Citizen involvement in COVID-19 contact tracing with digital tools: a qualitative study to explore citizens’ perspectives and needs

Abstract

Background Contact tracing (CT) is a key strategy when dealing with outbreaks of infectious diseases such as COVID-19. The scale of the COVID-19 pandemic has often left public health professionals (PHPs), who are responsible for the execution of CT, unable to keep up with the rapid and largescale spread of the virus. To enhance or support its execution, and potentially lower the workload for PHPs, citizens may be more actively involved in CT-tasks that are commonly executed by PHPs (referred to as ‘self-led CT’). There is limited insight into citizens’ perspectives on and needs for self-led CT for COVID-19. This study aims to explore the perspectives and needs of Dutch citizens on taking more responsibilities in the execution of CT for COVID-19, potentially through the use of digital tools. Methods An exploratory qualitative study was performed, in which online semi-structured interviews were conducted. Questions were based on the Reasoned Action Approach and Health Belief Model. Interviews were audio-recorded and transcribed verbatim. A thematic analysis was conducted to identify citizens’ perspectives and needs to participate in self-led CT. Results We conducted 27 interviews with Dutch citizens. Seven main themes were identified from the interviews: 1) ‘Citizens’ perspectives on self-led CT are influenced by prior experiences with regular CT’, 2) ‘Citizens’ felt responsibilities and the perceived responsibilities of the PHS in CT shape their perspectives on self-led CT’, 3) ‘Anticipated impacts of self-led CT on the CT-process’, 4) ‘Citizens’ attitude towards the application of self-led CT depends on their own perceived skills and the willingness and skills of others’, 5) ‘Shame and social stigma may hamper participation in self-led CT’, 6) ‘Concerns about privacy and data security: a barrier for self-led CT’, and 7) ‘Citizens’ perspectives and anticipated needs for the implementation and application of self-led CT in practice’. Conclusions Most interviewees hold a positive attitude towards self-led CT and using digital tools for this purpose. However, their intention for self-led CT may depend on various factors, such as prior experiences with regular CT, and their perceived self-efficacy to participate. Perspectives and needs of citizens should be considered for the future implementation of self-led CT in practice.

Determinants of Dutch public health professionals’ intention to use digital contact tracing support tools: A cross-sectional online questionnaire study

“…Although this was only a minor part of our questionnaire (assessed by one general question in questionnaire section 4), we still see this an unexpected result, also considering the emphasis that was placed on this topic by PHPs in previous qualitative research that we conducted [ 19 , 20 ]. As such, we strongly believe that privacy and data security should remain an important part of the (future) development of DCTS-tools, also because citizens (on whom the success of DCTS-tools ultimately depends) may value these issues more strongly [ 36 , 37 ] and because it is legally required to ensure certain standards when digitally collecting, exchanging, and storing medical and sensitive personal information [ 38 ].…”