JMIR Publications

ABSTRACT

Background:

The recent Covid-19 pandemic has contributed to the emergence of several technologies for infectious disease management. Although much focus has been placed on contact tracing applications, another promising new tactic is proximity tracing that focuses on health-related behavior and can be used for primary prevention. Underpinned by theories on behavioral design, a proximity detecting system can be devised that provides a user with immediate nudges to maintain physical distance to others. The practical feasibility of proximity detection during an infectious disease outbreak has not been sufficiently investigated.

Objective:

To evaluate the feasibility of using a wearable device to nudge for distance, and to gather important insights about how the functionality and interaction were experienced by the users. The results from this study can guide future research and design efforts in this emerging technology.

Methods:

This retrospective case study uses a mixed methods approach including interviews (n=8) and a survey (n=30), to compile the experiences of an event project which used a wearable proximity detecting technology to nudge users with auditory feedback to maintain a safe physical distance in their workplace.

Results:

Themes were generated from qualitative analysis based on data from interviews and survey open-text responses. The quantitative data was subsequently integrated into these themes: Feasibility (Implementation & Acceptance – Establishing a Shared Problem; Distance Tags in Context – Strategy, Environment and Activities; Understanding and Learning; Accomplishing the Purpose), and Design aspects (A Purposefully Annoying Device; Timing, Tone, and Proximity; Additional functions).

Conclusions:

This empirical study establishes the feasibility of using a wearable technology to nudge individuals to maintain a safe distance in their workplace during a pandemic. The usability of the technology is dependent on context, situation, and user's ability to adapt. At certain situations the audio signal is experienced as frustrating, but most users agree that it needs to be annoying to ensure a sufficient behavioral adaption. We propose a dual nudge that involves a vibration followed by a sound. There are indications that the technology facilitates learning, and that the preventive distancing behavior can persist beyond the context of use. This study demonstrates that the key value of this technology is that it places the user in control and enables immediate action in a situation when distance to others is not maintained. The study contributes to the emerging field of personal and wearable technologies used for primary preventive purposes during infectious disease outbreaks. Future research is needed to evaluate the preventive effect, and to investigate behavior change in more detail and in relation to different forms of feedback.