Factors affecting adoption of digital contact tracing during the COVID-19 pandemic: a literature review

Abstract

Background and Objective: Digital tools have been extensively used in handling the COVID-19 pandemic, but governments struggle with the low uptake of digital contact tracing (DCT). Since this limits its effectiveness in infectious disease control, this topic is important to epidemiology and public health. The objectives of this review are: (I) to discuss the factors affecting DCT adoption in different communities; (II) to compile suggestions to improve DCT uptake; (III) to discuss implications of DCT utilisation in the pandemic on further digital and mobile health development. Methods: Papers published in English from January 2020 to January 2022 were identified using Boolean operators on PubMed and the Journal of Medical Internet Research (JMIR). Key Content and Findings: Literature review shows consolidated agreement that factors affecting acceptance of DCT applications are: (I) technical factors (privacy protection protocols, application design, user experience); (II) social factors (social norms, media representation and coverage, perception of responsible corporations); (III) political factors (government promotion and education, government image); (IV) health concerns (perceived risk of COVID-19, perceived effects of using DCT); and (V) cultural factors. Additionally, it is agreed that intention to use these applications pre-release does not indicate actual usage. Privacy protection, favourable attitudes of society, trust in private corporations, trust in governments, transparency, open communication approaches, perceived health benefits, and values of collectivism favour DCT uptake. Literature disagrees on the association between health awareness and DCT adoption, but most identify a positive association. Conclusions: Specific to the COVID-19 pandemic, literature recommends repeating these studies in different communities at different time points because social, cultural and political factors are geo-specific and temporo-specific. Beyond the COVID-19 pandemic, developers of digital and mobile health applications should consider data security and privacy consider, perceived functional efficacy and application usability.