Accepted for/Published in: JMIR Formative Research
Date Submitted: Jun 9, 2021
Date Accepted: Sep 27, 2021
Date Submitted to PubMed: Sep 29, 2021
Pilot Evaluations of Two Bluetooth Contact Tracing Approaches on a University Campus: A Mixed Methods Study
ABSTRACT
Background:
Many have proposed the use of Bluetooth technology to help scale-up contact tracing for COVID-19. However, much remains unknown about the accuracy of this technology in real-world settings, attitudes of potential users, and differences between delivery formats (mobile applications vs. carriable or wearable devices).
Objective:
To address these knowledge gaps, we developed and pilot-tested two Bluetooth contact tracing technologies on a university campus.
Methods:
We used an explanatory-sequential mixed methods study design to evaluate two Bluetooth contact tracing technologies. Participants included graduate students and researchers working on a university campus during June-July 2020 and each pilot lasted two weeks. We first evaluated a mobile phone application, followed by a small, electronic “tag” which paired with a mobile syncing application. Both technologies used Bluetooth to detect interactions with other study participants. Participants validated a list of Bluetooth-identified contacts daily and reported additional close contacts not identified by Bluetooth. We used these data to estimate each technology’s sensitivity and specificity. Participants completed a post-participation survey regarding perceived appropriateness, usability, acceptability, and adherence, and provided additional feedback in a free-text box. We used tests of proportions to evaluate differences in survey responses between participants from each pilot, paired t-tests to measure differences between compatible survey questions, and qualitative analysis to evaluate the free-text responses.
Results:
We enrolled 25 participants in the App Pilot, in which 53 contact interactions were identified by Bluetooth and 61 by self-report. We enrolled 17 participants in the Tag Pilot, in which 171 contact interactions were identified via Bluetooth and four by self-report. The carriable tag had superior sensitivity (94% vs. 57%) and specificity (95% vs. 87%) compared to the mobile phone application. Most participants felt that Bluetooth contact tracing was appropriate on campus (81%) while significantly fewer participants felt that using GPS/Wi-Fi technology was appropriate (55%; p=0.024). Participants preferred technology developed and managed by the university rather than a third party (84%) and preferred not to have tracing applications on their personal phones (66%), due to “concerns with privacy.” There were no significant differences in self-reported adherence rates across pilots, although the tag was qualitatively described as “easy” to carry while participants in the App Pilot felt that something smaller than the study phone would have been “more convenient.”
Conclusions:
Faced with ongoing challenges to vaccine uptake and the appearance of new viral variants, contact tracing will remain critical to controlling and preventing COVID-19 outbreaks. Convenient and carriable Bluetooth technology may improve tracing efficiency while alleviating privacy concerns by shifting data collection away from personal devices. With accuracy comparable to, and in this case superior to, mobile phone applications, such approaches may be suitable for workplace or school settings able to purchase and maintain physical devices.
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