COVID Alert: Factors Influencing the Adoption of Exposure Notification Apps Among Canadian Residents

Oyibo, Kiemute; Morita, Plinio Pelegrini

doi:10.3389/fdgth.2022.842661

Cited by 8 publications

(9 citation statements)

References 45 publications

(52 reference statements)

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“…Privacy concerns turned out to be the most frequent influencing CTA adoption, followed by perceived benefit, perceived (dis)trust, perceived data security risk, and technology familiarity. The key recommendations based on the most frequent categories of factors include: (1) users' privacy concerns should be alleviated by implementing and communicating privacy protection measures, which include minimization of user data collected and giving users control over their data; (2) Stakeholders should emphasize the utility of CTAs (especially to the elderly) in the context of the “greater good,” and improve it through persuasive design such as self-monitoring and tangible reward; (3) Government should delegate the responsibility of digital contact tracing to public health authorities (with little or no oversight function) and make source code available to the public to foster trust and transparency; (4) Stakeholders should implement and communicate data security measures aimed to protect user data against cyberattacks, hacking and misuse; (5) CTAs should be designed to be consistent and compatible to existing similar apps to reduce the learning curve, increase users' perceived self-efficacy, and perceived ease of use ( 62 ). Future studies should focus on non-Western countries such as African, Asian and South American countries which are underrepresented in the current research on CTA adoption.…”

Section: Discussionmentioning

confidence: 99%

Factors Influencing the Adoption of Contact Tracing Applications: Systematic Review and Recommendations

Oyibo¹,

Sahu²,

Oetomo³

et al. 2022

Front. Digit. Health

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BackgroundThe emergence of new variants of COVID-19 causing breakthrough infections and the endemic potential of the coronavirus are an indication that digital contact tracing apps (CTAs) may continue to be useful for the long haul. However, the uptake of these apps in many countries around the world has been low due to several factors militating against their adoption and usage.ObjectiveIn this systematic review, we set out to uncover the key factors that facilitate or militate against the adoption of CTAs, which researchers, designers and other stakeholders should focus on in future iterations to increase their adoption and effectiveness in curbing the spread of COVID-19.Data SourcesSeven databases, including PubMed, CINAHL, Scopus, Web of Service, IEEE Xplore, ACM Digital Library, and Google Scholar, were searched between October 30 and January 31, 2020. A total of 777 articles were retrieved from the databases, with 13 of them included in the systematic review after screening.Study Eligibility Criteria, Participants, and InterventionThe criteria for including articles in the systematic review were that they could be user studies from any country around the world, must be peer-reviewed, written in English, and focused on the perception and adoption of COVID-19 contact tracing and/or exposure notification apps. Other criteria included user study design could be quantitative, qualitative, or mixed, and must have been conducted during the COVID-19 pandemic, which began in the early part of 2020.Study Appraisal and Synthesis MethodsThree researchers searched seven databases (three by the first author, and two each by the second and third authors) and stored the retrieved articles in a collaborative Mendeley reference management system online. After the removal of duplicates, each researcher independently screened one third of the articles based on title/abstract. Thereafter, all three researchers collectively screened articles that were in the borderline prior to undergoing a full-text review. Then, each of the three researchers conducted a full-text review of one-third of the eligible articles to decide the final articles to be included in the systematic review. Next, all three researchers went through the full text of each borderline article to determine their appropriateness and relevance. Finally, each researcher extracted the required data from one-third of the included articles into a collaborative Google spreadsheet and the first author utilized the data to write the review.ResultsThis review identified 13 relevant articles, which found 56 factors that may positively or negatively impact the adoption of CTAs. The identified factors were thematically grouped into ten categories: privacy and trust, app utility, facilitating conditions, social-cognitive factors, ethical concerns, perceived technology threats, perceived health threats, technology familiarity, persuasive design, and socio-demographic factors. Of the 56 factors, privacy concern turned out to be the most frequent factor of CTA adoption (12/13), followed by perceived benefit (7/13), perceived trust (6/13), and perceived data security risk (6/13). In the structural equation models presented by the authors of the included articles, a subset of the 56 elicited factors (e.g., perceived benefit and privacy concern) explains 16 to 77% of the variance of users' intention to download, install, or use CTAs to curb the spread of COVID-19. Potential adoption rates of CTA range from 19% (in Australia) to 75% (in France, Italy, Germany, United Kingdom, and United States). Moreover, actual adoption rates range from 37% (in Australia) to 50% (in Germany). Finally, most of the studies were carried out in Europe (66.7%), followed by North America (13.3%), and Australia, Asia, and South America (6.7% each).ConclusionThe results suggest that future CTA iterations should give priority to privacy protection through minimal data collection and transparency, improving contact tracing benefits (personal and social), and fostering trust through laudable gestures such as delegating contact tracing to public health authorities, making source code publicly available and stating who will access user data, when, how, and what it will be used for. Moreover, the results suggest that data security and tailored persuasive design, involving reward, self-monitoring, and social-location monitoring features, have the potential of improving CTA adoption. Hence, in addition to addressing issues relating to utility, privacy, trust, and data security, we recommend the integration of persuasive features into future designs of CTAs to improve their motivational appeal, adoption, and the user experience.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021259080 PROSPERO, identifier CRD42021259080.

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Section: Discussionmentioning

confidence: 99%

Factors Influencing the Adoption of Contact Tracing Applications: Systematic Review and Recommendations

Oyibo¹,

Sahu²,

Oetomo³

et al. 2022

Front. Digit. Health

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“…Self-monitoring is a persuasive feature that allows users to track their COVID-19 exposure levels over time. Figure 3 [ 34 , 51 , 52 ] illustrates the operational mechanism of self-monitoring. A person observes their own behavior and reflects on it, as though they are looking at themselves in the mirror.…”

Section: Methodsmentioning

confidence: 99%

“…The results showed that there was a main effect of app design within the nonadopter group, with a medium effect size (F 112,1 =12. 34…”

Section: No-exposure Status Interfacementioning

confidence: 99%

“…In addition, we searched Google Scholar between November 21, 2020, and January 31, 2021, using terms such as COVID-19 contact tracing app and COVID-19 exposure notification app . The systematic review, which uncovered the key factors that drive the acceptance of contact tracing apps, is published in Frontiers in Digital Health [ 34 ]. The protocol for this review was published in the Journal of Medical Internet Research [ 35 ].…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Persuasive Design on the Adoption of Exposure Notification Apps: Quantitative Study Based on COVID Alert

Oyibo¹,

Morita²

2022

JMIR Form Res

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Background The adoption of contact tracing apps worldwide has been low. Although considerable research has been conducted on technology acceptance, little has been done to show the benefit of incorporating persuasive principles. Objective This research aimed to investigate the effect of persuasive features in the COVID Alert app, created by Health Canada, by focusing on the no-exposure status, exposure status, and diagnosis report interfaces. Methods We conducted a study among 181 Canadian residents, including 65 adopters and 116 nonadopters. This study was based on screenshots of the 3 interfaces, of which each comprised a persuasive design and a control design. The persuasive versions of the first two interfaces supported self-monitoring (of exposure levels), and that of the third interface supported social learning (about how many other users have reported their diagnosis). The 6 screenshots were randomly assigned to 6 groups of participants to provide feedback on perceived persuasiveness and adoption willingness. Results A multivariate repeated-measure ANOVA showed that there is an interaction among interface, app design, and adoption status regarding the perceived persuasiveness of the interfaces. This resulted in a 2-way ANOVA for each interface. For the no-exposure interface, there was an interaction between adoption status and app design. Among adopters, there was no significant difference P=.31 between the persuasive design (mean 5.36, SD 1.63) and the control design (mean 5.87, SD 1.20). However, among nonadopters, there was an effect of app design (P<.001), with participants being more motivated by the persuasive design (mean 5.37, SD 1.30) than by the control design (mean 4.57, SD 1.19). For the exposure interface, adoption status had a main effect (P<.001), with adopters (mean 5.91, SD 1.01) being more motivated by the designs than nonadopters (mean 4.96, SD 1.43). For the diagnosis report interface, there was an interaction between adoption status and app design. Among nonadopters, there was no significant difference P=.99 between the persuasive design (mean 4.61, SD 1.84) and the control design (mean 4.77, SD 1.21). However, among adopters, there was an effect of app design (P=.006), with participants being more likely to report their diagnosis using the persuasive design (mean 6.00, SD 0.97) than using the control design (mean 5.03, SD 1.22). Finally, with regard to willingness to download the app, pairwise comparisons showed that nonadopters were more likely to adopt the app after viewing the persuasive version of the no-exposure interface (13/21, 62% said yes) and the diagnosis report interface (12/17, 71% said yes) than after viewing the control versions (3/17, 18% and 7/16, 44%, respectively, said yes). Conclusions Exposure notification apps are more likely to be effective if equipped with persuasive features. Incorporating self-monitoring into the no-exposure status interface and social learning into the diagnosis report interface can increase adoption by >30%.

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“…While small-scale Canadian studies have been done to evaluate design factors that influence user perception and adoption of contact tracing apps, to our knowledge, there have been no large-scale studies that characterize Canadians who have and have not downloaded these apps and the reasons why [24,25]. We aim to examine sociodemographic factors associated with Canadians who download these apps and investigate barriers and facilitators to app download.…”

Section: Introductionmentioning

confidence: 99%

Drivers of downloading and reasons for not downloading COVID-19 contact tracing and exposure notification apps: A national cross-sectional survey

et al. 2022

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Background Bluetooth-enabled smartphone apps have been developed and implemented in different sites globally to help overcome capacity limitations of traditional interview-based COVID-19 contact tracing. Two apps are currently available in Canada: ABTraceTogether exclusively in Alberta and COVID Alert in nine other provinces and territories. This study aims to examine factors associated with downloading of these apps to inform targeted promotion and marketing to increase app uptake. Methods We performed a cross-sectional survey with adult participants (≥18 years old) from an online national panel. Participants were asked if they had downloaded an app and, if applicable, reasons for not downloading. Logistic regression was used to identify sociodemographic factors and trusted information sources associated with downloading and reasons for not downloading. Results Of the included 4,503 respondents (36% response rate), 1,394 (31%) had downloaded an app. Demographic and socioeconomic factors positively associated with app download were: 1) being female, 2) higher household income, 3) higher education level attained, and 4) more liberal political views. The odds of downloading an app were higher for participants who trusted health-related information sources, and lower for those who trusted internet searches, family and friend, or Facebook. The most cited reasons for not downloading were related to data security concerns and perceived lack of benefit from the apps. Interpretation These findings identify sociodemographic segments with the lowest app uptake, reasons for not downloading and trusted information sources to inform targeted promotion and marketing strategies to improve uptake of apps to facilitate contact tracing.

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COVID Alert: Factors Influencing the Adoption of Exposure Notification Apps Among Canadian Residents

Cited by 8 publications

References 45 publications

Factors Influencing the Adoption of Contact Tracing Applications: Systematic Review and Recommendations

Factors Influencing the Adoption of Contact Tracing Applications: Systematic Review and Recommendations

The Effect of Persuasive Design on the Adoption of Exposure Notification Apps: Quantitative Study Based on COVID Alert

Drivers of downloading and reasons for not downloading COVID-19 contact tracing and exposure notification apps: A national cross-sectional survey

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