COVID-19 Contact Tracing Apps: Predicted Uptake in the Netherlands Based on a Discrete Choice Experiment

JMIR Mhealth Uhealth. 2020 Oct 9;8(10):e20741. doi: 10.2196/20741.

Abstract

Background: Smartphone-based contact tracing apps can contribute to reducing COVID-19 transmission rates and thereby support countries emerging from lockdowns as restrictions are gradually eased.

Objective: The primary objective of our study is to determine the potential uptake of a contact tracing app in the Dutch population, depending on the characteristics of the app.

Methods: A discrete choice experiment was conducted in a nationally representative sample of 900 Dutch respondents. Simulated maximum likelihood methods were used to estimate population average and individual-level preferences using a mixed logit model specification. Individual-level uptake probabilities were calculated based on the individual-level preference estimates and subsequently aggregated into the sample as well as subgroup-specific contact tracing app adoption rates.

Results: The predicted app adoption rates ranged from 59.3% to 65.7% for the worst and best possible contact tracing app, respectively. The most realistic contact tracing app had a predicted adoption of 64.1%. The predicted adoption rates strongly varied by age group. For example, the adoption rates of the most realistic app ranged from 45.6% to 79.4% for people in the oldest and youngest age groups (ie, ≥75 years vs 15-34 years), respectively. Educational attainment, the presence of serious underlying health conditions, and the respondents' stance on COVID-19 infection risks were also correlated with the predicted adoption rates but to a lesser extent.

Conclusions: A secure and privacy-respecting contact tracing app with the most realistic characteristics can obtain an adoption rate as high as 64% in the Netherlands. This exceeds the target uptake of 60% that has been formulated by the Dutch government. The main challenge will be to increase the uptake among older adults, who are least inclined to install and use a COVID-19 contact tracing app.

Keywords: COVID-19; app; contact tracing; discrete choice experiment; mobile phone; participatory epidemiology; participatory surveillance; prediction; privacy; smartphone; transmission; uptake.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • COVID-19
  • Choice Behavior*
  • Contact Tracing / methods*
  • Coronavirus Infections / epidemiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mobile Applications / statistics & numerical data*
  • Netherlands / epidemiology
  • Pandemics
  • Pneumonia, Viral / epidemiology*
  • Privacy
  • Young Adult