JMIR Publications

ABSTRACT

Background:

In 2020, the Singapore government rolled out the TraceTogether (TT) Programme, a digital system to facilitate contact tracing efforts in response to the COVID-19 pandemic. This system is available as a smartphone app and Bluetooth-enabled token to help identify close contacts. As of February 1 2021, more than 80% of the population have either downloaded the mobile app or collected the token in Singapore. Despite the high adoption rate of the TT mobile app and token (i.e. device), it is unclear about the uptake and usage by the public, which is the key to contain the spread of COVID-19 in the community.

Objective:

This study aimed to examine the normative influences on the TT device use for contact tracing purposes, informed by the Theory of Normative Social Behavior (TNSB).

Methods:

Cross-sectional data (n = 1,137) were collected from January to February 2021 by a local research company through sending invitation emails to their panel members about participation in an online survey. Multivariate (linear and ordinal logistic) regression analyses were carried out to assess the relationships of the outcome variables (TT device usage and behavioral intentions) to potential predictors including perceived social norms, perceived community and interpersonal communication.

Results:

Multivariate regression analyses indicated that descriptive norms (unstandardized regression coefficient, β = 0.31, SE = 0.29, p < .001) and injunctive norms (β = 0.16, SE = 0.16, p< .001) were significantly, positively associated with intentions to use TT device. It was also found that descriptive norms were a significant predictor of TT device use frequency (adjusted odds ratio, OR = 2.08, 95% CI: 1.66 – 2.61, p < .001). Though not significantly related to TT device use frequency, injunctive norms moderated the relationship between descriptive norms and the outcome variable (OR = 1.12, 95% CI: 1.03 – 1.21, p = .005).

Conclusions:

This study provides useful implications for the design of effective intervention strategies to promote the uptake and usage of the digital methods for contact tracing in a multi-ethnic Asian population. Our findings highlight that influence from social networks plays an important role in developing normative perceptions in relation to TT device use for contact tracing. To promote the uptake of TT device and other preventive behaviors for COVID-19, it would be useful to devise norm-based interventions that address these normative perceptions by presenting high prevalence and approval of important social referents, such as family and close friends.