JMIR Publications

ABSTRACT

Background:

In pandemic situations, digital contact tracing (DCT) can be an effective way to assess one's risk of infection and to inform others in case of infection. DCT applications can support the information gathering and analysis processes of users aiming to trace contacts. However, users' use intention and utilization of DCT information may depend on the perceived benefits of contact tracing. While existing research examined acceptance in DCT, automation-related user experience factors have been overlooked.

Objective:

We pursued three goals: 1) Analyze how automation-related user experience (i.e., perceived trustworthiness, traceability, and usefulness) relates to user behavior towards a DCT app; 2) contextualize these effects with health behavior factors (i.e., threat appraisal and moral obligation); and 3) collect qualitative data on user demands for improved DCT communication.

Methods:

Survey data were collected from N = 317 users of a nationwide distributed DCT app during the COVID-19 pandemic after it had been in app stores for >1 year, using an online convenience sample. We assessed automation-related user experience. In addition, we assessed threat appraisal and moral obligations about DCT use to estimate a partial least squares structural equation model (PLS-SEM) predicting use intention. To provide practical steps to improve the user experience, we surveyed users' needs for improved communication of information via the app and analyzed their responses using thematic analysis.

Results:

Data Validity and Perceived Usefulness showed a significant correlation of r = .38 (P < .001), Goal Congruity and Perceived Usefulness correlated at r = .47 (P < .001), and Result Diagnosticity and Perceived Usefulness had a strong correlation of r = .56 (P < .001). Additionally, a correlation of r = .35 (P < .001) was observed between SIPA and Perceived Usefulness, suggesting that automation-related changes might influence the perceived utility of DCT. Lastly, a moderate positive correlation of r = .47 (P < .001) was found between Perceived Usefulness and Use Intention, highlighting the connection between user experience variables and Use Intention. PLS-SEM explained 55.6% of the variance in Use Intention, with the strongest direct predictor being Perceived Trustworthiness (β = .54, P < .001), followed by moral obligation (β = .22, P < .001). Based on qualitative data, users mainly demanded more detailed information about contacts, e.g., place and time of contact. They also wanted to share information, e.g., whether they wore a mask, to improve the accuracy and diagnosticity of risk calculation.

Conclusions:

The perceived diagnosticity of DCT applications is crucial for perceived trustworthiness and use intention. By designing for high diagnosticity for the user, DCT apps could improve their support in the action regulation of users, resulting in higher perceived trustworthiness and utilization in pandemic situations. In general, automated-related user experience has greater importance for use intention, than general health behavior or experience. Clinical Trial: This study has been registered under 2022-413 at the Ethics Board of the University of Lübeck.