Drivers of Acceptance of COVID-19 Proximity Tracing Apps in Switzerland: Panel Survey Analysis

Viktor von Wyl; Marc Höglinger; Chloé Sieber; Marco Kaufmann; André Moser; Miquel Serra-Burriel; Tala Ballouz; Dominik Menges; Anja Frei; Milo Alan Puhan

doi:10.2196/25701

Drivers of Acceptance of COVID-19 Proximity Tracing Apps in Switzerland: Panel Survey Analysis

JMIR Public Health and Surveillance ◽

10.2196/25701 ◽

2021 ◽

Vol 7 (1) ◽

pp. e25701

Author(s):

Viktor von Wyl ◽

Marc Höglinger ◽

Chloé Sieber ◽

Marco Kaufmann ◽

André Moser ◽

...

Keyword(s):

Mitigation Strategies ◽

Panel Survey ◽

Survey Analysis ◽

Citizenship Status ◽

Privacy Concerns ◽

Swiss German ◽

Online Panel ◽

Health Authorities ◽

Perceived Benefit ◽

Language Region

Background Digital proximity tracing apps have been released to mitigate the transmission of SARS-CoV-2, the virus known to cause COVID-19. However, it remains unclear how the acceptance and uptake of these apps can be improved. Objective This study aimed to investigate the coverage of the SwissCovid app and the reasons for its nonuse in Switzerland during a period of increasing incidence of COVID-19 cases. Methods We collected data between September 28 and October 8, 2020, via a nationwide online panel survey (COVID-19 Social Monitor, N=1511). We examined sociodemographic and behavioral factors associated with app use by using multivariable logistic regression, whereas reasons for app nonuse were analyzed descriptively. Results Overall, 46.5% (703/1511) of the survey participants reported they used the SwissCovid app, which was an increase from 43.9% (662/1508) reported in the previous study wave conducted in July 2020. A higher monthly household income (ie, income >CHF 10,000 or >US $11,000 vs income ≤CHF 6000 or <US $6600 [reference]: odds ratio [OR] 1.92, 95% CI 1.40-2.64), more frequent internet use (ie, daily [reference] vs less than weekly: OR 0.37, 95% CI 0.16-0.85), better adherence to recommendations for wearing masks (ie, always or most of the time [reference] vs rarely or never: OR 0.28, 95% CI 0.15-0.52), and nonsmoker status (OR 1.32, 95% CI 1.01-1.71) were associated with an increased likelihood for app uptake. Citizenship status (ie, non-Swiss citizenship vs. Swiss [reference]: OR 0.61, 95% CI 0.43-0.87), and language region (French vs Swiss German [reference]: OR 0.61, 95% CI 0.46-0.80) were associated with a lower likelihood for app uptake. Further analysis in a randomly selected subsample (n=712) with more detailed information showed that higher levels of trust in government and health authorities were also associated with a higher likelihood for app uptake (ie, high vs low [reference] trust: OR 3.13, 95% CI 1.58-6.22). The most frequent reasons for app nonuse were lack of perceived benefit of using the app (297/808, 36.8%), followed by the lack of a compatible phone (184/808, 22.8%), and privacy concerns (181/808, 22.4%). Conclusions Eliminating technical hurdles and communicating the benefits of digital proximity tracing apps are crucial to promote further uptake and adherence of such apps and, ultimately, enhance their effectiveness to aid pandemic mitigation strategies.

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Drivers of Acceptance of COVID-19 Proximity Tracing Apps in Switzerland: Panel Survey Analysis (Preprint)

10.2196/preprints.25701 ◽

2020 ◽

Author(s):

Viktor von Wyl ◽

Marc Höglinger ◽

Chloé Sieber ◽

Marco Kaufmann ◽

André Moser ◽

...

Keyword(s):

Mitigation Strategies ◽

Panel Survey ◽

Survey Analysis ◽

Citizenship Status ◽

Privacy Concerns ◽

Swiss German ◽

Online Panel ◽

Health Authorities ◽

Perceived Benefit ◽

Language Region

BACKGROUND Digital proximity tracing apps have been released to mitigate the transmission of SARS-CoV-2, the virus known to cause COVID-19. However, it remains unclear how the acceptance and uptake of these apps can be improved. OBJECTIVE This study aimed to investigate the coverage of the SwissCovid app and the reasons for its nonuse in Switzerland during a period of increasing incidence of COVID-19 cases. METHODS We collected data between September 28 and October 8, 2020, via a nationwide online panel survey (COVID-19 Social Monitor, N=1511). We examined sociodemographic and behavioral factors associated with app use by using multivariable logistic regression, whereas reasons for app nonuse were analyzed descriptively. RESULTS Overall, 46.5% (703/1511) of the survey participants reported they used the SwissCovid app, which was an increase from 43.9% (662/1508) reported in the previous study wave conducted in July 2020. A higher monthly household income (ie, income >CHF 10,000 or >US $11,000 vs income ≤CHF 6000 or <US $6600 [reference]: odds ratio [OR] 1.92, 95% CI 1.40-2.64), more frequent internet use (ie, daily [reference] vs less than weekly: OR 0.37, 95% CI 0.16-0.85), better adherence to recommendations for wearing masks (ie, always or most of the time [reference] vs rarely or never: OR 0.28, 95% CI 0.15-0.52), and nonsmoker status (OR 1.32, 95% CI 1.01-1.71) were associated with an increased likelihood for app uptake. Citizenship status (ie, non-Swiss citizenship vs. Swiss [reference]: OR 0.61, 95% CI 0.43-0.87), and language region (French vs Swiss German [reference]: OR 0.61, 95% CI 0.46-0.80) were associated with a lower likelihood for app uptake. Further analysis in a randomly selected subsample (n=712) with more detailed information showed that higher levels of trust in government and health authorities were also associated with a higher likelihood for app uptake (ie, high vs low [reference] trust: OR 3.13, 95% CI 1.58-6.22). The most frequent reasons for app nonuse were lack of perceived benefit of using the app (297/808, 36.8%), followed by the lack of a compatible phone (184/808, 22.8%), and privacy concerns (181/808, 22.4%). CONCLUSIONS Eliminating technical hurdles and communicating the benefits of digital proximity tracing apps are crucial to promote further uptake and adherence of such apps and, ultimately, enhance their effectiveness to aid pandemic mitigation strategies.

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Drivers of acceptance of COVID-19 proximity tracing apps in Switzerland

10.1101/2020.08.29.20184382 ◽

2020 ◽

Cited By ~ 2

Author(s):

Viktor von Wyl ◽

Marc Höglinger ◽

Chloé Sieber ◽

Marco Kaufmann ◽

André Moser ◽

...

Keyword(s):

Household Income ◽

Panel Survey ◽

Citizenship Status ◽

Privacy Concerns ◽

Swiss German ◽

Use Of Data ◽

Online Panel ◽

Health Authorities ◽

Perceived Benefit ◽

Language Region

AbstractBackgroundDigital proximity tracing (DPT) apps have been released to mitigate SARS-CoV-2 transmission. But it remains unclear how their acceptance and uptake can be improved. The aim of this study was to investigate SwissCovid app coverage and reasons for not using the app in Switzerland during a time of increasing SARS-CoV-2 incidence.MethodsBy use of data collected between 28.09.2020 to 08.10.2020 for a nationwide online panel survey (Covid-19 Social Monitor, n=1’511 participants), socio-demographic and behavioral factors associated with app usage were examined using multivariable logistic regression. Reasons for app non-use were analyzed descriptively.ResultsOverall, 46.5% of participants reported using the SwissCovid app (up from 43.9% in a study wave conducted in July 2020).A higher monthly household income (e.g. OR 1.92 [1.40-2.64] for an income >CHF 10’000 vs. an income ≤ CHF 6’000), more frequent internet use (e.g., daily (reference) vs. less than weekly OR 0.37 [0.16-0.85]), better adherence to mask-wearing recommendations (e.g., always or most of the time (reference) vs. rarely or never OR 0.28 [0.15-0.52]), and being a non-smoker (OR 1.32 [1.01-1.71]) were associated with an increased likelihood for app uptake. Citizenship status (e.g., non-Swiss citizenship 0.61 [0.43-0.87] vs. Swiss citizenship only), and language region (French 0.61 [0.46-0.80], vs. Swiss German) were associated with a lower app uptake probability.In a randomly selected subsample (n=711) with more detailed information, higher levels of trust in government and health authorities were additionally associated with a higher app uptake probability (e.g., OR 3.13 [1.58-6.22] for high vs. low trust (reference)).The most frequent reasons for app non-use was lack of perceived benefit of the app (36.8%), 22.8% reported to have no compatible phone, and 22.4% had privacy concerns.ConclusionRemoving technical hurdles and communicating the benefits of DPT-apps are crucial to promote further uptake, compliance, and ultimately to enhance effectiveness of DPT-apps for pandemic mitigation.

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Use of Venn Diagrams to Evaluate Digital Contact Tracing: Results from a Panel Survey Analysis (Preprint)

10.2196/preprints.30004 ◽

2021 ◽

Author(s):

Paola Daniore ◽

Vasilis Nittas ◽

André Moser ◽

Marc Höglinger ◽

Viktor von Wyl

Keyword(s):

Panel Data ◽

Preventive Measures ◽

Panel Study ◽

Population Level ◽

Contact Tracing ◽

Venn Diagram ◽

Panel Survey ◽

Survey Analysis ◽

Venn Diagrams ◽

Health Authorities

BACKGROUND Mitigation of pandemic spread relies on targeted approaches aimed at preventing non-household interactions. Contact tracing in the form of digital proximity tracing (DPT) apps has been widely adopted in multiple countries due to its perceived added benefits of tracing speed and breadth in comparison to traditional manual contact tracing (MCT). Monitoring of user responses to exposure notifications (EN) can provide insights into the effect of DPT app use on managing the spread of SARS-CoV-2. OBJECTIVE The aim of this study was to assess the effectiveness of DPT apps in users taking mitigative actions to reduce infection spread based on nationwide panel data on DPT app use in Switzerland. METHODS We assessed data from the COVID-19 Social Monitor, a nationwide panel study of Swiss residents that classified (a) non-users of the SwissCovid app, (b) users of the SwissCovid app and (c) users of the SwissCovid app who received exposure notifications (EN). A Venn diagram framework was applied to describe the (non-)overlap of these subpopulations with SARS-CoV-2 outcomes. RESULTS 12525 assessments of 2403 participants were included. DPT app users revealed higher adherence to preventive measures than app non-users. 75.9% (95% CI: 60.3-91.5%) of DPT app users revealed taking at least one mitigative action after receiving EN. 30.0% (95% CI: 11.9-54.3%) of the DPT app users also tested positive for SARS-CoV-2 following receipt of EN, which is over three times more than DPT app users who did not receive EN (8.0%, 95% CI: 5.0-11.9%). CONCLUSIONS Response from three out of four individuals to EN reveals a possible contribution of DPT apps to users taking mitigative actions to limit SARS-CoV-2 spread. The analytic approach proposed in this study provides a foundation to researchers and health authorities to comprehensively assess population-level DPT app effectiveness by providing an intuitive framework for monitoring indicator construction. CLINICALTRIAL N/A

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Modeling infection dynamics and mitigation strategies to support K-6 in-person instruction during the COVID-19 pandemic

10.1101/2021.02.27.21252535 ◽

2021 ◽

Author(s):

Douglas E. Morrison ◽

Roch Nianogo ◽

Vladimir Manuel ◽

Onyebuchi A. Arah ◽

Nathaniel Anderson ◽

...

Keyword(s):

School Attendance ◽

Secondary Infection ◽

Mitigation Strategies ◽

Transmission Dynamics ◽

Model Parameters ◽

Safety Education ◽

Vaccination Rates ◽

Health Authorities ◽

Infection Dynamics ◽

Public Health Authorities

AbstractObjectiveTo support safer in-person K-6 instruction during the coronavirus disease 2019 (COVID- 19) pandemic by providing public health authorities and school districts with a practical model of transmission dynamics and mitigation strategies.MethodsWe developed an agent-based model of infection dynamics and preventive mitigation strategies such as distancing, health behaviors, surveillance and symptomatic testing, daily symptom and exposure screening, quarantine policies, and vaccination. The model parameters can be updated as the science evolves and are adjustable via an online user interface, enabling users to explore the effects of interventions on outcomes of interest to states and localities, under a variety of plausible epidemiological and policy assumptions.ResultsUnder default assumptions, secondary infection rates and school attendance are substantially affected by surveillance testing protocols, vaccination rates, class sizes, and effectiveness of safety education.ConclusionsOur model helps policymakers consider how mitigation options and the dynamics of school infection risks affect outcomes of interest. The model’s parameters can be immediately updated in response to changes in epidemiological conditions, science of COVID-19 transmission dynamics, testing and vaccination resources, and reliability of mitigation strategies.

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Is my fear of missing out (FOMO) causing fatigue? Advertising, social media fatigue, and the implications for consumers and brands

Internet Research ◽

10.1108/intr-03-2017-0112 ◽

2018 ◽

Vol 28 (5) ◽

pp. 1213-1227 ◽

Cited By ~ 17

Author(s):

Laura Frances Bright ◽

Kelty Logan

Keyword(s):

Social Media ◽

Consumer Perceptions ◽

Web Based ◽

Content Type ◽

Privacy Concerns ◽

Fear Of Missing Out ◽

Media Usage ◽

Online Panel ◽

Subject Pool ◽

Driving Fatigue

Purpose Social media usage has become ubiquitous in our society – consumers are spending upwards of 20 percent of their media time on social sites interacting with friends, family and brands (Adler, 2016) and all of this usage is driving fatigue. The purpose of this paper is to examine how advertising factors such as attitude and intrusiveness impact social media fatigue as well as two consumer behavior factors, fear of missing out (FOMO) and privacy. Design/methodology/approach A 190-item questionnaire was developed and administered to an opt-in subject pool recruited for web-based research (i.e. online panel). A representative sample of 750 US social media users was recruited for the survey of which 518 respondents were valid and usable. Findings Results indicate that FOMO has the greatest impact on social media fatigue, not advertising factors as predicted. In addition, privacy concerns continue to plague consumers and should be monitored by advertisers. Research limitations/implications With regard to limitation, the survey contained a variety of self-reported measures that can tend to be under-reported, especially when it comes to social media usage as evidenced in a recent study (Adler, 2016). Originality/value This research undertook an investigation of consumer perceptions of social media advertising and how those relate to social media fatigue and psychological factors such as privacy and FOMO. In looking at these constructs, a clearer picture of how consumer perceptions of advertising impact levels of social media fatigue has emerged. In addition, the results provide a better understanding of FOMO, a psychological factor that significantly contributes to social media fatigue.

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Epilepsy Treatment Complacency in Patients, Caregivers, and Healthcare Professionals

Neurology Clinical Practice ◽

10.1212/cpj.0000000000001066 ◽

2021 ◽

pp. 10.1212/CPJ.0000000000001066

Author(s):

Patricia E. Penovich ◽

John M. Stern ◽

Danielle A. Becker ◽

Lucretia Long ◽

Nancy Santilli ◽

...

Keyword(s):

Healthcare Professionals ◽

Treatment Decisions ◽

Adult Patients ◽

Survey Analysis ◽

Chi Square ◽

Online Panel ◽

Patient Voice ◽

Treatment Changes ◽

Patients With Epilepsy ◽

The Impact

ABSTRACTObjective:To explore the perspectives of adult patients with epilepsy, caregivers, and healthcare professionals (HCPs) on treatment for seizures and treatment decisions, we developed and administered the STEP Survey (Seize the Truth of Epilepsy Perceptions).Methods:Participants were recruited from online panel M3 and by Rare Patient Voice and completed the self-administered online STEP Survey. Analysis of variance and chi-square tests were used for group comparisons.Results:The STEP Survey was completed by 400 adult patients, 201 caregivers, and 258 HCPs. Patients estimated reporting 45% of their seizures to their HCP, whereas caregivers estimated 83% and HCPs estimated 73% were reported. The most common reason for not reporting seizures was the seizures were “not serious enough to mention” (patients 57%; caregivers 66%). A minority of patients (25%) and caregivers (30%) were very or extremely likely to ask their HCP about changing antiseizure medication (ASM) in the next 12 months. The HCP was most frequently selected by patients, caregivers, and HCPs as the person who initiates discussion of changing ASMs (patients 73%/caregivers 66%/HCPs 75%) and increasing ASM dosage (patients 77%/caregivers 68%/HCPs 81%). A majority of patients (65%) and caregivers (68%) somewhat or strongly agreed they do not change ASMs due to fear of getting worse. HCPs perceive this fear less often, stating 50% of their patients feel afraid when a second ASM was added.Conclusions:Improved reporting of all seizures, discussion of treatment changes, and the impact of fear on treatment decisions provide opportunities to reduce complacency and optimize patient outcomes.

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Adoption and continued use of mobile contact tracing technology: Multilevel explanations from a three-wave panel survey and linked data

10.1101/2021.07.13.21260444 ◽

2021 ◽

Author(s):

Laszlo Horvath ◽

Susan Banducci ◽

Joshua Blamire ◽

Cathrine Degnen ◽

Oliver James ◽

...

Keyword(s):

Repeated Measures ◽

Regional Distribution ◽

Data Access ◽

Dropout Rate ◽

Mobile App ◽

Drop Out ◽

Contact Tracing ◽

Panel Survey ◽

Privacy Concerns ◽

Continued Use

Objective: To identify the key individual-level (demographics, attitudes, mobility) and contextual (Covid-19 case numbers, tiers of mobility restrictions, urban districts) determinants of adopting the NHS Covid-19 contact tracing app and continued use over-time. Design and setting: A three-wave panel survey conducted in England in July 2020 (background survey), November 2020 (first measure of mobile app adoption), and March 2021 (continued use of app and new adopters) linked with official data. Primary outcome: Repeated measures of self-reported app usage. Participants: N = 2,500 adults living in England, representative of England's population in terms of regional distribution, age, and gender (2011 census). Results: We observe initial app uptake at 41%, 95% CI [0.39,0.43], in November 2020 with a 12% dropout rate by March 2021, 95% CI [0.10,0.14]. We also found that 7% of nonusers as of wave 2 became new adopters by wave 3, 95% CI [0.05,0.08]. Initial uptake (or failure to use) of the app associated with social norms, privacy concerns, and misinformation about third-party data access, with those living in postal districts with restrictions on mobility less likely to use the app. Perceived lack of transparent evidence of effectiveness was associated with drop out of use. In addition, those who trusted the government were more likely to adopt in wave 3 as new adopters. Conclusions: Successful uptake of the contact tracing app should be evaluated within the wider context of the UK Government's response to the crisis. Trust in government is key to adoption of the app in wave 3 while continued use is linked to perceptions of transparent evidence. Providing clear information to address privacy concerns could increase uptake, however, the disparities in continued use among ethnic minority participants needs further investigation as differences are not fully explained via attitudinal measures.

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Privacy and Anonymity Challenges When Collecting Data for Public Health Purposes

The Journal of Law Medicine & Ethics ◽

10.1111/jlme.12036 ◽

2013 ◽

Vol 41 (S1) ◽

pp. 37-41 ◽

Cited By ~ 4

Author(s):

Khaled El Emam ◽

Ester Moher

Keyword(s):

Public Health ◽

Personal Health Information ◽

Personal Health ◽

Patient Privacy ◽

Privacy Concerns ◽

Public Health Data ◽

Health Authorities ◽

Public Health Authorities ◽

Privacy And Anonymity ◽

Hipaa Privacy Rule

Even though health care provider reporting of diseases to public health authorities is common, often there is under-reporting by providers, including for notifiable diseases; frequently, under-reporting occurs by wide margins. Two causal factors for this under-reporting by providers have been that: (1) disclosing data may violate their patients’ privacy, and (2) disclosed data may be used to evaluate their performance. A reluctance to disclose information due to privacy concerns exists despite the U.S. Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule permitting disclosures of personal health information (PHI) for public health purposes without patient authorization. On the other hand, such patient privacy concerns are somewhat justified: there have been documented breaches of patient information from public health data custodians.A common way to address this privacy issue is to de-identify patient data before it is disclosed to public health.

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