Background Contact tracing remains a critical part of controlling COVID-19 spread. Many countries have developed novel software applications (Apps) in an effort to augment traditional contact tracing methods. Aim Conduct a national survey of the Irish population to examine barriers and levers to the use of a contact tracing App. Methods Adult participants were invited to respond via an online survey weblink sent via e-mail and messaging Apps and posted on our university website and on popular social media platforms, prior to launch of the national App solution. Results A total of 8088 responses were received, with all 26 counties of the Republic of Ireland represented. Fifty-four percent of respondents said they would definitely download a contact-tracing App, while 30% said they would probably download a contact tracing App. Ninety-five percent of respondents identified at least one reason for them to download such an App, with the most common reasons being the potential for the App to help family members and friends and a sense of responsibility to the wider community. Fifty-nine percent identified at least one reason not to download the App, with the most common reasons being fear that technology companies or the government might use the App technology for greater surveillance after the pandemic. Conclusion The Irish citizens surveyed expressed high levels of willingness to download a public health-backed App to augment contact tracing. Concerns raised regarding privacy and data security will be critical if the App is to achieve the large-scale adoption and ongoing use required for its effective operation.

Background Digital Contact Tracing is seen as a key tool in reducing the propagation of Covid-19. But it requires high uptake and continued participation across the population to be effective. To achieve sufficient uptake/participation, health authorities should address, and thus be aware of, user concerns. Aim This work manually analyzes user reviews of the Irish Heath Service Executive’s (HSE) Contact Tracker app, to identify user concerns and to lay the foundations for subsequent, large-scale, automated analyses of reviews. While this might seem tightly scoped to the Irish context, the HSE app provides the basis for apps in many jurisdictions in the USA and Europe. Methods Manual analysis of (1287) user reviews from the Google/Apple playstores was performed, to identify the aspects of the app that users focused on, and the positive/negative sentiment expressed. Results The findings suggest a largely positive sentiment towards the app, and that users thought it handled data protection and transparency aspects well. But feedback suggests that users would appreciate more targeted feedback on the incidence of the virus, and facilities for more proactive engagement, like notifications that prompt users to submit their health status daily. Finally, the analysis suggests that the “android battery” issue and the backward-compatibility issue with iPhones seriously impacted retention/uptake of the app respectively. Conclusion The HSE have responded to the public’s desire for targeted feedback in newer versions, but should consider increasing the app’s proactive engagement. The results suggest they should also raise the backward compatibility issue, regarding older iPhones, with Apple.

Abstract Background: Contact tracing remains a critical part of controlling the spread of COVID-19. Many countries have developed novel software applications (Apps) in an effort to augment traditional contact tracing methods. Aim: To conduct a national survey of the Irish population to examine barriers and levers to the use of a contact tracing App.Methods: Adult participants were invited to respond via an online survey weblink sent via email and messaging Apps and posted on our university website and on popular social media platforms. Results: A total of 8,088 responses were received, with all 26 counties of the Republic of Ireland represented. 54% of respondents said they would definitely download a contact tracing App, while 30% said they would probably download a contact tracing App. 95% of respondents identified at least one reason for them to download the App, with the most common reasons being the potential for the App to help family members and friends and a sense of responsibility to the wider community. 59% identified at least one reason not to download the App, with the most common reasons being fear that technology companies or the government might use the App technology for greater surveillance after the pandemic.Conclusion: Irish citizens surveyed express high levels of willingness to download a public health-backed App to augment contact tracing. Concerns raised regarding privacy and data security will be critical if the App is to achieve the large-scale adoption and ongoing use required for its effective operation.

Background Digital contact tracing apps have the potential to augment contact tracing systems and disrupt COVID-19 transmission by rapidly identifying secondary cases prior to the onset of infectiousness and linking them into a system of quarantine, testing, and health care worker case management. The international experience of digital contact tracing apps during the COVID-19 pandemic demonstrates how challenging their design and deployment are. Objective This study aims to derive and summarize best practice guidance for the design of the ideal digital contact tracing app. Methods A collaborative cross-disciplinary approach was used to derive best practice guidance for designing the ideal digital contact tracing app. A search of the indexed and gray literature was conducted to identify articles describing or evaluating digital contact tracing apps. MEDLINE was searched using a combination of free-text terms and Medical Subject Headings search terms. Gray literature sources searched were the World Health Organization Institutional Repository for Information Sharing, the European Centre for Disease Prevention and Control publications library, and Google, including the websites of many health protection authorities. Articles that were acceptable for inclusion in this evidence synthesis were peer-reviewed publications, cohort studies, randomized trials, modeling studies, technical reports, white papers, and media reports related to digital contact tracing. Results Ethical, user experience, privacy and data protection, technical, clinical and societal, and evaluation considerations were identified from the literature. The ideal digital contact tracing app should be voluntary and should be equitably available and accessible. User engagement could be enhanced by small financial incentives, enabling users to tailor aspects of the app to their particular needs and integrating digital contact tracing apps into the wider public health information campaign. Adherence to the principles of good data protection and privacy by design is important to convince target populations to download and use digital contact tracing apps. Bluetooth Low Energy is recommended for a digital contact tracing app's contact event detection, but combining it with ultrasound technology may improve a digital contact tracing app's accuracy. A decentralized privacy-preserving protocol should be followed to enable digital contact tracing app users to exchange and record temporary contact numbers during contact events. The ideal digital contact tracing app should define and risk-stratify contact events according to proximity, duration of contact, and the infectiousness of the case at the time of contact. Evaluating digital contact tracing apps requires data to quantify app downloads, use among COVID-19 cases, successful contact alert generation, contact alert receivers, contact alert receivers that adhere to quarantine and testing recommendations, and the number of contact alert receivers who subsequently are tested positive for COVID-19. The outcomes of digital contact tracing apps' evaluations should be openly reported to allow for the wider public to review the evaluation of the app. Conclusions In conclusion, key considerations and best practice guidance for the design of the ideal digital contact tracing app were derived from the literature.

Digital Contact Tracing (DCT) is seen as a key tool in reducing the propagation of viruses such as Covid-19, but it requires uptake and participation in the technology across a large proportion of the population to be effective. While we observe the pervasive uptake of mobile device usage across our society, the installation and usage of contact tracing apps developed by governments and health services globally have faced difficulties. These difficulties range across the user-populations’ issues with the installation of the apps, us-ability and comprehension challenges, trust in the efficacy of the technology, performance issues such as the effect on battery life, and concerns about data protection and privacy. In this work, we present our findings from a comprehensive review of the online user feedback relating to the initial release of the HSE Contact Tracker app, in an effort to inform later iterations and thus help sustain and potentially increase usage of the technology. While this might seem quite tightly scoped to the Irish context only, this app provides the basis for apps in many jurisdictions in the United States and Europe. Our findings suggest a largely positive sentiment towards the app, and that users thought it handled data protection and transparency aspects well. But feedback also suggested that users would appreciate more targeted feedback,more proactive engagement and also suggested that both the ‘android-battery’ issue and the backward-compatibility issue with iPhones seriously impacted retention/uptake of the app respectively.

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Contact Tracing (CT) is seen as a key tool in reducing the propagation of viruses, such as Covid-19. Given near ubiquitous societal usage of mobile devices, governments globally are choosing to augment manual CT with CT applications (CTAs) on smart phones. While a plethora of solutions have been spawned, their overall effectiveness is based on majority population uptake. Unfortunately, their rapid deployment and the nature of the information they gather has prompted a variety of user concerns such as information privacy and Data Protection (DP). Therefore selecting an optimal solution to maximise user trust and uptake is crucial. In this work, we present our initial deliberations towards a CTA evaluation taxonomy for societal concerns. This is a subset of a larger taxonomy which is being developed as part of the Science Foundation Ireland project -COVIGILANT, which will ultimately be utilized to evaluate and compare numerous CTAs to select the optimal solution for a given population. In this paper we present our preliminary CTAs with respect to the societal concerns of security, data protection and transparency. We then elaborate on these CTAs by means of two illustrative examples in order to promote discussion, evaluation and refinement.Index Terms-data-protection transparency covid-19 taxonomy GDPR mhealth,

Background The silent transmission of COVID-19 has led to an exponential growth of fatal infections. With over 4 million deaths worldwide, the need to control and stem transmission has never been more critical. New COVID-19 vaccines offer hope. However, administration timelines, long-term protection, and effectiveness against potential variants are still unknown. In this context, contact tracing and digital contact tracing apps (CTAs) continue to offer a mechanism to help contain transmission, keep people safe, and help kickstart economies. However, CTAs must address a wide range of often conflicting concerns, which make their development/evolution complex. For example, the app must preserve citizens’ privacy while gleaning their close contacts and as much epidemiological information as possible. Objective In this study, we derived a compare-and-contrast evaluative framework for CTAs that integrates and expands upon existing works in this domain, with a particular focus on citizen adoption; we call this framework the Citizen-Focused Compare-and-Contrast Evaluation Framework (C3EF) for CTAs. Methods The framework was derived using an iterative approach. First, we reviewed the literature on CTAs and mobile health app evaluations, from which we derived a preliminary set of attributes and organizing pillars. These attributes and the probing questions that we formulated were iteratively validated, augmented, and refined by applying the provisional framework against a selection of CTAs. Each framework pillar was then subjected to internal cross-team scrutiny, where domain experts cross-checked sufficiency, relevancy, specificity, and nonredundancy of the attributes, and their organization in pillars. The consolidated framework was further validated on the selected CTAs to create a finalized version of C3EF for CTAs, which we offer in this paper. Results The final framework presents seven pillars exploring issues related to CTA design, adoption, and use: (General) Characteristics, Usability, Data Protection, Effectiveness, Transparency, Technical Performance, and Citizen Autonomy. The pillars encompass attributes, subattributes, and a set of illustrative questions (with associated example answers) to support app design, evaluation, and evolution. An online version of the framework has been made available to developers, health authorities, and others interested in assessing CTAs. Conclusions Our CTA framework provides a holistic compare-and-contrast tool that supports the work of decision-makers in the development and evolution of CTAs for citizens. This framework supports reflection on design decisions to better understand and optimize the design compromises in play when evolving current CTAs for increased public adoption. We intend this framework to serve as a foundation for other researchers to build on and extend as the technology matures and new CTAs become available.