To Use or Not to Use a COVID-19 Contact Tracing App: Mixed Methods Survey in Wales

Background:Background Many countries remain in the grip of the COVID-19 global pandemic with a considerable journey still ahead to emerge into a semblance of normality and freedom. Contact tracing smartphone apps are among a raft of measures introduced to reduce spread of the virus.Objective:The aim of this study was to ascertain the views of citizens in Wales on their intended use of a contact tracing app, with self-proposed reasons for or against, and what could lead to a change of decision.Methods:We distributed an anonymous survey among 4,000 HealthWise Wales participants in May 2020. We took a mixed methods approach: responses to closed questions were analysed using descriptive and inferential statistics; open question responses were analysed and grouped into categories.Results:A total of 976 (24.4%) people completed the survey. Smartphone usage was 91.5% overall, but this varied between age groups. 97.1% were aware of contact tracing apps, but only 67.2% felt sufficiently informed. 55.7% intended to use an app, 23.3% said no, and 21.0% were unsure. The top reasons for app use were: controlling spread of the virus, mitigating risks for others and self, and increasing freedoms. The top reasons against were: mistrusting the government, concerns about data security and privacy, and doubts about efficacy. The top response for changing their mind about app use from willing to unwilling was that nothing would. This was also the case for unwilling to willing. Among the unsure, it was the need for more information.Conclusions:Respondents demonstrated a keenness to help themselves, others, society and government to avoid the virus and to control its spread. However, digital inclusion varied among age groups, precluding participation for some people. Considering the nature of the concerns raised, and the perceived lack of information, policy and decision-makers need to do more to act openly, increase communications and demonstrate trustworthiness if members of the public are to be confident in using an app