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Public Adoption of and Trust in the NHS COVID-19 Contact Tracing App in the United Kingdom: Quantitative Online Survey Study

Dowthwaite, Liz; Fischer, Joel; Perez Vallejos, Elvira; Portillo, Virginia; Nichele, Elena; Goulden, Murray; McAuley, Derek

Public Adoption of and Trust in the NHS COVID-19 Contact Tracing App in the United Kingdom: Quantitative Online Survey Study Thumbnail


Professor of Human-Computer Interaction

Elena Nichele

Derek McAuley


Background: Digital contact tracing is employed to monitor and manage the spread of Covid-19. However, to be effective the system must be adopted by a substantial proportion of the population. Studies of (mostly hypothetical) contact tracing apps show generally high acceptance, but little is known about the drivers and barriers to adoption of deployed systems.

Objective: The aim of this study is to investigate adoption and attitudes towards the NHS Covid-19 smartphone app, the digital contact tracing solution in the UK.

Methods: An online survey based on the technology acceptance model (TAM2) with the added factor of trust was carried out with a representative sample of the UK population. Statistical analysis shows adoption rates, attitudes towards and trust in the app, compliance with self-isolation advice, and highlights differences for vulnerable populations (older adults over 65 years of age and members of Black, Asian, and Minority Ethnic (BAME) communities).

Results: Around half of the 1,001 (50.9%, 95% CI:47.8-54.0%) respondents had downloaded and kept the app, but more than a third (35.8%, CI:32.8-38.8%) either did not intend to download it or had deleted it. Significantly more BAME respondents had deleted the app (13.9%, CI :11.8-16.0%, vs 7.4%, CI: 5.8-9.0%), and significantly more older adults over 65 years old did not intend to download it (34.6%, CI: 31.7-37.5% vs 25.2% CI: 22.5-27.9%). Reasons for uptake were broadly to help the NHS and other people, especially among older adults, although significantly fewer BAME agreed that they did so to help the NHS. Reported compliance with received notifications to self-isolate was high, but significantly lower than reported intended compliance without received notifications. Only a fifth (19.5%, CI: 17.0-22.0%) understood that the decision to send self-isolation notifications is automated by the app. There were a range of significantly more negative views among BAME participants, including lower trust in the NHS, whilst older adults were often significantly more positive. Respondents without the app reported significantly lower trust and more negative views towards the app and were less likely to report they understood how the app works.

Conclusions: Whilst compliance of the ~50% who have the app is fairly high, there are issues surrounding trust and understanding that hinder adoption and therefore the effectiveness of digital contact tracing, particularly amongst BAME communities. The study highlights that more needs to be done to improve adoption among groups who are more vulnerable to the effects of the virus to enhance uptake and acceptance of contact tracing apps.

Journal Article Type Article
Acceptance Date Jul 9, 2021
Online Publication Date Sep 17, 2021
Publication Date 2021-09
Deposit Date Jul 19, 2021
Publicly Available Date Sep 17, 2021
Journal Journal of Medical Internet Research
Electronic ISSN 1438-8871
Publisher JMIR Publications Inc.
Peer Reviewed Peer Reviewed
Volume 23
Issue 9
Article Number e29085
Keywords Health Informatics
Public URL
Publisher URL


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