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What uses of consumer digital information for COVID-19 control are most acceptable to US adults, and what factors are associated with higher or lower approval of use of this information?
In this cross-sectional survey study of 6284 US adults, approval was generally low for use of consumer digital data for activities such as case identification, digital contact tracing, policy setting, and enforcing quarantines. Political ideology and race/ethnicity were associated with approval for scenarios in which digital data were used, whereas local COVID-19 incidence and family experience with COVID were not.
The findings suggest that in current and future pandemics, public health departments should use multiple strategies to gain public trust and accelerate adoption of tools such as digital contact tracing applications.
Curbing COVID-19 transmission is currently the greatest global public health challenge. Consumer digital tools used to collect data, such as the Apple-Google digital contact tracing program, offer opportunities to reduce COVID-19 transmission but introduce privacy concerns.
To assess uses of consumer digital information for COVID-19 control that US adults find acceptable and the factors associated with higher or lower approval of use of this information.
Design, Setting, and Participants
This cross-sectional survey study obtained data from a nationally representative sample of 6284 US adults recruited by email from the web-based Ipsos KnowledgePanel in July 2020. Respondents evaluated scenarios reflecting uses of digital data for COVID-19 control (case identification, digital contact tracing, policy setting, and enforcement of quarantines).
Main Outcomes and Measures
Levels of support for use of personal digital data in 9 scenarios to mitigate the spread of COVID-19 infection, rated on a Likert scale, ranging from 1 (strongly disagree) to 5 (strongly agree). Multivariable linear regression models were fitted for each scenario and included factors hypothesized to be associated with views about digital data use for COVID-19 mitigation measures. Black and Hispanic survey respondents were oversampled; thus, poststratification weights were used so that results are representative of the general US population.
Of 6284 individuals invited to participate in the study, 3547 responded, for a completion rate of 56%. A total of 1762 participants (52%) were female, 715 (21%) identified as Black, 790 (23%) identified as Hispanic, and 1224 (36%) were 60 years or older; mean (SD) age was 51.7 (16.6) years. Approval of scenarios was low, ranging from 28% to 43% (52%-67% when neutral responses were included). Differences were found based on digital data source (smartphone vs social media: coefficient, 0.29 [95% CI, 0.23-0.35]; P < .001; smart thermometer vs social media: coefficient, 0.09 [95% CI, 0.03-0.16]; P = .004). County COVID-19 rates (coefficient, −0.02; 95% CI, −0.16 to 0.13 for quartile 4 compared with quartile 1) and prior family diagnosis of COVID-19 (coefficient, 0.00; 95% CI, −0.25 to 0.25) were not associated with support. Compared with self-described liberal individuals, conservative (coefficient, −0.81; 95% CI, −0.96 to −0.66; P < .001) and moderate (coefficient, −0.52; 95% CI, −0.67 to −0.38; P < .001) individuals were less likely to support the scenarios. Similarly, large political differences were observed in support of the Apple-Google digital contact tracing program, with less support from conservative (coefficient, −0.99; 95% CI, −1.11 to −0.87; P < .001) and moderate (coefficient, −0.59; 95% CI, −0.69 to −0.48; P < .001) individuals compared with liberal individuals. Respondents from racial/ethnic minority groups were more supportive of the scenarios than were White, non-Hispanic respondents. For example, compared with White respondents, Black respondents were more supportive of the Apple-Google contact tracing program (coefficient, 0.20; 95% CI, 0.07-0.32; P = .002).
Conclusions and Relevance
In this survey study of US adults, many were averse to their information being used on digital platforms to mitigate transmission of COVID-19. These findings suggest that in current and future pandemics, public health departments should use multiple strategies to gain public trust and accelerate adoption of tools such as digital contact tracing applications.
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Accepted for Publication: March 29, 2021.
Published: May 19, 2021. doi:10.1001/jamanetworkopen.2021.10918
Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Grande D et al. JAMA Network Open.
Corresponding Author: David Grande, MD, MPA, Leonard Davis Institute of Health Economics, University of Pennsylvania, 3641 Locust Walk, CPC 407, Philadelphia, PA 19104 (email@example.com).
Author Contributions: Dr Grande had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: Grande, Merchant, Asch, Cannuscio.
Acquisition, analysis, or interpretation of data: Grande, Mitra, Luna Marti, Asch, Dolan, Sharma, Cannuscio.
Drafting of the manuscript: Grande, Luna Marti, Merchant, Dolan, Sharma.
Critical revision of the manuscript for important intellectual content: Grande, Mitra, Luna Marti, Merchant, Asch, Cannuscio.
Statistical analysis: Grande, Mitra.
Obtained funding: Grande.
Administrative, technical, or material support: Grande, Luna Marti, Merchant, Dolan, Sharma.
Conflict of Interest Disclosures: Dr Grande reported receiving grants from the National Human Genome Research Institute (NHGRI), National Institutes of Health (NIH) during the conduct of the study and receiving grants from the Robert Wood Johnson Foundation, the Patient-Centered Outcomes Research Institute, and the National Heart, Lung, and Blood Institute outside the submitted work. Dr Mitra reported receiving grants from the NIH during the conduct of the study. Ms Luna Marti reported receiving grants from the NHGRI during the conduct of the study. Dr Merchant reported receiving grants from the NIH during the conduct of the study. Dr Asch reported receiving grants from the NIH during the conduct of the study and receiving personal fees from VAL Health, Healthcare Financial Management Association, National Alliance of Health Care Purchasing Coalitions, Alliance for Continuing Education in the Health Professions, Deloitte, the American Association for Physician Leadership, and the North American Center for Continuing Medical Education outside the submitted work. Ms Dolan reported receiving grants from the NHGRI, NIH during the conduct of the study. Ms Sharma reported receiving grants from the NHGRI, NIH during the conduct of the study. Dr Cannuscio reported receiving grants from the NIH during the conduct of the study.
Funding/Support: This research was supported by grant 5R01HG009655-04 (Dr Grande) from the NHGRI, NIH.
Role of the Funder/Sponsor: The NHGRI/NIH had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
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