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COVID-19 exposure-notification apps have struggled to gain adoption. Existing literature posits as potential causes of this low adoption: privacy concerns, insufficient data transparency, and the type of appeal – collective- vs. individual-good – used to frame the app. As policy guidance suggests using tailored advertising to evaluate the effects of these factors, we present the first field study of COVID-19 contact tracing apps with a randomized, control trial of 14 different advertisements for CovidDefense, Louisiana’s COVID-19 exposure-notification app. We find that all three hypothesized factors – privacy, data transparency, and appeals framing – relate to app adoption, even when controlling for age, gender, and community density. Our results offer (1) the first field evidence supporting the use of collective-good appeals, (2) nuanced findings regarding the efficacy of data and privacy transparency, the effects of which are moderated by appeal framing and potential users’ demographics, and (3) field-evidence-based guidance for future efforts to encourage pro-social health technology adoption.
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Epidemic management and control through risk-dependent individual contact interventions
Testing, contact tracing, and isolation (TTI) is an epidemic management and control approach that is difficult to implement at scale because it relies on manual tracing of contacts. Exposure notification apps have been developed to digitally scale up TTI by harnessing contact data obtained from mobile devices; however, exposure notification apps provide users only with limited binary information when they have been directly exposed to a known infection source. Here we demonstrate a scalable improvement to TTI and exposure notification apps that uses data assimilation (DA) on a contact network. Network DA exploits diverse sources of health data together with the proximity data from mobile devices that exposure notification apps rely upon. It provides users with continuously assessed individual risks of exposure and infection, which can form the basis for targeting individual contact interventions. Simulations of the early COVID-19 epidemic in New York City are used to establish proof-of-concept. In the simulations, network DA identifies up to a factor 2 more infections than contact tracing when both harness the same contact data and diagnostic test data. This remains true even when only a relatively small fraction of the population uses network DA. When a sufficiently large fraction of the population (≳ 75%) uses network DA and complies with individual contact interventions, targeting contact interventions with network DA reduces deaths by up to a factor 4 relative to TTI. Network DA can be implemented by expanding the computational backend of existing exposure notification apps, thus greatly enhancing their capabilities. Implemented at scale, it has the potential to precisely and effectively control future epidemics while minimizing economic disruption.
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- Award ID(s):
- 1835576
- PAR ID:
- 10381663
- Editor(s):
- Moreno, Yamir
- Date Published:
- Journal Name:
- PLOS Computational Biology
- Volume:
- 18
- Issue:
- 6
- ISSN:
- 1553-7358
- Page Range / eLocation ID:
- e1010171
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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- Free Publicly Accessible Full Text
-
Accepted Manuscript1.0
- Journal Article:
- https://doi.org/10.1371/journal.pcbi.1010171
