By Dr Carlos Ferreira and Professor Maureen Meadows, Centre for Business in Society

In order to serve as tools for addressing social problems, digital technologies need acceptance from society. In a study exploring adoption of the NHS COVID-19 app, we find that there was scope for improving communication to the public around what the app can do: some users had high hopes for aspects which the app could not address, such as providing a unified contact point for all issues related to COVID-19, from scheduling tests and reporting results to reporting the user’s vaccination status. When communicating about these types of technologies in the future, developers and organisations should be careful to both explain the benefits and manage public expectations.

Launch of the NHS COVID-19 app, and purpose of our study

In September 2020, roughly six months into the COVID-19 pandemic and associated lockdowns, NHS England launched a voluntary contact tracing smartphone application, the NHS COVID-19 app. The app was promoted by ministers and health officials as an important component of the response to the pandemic, by providing users with early warning of contact with infected individuals and instructing them to self-isolate to reduce transmission of the virus. The app had a difficult job: simultaneously tracing users’ contacts and managing their behaviour. It was a society-wide experiment in behaviour regulation, happening during an unprecedented emergency.

Our study explored the attitudes and experiences of both users and non-users of the NHS COVID-19 app. Starting in early January 2021, users were asked to keep a diary of their interactions with the app. After this, we conducted focus groups with both users and non-users of the app, between February and May 2021.

Can we get ‘back to normal’, please?

The results suggest that the app was understood in the context of widespread uncertainty caused by the pandemic. The unprecedented nature of the restrictions put in place to address the pandemic, and the ongoing questions about how to reduce the spread of the disease while returning to ‘normal life’, meant that both users and non-users were looking for a more predictable environment. For many users, the app had a utilitarian function: it was seen as a way to access venues such as restaurants, cafés and pub, and engage in social activities.

[I downloaded it] to check into pubs and bars, because otherwise you wouldn’t be allowed in if you didn’t do it.

Why are there no clear and consistent rules around app usage?

One of the obstacles to adoption of the app was uncertainty. Both users and non-users favoured strict and clear rules around usage of the app, in work or social settings. Neither group wanted to have to navigate and negotiate different usage regimes in different contexts, subject to different social norms or rules – such as having to turn off the app at work, or not knowing whether they needed to scan the app to enter a venue. Participants wanted consistency and certainty of rules demanding app usage.

Most important thing, I would say, is I think there should be a clear and general consensus on what is required. As much as I wouldn’t want to be forced, I don’t think it’s very workable if only some people have it and some people don’t. (…) I think the government needs to be realistic on whether or not it’s optional.

One of the results of the inconsistent rules around usage of the app was, in the view of participants, that the app became less useful. Given that the effectiveness of the app increased with the number of users, participants reported that they were less likely to use the app if they saw others not using it when entering public spaces. There was a positive feedback loop: the less people used the app, the less effective it became, and the less other people were likely to use it.

Who’s tracking me, and why?

A final issue impacting how likely participants were to use the NHS COVID-19 app was concern about privacy. Both users and non-users showed concern about what data the app collected and who had access to it. Some non-users reported fearing that, through the app, authorities might be able to track their whereabout, which made them uncomfortable. Others were afraid that the app could access other information on their phones, and contribute to identity theft. Despite the government’s guarantees that the app would protect users’ privacy, for some the questions remained.

I think it’s quite intrusive, wanting to know exactly where you are all the time. Yes, as soon as I found that out, just deleted it and I wouldn’t download it again.

Learning for the future – public policy, technology adoption and personal data

As experts express concern about a possible COVID wave for winter 2022, it is important to ask what we have learnt about the use of digital technologies such as apps in helping to address health pandemics and other societal issues. In order to serve as tools for addressing social problems, digital technologies need to be seen as trustworthy and legitimate. The issues raised above – lack of clear rules for using the app, inconsistent usage, low take-up, and privacy concerns – affected the take-up of the app and, ultimately, its usefulness. It is important that future developers of similar technologies are aware of the social context in which their work will be used. Further research into how the trustworthiness and legitimacy of new digital technologies can be established would help to improve our understanding of how apps can be used most effectively to address future health and other societal issues.

You can read the full report of our study here.

References

Callaway, E. (2022). Will there be a COVID winter wave? What scientists say. Nature, 610(7931), 239–241. https://doi.org/10.1038/d41586-022-03157-x

Ferreira, C., & Meadows, M. (2022). Personal data, public policy. Public views of the NHS COVID-19 app. Coventry University. https://www.coventry.ac.uk/globalassets/media/global/08-new-research-section/cbis/white-papers/nhs-covid-19-app-report_final.pdf

UK Government. (n.d.). NHS COVID-19 app. GOV.UK. Retrieved 24 October 2022, from https://www.gov.uk/government/collections/nhs-covid-19-app

Through understanding the impact of organisations’ activities, behaviours and policies, the Centre for Business in Society at Coventry University seeks to promote responsibility, to change behaviours, and to achieve better outcomes for economies, societies and the individual.

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