Early Perceptions of COVID-19 Contact Tracing Apps in German-Speaking Countries: Comparative Mixed Methods Study

Zimmermann, Bettina; Fiske, Amelia; Prainsack, Barbara; Hangel, Nora; McLennan, Stuart; Buyx, Alena

doi:10.2196/25525

Cited by 99 publications

(84 citation statements)

References 67 publications

(65 reference statements)

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“…Semi-structured interviews with inhabitants in Germany and the German-speaking part of Switzerland were conducted as part of a qualitative, longitudinal, and multinational research study in collaboration with the SolPan research commons. 44,45 SolPan's aim and interview guide were informed by the theoretical framework of solidarity as proposed by Prainsack and Buyx. 11,12 The interviews did not focus on solidarity specifically but asked about interviewees' experiences during the pandemic, as well as their motivations for complying with COVID-19 related public health policies during the first pandemic wave in April 2020.…”

Section: Methodsmentioning

confidence: 99%

Motivations and Limits for COVID-19 Policy Compliance in Germany and Switzerland

Zimmermann

Fiske

McLennan

et al. 2021

Int J Health Policy Manag

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Background: In contrast to neighboring countries, German and Swiss authorities refrained from general curfews during the first pandemic wave in spring 2020, calling for solidarity and personal responsibility instead. Using a qualitative methodology, this study aims to explore why people in Germany and Switzerland were motivated to comply with policy measures during the first wave of the coronavirus disease 2019 (COVID-19) pandemic, and what factors hindered or limited their motivation. While quantitative surveys can measure the level of compliance, or broadly ask what motives people had for compliance, we here strive to explain why and how these motives lead to compliance. Methods: This publication has been made possible by the joint work of the members of the "Solidarity in times of pandemics" (SolPan) research commons. Seventy-seven semi-structured qualitative interviews were conducted with members of the general public in Germany (n = 46) and the German-speaking part of Switzerland (n = 31) in April 2020. Interviews were transcribed and analyzed following a grounded theory approach. Results: Three themes were identified that summarize factors contributing to compliant or noncompliant behavior. (1) Social cohesion was, on the one hand, an important motivator for compliance, but at the same time related to conflicting needs, illustrating the limits of compliance. (2) Consequences were considered on both the individual level (eg, consequences of individual infection) and societal level (eg, the societal and economic consequences of restrictions). (3) While for some participants following the rules was perceived as a matter of principle, others stressed the importance of making their own risk assessment, which was often associated with with a need for evidence on the effectiveness and reasons behind measures. Conclusion: A variety of motives contribute to COVID-19 related compliance. Authorities should seek to address these multi-faceted aspects to support motivation for compliance in a large proportion of the population.

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Section: Methodsmentioning

confidence: 99%

Motivations and Limits for COVID-19 Policy Compliance in Germany and Switzerland

Zimmermann

Fiske

McLennan

et al. 2021

Int J Health Policy Manag

Self Cite

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“…In a study on the Australian CTA, the majority of the participants thought that the app would detect when COVID-19 carriers are near them [ 81 ]. In a qualitative study conducted in Germany and Switzerland before the release of the CTAs, the same misconception was expressed by several participants [ 82 ]. Some of the official communication around the assessed CTAs might foster such a misunderstanding.…”

Section: Discussionmentioning

confidence: 95%

Self-Focused and Other-Focused Health Concerns as Predictors of the Uptake of Corona Contact Tracing Apps: Empirical Study

Deters¹,

Meier²,

Milek³

et al. 2021

J Med Internet Res

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Background Corona contact tracing apps are a novel and promising measure to reduce the spread of COVID-19. They can help to balance the need to maintain normal life and economic activities as much as possible while still avoiding exponentially growing case numbers. However, a majority of citizens need to be willing to install such an app for it to be effective. Hence, knowledge about drivers for app uptake is crucial. Objective This study aimed to add to our understanding of underlying psychological factors motivating app uptake. More specifically, we investigated the role of concern for one’s own health and concern to unknowingly infect others. Methods A two-wave survey with 346 German-speaking participants from Switzerland and Germany was conducted. We measured the uptake of two decentralized contact tracing apps officially launched by governments (Corona-Warn-App, Germany; SwissCovid, Switzerland), as well as concerns regarding COVID-19 and control variables. Results Controlling for demographic variables and general attitudes toward the government and the pandemic, logistic regression analysis showed a significant effect of self-focused concerns (odds ratio [OR] 1.64, P=.002). Meanwhile, concern of unknowingly infecting others did not contribute significantly to the prediction of app uptake over and above concern for one’s own health (OR 1.01, P=.92). Longitudinal analyses replicated this pattern and showed no support for the possibility that app uptake provokes changes in levels of concern. Testing for a curvilinear relationship, there was no evidence that “too much” concern leads to defensive reactions and reduces app uptake. Conclusions As one of the first studies to assess the installation of already launched corona tracing apps, this study extends our knowledge of the motivational landscape of app uptake. Based on this, practical implications for communication strategies and app design are discussed.

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“…However, Western societies particularly value privacy [ 37 , 136 ]. Maximizing population penetration of a voluntary DCTA in these societies will require health authorities to convince target users that their privacy will be protected [ 68 , 72 , 77 , 137 ]. The nature of data collected, whether it be proximity data, location data, or both, hinges on whether it is deemed to be proportionate to the aim pursued.…”

Section: Resultsmentioning

confidence: 99%

“…• Loss of trust in public health authorities and public health measures [14, 56,66] The IDCTA should be voluntary and consent-based according to the WHO and ECDC ethical guidance on DCTAs, and this view is also prevalent in the academic literature [40,[51][52][53][54][55]. For voluntary DCTAs, ensuring transparency and trustworthiness is important to maximize population penetration [52,53,[71][72][73][74][75][76][77][78][79].…”

Section: Clinicalmentioning

confidence: 99%

Best Practice Guidance for Digital Contact Tracing Apps: A Cross-disciplinary Review of the Literature

O’Connell

Abbas

Beecham

et al. 2021

JMIR Mhealth Uhealth

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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.

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Early Perceptions of COVID-19 Contact Tracing Apps in German-Speaking Countries: Comparative Mixed Methods Study

Cited by 99 publications

References 67 publications

Motivations and Limits for COVID-19 Policy Compliance in Germany and Switzerland

Motivations and Limits for COVID-19 Policy Compliance in Germany and Switzerland

Self-Focused and Other-Focused Health Concerns as Predictors of the Uptake of Corona Contact Tracing Apps: Empirical Study

Best Practice Guidance for Digital Contact Tracing Apps: A Cross-disciplinary Review of the Literature

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