JMIR Publications

ABSTRACT

Background:

COVID-19 is an international health crisis of particular cause for concern in the United States, which has seen surges in infections with the lifting of lockdowns and relaxed social distancing. Young adults have proven to be a critical factor for COVID-19 transmission and should be an important target in efforts to contain the pandemic. Scalable digital public health technologies could be deployed to prevent COVID-19 transmission but depend on the willingness of young adults to participate in surveillance.

Objective:

The aim of this study is to determine the attitudes of young adults regarding COVID-19 digital surveillance, including which aspects they would accept and which they would not, as well as to determine factors that influence their willingness to participate.

Methods:

An online survey was conducted of adults 18-24 throughout the United States on June 19, 2020. The questionnaire contained predominantly close-ended response options with one open-ended question. Descriptive statistics were calculated including the use of chi-square and t-tests for bivariate analyses. Logistic regression was performed to determine the independent factors related to willingness to be tracked.

Results:

Of 513 young adult respondents, 383 (75%) agreed that COVID-19 poses a public health crisis, although only 45.1% agreed to actively share their COVID-19 status or symptoms for monitoring and only 33.4% reported willingness to allow access to their cellphone for passive tracking of location or contact tracing. Those study participants residing in western states were more likely to be unwilling to be tracked (aOR 1.20, 95% CI 1.05-1.37), as were individuals with increasing levels of disbelief in COVID-19 as a public health crisis (aOR 1.11, 95% CI 1.07-1.48) and those with increasing concerns about privacy (aOR 1.06, 95% CI 1.02-1.07).

Conclusions:

Despite largely agreeing that COVID-19 represents a serious public health risk, the majority of young adults sampled were reluctant to participate in digital monitoring to manage the pandemic. This was true for both commonly used methods of public health surveillance (such as contact tracing) and novel methods designed to facilitate a return to normal (such as frequent symptom checking through digital apps). Reluctance to provide personal information was seen regardless of tracking methods used, the entities collecting the data, the type of data collected, or the specific purpose for which surveillance is conducted. These results may pose an obstacle to proposed plans for reopening (many of which rely on widespread surveillance) and may reflect a need for greater education on the benefits of public health digital surveillance to young adults.