ABSTRACT
BACKGROUND: The German Corona-Warn-App (CWA) is a contact tracing app to mitigate the spread of SARS-CoV-2. As of today, it has been downloaded approximately 45 million times. OBJECTIVE: This study aims to investigate the influence of (non)users' social environments on the usage of the CWA during 2 periods with relatively lower death rates and higher death rates caused by SARS-CoV-2. METHODS: We conducted a longitudinal survey study in Germany with 833 participants in 2 waves to investigate how participants perceive their peer groups' opinion about making use of the German CWA to mitigate the risk of SARS-CoV-2. In addition, we asked whether this perceived opinion, in turn, influences the participants with respect to their own decision to use the CWA. We analyzed these questions with generalized estimating equations. Further, 2 related sample tests were performed to test for differences between users of the CWA and nonusers and between the 2 points in time (wave 1 with the highest death rates observable during the pandemic in Germany versus wave 2 with significantly lower death rates). RESULTS: Participants perceived that peer groups have a positive opinion toward using the CWA, with more positive opinions by the media, family doctors, politicians, and virologists/Robert Koch Institute and a lower, only slightly negative opinion originating from social media. Users of the CWA perceived their peer groups' opinions about using the app as more positive than nonusers do. Furthermore, the perceived positive opinion of the media (P=.001) and politicians (P<.001) was significantly lower in wave 2 compared with that in wave 1. The perceived opinion of friends and family (P<.001) as well as their perceived influence (P=.02) among nonusers toward using the CWA was significantly higher in the latter period compared with that in wave 1. The influence of virologists (in Germany primarily communicated via the Robert Koch Institute) had the highest positive effect on using the CWA (B=0.363, P<.001). We only found 1 decreasing effect of the influence of politicians (B=-0.098, P=.04). CONCLUSIONS: Opinions of peer groups play an important role when it comes to the adoption of the CWA. Our results show that the influence of virologists/Robert Koch Institute and family/friends exerts the strongest effect on participants' decisions to use the CWA while politicians had a slightly negative influence. Our results also indicate that it is crucial to accompany the introduction of such a contact tracing app with explanations and a media campaign to support its adoption that is backed up by political decision makers and subject matter experts.
ABSTRACT
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.
ABSTRACT
The World Health Organization declared the emergence of the novel coronavirus (SARS-CoV-2) in January 2020. To trace infection chains, Germany launched its smartphone contact tracing app, the "Corona-Warn-App" (CWA), in June 2020. In order to be successful as a tool for fighting the pandemic, a high adoption rate is required in the population. We analyse the respective factors influencing app adoption based on the health belief model (HBM) with a cross-sectional online study including 1752 participants from Germany. The study was conducted with a certified panel provider from the end of December 2020 to January 2021. This model is primarily known from evaluations of medical treatments, such as breast cancer screenings, but it was rarely applied in prior work for a health-related information system such as the CWA. Our results indicate that intrinsic and extrinsic motivation to use the CWA are the strongest drivers of app use. In contrast, technical barriers, privacy concerns and lower income are the main inhibitors. Our findings contribute to the literature on the adoption of contact tracing apps by questioning actual users and non-users of the CWA, and we provide valuable insights for policymakers regarding influences of adoption and potential user groups of disease prevention technologies in times of pandemics.