Scoping Review of Mobile Phone App Uptake and Engagement to Inform Digital Contact Tracing Tools for Covid-19

Abstract

BACKGROUNDDigital contact tracing apps have been proposed as a method of controlling the spread of Covid-19. The effectiveness of this tool depends largely on adequate levels of uptake (e.g. whether the user downloads and registers on the application) and engagement (e.g. the extent of usage of the application or its components over time). It has been estimated that approximately 60% of the population would need to use the NHSX application in order for it to be effective in reducing the spread of COVID-19. It is therefore crucial that we understand the level of, and factors influencing, uptake and engagement with digital tracing applications in order to put appropriate measures in place to mitigate those issues.AIMS1.To quantify the current data on COVID-19 digital contact tracing applicationsa.Uptake and engagement of COVID-19 digital contact tracing applicationsb.Examine whether uptake differs between countries c.Identify any predictors or correlates of uptake and engagement2.To conduct two scoping reviews to identify key barriers and facilitators influencing engagement and uptake of a.COVID-19 digital contact tracing applications b.Health behaviour change applications, including government approved applications, from academic literature and behaviour change guidelinesCONCLUSIONS•There is no evidence on the level of uptake and engagement with COVID-19 digital contact tracing applications.•There is a dearth of evidence regarding the barriers and facilitators to uptake and engagement with COVID-19 digital contact tracing applications.•The health behaviour change literature suggests a number of barriers and facilitators associated with uptake and engagement with applications.

The vital role of health psychology in the response to COVID‐19

“…There are currently 155 health psychology professionals registered as part of the Health Psychology Exchange, who have liaised with the BPS Behavioural Science and Disease Prevention Taskforce (which includes some HPX collaborators), written three rapid reviews (Ghio et al, 2020; Rodham et al, 2020; Thorneloe et al, 2020), led four webinars, produced two articles in The Psychologist (Redsell, Laidlaw, Varkonyi‐Sepp, & Hotham, 2020; Watson, 2020), and worked with 17 organizations to support COVID‐19 response activities. These activities have included helping organizations to understand how to reduce the potential psychological effects of COVID‐19 on their staff, advising on public health messaging, and supporting development of services and policies to reduce the impact of lockdown on physical health and health behaviours.…”

Digital contact-tracing during the Covid-19 pandemic: An analysis of newspaper coverage in Germany, Austria, and Switzerland

“…Experts highlighted the low data quality and Bluetooth technology’s inaccuracy for proximity tracing, and that including citizen’s self-diagnosis along with official validated tests propagates false positives [ 7 , 10 ]. Furthermore, although a significant percent of the population needs to participate for efficacy, in countries like Singapore the adoption rate has been below 20% [ 11 ]. The opt-in approach can thus undermine effectiveness through lack of critical mass, however making it mandatory would sacrifice autonomy [ 12 , 13 ].…”

Towards a digital solution: Predicting public take-up of Singapore’s contact tracing mobile application during the COVID-19 crisis

“…To increase uptake, the Gulf state Qatar made it compulsory for residents to use the official application, imposing a fine of $55,000 or imprisonment of 3 years for those who do not comply (Al Jazeera News, 2020). Given that most countries do not have this legislation, however, public health agencies would benefit from an improved understanding of sociodemographic factors that predict uptake (Thorneloe et al, 2020). In turn, this information can be used to encourage members of the public to opt-in.…”

“…This omission is notable: prior to our study, it would have been conceivable that only a subset of the population would download a contact tracing application. For example, when other technological innovations have been introduced (such as medical advice delivered via phone applications), uptake has been predicted by demographic factors such as gender or education level (Karekla et al, 2019;Thorneloe et al, 2020). Similarly, the performance of health-related behaviors has been associated with demographic characteristics (e.g., Long and Liu, 2020).…”

“…Although this legislation led to high download rates (>90%, [23]), the potential backlash from the public (e.g., because of privacy concerns [24, 25]) means that few countries are likely to follow suit. Correspondingly, public health agencies would benefit from an understanding of what predicts voluntary downloads [26], providing an empirical base to nudge citizens to opt in [27].…”