JMIR Publications

ABSTRACT

Background:

In November 2020 WA Notify, Washington State’s COVID-19 exposure notification tool, was launched statewide to mitigate ongoing COVID-19 transmission. This smartphone-based tool relies on sufficient population-level activation to be effective, however little is known about its adoption among communities disproportionately impacted by the COVID-19 pandemic. While previous mHealth studies have highlighted health and digital literacy levels, trust, usability factors, and issues related to accessibility, relevance, and clarity of content as key determinants of adoption among diverse populations, it is unclear if and to what extent these determinants influence engagement with this novel intervention.

Objective:

The purpose of this study was to explore equity-related issues influencing access, adoption, and use of WA Notify in collaboration with community leaders and generate recommendations for promoting the equitable access to and impact of this novel intervention for communities disproportionately impacted by the COVID-19 pandemic.

Methods:

We used a two-step data collection process to gather perspectives of community leaders across Washington regarding the launch and implementation of WA Notify in their communities. A brief informational survey measured perceptions of community-level familiarity and effectiveness at slowing the spread of COVID-19 and identified potential barriers and concerns to accessing and adopting WA Notify (N = 17). Semi-structured listening sessions sought to expand upon survey findings and explore in greater depth the community-level awareness, barriers, facilitators, and concerns related to activating WA Notify reported by participants (N = 13).

Results:

Our findings overlap considerably with those from previous mHealth equity studies and suggest that digital literacy, trust, information accessibility, and misinformation are key determinants of adoption of WA Notify. Recommended approaches to improve engagement among communities disproportionately impacted by COVID-19 include tailoring informational materials for low literacy levels, providing technology navigation, and engaging trusted community messengers.

Conclusions:

As digital public health tools like WA Notify emerge to address public health problems, it will be critical to evaluate these key determinants of adoption and incorporate equity-focused recommendations into the development, implementation, and communication efforts around these tools to ensure they work to actively mitigate existing health inequities.