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Open accessJournal ArticleDOI: 10.2196/25726

Adoption of COVID-19 Contact Tracing Apps: A Balance Between Privacy and Effectiveness.

04 Mar 2021-Journal of Medical Internet Research (JMIR Publications Inc.)-Vol. 23, Iss: 3
Abstract: With the relative ubiquity of smartphones, contact tracing and exposure notification apps have been looked to as novel methods to help reduce the transmission of COVID-19. Many countries have created apps that lie across a spectrum from privacy-first approaches to those that have very few privacy measures. The level of privacy incorporated into an app is largely based on the societal norms and values of a particular country. Digital health technologies can be highly effective and preserve privacy at the same time, but in the case of contact tracing and exposure notification apps, there is a trade-off between increased privacy measures and the effectiveness of the app. In this article, examples from various countries are used to highlight how characteristics of contract tracing and exposure notification apps contribute to the perceived levels of privacy awarded to citizens and how this impacts an app's effectiveness. We conclude that finding the right balance between privacy and effectiveness, while critical, is challenging because it is highly context-specific.

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Open accessJournal ArticleDOI: 10.1016/J.IJMEDINF.2021.104639
Zoie Shui-Yee Wong1, Michael Rigby2Institutions (2)
Abstract: Background and objective The COVID-19 pandemic has accelerated digital health applications in multifaceted disease management dimensions. This study aims (1) to identify risk issues relating to the rapid development and redeployment of COVID-19 related e-health systems, in primary care, and in the health ecosystems interacting with it and (2) to suggest evidence-based evaluation directions under emergency response. Method After initial brainstorming of digital health risks posed in this pandemic, a scoping review method was adopted to collect evidence across databases of PubMed, CINAHL, and EMBASE. Peer-review publications, reports, news sources, and websites that credibly identified the challenges relating digital health scaled for COVID-19 were scrutinized. Additional supporting materials were obtained through snowball sampling and the authors’ global digital health networks. Studies satisfying the selection criteria were charted based on their study design, primary care focus, and coverage of e-health areas of risk. Results Fifty-eight studies were mapped for qualitative synthesis. Five identified digital health risk areas associated with the pandemic were governance, system design and coordination, information access, service provision, and user (professional and public) reception. We observed that rapid digital health responses may embed challenges in health system thinking, the long-term development of digital health ecosystems, and interoperability of health IT infrastructure, with concomitant weaknesses in existing evaluation theories. Conclusion Through identifying digital health risks posed during the pandemic, this paper discussed potential directions for next-generation informatics evaluation development, to better prepare for the post-COVID-19 era, a new future epidemic, or other unforeseen global health emergencies. An updated evidence-based approach to health informatics is essential to gain public confidence in digital health across primary and other health sectors.

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Topics: Digital health (66%), Health informatics (63%), Global health (59%) ... show more

Open accessProceedings ArticleDOI: 10.1145/3474717.3484269
Sitao Min1, Ritesh Ahuja2, Yingzhe Liu2, Abbas Zaidi2  +3 moreInstitutions (2)
02 Nov 2021-
Abstract: CrowdMap is an anonymous occupancy monitoring system developed in response to the COVID-19 pandemic. CrowdMap collects, cleans, and visualizes occupancy data derived from connection logs generated by large arrays of Wi-Fi access points. Thus, CrowdMap is a passive digital tracking tool that can be used to reopen buildings safely, as it helps actively manage occupancy limits and identify utilization trends at scale. Occupancy monitoring is possible at various levels of resolution over large spatial (e.g., from individual rooms to entire buildings) and temporal (e.g., from hours to months) extents. The CrowdMap web-based front-end implements powerful spatiotemporal querying and visualization tools to quickly and effectively explore occupancy patterns throughout large campuses. We will demonstrate CrowdMap and its spatiotemporal GUI that was deployed for an entire university campus with data continuously being collected since summer 2020.

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Topics: Occupancy (53%)

Open accessJournal ArticleDOI: 10.2196/30871
John S. Seberger1, Sameer Patil2Institutions (2)
Abstract: Background: Smartphone-based apps designed and deployed to mitigate the COVID-19 pandemic may become infrastructure for postpandemic public health surveillance in the United States. Through the lenses of privacy concerns and user expectations of digital pandemic mitigation techniques, we identified possible long-term sociotechnical implications of such an infrastructure. Objective: We explored how people in the United States perceive the possible routinization of pandemic tracking apps for public health surveillance in general. Our interdisciplinary analysis focused on the interplay between privacy concerns, data practices of surveillance capitalism, and trust in health care providers. We conducted this analysis to achieve a richer understanding of the sociotechnical issues raised by the deployment and use of technology for pandemic mitigation. Methods: We conducted scenario-based, semistructured interviews (n=19) with adults in the United States. The interviews focused on how people perceive the short- and long-term privacy concerns associated with a fictional smart thermometer app deployed to mitigate the “outbreak of a contagious disease.” In order to elicit future-oriented discussions, the scenario indicated that the app would continue functioning “after the disease outbreak has dissipated.” We analyzed interview transcripts using reflexive thematic analysis. Results: In the context of pandemic mitigation technology, including app-based tracking, people perceive a core trade-off between public health and personal privacy. People tend to rationalize this trade-off by invoking the concept of “the greater good.” The interplay between the trade-off and rationalization forms the core of sociotechnical issues that pandemic mitigation technologies raise. Participants routinely expected that data collected through apps related to public health would be shared with unknown third parties for the financial gain of the app makers. This expectation suggests a perceived alignment between an app-based infrastructure for public health surveillance and the broader economics of surveillance capitalism. Our results highlight unintended and unexpected sociotechnical impacts of routinizing app-based tracking on postpandemic life, which are rationalized by invoking a nebulous concept of the greater good. Conclusions: While technologies such as app-based tracking could be useful for pandemic mitigation and preparedness, the routinization of such apps as a form of public health surveillance may have broader, unintentional sociotechnical implications for individuals and the societies in which they live. Although technology has the potential to increase the efficacy of pandemic mitigation, it exists within a broader network of sociotechnical concerns. Therefore, it is necessary to consider the long-term implications of pandemic mitigation technologies beyond the immediate needs of addressing the COVID-19 pandemic. Potential negative consequences include the erosion of patient trust in health care systems and providers, grounded in concerns about privacy violations and overly broad surveillance.

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Topics: Public health surveillance (56%), Sociotechnical system (54%), Health care (52%) ... show more

Open accessJournal ArticleDOI: 10.3390/FI13110286
15 Nov 2021-Future Internet
Abstract: Together with vaccines, contact tracing systems (CTS) have proved to be one of the best strategies to deal with the current COVID-19 pandemic. However, the adoption of such systems has been quite limited in EU countries, and Italy was no exception. The present research aimed to investigate the factors drawn from the most relevant psychological models in the literature, most associated with the adoption of CTS. The data analysis of the 501 surveyed answers (329 from CTS adopters) showed that knowing important others who have downloaded the CTS, CTS attitudes, CTS perceived efficacy, COVID-19 risk perception, and trust in the government and its actions influenced the adoption of the Italian CTS (52% of explained variance). These factors defined a new specific model that can be used to more effectively promote CTS adoption and thus increase the protective potential of these technologies, whose effectiveness is inevitably linked to adoption.

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Open accessJournal ArticleDOI: 10.2196/28146
Annika Scholl1, Kai Sassenberg1Institutions (1)
Abstract: Background: Official contact tracing apps have been implemented and recommended for use across nations to track and contain the spread of COVID-19. Such apps can be effective if people are willing to use them. Accordingly, many attempts are being made to motivate citizens to make use of the officially recommended apps. Objective: The aim of this research was to contribute to an understanding of the preconditions under which people are willing to use a COVID-19 contact tracing app (ie, their use intentions and use). To go beyond personal motives in favor of app use, it is important to take people’s social relationships into account, under the hypothesis that the more people identify with the beneficiaries of app use (ie, people living close by in their social environment) and with the source recommending the app (ie, members of the government), the more likely they will be to accept the officially recommended contact tracing app. Methods: Before, right after, and 5 months after the official contact tracing app was launched in Germany, a total of 1044 people participated in three separate surveys. Structural equation modeling was used to test the hypotheses, examining the same model in all studies at these critical points in time. Results: Across the three surveys, both identification with the beneficiaries (people living in their social environment) and with the source recommending the app (members of the government) predicted greater intention to use and use (installation) of the official contact tracing app. Trust in the source (members of the government) served as a mediator. Other types of identification (with people in Germany or people around the world) did not explain the observed results. The findings were highly consistent across the three surveys. Conclusions: Attempts to motivate people to use new health technology (or potentially new measures more generally) not only for their personal benefit but also for collective benefits should take the social context into account (ie, the social groups people belong to and identify with). The more important the beneficiaries and the sources of such measures are to people’s sense of the self, the more willing they will likely be to adhere to and support such measures.

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Topics: Social environment (53%), Social group (52%)

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Open accessJournal ArticleDOI: 10.2196/20572
Abstract: Background: To track and reduce the spread of COVID-19, apps have been developed to identify contact with individuals infected with SARS-CoV-2 and warn those who are at risk of having contracted the virus. However, the effectiveness of these apps depends highly on their uptake by the general population. Objective: The present study investigated factors influencing app use intention, based on the health belief model. In addition, associations with respondents’ level of news consumption and their health condition were investigated. Methods: A survey was administered in Flanders, Belgium, to 1500 respondents, aged 18 to 64 years. Structural equation modeling was used to investigate relationships across the model’s constructs. Results: In total, 48.70% (n=730) of respondents indicated that they intend to use a COVID-19 tracing app. The most important predictor was the perceived benefits of the app, followed by self-efficacy and perceived barriers. Perceived severity and perceived susceptibility were not related to app uptake intention. Moreover, cues to action (ie, individuals’ exposure to [digital] media content) were positively associated with app use intention. As the respondents’ age increased, their perceived benefits and self-efficacy for app usage decreased. Conclusions: Initiatives to stimulate the uptake of contact tracing apps should enhance perceived benefits and self-efficacy. A perceived barrier for some potential users is privacy concerns. Therefore, when developing and launching an app, clarification on how individuals’ privacy will be protected is needed. To sustain perceived benefits in the long run, supplementary options could be integrated to inform and assist users.

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Topics: Health belief model (55%), Population (51%)

66 Citations


Open accessJournal ArticleDOI: 10.1038/S41591-020-0928-Y
Tanusree Sharma1, Masooda Bashir1Institutions (1)
01 Aug 2020-Nature Medicine
Abstract: Mobile apps provide a convenient source of tracking and data collection to fight against the spread of COVID-19. We report our analysis of 50 COVID-19-related apps, including their use and their access to personally identifiable information, to ensure that the right to privacy and civil liberties are protected.

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52 Citations


Open accessPosted ContentDOI: 10.1101/2020.08.29.20184135
Matthew Abueg1, Robert Hinch2, Neo Wu1, Luyang Liu1  +14 moreInstitutions (3)
02 Sep 2020-medRxiv
Abstract: Contact tracing is increasingly being used to combat COVID-19, and digital implementations are now being deployed, many of them based on Apple and Google’s Exposure Notification System. These systems are new and are based on smartphone technology that has not traditionally been used for this purpose, presenting challenges in understanding possible outcomes. In this work, we use individual-based computational models to explore how digital exposure notifications can be used in conjunction with non-pharmaceutical interventions, such as traditional contact tracing and social distancing, to influence COVID-19 disease spread in a population. Specifically, we use a representative model of the household and occupational structure of three counties in the state of Washington together with a proposed digital exposure notifications deployment to quantify impacts under a range of scenarios of adoption, compliance, and mobility. In a model in which 15% of the population participated, we found that digital exposure notification systems could reduce infections and deaths by approximately 8% and 6%, effectively complementing traditional contact tracing. We believe this can serve as guidance to health authorities in Washington state and beyond on how exposure notification systems can complement traditional public health interventions to suppress the spread of COVID-19.

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Topics: Population (53%)

45 Citations


Open accessJournal ArticleDOI: 10.1093/JLB/LSAA034
Abstract: Digital surveillance has played a key role in containing the COVID-19 outbreak in China, Singapore, Israel, and South Korea. Google and Apple recently announced the intention to build interfaces to allow Bluetooth contact tracking using Android and iPhone devices. In this article, we look at the compatibility of the proposed Apple/Google Bluetooth exposure notification system with Western privacy and data protection regimes and principles, including the General Data Protection Regulation (GDPR). Somewhat counter-intuitively, the GDPR's expansive scope is not a hindrance, but rather an advantage in conditions of uncertainty such as a pandemic. Its principle-based approach offers a functional blueprint for system design that is compatible with fundamental rights. By contrast, narrower, sector-specific rules such as the US Health Insurance Portability and Accountability Act (HIPAA), and even the new California Consumer Privacy Act (CCPA), leave gaps that may prove difficult to bridge in the middle of an emergency.

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43 Citations


Performance
Metrics
No. of citations received by the Paper in previous years
YearCitations
20221
20217