Reasons for Nonuse, Discontinuation of Use, and Acceptance of Additional Functionalities of a COVID-19 Contact Tracing App: Cross-sectional Survey Study

Abstract

Background In several countries, contact tracing apps (CTAs) have been introduced to warn users if they have had high-risk contacts that could expose them to SARS-CoV-2 and could, therefore, develop COVID-19 or further transmit the virus. For CTAs to be effective, a sufficient critical mass of users is needed. Until now, adoption of these apps in several countries has been limited, resulting in questions on which factors prevent app uptake or stimulate discontinuation of app use. Objective The aim of this study was to investigate individuals’ reasons for not using, or stopping use of, a CTA, in particular, the Coronalert app. Users’ and nonusers’ attitudes toward the app’s potential impact was assessed in Belgium. To further stimulate interest and potential use of a CTA, the study also investigated the population’s interest in new functionalities. Methods An online survey was administered in Belgium to a sample of 1850 respondents aged 18 to 64 years. Data were collected between October 30 and November 2, 2020. Sociodemographic differences were assessed between users and nonusers. We analyzed both groups’ attitudes toward the potential impact of CTAs and their acceptance of new app functionalities. Results Our data showed that 64.9% (1201/1850) of our respondents were nonusers of the CTA under study; this included individuals who did not install the app, those who downloaded but did not activate the app, and those who uninstalled the app. While we did not find any sociodemographic differences between users and nonusers, attitudes toward the app and its functionalities seemed to differ. The main reasons for not downloading and using the app were a perceived lack of advantages (308/991, 31.1%), worries about privacy (290/991, 29.3%), and, to a lesser extent, not having a smartphone (183/991, 18.5%). Users of the CTA agreed more with the potential of such apps to mitigate the consequences of the pandemic. Overall, nonusers found the possibility of extending the CTA with future functionalities to be less acceptable than users. However, among users, acceptability also tended to differ. Among users, functionalities relating to access and control, such as digital certificates or “green cards” for events, were less accepted (358/649, 55.2%) than functionalities focusing on informing citizens about the spread of the virus (453/649, 69.8%) or making an appointment to get tested (525/649, 80.9%). Conclusions Our results show that app users were more convinced of the CTA’s utility and more inclined to accept new app features than nonusers. Moreover, nonusers had more CTA-related privacy concerns. Therefore, to further stimulate app adoption and use, its potential advantages and privacy-preserving mechanisms need to be stressed. Building further knowledge on the forms of resistance among nonusers is important for responding to these barriers through the app’s further development and communication campaigns.

The Dutch COVID-19 Notification App: Lessons Learned From a Mixed Methods Evaluation Among End Users and Contact-Tracing Employees

“…Before the spread of the omicron variant of the SARS-CoV-2, epidemiological studies in the United Kingdom have found that CTAs are effective when adopted by the public [ 3 ]. A German study [ 10 ] found that a higher level of education led to improved adoption of pandemic apps. In Belgium, a survey found a large majority of nonusers This refusal of use was largely due to privacy concerns and ambivalence about the app’s utility [ 11 ].…”

Interest in mHealth Among Patients With Low Back Pain: Cross-Sectional Study

“…Three recent studies have assessed the characteristics and associations of users and nonusers of different mHealth apps, all using participants from the general population, but still lacking consensus. Walrave et al [ 25 ] identified no sociodemographic differences between users and nonusers of contact tracking alert apps, including the Belgian Corona alert app. A study of the general US population identified strong associations of age, gender, and education level with the use of fitness apps and calorie counters [ 26 ].…”

An assessment on the interplay of digital proximity app use and vaccine uptake for SARS-CoV-2 transmission mitigation in Switzerland

“…Observed app uninstalling might be due to a lack of perceived bene ts from the app or due to experienced di culties in using the app. 8,42 App uninstalling among vaccinated participants, particularly, can also be explained by ongoing misconceptions during the alpha and delta variant waves that vaccination could prevent all SARS-CoV-2 infections, making app use seem unnecessary. 43 Nevertheless, our failure time analyses depicted a dichotomy of participants who did not use the SwissCovid app and did not get vaccinated (16% of pooled study population) versus participants who used the app and got vaccinated (40% of pooled study population) during the study period.…”