JMIR Publications

ABSTRACT

Background:

The COVID-19 pandemic has caused changes on how we use technology across the world, both socially and economically. Due to the urgency and severity of the crisis different virus control measures were explored. One of the means how technology could help in this situation was by helping trace the contacts of people to prevent the spread of the disease. Many governments and public health authorities across the world have launched a number of contact tracing mobile apps (CTA). By the end of 2020, there are more than 50 contact tracing apps in both Google Play and iOS App Store [1]. Despite the wide availability, the download rates are low and usage rates are even lower [2][3]. There could be many reasons why the adoption is so low, but most certainly one variable that has been overlooked is the level of trust that potential users need to feel comfortable using an app. In Estonia, the CTA named HOIA has been developed as a means of digital contact tracing. By the middle of January 2021, there have been approximately 250 000 downloads but only 1763 (around 4,7% of all COVID-19 positive in Estonia by that time) people have registered as being tested COVID-19 positive [4]. It shows that HOIA has not proved to be efficient means to reduce the spread of the pandemic. Modeling evidence suggests that in order to be effective, the use of contact tracing apps would need to be very high, at least 80% of smartphone users to stop the pandemic [5]. 40% of Estonian people who don’t have HOIA do not believe that HOIA is effective and does what is promised. The concern about security and privacy was in the second place [6].

Objective:

The goal of this study was to assess Estonian's trust towards the HOIA app and what has caused the shortage in trust. Namely, assess how much Estonians trust Covid-19 contact tracing app HOIA and what aspects are perceived as distrust by them. The study contributes to designers' understanding and awareness of designing trustworthy technology.

Methods:

The study comprised of measuring trust in HOIA CTA application using human-computer Trust psychometric scale [22]. A convenience sample was used in data collection, this includes all potential HOIA among the Estonian population.

Results:

Results indicate significant positive correlations between participants' trust towards the Estonian COVID tracing application (HOIA) and their perceptions of risk (p-value 0.000), competency (P-value 0.000), Benevolence (P-value=0.025), and reciprocity (P-value 0.015).

Conclusions:

With the COVID-19 crisis, the new phenomenon of contact tracing apps was introduced to fight against the pandemic. CTAs were hoped to be a technological breakthrough to decrease the spread of the virus. However, this has not happened around the world. The same has happened in Estonia and evidence shows, that one of the reasons could be the low level of trust. The results of the study confirm, that trust in HOIA among Estonian habitants does affect their predisposition to use and indicated that participants do not believe HOIA is able to fulfill the main goal and decrease the spread of the virus. The result of this work is not only limited to HOIA but can be implemented by other CTAs as well. The results of this study contribute to designers' understanding and awareness of designing trustworthy technology. Eventually helps to provide design recommendations that ensure trustworthiness in the CTAs AI ability to use highly sensitive data and serve society. Regarding the limitations of this study, the survey was able to gather insight about the perceptions of HOIA, was enough to make a statistical generalization about the users’ perception and usage habits but more data needs to be collected if the intention is to generalize the results to the whole population of Estonia. Also, we should pay attention to the different minority groups to reach a valid conclusion. Clinical Trial: no trial registration.