The relationship between trust and attitudes towards the COVID-19 digital contact-tracing app in the UK

Abstract

During the COVID-19 pandemic, digital contact-tracing has been employed in many countries to monitor and manage the spread of the disease. However, to be effective such a system must be adopted by a substantial proportion of the population; therefore, public trust plays a key role. This paper examines the NHS COVID-19 smartphone app, the digital contact-tracing solution in the UK. A series of interviews were carried out prior to the app’s release (n = 12) and a large scale survey examining attitudes towards the app (n = 1,001) was carried out after release. Extending previous work reporting high level attitudes towards the app, this paper shows that prevailing negative attitudes prior to release persisted, and affected the subsequent use of the app. They also show significant relationships between trust, app features, and the wider social and societal context. There is lower trust amongst non-users of the app and trust correlates to many other aspects of the app, a lack of trust could hinder adoption and effectiveness of digital contact-tracing. The design of technology requiring wide uptake, e.g., for public health, should embed considerations of the complexities of trust and the context in which the technology will be used.

Exploring individual's public trust in the NHS Test and Trace System – A pragmatic reflexive thematic analysis

“…As of October 2021, less than a third of the UK population were estimated to have downloaded the COVID-19 app and it was acknowledged that some people were choosing to not use it ( Committee of Public Accounts, 2021 ). Findings from 1001 responders to the survey deployed by this research group found over half ( n = 511) had not downloaded the app, whom also had significantly lower trust than those who had downloaded the app ( Dowthwaite et al, 2022 ). It cannot be assumed that the public will use something because it has been developed with governmental or health services.…”

“…However, recent reports relating to problems implementing the new COVID-19 app ( Best, 2019 ) echoes back to the NHS not being capable of producing safe and reliable digital health care. Responses from the survey associated with these interviews showed higher trust was associated with perceived understanding, usefulness, and ease-of-use of the COVID-19 app ( Dowthwaite et al, 2022 ). Further work on understanding public adoption of the T&T app found a lack of understanding of how the app worked was highest in those who did not trust the app, and BAME communities had the lowest rates of uptake and use ( Dowthwaite et al, 2021b ).…”

Perceptions of the Agency and Responsibility of the NHS COVID-19 App on Twitter: Critical Discourse Analysis

“…They also found that there were issues surrounding trust and understanding that hindered the effective adoption of the app. A follow-up analysis showed that there were statistically significant correlations between lower trust among nonusers, many aspects of the app, and the wider social and societal context [46]. A year after the app was launched, Pepper et al [2] identified 5 main themes during follow-up interview discussions: flaws in the app, usefulness and functionality affecting trust in the app, low trust in the UK government, varying degrees of trust in other stakeholders, and public disinterest.…”

The “allergic nose as a pollen detector” concept: e‐Diaries to predict pollen trends

“…During the SARS‐CoV‐2 pandemic, smartphone‐based alert systems informed citizens about physical proximity to a later infected person. With this help of contact monitoring, app users could voluntarily take preventative measures and isolate themselves or get tested regularly to detect a potential infection and disrupt the transmission chain 53,54 . Similarly, time‐dynamic pollen and air quality maps, available on the smartphone, may be useful likewise the traffic navigation systems we use every day.…”

“…With this help of contact monitoring, app users could voluntarily take preventative measures and isolate themselves or get tested regularly to detect a potential infection and disrupt the transmission chain. 53,54 Similarly, time-dynamic pollen and air quality maps, available on the smartphone, may be useful likewise the traffic navigation systems we use every day. Patients may be induced to precisely prevent symptoms by avoiding times/places with high concentrations of the pollen to which they are allergic.…”