JMIR Publications

ABSTRACT

Background:

Personal information is often collected electronically, analyzed, and utilized for health services, as in the case of personal health records. Against this background, several countries have been actively attempting to use mobile phones for infectious disease control through mobile applications. These collect data, such as activity logs and contact history, as a countermeasure against diseases such as COVID-19. In Japan, the Ministry of Health, Labour and Welfare has developed and distributed a contact-confirming application (COCOA) to the public, which detects and notifies individuals if they have been near someone who tested positive for COVID-19.

Objective:

This study investigates the possible trade-off between effectiveness in preventing infectious diseases and infringements of personal privacy in COCOA. In addition, we analyzed whether this resistance changes if COCOA contributed to public health, or if a discount for mobile phone charges was provided.

Methods:

A cross-sectional, quantitative survey of Japanese citizens is conducted using "Survey Monkey," a general-purpose online survey platform. When developing the questions for the questionnaire, we included the installation status of COCOA and recorded the anxiety stemming from a potential leakage or misuse of personal information collected for the purpose of COVID-19 infection control. Respondents are asked to rate various factors to determine their perceptions on a five-point scale.

Results:

A total of 1,058 participants are included in the final analysis. In response to the question of whether the disease’s spread was being controlled by the infection control measures taken by the government, 25.8% of respondents answered that they strongly agreed or agreed. One quarter of the respondents indicated that they had already installed COCOA. This study found that the sense of resistance to the government’s intervention was not alleviated by benefits provided to individuals for using the app. The only factors that were positively associated with the response "absolutely opposed to use" of the app, even if there was a discount on mobile phone usage charges, were those concerned about leaks and misuse of personal information; this was true for all functions (Function A odds ratio 1.8; 95% C.I. 1.3-2.4, Function B odds ratio 1.9; 95% C.I. 1.5-2.6, Function C odds ratio 1.8; 95% C.I. 1.4-2.4).

Conclusions:

This study finds that it is more important for public organizations to increase the general benefits of handling personal information and the assurance that this is being done safely, rather than to offer benefits to individuals who provide such personal information. This could provide insights into the analysis of strategies for governmental use of private information through mobile devices. Clinical Trial: This study was reviewed and approved by the Biomedical Research Ethics Committee of the National Hospital Organization Tokyo Medical Center in May 2021 (Approval number R21-030).