Digital Contact Tracing (D-CT) apps - digital interventions that allow governments and epidemiologists to track and trace the spread of COVID-19 - represent a promising and also controversial pandemic response tool. Yet, little research has been done regarding the relationship between user-engagement and the efficacy and impact of such applications. In response to this problem, the Digital Global Health and Humanitarianism (DGHH) Lab conducted an international study and, over the past month, has published Modules One through Eight of its Practitioner Guide titled “Exploring User-Uptake of Digital Contact Tracing Apps.” The ninth and final research module, “Recommendations & Future Research,” has been released on March 22, 2021.

Led by York University’s Dr. Jennie Phillips, and in collaboration with Dr. Aaida Mamuji and the talented DGHH Lab interdisciplinary research team, the research series examines user-engagement, specifically user-uptake (i.e. people downloading the app), of D-CT mobile apps. This research series aims to help fill the knowledge gap by addressing questions such as

• Why is there higher user-uptake of D-CT apps in some countries over others?
• How does uptake vary across contexts?
• What factors influence uptake across contexts?
• How does risk-benefit perception influence uptake?
• How can we improve the design & implementation of D-CT apps to enhance user engagement while minimizing risk?

Check out Dr. Phillips as she speaks to CTV News regarding the uptake of D-CT's and how accessibility and inclusion challenges along with privacy concerns that are deterring users from downloading the COVID Alert app.

View the interview here: https://www.ctvnews.ca/video?clipId=2178979&jwsource=cl

Drawing on case studies of Iceland, Cyprus, Ireland, Scotland, and South Africa - as well as workshops, interviews, literature reviews, and critical analysis - the DGHH Lab’s research reveals that eight individual, community, and system-level factors influence the uptake of D-CT applications: perceptions of data collection and management, sense of community, communications and misinformation, accessibility and inclusion, trust in public/private institutions, policy and governance, response infrastructure, and digital capability. “Using a systems approach to conduct our analysis, this research creates new insights on D-CT app usage by situating app users in their context to better understand their motivations, constraints, and fears'' says Dr. Jennie Phillips, Director of the DGHH Lab.

Results also reveal that across case studies and the broader literature, D-CT application uptake has been hindered by five critical challenges:

• fears of immediate and future surveillance
• privacy perceptions may override privacy-by-design principles
• some communities are disproportionately affected by and/or excluded from D-CT applications/measures
• perceptions of D-CT app effectiveness are poor
• digital limitations inhibit people from downloading D-CT apps

The DGHH Lab’s research also highlights the human rights implications of D-CT apps. “The intricacies of contact tracing applications must be analyzed from a human rights perspective, one which holistically interrogates different contexts and risks that people face, particularly marginalized communities who are already at a higher risk of COVID-19” says Petra Molnar, the project’s legal expert.

These findings culminate into the DGHH Lab’s “Recommendations & Future Research'' module, which operationalizes the findings into 23 practical, real-world solutions that can be employed by practitioners – including implementers, developers, and regulators at home and abroad. “It is hoped that our findings can help enhance the efficacy of D-CT apps by prioritizing the needs and wants of the individuals expected to use these apps,” Phillips says.

The DGHH Lab would also like to acknowledge Dr. James Orbinski of the Dahdaleh Institute for Global Health Research and Rebecca Babcock as well as research assistants Tiana Putric, Alisha Gauhar, Laksmiina Balasubramaniam, Dyllan Goldstein, and Sarah Quayyum for their ongoing support in turning this idea into action. Of course, “York University’s rapid support of COVID-19 research ensured that our team could embark on timely, transnational research at a time when the benefits of digital contract for curbing the spread of the pandemic was gaining global traction,” adds Dr. Mamuji.

Students, professors, and practitioners interested in learning more about the DGHH Lab’s “Exploring User-Uptake of Digital Contact Tracing Apps” research series, as well as the Lab’s other research areas and initiatives surrounding the Digital Response to COVID-19, are encouraged to visit https://dghhlab.com, follow @DGHHlab on Twitter, or email info@dghhlab.com.

About the DGHH Lab

The DGHH Lab is a forward-thinking research group that aims to shed insight into the different ways digital technologies are used in disasters and emergencies and provide strategies for efficacy-focused, ethical, low-risk interventions around the world. The DGHH Lab engages local and global experts and organizations, both academic and practitioner, across disciplines to evolve research at the intersection of systems to enhance context-driven understanding. The Lab is currently seeking further funding, research opportunities, and research partnerships, as it continues to evolve.

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