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

Lookup NU author(s): Professor Cathrine Degnen



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Objective: To identify the key individual-level (demographics, attitudes, mobility) andcontextual (Covid-19 case numbers, tiers of mobility restrictions, urban districts)determinants of adopting the NHS Covid-19 contact tracing app and continued use overtime.Design and setting: A three-wave panel survey conducted in England in July 2020(background survey), November 2020 (first measure of app adoption), and March 2021(continued use of app and new adopters) linked with official data.Participants: N = 2,500 adults living in England, representative of England’s population interms of regional distribution, age, and gender (2011 census).Primary outcome: Repeated measures of self-reported app usage.Analytical approach: Multilevel logistic regression linking a range of individual-level (fromsurvey) and contextual (from linked data) determinants to app usage.Results: We observe initial app uptake at 41%, 95% CI [0.39,0.43], and a 12% dropout rateby March 2021, 95% CI [0.10,0.14]. We also found that 7% of nonusers as of wave 2became new adopters by wave 3, 95% CI [0.05,0.08]. Initial uptake (or failure to use) of theapp associated with social norms, privacy concerns, and misinformation about third-partydata access, with those living in postal districts with restrictions on mobility less likely to usethe app. Perceived lack of transparent evidence of effectiveness was associated with dropout of use. In addition, those who trusted the government were more likely to adopt in wave3 as new adopters.Conclusions: Successful uptake of the contact tracing app should be evaluated within thewider context of the UK Government’s response to the crisis. Trust in government is key toadoption of the app in wave 3 while continued use is linked to perceptions of transparentevidence. Providing clear information to address privacy concerns could increase uptake,however, the disparities in continued use among ethnic minority participants needs furtherinvestigation.

Publication metadata

Author(s): Horvath L, Banducci S, Blamire J, Degnen C, James O, Jones A, Stevens D, Tyler K

Publication type: Article

Publication status: Published

Journal: BMJ Open

Year: 2022

Volume: 12

Issue: 1

Print publication date: 17/01/2022

Online publication date: 17/01/2022

Acceptance date: 23/12/2021

Date deposited: 07/02/2022

ISSN (electronic): 2044-6055

Publisher: BMJ Publishing Group


DOI: 10.1136/bmjopen-2021-053327


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