the lack of criteria to help ensure this, we present two requirements for those exploring using ML to follow. The requirements we presented work to uphold international data quality standards put forth for ML. We then identify where our requirements can be met, as countries have varying contact tracing apps and smartphone usages. Lastly, the advantages, limitations, and ethical considerations of our approach are discussed.

Understanding the perceptions of UK COVID-19 contact tracing app in the BAME community in Leicester

Purpose Digital contact tracing technologies are critical to the fight against COVID-19 in many countries including the UK. However, a number of ethical, legal and socio-economic concerns that can affect uptake of the app have been raised. The purpose of this research is to explore the perceptions of the UK digital contact tracing app in the Black, Asian and Minority Ethnic (BAME) community in Leicester and how this can affect its deployment and implementation. Design/methodology/approach Data was collected through virtual focus groups in Leicester, UK. A total of 28 participants were recruited for the study. All participants are members of the BAME community, and data was thematically analysed with NVivo 11. Findings A majority of the participants were unwilling to download and use the app owing to legal and ethical concerns. A minority were willing to use the app based on the need to protect public health. There was a general understanding that lack of uptake will negatively affect the fight against COVID-19 in BAME communities and an acknowledgement of the need for the government to rebuild trust through transparency and development of regulatory safeguards to enhance privacy and prevent misuse. Originality/value To the best of the authors’ knowledge, the research makes original contributions being the first robust study conducted to explore perceptions of marginalised communities, particularly BAME which may be adversely impacted by the deployment of the app. By exploring community-based perceptions, this study further contributes to the emerging citizens’ perceptions on digital contact tracing which is crucial to the effectiveness and the development of an efficient, community-specific response to public attitudes towards the app. The findings can also help the development of responsible innovation approaches that balances the competing interests of digital health interventions with the needs and expectations of the BAME community in the UK.

Default options: a powerful behavioral tool to increase COVID-19 contact tracing app acceptance in Latin America?

AbstractGiven the rates of transmission of COVID-19, relying only on manual contact tracing might be infeasible to control the epidemic without sustained costly lockdowns or rapid vaccination efforts. In the first study of its kind in Latin America, we find through a phone survey of a nationally representative sample of ten countries that an opt-out regime (automatic installation) increases self-reported intention to accept a contact tracing app with exposure notification by 22 percentage points compared to an opt-in regime (voluntary installation). This effect is triple the size and of opposite sign of the effect found in Europe and the United States, potentially due to lower concerns regarding privacy and lower levels of interpersonal trust. We see that an opt-out regime is more effective in increasing willingness to accept for those who do not trust the government or do not use their smartphones for financial transactions. The local severity of the pandemic does not affect our results, but feeling personally at risk increases intent to accept such apps in general. These results can shed light on the use of default options not only for contact tracing apps but in public health overall in the context of a pandemic in Latin America.

Quantifying the effects of fake news on behavior: Evidence from a study of COVID-19 misinformation.

Previous research has argued that fake news may have grave consequences for health behavior, but surprisingly, no empirical data have been provided to support this assumption. This issue takes on new urgency in the context of the coronavirus pandemic, and the accompanying wave of online misinformation. In this large preregistered study (N = 3,746), we investigated the effect of a single exposure to fabricated news stories about COVID-19 on related behavioral intentions. We observed small but measurable effects on some behavioral intentions but not others-for example, participants who read a story about problems with a forthcoming contact-tracing app reported a 5% reduction in willingness to download the app. These data suggest that one-off fake news exposure may have behavioral consequences, though the effects are not large. We also found no effects of providing a general warning about the dangers of online misinformation on response to the fake stories, regardless of the framing of the warning in positive or negative terms. This suggests that generic warnings about online misinformation, such as those used by governments and social media companies, are unlikely to be effective. We conclude with a call for more empirical research on the real-world consequences of fake news. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Privacy Analysis and Comparison of Pandemic Contact Tracing Apps

Privacy Analysis and Comparison of Pandemic Contact Tracing Apps

How Identification With the Social Environment and With the Government Guide the Use of the Official COVID-19 Contact Tracing App: Three Quantitative Survey Studies.

BackgroundOfficial contact tracing apps have been implemented and recommended for use across nations to track and contain the spread of COVID-19. Such apps can be effective if people are willing to use them. Accordingly, many attempts are being made to motivate citizens to make use of the officially recommended apps.ObjectiveThe aim of this research was to contribute to an understanding of the preconditions under which people are willing to use a COVID-19 contact tracing app (ie, their use intentions and use). To go beyond personal motives in favor of app use, it is important to take people’s social relationships into account, under the hypothesis that the more people identify with the beneficiaries of app use (ie, people living close by in their social environment) and with the source recommending the app (ie, members of the government), the more likely they will be to accept the officially recommended contact tracing app.MethodsBefore, right after, and 5 months after the official contact tracing app was launched in Germany, a total of 1044 people participated in three separate surveys. Structural equation modeling was used to test the hypotheses, examining the same model in all studies at these critical points in time.ResultsAcross the three surveys, both identification with the beneficiaries (people living in their social environment) and with the source recommending the app (members of the government) predicted greater intention to use and use (installation) of the official contact tracing app. Trust in the source (members of the government) served as a mediator. Other types of identification (with people in Germany or people around the world) did not explain the observed results. The findings were highly consistent across the three surveys.ConclusionsAttempts to motivate people to use new health technology (or potentially new measures more generally) not only for their personal benefit but also for collective benefits should take the social context into account (ie, the social groups people belong to and identify with). The more important the beneficiaries and the sources of such measures are to people’s sense of the self, the more willing they will likely be to adhere to and support such measures.

It Takes Two to Techno-Tango: An Analysis of a Close Embrace Between Google/Apple and the EU in Fighting the Pandemic Through Contact Tracing Apps

All of us at Apple and Google believe there has never been a more important moment to work together to solve one of the world's most pressing problems. Through close cooperation and collaboration w...

The UK COVID-19 contact tracing app as both an emerging technology and public health intervention: The need to consider promissory discourses.

The UK's National Health Service (NHS) COVID-19 contact tracing app was announced to the British public on 12th April 2020. The UK government endorsed the app as a public health intervention that would improve public health, protect the NHS and 'save lives'. On 5th May 2020 the technology was released for trial on the Isle of Wight. However, the trial was halted in June 2020, reportedly due to technological issues. The app was later remodelled and launched to the public in September 2020. The rapid development, trial and discontinuation of the app over a short period of a few months meant that the mobilisation and effect of the discourses associated with the app could be traced relatively easily. In this paper we aimed to explore how these discourses were constructed in the media, and their effect on actors - in particular, those who developed and those who trialled the app. Promissory discourses were prevalent, the trajectory of which aligned with theories developed in the sociology of expectations. We describe this trajectory, and then interpret its implications in terms of infectious disease public health practices and responsibilities.

To Use or Not to Use a COVID-19 Contact Tracing App: Mixed Methods Survey in Wales.

BackgroundMany countries remain in the grip of the COVID-19 global pandemic, with a considerable journey still ahead toward normalcy and free mobility. Contact tracing smartphone apps are among a raft of measures introduced to reduce spread of the virus, but their uptake depends on public choice.ObjectiveThe objective of this study was to ascertain the views of citizens in Wales on their intended use of a COVID-19 contact tracing smartphone app, including self-proposed reasons for or against use and what could lead to a change of decision.MethodsWe distributed an anonymous survey among 4000 HealthWise Wales participants in May 2020. We adopted a mixed methods approach: responses to closed questions were analyzed using descriptive and inferential statistics; open question responses were analyzed and grouped into categories.ResultsA total of 976 (24.4%) people completed the survey. Smartphone usage was 91.5% overall, but this varied among age groups. In total, 97.1% were aware of contact tracing apps, but only 67.2% felt sufficiently informed. Furthermore, 55.7% intended to use an app, 23.3% refused, and 21.0% were unsure. The top reasons for app use were as follows: controlling the spread of the virus, mitigating risks for others and for oneself, and increasing freedoms. The top reasons against app use were as follows: mistrusting the government, concerns about data security and privacy, and doubts about efficacy. The top response for changing one’s mind about app use from being willing to being unwilling was that nothing would; that is, they felt that nothing would cause them to become unwilling to use a contact tracing app. This was also the top response for changing one’s mind from being unwilling to being willing to use contact tracing apps. Among those who were unsure of using contact tracing apps, the top response was the need for more information.ConclusionsRespondents demonstrated a keenness to help themselves, others, society, and the government to avoid contracting the virus and to control its spread. However, digital inclusion varied among age groups, precluding participation for some people. Nonetheless, unwillingness was significant, and considering the nature of the concerns raised and the perceived lack of information, policy and decision-makers need to do more to act openly, increase communication, and demonstrate trustworthiness if members of the public are to be confident in using an app.

Business as usual through contact tracing app: what influences intention to download?

ABSTRACT A contact tracing app can positively support the requirement of social and physical distancing during a pandemic. However, there are aspects of the user’s intention to download the app that remain under-researched. To address this, we investigate the role of perceived privacy risks, social empowerment, perceived information transparency and control, and attitudes towards government, in influencing the intention to download the contact tracing app. Using fuzzy set qualitative comparative analysis (fsQCA), we found eight different configurations of asymmetrical relationships of conditions that lead to the presence or absence of an intention to download. In our study, social empowerment significantly influences the presence of an intention to download. We also found that perceived information transparency significantly influences the absence of an intention to download the app.

Digitization and Health in Germany: Cross-sectional Nationwide Survey.

BackgroundDigital technologies are shaping medicine and public health.ObjectiveThe aim of this study was to investigate the attitudes toward and the use of digital technologies for health-related purposes using a nationwide survey.MethodsWe performed a cross-sectional study using a panel sample of internet users selected from the general population living in Germany. Responses to a survey with 28 items were collected using computer-assisted telephone interviews conducted in October 2020. The items were divided into four topics: (1) general attitudes toward digitization, (2) COVID-19 pandemic, (3) physical activity, and (4) perceived digital health (eHealth) literacy measured with the eHealth Literacy Scale (eHEALS; sum score of 8=lowest to 40=highest perceived eHealth literacy). The data were analyzed in IBM-SPSS24 using relative frequencies. Three univariate multiple regression analyses (linear or binary logistic) were performed to investigate the associations among the sociodemographic factors (age, gender, education, and household income) and digital technology use.ResultsThe participants included 1014 internet users (n=528, 52.07% women) aged 14 to 93 years (mean 54, SD 17). Among all participants, 66.47% (674/1014) completed up to tertiary (primary and secondary) education and 45.07% (457/1017) reported a household income of up to 3500 Euro/month (1 Euro=US $1.18). Over half (579/1014, 57.10%) reported having used digital technologies for health-related purposes. The majority (898/1014, 88.56%) noted that digitization will be important for therapy and health care, in the future. Only 25.64% (260/1014) reported interest in smartphone apps for health promotion/prevention and 42.70% (433/1014) downloaded the COVID-19 contact-tracing app. Although 52.47% (532/1014) reported that they come across inaccurate digital information on the COVID-19 pandemic, 78.01% (791/1014) were confident in their ability to recognize such inaccurate information. Among those who use digital technologies for moderate physical activity (n=220), 187 (85.0%) found such technologies easy to use and 140 (63.6%) reported using them regularly (at least once a week). Although the perceived eHealth literacy was high (eHEALS mean score 31 points, SD 6), less than half (43.10%, 400/928) were confident in using digital information for health decisions. The use of digital technologies for health was associated with higher household income (odds ratio [OR] 1.28, 95% CI 1.11-1.47). The use of digital technologies for physical activity was associated with younger age (OR 0.95, 95% CI 0.94-0.96) and more education (OR 1.22, 95% CI 1.01-1.46). A higher perceived eHealth literacy score was associated with younger age (β=–.22, P<.001), higher household income (β=.21, P<.001), and more education (β=.14, P<.001).ConclusionsInternet users in Germany expect that digitization will affect preventive and therapeutic health care in the future. The facilitators and barriers associated with the use of digital technologies for health warrant further research. A gap exists between high confidence in the perceived ability to evaluate digital information and low trust in internet-based information on the COVID-19 pandemic and health decisions.

The First GAEN-Based COVID-19 Contact Tracing App in Norway Identifies 80% of Close Contacts in "Real Life" Scenarios.

The coronavirus disease 2019 (COVID-19) response in most countries has relied on testing, isolation, contact tracing, and quarantine (TITQ), which is labor- and time-consuming. Therefore, several countries worldwide launched Bluetooth-based apps as supplementary tools. The aim of using contact tracing apps is to rapidly notify people about their possible exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and thus make the process of TITQ more efficient, especially upon exposure in public places. We evaluated the Norwegian Google Apple exposure notification (GAEN)-based contact tracing app Smittestopp v2 under relevant “real-life” test scenarios. We used a total of 40 devices, representing six different brands, and compared two different exposure configurations, experimented with different time thresholds and weights of the Bluetooth attenuation levels (buckets), and calculated the true notification rates among close contacts (≤2 m and ≥15 min) and false notification of sporadic contacts. In addition, we assessed the impact of using different operating systems and locations of the phone (hand/pocket). The best configuration tested to trigger exposure notification resulted in the correct notification of 80% of the true close contacts and incorrect notification of 34% of the sporadic contacts. Among those who incorrectly received notifications, most (67%) were within 2 m but the duration of contact was <15 min and thus they were not, per se, considered as “close contacts.” Lower sensitivity was observed when using the iOS operating systems or carrying the phone in the pocket instead of in the hand. The results of this study were used to improve and evaluate the performance of the Norwegian contact-tracing app Smittestopp.

Designing Better Exposure Notification Apps: The Role of Persuasive Design.

BackgroundDigital contact tracing apps have been deployed worldwide to limit the spread of COVID-19 during this pandemic and to facilitate the lifting of public health restrictions. However, due to privacy-, trust-, and design-related issues, the apps are yet to be widely adopted. This calls for an intervention to enable a critical mass of users to adopt them.ObjectiveThe aim of this paper is to provide guidelines to design contact tracing apps as persuasive technologies to make them more appealing and effective.MethodsWe identified the limitations of the current contact tracing apps on the market using the Government of Canada’s official exposure notification app (COVID Alert) as a case study. Particularly, we identified three interfaces in the COVID Alert app where the design can be improved. The interfaces include the no exposure status interface, exposure interface, and diagnosis report interface. We propose persuasive technology design guidelines to make them more motivational and effective in eliciting the desired behavior change.ResultsApart from trust and privacy concerns, we identified the minimalist and nonmotivational design of exposure notification apps as the key design-related factors that contribute to the current low uptake. We proposed persuasive strategies such as self-monitoring of daily contacts and exposure time to make the no exposure and exposure interfaces visually appealing and motivational. Moreover, we proposed social learning, praise, and reward to increase the diagnosis report interface’s effectiveness.ConclusionsWe demonstrated that exposure notification apps can be designed as persuasive technologies by incorporating key persuasive features, which have the potential to improve uptake, use, COVID-19 diagnosis reporting, and compliance with social distancing guidelines.

Features of COVID-19 applications and their impact on contact tracing: results of preliminary review

Digital technologies and telehealth, specifically contact tracing applications can complement traditional approaches for contact tracing of COVID-19 and overall COVID-19 control strategies. Despite the potential benefits of these novel approaches, concerns regarding privacy and basic rights have challenged application development and adoption. We explore the features of tracing applications, focusing on the trade-off between technical possibilities and privacy concerns. Our main objective is to map out central features of applied technology solutions that may prove as drivers or constrains for future development. Our secondary aim was to review how the effectiveness of tracing applications was being apprehended in research. We conducted a literature review of COVID-19 tracing applications and related privacy issues using the PubMed database. For analysis, we conceptualized contact tracing and data privacy. Our review identified various technologies with potential for contact tracing, with Bluetooth and GPS based solutions being the most common. Effectiveness of the applications is dependent on how widely these are adopted. However, technological approaches of the applications vary markedly, affecting their effectiveness for pandemic control. Privacy and trust are key limitations affecting application adoption. Existing privacy solutions are based on voluntary use, user consent, cryptographic data storage, minimum data collection, limited data usage, and transparency of the contact tracing applications and frameworks. Although evidence of applications’ outcomes and benefits is yet tentative, the first evaluation frameworks for the applications are under development. In order to obtain maximum potential benefit from the applications, real-world evidence needs to be analyzed and evaluated carefully. However, along with contact tracing apps and comprehensive health programs, regulatory frameworks and safeguards are necessary to ensure that health information is not used for surveillance purposes and that app users’ privacy is maintained.

From Shadow Profiles to Contact Tracing: Qualitative Research into Consent and Privacy

For many privacy scholars, consent is on life support, if not dead. In July 2020, we held six focus groups in Australia to test this claim by gauging attitudes to consent and privacy, with a spotlight on smartphones. These focus groups included discussion of four case studies: ‘shadow profiles’, eavesdropping by companies on smartphone users, non-consensual government surveillance of its citizens and contact tracing apps developed to combat COVID-19. Our participants expressed concerns about these practices and said they valued individual consent and saw it as a key element of privacy protection. However, they saw the limits of individual consent, saying that the law and the design of digital services also have key roles to play. Building on these findings, we argue for a blend of good law, good design and an appreciation that individual consent is still valued and must be fixed rather than discarded - ideally in ways that are also collective. In other words, consent is dead; long live consent.

To App or Not to App? Understanding Public Resistance to COVID-19 Digital Contact Tracing and its Criminological Relevance

In the context of the COVID-19 pandemic, digital contact tracing has been developed and promoted in many countries as a valuable tool to help the fight against the virus, allowing health authorities to react quickly and limit contagion. Very often, however, these tracing apps have faced public resistance, making their use relatively sparse and ineffective. Our study relies on an interdisciplinary approach that brings together criminological and computational expertise to consider the key social dynamics underlying people’s resistance to using the NHS contact-tracing app in England and Wales. The present study analyses a large Twitter dataset to investigate interactions between relevant user accounts and identify the main narrative frames (lack of trust and negative liberties) and mechanisms (polluted information, conspiratorial thinking and reactance) to explain resistance towards use of the NHS contact-tracing app. Our study builds on concepts of User eXperience (UX) and algorithm aversion and demonstrates the relevance of these elements to the key criminological problem of resistance to official technologies.

Understanding digital contact tracing app continuance: Insights from India

ObjectivesDigital contact tracing (DCT) was touted as an effective alternative to lockdown and other restrictive measures in controlling the spread of the COVID-19 pandemic. Despite considerable investments in research and development, the usage of DCT apps was found to be phenomenally low across the world. In this context, the current study investigates the factors influencing citizens’ continuance intentions to use the DCT app. MethodsA theoretical framework was developed by extending the Expectation-confirmation model (ECM) of Information system continuance with Technology trust theory and a contextual factor perceived security and privacy to predict citizens’ continuance intentions to use the DCT app. The model was empirically tested using data from a field survey of 206 actual users of a DCT app implemented in India. ResultsThe findings reveal that user satisfaction, trust in government, and trust in technology are significant predictors of citizens’ continuance intention. The model demonstrates high explanatory power by explaining 57.8% of the variance of continuance intention. It also validates the role of perceived security and privacy and trust in technology in determining user satisfaction. ConclusionThe study makes a theoretical contribution by extending the ECM framework to predict DCT app continuance behavior. The insights from the study could be helpful for developers and policymakers in crafting strategies to improve the usage of DCT apps during future disease outbreaks.

Mining user reviews of COVID contact-tracing apps: An exploratory analysis of nine European apps

Context:More than 78 countries have developed COVID contact-tracing apps to limit the spread of coronavirus. However, many experts and scientists cast doubt on the effectiveness of those apps. For each app, a large number of reviews have been entered by end-users in app stores. Objective:Our goal is to gain insights into the user reviews of those apps, and to find out the main problems that users have reported. Our focus is to assess the “software in society” aspects of the apps, based on user reviews. Method:We selected nine European national apps for our analysis and used a commercial app-review analytics tool to extract and mine the user reviews. For all the apps combined, our dataset includes 39,425 user reviews. Results:Results show that users are generally dissatisfied with the nine apps under study, except the Scottish (“Protect Scotland”) app. Some of the major issues that users have complained about are high battery drainage and doubts on whether apps are really working. Conclusion:Our results show that more work is needed by the stakeholders behind the apps (e.g., app developers, decision-makers, public health experts) to improve the public adoption, software quality and public perception of these apps.