The resistance toward COVID-19 contact tracing apps: A study of psychological reactance among young adults in Italy

Western governments' attempts to encourage young adults to adopt COVID-19 contact tracing apps (CTAs) have been unsuccessful. Drawing on psychological reactance theory, we propose that government-imposed containment measures (e.g., lockdowns, curfews) may cause young adults to resist CTAs. We investigate how and when threats to freedom posed by government-imposed containment measures to young adults reduce their CTA adoption intentions. We conducted a survey of young adults during the second general lockdown (March‒April 2021) in Italy. The results show that when young Italian adults focus on the restrictive nature of government-imposed containment measures, their sense of freedom is threatened. Threats to freedom produce psychological states of either helplessness or reactance, depending on if young Italian adults think they can recover their freedom. Helpless young adults are motivated to adopt CTAs because they seek guidance from containment measures. Reactant young adults resist CTAs because they exhibit aversive psychological states toward containment measures. These results offer relevant insights for policymakers. They shed light on young Italian adults' resistance toward CTAs. They also inform governments on how to interact more efficiently with young adults if a novel pandemic should occur.

A privacy calculus model for contact tracing apps: Analyzing the use behavior of the German Corona-Warn-App with a longitudinal user study

The SARS-CoV-2 pandemic is a pressing societal issue today. The German government promotes a contract tracing app named Corona-Warn-App (CWA), aiming to change citizens' health behaviors during the pandemic by raising awareness about potential infections and enable infection chain tracking. Technical implementations, citizens' perceptions, and public debates around apps differ between countries, e. g., in Germany there has been a huge discussion on potential privacy issues of the app. Thus, we analyze effects of privacy concerns regarding the CWA, perceived CWA benefits, and trust in the German healthcare system to answer why citizens use the CWA. In our initial conference publication at ICT Systems Security and Privacy Protection - 37th IFIP TC 11 International Conference, SEC 2022, we used a sample with 1752 actual users and non-users of the CWA and and support for the privacy calculus theory, i. e., individuals weigh privacy concerns and benefits in their use decision. Thus, citizens privacy perceptions about health technologies (e. g., shaped by public debates) are crucial as they can hinder adoption and negatively affect future fights against pandemics. In this special issue, we adapt our previous work by conducting a second survey 10 months after our initial study with the same pool of participants (830 participants from the first study participated in the second survey). The goal of this longitudinal study is to assess changes in the perceptions of users and non-users over time and to evaluate the influence of the significantly lower hospitalization and death rates on the use behavior which we could observe during the second survey. Our results show that the privacy calculus is relatively stable over time. The only relationship which significantly changes over time is the effect of privacy concerns on the use behavior which significantly decreases over time, i. e., privacy concerns have a lower negative effect one the CWA use indicating that it did not play such an important role in the use decision at a later point in time in the pandemic. We contribute to the literature by introducing one of the rare longitudinal analyses in the literature focusing on the privacy calculus and changes over time in the relevant constructs as well as the relationships between the calculus constructs and target variables (in our case use behavior of a contact tracing app). We can see that the explanatory power of the privacy calculus model is relatively stable over time even if strong externalities might affect individual perceptions related to the model.

Breaking the chain with individual gain? Investigating the moral intensity of COVID-19 digital contact tracing

During the COVID-19 pandemic, contact tracing apps such as the German Corona-Warning-App (CWA) were introduced to facilitate contact tracing of infected individuals with the aim of breaking chains of infection. Therefore, using a contact tracing app is beneficial to society as a whole. Even though this is a good cause, the rather reluctant use of the CWA in the beginning indicated that the pains (e.g., privacy concerns) obviously outweighed the gains (helping others) at the level of the individual user. Thus, in order to identify what lies behind the gain of this app and how it can be promoted, we were interested in the individual's moral perspective (helping others) on the app. We expected a positive relation between CWA download and moral intensity derived from (i) the magnitude or seriousness of consequences, (ii) social norms about app use, (iii) the individual proximity to COVID-19 cases, and (iv) the probability of the app's positive effect. Using a heterogeneous German sample of N = 1,454, we found a strong influence of moral intensity on app download. Furthermore, a manipulation of moral intensity among non-users led to a higher number of downloads in a follow-up study (N = 662) as compared to the population. Our results show possibilities to enhance the adoption of contact tracing apps and potentially other apps for the common good in the population.

Sovereignty in the Digital and Contact Tracing Apps

Recently, the concept of sovereignty in the digital has attracted much attention. Several publications dealing with this concept assume that it can best be described as a network of different, overlapping exercises of power. Nevertheless, there is a need for further research on how exactly sovereignty in the digital can be understood. In order to contribute to a better understanding of this concept, I illustrate its complex structure using contact tracing apps as a paradigmatic example. I conduct a narrative review to show what sovereignty looks like in the context of these apps. In the context of digital contact tracing apps, sovereignty is best understood as a complex network of three actors-nations, (big tech) companies, and individuals-that exercise various forms of power against or on behalf of each other to claim sovereignty for themselves and to either weaken or strengthen the sovereignty claims of other actors. Since large parts of the results can be generalized from the particular context of contact tracing apps, they contribute to a better overall understanding of the concept of sovereignty in digital. This might, in turn, be helpful for discussions about this technology as well as about the regulation and governance of the digital in general.

Governing digital crisis responses: platform standards and the dilemma of COVID-19 contact tracing

In response to the impact of the SARS-CoV-2 (COVID-19) pandemic, various developers turned to smartphone-based contact tracing to address the challenges of manual tracing. Due to the presence of network effects, i.e., the effectiveness of contact tracing applications increases with the number of users, information technology standards were critical to the technology's success. The standardization efforts in Europe led to a variety of trade-offs concerning the choice of an appropriate technological architecture due to the contradictory tensions resulting from the dualism between the need for contact tracing data to contain the pandemic and the need for data minimization to preserve user privacy. Drawing predominantly on the software platform and standards literature, we conduct an interpretive case study to examine the emergence and consequences of this multi-layered decision situation. Our findings reveal how Google and Apple were able to limit the individual leeway of external developers, thereby effectively resolving the European standards war. Furthermore, we identify and discuss the various short-term and long-term trade-offs associated with the standardization of contact tracing applications and translate our findings into recommendations for policy makers with respect to future crisis situations. Specifically, we propose a strategy grounded in our data that enables responsible actors to make goal-oriented and rapid decisions under time constraints.

Mobile health technology as a solution to self-control problems: The behavioral impact of COVID-19 contact tracing apps in Japan

Rationale

Mobile technology has been widely utilized as an effective healthcare tool during the COVID-19 pandemic. Notably, over 50 countries have released contact-tracing apps to trace and contain infection chains. While earlier studies have examined obstacles to app uptake and usage, whether and how this uptake affects users’ behavioral patterns is not well understood. This is crucial because uptake can theoretically increase or decrease behavior that carries infection risks.

Objective

The goal of this study is to evaluate the impact of app uptake on the time spent out of home in Japan. It tests four potential underlying mechanisms that drive the uptake effect: compliance with stay-at-home requirements, learning about infection risk, reminders, and commitment device.

Method

We use unique nationwide survey data collected from 4,379 individuals aged between 20 and 69 in December 2020 and February 2021 in Japan. Japan has features suitable for this exercise. The Japanese government released a contact tracing app in June 2020, which sends a warning message to users who have been in close contact with an infected person. We conduct a difference-in-differences estimation strategy combined with the entropy balancing method.

Results

App uptake reduces the time spent out of home. Sensitivity analysis shows that it cannot be explained by unobserved confounders. Importantly, the impact is large even among users who have not received a warning message from the app, and even larger for those with poor self-control ability. Furthermore, individuals’ self-control ability is negatively associated with the uptake decision, supporting our hypothesis that the apps serve as a commitment device.

Conclusions

It may be beneficial to encourage citizens to uptake contact tracing apps and other forms of commitment devices. This study also contributes to the literature on mobile health (mHealth) by demonstrating its efficacy as a commitment device.

Contact tracing apps for the COVID-19 pandemic: a systematic literature review of challenges and future directions for neo-liberal societies

PURPOSE

The COVID-19 pandemic has spread with increased fatalities around the world and has become an international public health crisis. Public health authorities in many countries have introduced contact tracing apps to track and trace infected persons as part of measures to contain the spread of the Severe Acute Respiratory Syndrome-Coronavirus 2. However, there are major concerns about its efficacy and privacy which affects mass acceptance amongst a population. This systematic literature review encompasses the current challenges facing this technology and recommendations to address such challenges in the fight against the COVID-19 pandemic in neo-liberal societies.

METHODS

The systematic literature review was conducted by searching databases of Google Scholar, Web of Science, PubMed, IEEE Xplore Digital Library, PsycInfo and ScienceDirect using the search terms ("Contact Tracing" OR "Contact Tracing apps") AND ("COVID-19" OR "Coronavirus") to identify relevant literature. The searches were run against the title, keywords, or abstract, depending on the search platforms. The searches were conducted between January 1, 2020, through 31st January 2021. Further inputs were also taken from preprints, published government and technical reports. We explore and discuss from the selected literature, the key challenges and issues that influence unwillingness to use these contact tracing apps in neo-liberal societies which include the plausibility of abuse of user privacy rights and lack of trust in the government and public health authorities by their citizens. Other challenges identified and discussed include ethical issues, security vulnerabilities, user behaviour and participation, and technical constraints.

RESULTS AND CONCLUSION

Finally, in the analysis of this systematic literature review, recommendations to address these challenges, future directions, and considerations in the use of digital contact tracing apps and related technologies to contain the spread of future pandemic outbreaks are presented. For policy makers in neo-liberal societies, this study provides an in-depth review of issues that must be addressed. We highlight recommendations to improve the willingness to use such digital technologies and could facilitate mass acceptance amongst users.

Privacy concerns can explain unwillingness to download and use contact tracing apps when COVID-19 concerns are high

Governments around the world have increasingly relied on technology to promote public health, such as using electronic health records and portable fitness devices. During the COVID-19 pandemic, “contact tracing apps” for smartphones have also been promoted in many countries as a way to allow public officials to facilitate contact tracing. But uptake in virtually all countries where such apps have been promoted is slow, one reason being privacy concerns. Conducting three experiments across France (n = 471), Australia (n = 202), and the United States (n = 1005), we explore if salient COVID-19 concerns, which intuitively should increase concerns about personal and public health, might in fact increase privacy concerns and thereby reduce uptake of contact tracing apps. Using an experimental design where we randomly assign participants to either a disease concerns or control condition, we find that salient COVID-19 concerns decrease intentions to download contact tracing apps. Mediation results reveal that greater valuations of privacy explain the lower willingness. We therefore explain why COVID-19 contact tracing apps that are promoted when the pandemic is at its peak see low levels of uptake. Our results provide policy makers with implications concerning how to promote uptake to help “flatten the curve” of not just the current pandemic but potentially also future ones.

Digital contact tracing and exposure notification: ethical guidance for trustworthy pandemic management

There is growing interest in contact tracing apps (CT apps) for pandemic management. It is crucial to consider ethical requirements before, while, and after implementing such apps. In this paper, we illustrate the complexity and multiplicity of the ethical considerations by presenting an ethical framework for a responsible design and implementation of CT apps. Using this framework as a starting point, we briefly highlight the interconnection of social and political contexts, available measures of pandemic management, and a multi-layer assessment of CT apps. We will discuss some trade-offs that arise from this perspective. We then suggest that public trust is of major importance for population uptake of contact tracing apps. Hasty, ill-prepared or badly communicated implementations of CT apps will likely undermine public trust, and as such, risk impeding general effectiveness.

COVID-19 and Contact Tracing Apps: Ethical Challenges for a Social Experiment on a Global Scale

Mobile applications are increasingly regarded as important tools for an integrated strategy of infection containment in post-lockdown societies around the globe. This paper discusses a number of questions that should be addressed when assessing the ethical challenges of mobile applications for digital contact-tracing of COVID-19: Which safeguards should be designed in the technology? Who should access data? What is a legitimate role for "Big Tech" companies in the development and implementation of these systems? How should cultural and behavioural issues be accounted for in the design of these apps? Should use of these apps be compulsory? What does transparency and ethical oversight mean in this context? We demonstrate that responses to these questions are complex and contingent and argue that if digital contract-tracing is used, then it should be clear that this is on a trial basis and its use should be subject to independent monitoring and evaluation.

Contact tracing apps: an ethical roadmap

This research statement presents a roadmap for the ethical evaluation of contact tracing apps. Assuming the possible development of an effective and secure contact tracing app, this roadmap explores three ethical concerns-privacy, data monopolists and coercion- based on three scenarios. The first scenario envisions and critically evaluates an app that is built on the conceptualization of privacy as anonymity and a mere individual right rather than a social value. The second scenario sketches and critically discusses an app that adequately addresses privacy concerns but is facilitated by data monopolists such as Google and Apple. The final scenario discusses the coerced installation and use of a privacy-friendly, independently developed contact tracing app. The main worry is coercion through societal exclusion and limited societal participation. The statement concludes with three suggestions for designing an ethical contact tracing app and a research agenda.

Contact tracing apps and values dilemmas: A privacy paradox in a neo-liberal world

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Contact tracing as an extreme case of the privacy paradox: which values?

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Present benefits: freedom of movement, not morally responsible.

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Future risks: privacy, habituation to security policies and health.

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In crisis situations, contact tracing apps contribute to self-disciplining.

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French government plays on the paradox and downplays long term concerns.

Contact tracing apps are presented as a solution, if not the solution, to curb pandemics in the Covid-19 crisis. In France, despite heated public institutional debate on privacy related issues, the app was presented by government as an essential benefit for protecting health and lives, thus avoiding both politicians and citizens to feel morally responsible and looking guilty, and as essential to recover our freedom to move. However we argue that, while detection of cases have still not been reported after 10 days and one million app downloads - a situation comparable to Australia who launched its app a month before -, the adoption of the app generates important risks to our informational privacy, surveillance and habituation to security policies. It also may create discrimination, distrust and generate other health problems such as addiction and others as 5G technology continues to be deployed without prior impact studies. Finally the smartphone app against covid epidemics appears as an extreme case of the privacy paradox where the government plays on the immediate benefits and downplays long-term concerns while inducing a technology of self. Contact tracing apps may become an emblematic case for digital transformation and value changes in the western world.