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Original Research

COVID-19 Contact-Tracing Technology: Acceptability and Ethical Issues of Use

ORCID Icon, ORCID Icon & ORCID Icon
Pages 1639-1647 | Published online: 18 Sep 2020

Abstract

Background

The contact-tracing COVID-19 technology allows for tracing people that come in contact to individuals with COVID-19 wherever they are located. The number of tracing COVID-19 infection technology and devices is rapidly increasing. This has prompted many researchers to study the acceptability and ethical issues related to the implementation of such technology.

Aim

The purpose of this study was to determine the acceptability of COVID-19 contact-tracing technology and ethical issues of use.

Methods

A cross-sectional questionnaire-based study was used. The target population was Jordanian adults (>18 years). The survey was distributed to a convenience sample of 2000 general public in Jordan.

Results

The results found that the number of people who accept to use COVID-19 contact-tracing technology was 71.6%. However, the percentage of people who were using this technology was 37.8. The main ethical concerns for many of participants were privacy, voluntariness, and beneficence of the data. Only income and living area were predictors for acceptability and use of tracing technology (p≤ 0.01).

Conclusion

The majority of Jordanians accept the implementation of contact-tracing technology for COVID-19 infection. Among ethical concerns of the implementation of such technology were privacy, beneficence and voluntariness.

Implications

The results of this study would help in improving the state of science regarding acceptability to use contact-tracing technology for health purposes. Moreover, the present findings provide evidence of predictors of acceptance and ethical concerns among Jordanian population about COVID-19 contact-tracing technology.

Introduction

The coronavirus SARS-CoV-2 disease (COVID-19) is the most current threat that challenges health and economic sectors in the world. The impact of this infection continues to rise, affecting more individuals every second, with deaths estimated to reach 40 million if untreated.Citation1 One of the most effective ways to decrease the spread of this infection is tracing the primary and secondary contacts of confirmed COVID-19 cases using contact-tracing technology and devices. China has been very successful at controlling the spread of COVID-19 using this tracing technology.Citation1Citation3 Given the pressing need for expanding COVID-19 infection tracing option to other developing countries,Citation1 there is great enthusiasm for using such technology using smart phones, and devices for preventing the spread of the disease and making therapy more accessible. Thus, the number of COVID-19 infection tracing technologies has rapidly increased. They now include proximity tracking tools that use location-based (GPS) or Bluetooth technology to trace the movements of individuals to determine people who may have been exposed to an infected person. Other technologies such as characteristic tracking tools collect self-reported signs and symptoms to assess severity or the probability of infection due to COVID19. These tools may also be helpful when integrated into the contact-tracing process.

Among the countries that implanted COVID-19 infection tracing technology is Singapore, which developed a mobile-based application called “Trace Together”, that could help responsible healthcare professional to trace and identify infected individuals and who exposed to them.Citation4 Similarly, in Israel, the government obligates all citizens to download a mobile application to track the infected people and their contacts.Citation5 In Western countries, such as the United States and United Kingdom, telemedicine technology using mobile applications was expanded to include COVID-19 to limit the spread of the virus.Citation6,Citation7 In Jordan, the Ministry of Health has announced new initiatives to trace the COVID-19 infection using “Aman” mobile application and bracelet tracking devices.

While the COVID-19 infection tracing technologies might be beneficial in limiting the spread of the virus, there is a concern by some individuals that these applications can have access to other personal information in the users’ smart mobiles.Citation8 Furthermore, while safety and effectiveness are important issues, increased regulation for COVID-19 tracing technology did not address other important ethical challenges such as privacy and informed consent. In developed countries, the use of such technologies could fall under regulations concerning the protection of personal data, informed consent, as well as use of health technology and devices, which are well established.Citation9Citation12 However, no universal guidelines exist to ensure quality of these tracing technologies and applications to a gold standard. Moreover, many of the ethical challenges concerning tracing COVID-19 infection are rooted to human rights issues.Citation3 Therefore, the purpose of this study was to determine the acceptability of COVID-19 contact-tracing technology and ethical issues of use in Jordan as an example of developing countries.

Methods

A descriptive cross-sectional design was employed through an online survey that was distributed during July 2020 using Google forms. The study was advertised using social media and emails. The study survey was distributed to a convenience sample of 2000 general public in Jordan. Inclusion criteria were being at least 18 years old read and write in Arabic fluently. A total of 1654 individuals agreed to participate in the study (response rate was 83%). The targeted individuals were requested to willingly participate in the research by filling the consent form in the first electronic page of the survey. Once filled, the study participant was allowed to fill out the complete online questionnaire.

The instrument included four domains. The first domain collected demographic information such as age, gender, income, education. The second domain asked about acceptance and use of COVID-19 trace technology (4 items). The third domain was about the components and description of objective, instillation, management, and benefits for the users of COVID-19 tracing technology (10 items). The fourth domain included statements reflecting the general ethical issues related to use of the technology (10 items). The instrument of the study was developed by the authors and verified for validity and reliability among the general public, with an internal consistency of 0.77.

To review the content, face, and construct validities for the instrument, a pilot study was conducted before the actual research. The face validity was first checked by several colleagues who reviewed the draft of the questionnaire. The associates were requested to provide their take on clarity and question accuracy. The questionnaire was then adjusted according to their suggestions. Later, to guarantee participants understanding what the questions required, the verbal protocol was used to validate the questionnaire further. This involved separately recruiting ten respondents and requesting them to complete the questionnaire. The respondents were requested to think aloud, and to explain what each of their answers meant, and what each question meant to them. The researchers recorded each of their answers, where the questionnaire had an appropriate adaptation. The final version of the instrument will be provided to interested individuals upon request from the corresponding author.

Ethical Considerations

This study approved by Jordan University of Science and Technology’s IRB (approval ID: 2020339). Participants received an electronic consent form. The questionnaire was anonymous and thus no personal information/identification data were collected. The questionnaire required between 15–20 minutes to fill and no incentives were offered to participation. On the cover page of the questionnaire, the objectives of the study were explained. In addition, a statement that indicates the anonymity of the questionnaire and that no personal information will be collected was included. The collected information was stored in secure laptop and only the research team had an access to the data.

Data Analysis

The authors used SPSS version 23 to analyze the results of the study. Only completed questionnaires were analyzed. Descriptive statistics were employed for demographic characteristics such as gender, income, education. Moreover, acceptability and ethical consideration were analyzed using means and percentages. Multiple regressions test was used to determine the predictors of acceptability and use of tracing technology.

Results

Demographic Variables

The total number who agreed to participate was 1654 individuals. The number of females was 1056 (63.8) and the number of males was 598 (36.2). The mean age = 29.5 (SD=7.7). See

Table 1 Demographic and Work Characteristic of Study Participants (N = 1654)

Acceptance of Use

The number of people who indicated they will accept to use this technology was 71.6%. Only 37.80% were current users of this technology. Additionally, 70% of participants indicated that they usually read the privacy instructions before using such a new technology. Moreover, most of the participants agreed that the community should regulate this technology (82.3%) (see ).

Table 2 Response to Who Should Reach the Information Gained from COVID-19 Contact-Tracing Technology

Information for Users Regarding COVID-19 Tracing Technology

There are a number of issues that need to be taken into consideration when applying such a new technology. They included the objective and description of the technology 96.1%, how it works 92.3%, sponsors of this technology 80.2%, potential burdens 80.2%, possible benefits 88.2%, expected required time 84%, any type of incentives for use 83.6%, and the voluntariness for using such technology 84.5%. Regarding the best description of utilization of this technology, participants indicated that it is intended to monitor infection among people 74.1%, monitor people and gather their information 14.10%, and for scientific research 11.8%. Regarding who could have access to data collected by such a tracing technology, most of the respondents agreed that the World Health Organization 85.6% and COVID-19 technology tracing software companies 82.2% should have such access. However, many participants disagreed that people who used or download technology 79% to be allowed to control or manage this technology.

When asked about who should have access to the information gained from COVID-19 contact-tracing technology? The highest agreement was on individuals who respond to trace the COVID-19 infection 80.1% and governmental sectors in general 80.7%, . Further, when asked about the benefits from the technology, the majority believed that this technology could decrease the rate of infection 74.6%, helps reach disadvantaged people 67.8%, give accordable data 68.8%, and are more efficient than other contact-tracing methods 48.8%.

Table 3 Ethical Consideration for Using COVID-19 Contact-Tracing Technology

Main Ethical Concerns

The participants of this study agreed that this technology may raise multiple ethical concerns such as privacy of information 88.6% and use of the collected information 82.5%, obligation of use of the technology 48.1%, and the clarity of conditions and privacy statements provided 42.1%, .

Predictors of Acceptability and Use of Tracing Technology

The multiple regressions test was used to determine the predictors of acceptability and use of tracing technology. The model was significant which means some factors may impact predictors of acceptability and use of tracing technology (F= 4.37, p≤ 0.001). These factors were income (B= −.13, p≤ 0.001) and area of living (B=0.08, p=0.002). This means only these two factors were predictors of acceptability and use of tracing technology and other factors were insignificant (p> 0.05).

Discussion

During COVID-19 pandemic, governments and private institutions have been depending on location, health, and population data to understand the rates of infection, the efficiency of social distancing directives, and factors of disease transmission.Citation12Citation14 These institutions must ethically, robustly and transparently use this data to avert mass skepticism, violation of privacy rights, and the possible establishment of a dictatorial police after COVID-19 outbreak.

Technology Acceptance

Our contribution to the understanding of COVID-19 tracing technology adoption offer benefits at both personal and societal levels. The multi-faceted benefits of such technologies were providing the location and contact information of an individual to trace COVID-19 cases. The results of this study showed that more than 70% of people would accept using this technology. This indicates positive attitudes of Jordanians regarding the implementation of such technology for the control of COVID-19 spread. However, only 37.5% of participants were current users of this technology. Thus, more motivation of people to download such applications is needed, probably, using governmental channels and media. The acceptance rate reported in this study is similar to that reported in other countries such as China and Singapore.Citation16,Citation18

About one third of the sample of this study indicated that they would not accept using this technology. According to White & Peloza,Citation14 suggestions from past research indicate that the usefulness of self-gain attraction can fail in situations where individuals can be made responsible for not participating in the combined attempt, such as the case of tracing contact applications. The researchers determined that individual benefit did not inspire installation, whether as a unique attraction (based on past research) or in combination with a societal-gain attraction (an extension of an earlier research).Citation14 During pandemics, the appeals of benefits are only useful if they favor the altruistic and combined effort-centered concerns of the citizens.Citation15Citation17 The COVID-19 pandemic could expedite the approval of these steps that the public would reject under normal circumstances. If this technology is applied in a manner that lowers infections and, consequently, the number of deaths, it may have a widespread application acceptance from the public. Nevertheless, enforcing such a technique at a large scale exposes very cloudy moral challenges about which type of monitoring technology is unreasonable.Citation15,Citation16 In the pandemic risk context, individuals may consider it necessary for their governments to implement techniques to monitor the spread of the outbreak and possibly manage it.

Concerns About COVID-19 Tracing Contact Application

One of the most agreeable points for more than 80% of the participants in this study was regarding the lack of information about COVID-19 tracing contact application such as objectives, description of the application, how it works, sponsors of this technology, potential burdens to use, possible benefits, and the voluntariness for using such technology. This was consistent with Hui and Mello studies, which found that most people were concerned and even, searched for a complete description of COVID-19 tracing contact application.Citation18,Citation19

Extensive, refined, and mandated guidelines that stress the steps to be followed after data gathering, data utilization, and analysis are critical and should accompany any guidance to be deemed authoritative regarding COVID-19 virus data utilization.Citation16,Citation20 Next, the researchers must enforce mechanisms of contacting the citizens after collecting and analyzing their data. Such a means would allow the fostering of communication between the user and the provider of the data to have the answers concerning the utilization of each data point.Citation14,Citation21

Data Users,

Regarding who could manage and have access, the majority of participants agreed that WHO (85.6%) and COVID-19 software technology tracing software companies were the most important to have the access. It was previously reported that an effective collaboration between technology providers, and epidemiological health professionals would be the most productive effort to trace contacts and will need the collection of the least amount of data from users of smartphones.Citation22Citation24 However, other studies found that users of smartphones may fail to participate because of fear or concerns those technology providers and/or, the government could utilize the technology in increasing monitoring measures even after the end of the pandemic.Citation7,Citation24

The achievement of the technology will significantly rely on third-party organizations to ensure the privacy and safety of the citizens while using the contact-tracing app. To promote public confidence, users of smartphones should be informed that contact-tracing works without absolute location data utilization. It is evident that in this pandemic, world citizens may be compelled to share information that they do not usually share under normal circumstances to contribute to the protection of the global community’s broader well-being. The elevated use of monitoring technology may be essential in saving lives during the pandemic.Citation15,Citation16

Ethical Concerns

Multiple ethical concerns were raised during the pandemic related to the use of COVID-19 contact-tracing application. These concerns were beneficence (who benefit from the data), privacy, voluntariness and incentives. The present study found that beneficence of information was one of the concerns of most participants (82.5%). Regarding the benefits using this technology, current study participant indicated that COVID-19 contact-tracing technology could decrease the rate of infection, reach disadvantaged people, give accordable data, and have more positive effect than other non-technology-based methods. According to White & Simpson,Citation25 calls for benefits can be widely understood as appeals for measures that give reasons for embracing individual conduct. The first concerns for participant was accepting to install the app because of their wants and needs, a choice facilitated by calculating cost-benefit.Citation26 Contrarily, according to White & PelozaCitation27 and White & Simpson,Citation25 to the second concern alienating individual needs and prioritizing what others need, a choice prompted by the impetus to adhere to social expectations or altruism. Venkatesh et alCitation28 contend that the question of how users receive benefits when using an app influences approval and have been investigated in various fields, such as health technology.Citation15,Citation16

Since such technology benefits the individual and the whole community, the decisions of well-informed citizens to install the app does not meet the usual motives of consumers and does not only promote the choice, but rather it instead reveals self-beneficial/prosocial conduct.Citation25,Citation27 Consequently, when it is time for policymakers to market the app, they must use benefit appeals in deciding which benefit(s) to highlight. The literature on sensitive data and privacy concerns informs this study by explaining how privacy design influences the acceptance of the app by users.Citation29Citation32 Another major concern in this study for the participants was privacy and confidentiality. In our case, privacy is the right of people to keep their health and personal information private, whereas confidentiality refers to the duty to keep information of others private.Citation32 It worth to mention that this application still have an access to all information that present in the phone such as pictures and social media that include sensitive information.

According to Bélanger & Crossler,Citation33 the privacy of information is when individuals can control the circumstances in which their details are gathered and utilized. The privacy design of an app can be different regarding the quantity and the kind of required sensitive details (for example, “data reduction”, that is strictly gathering what is essential) and the access control level (eg, “principle of information and reduced advantages”, i.e. the data repository and who accesses the data).Citation34 According to Malhotra et al,Citation35 since losing the privacy of information exposes users to various threats to confidentiality, they analyze the sensitivity of the information and the inability to control the information before releasing the details. For instance, mobile device and technology research has revealed how various designs of hardware affect privacy interest and user approval,Citation28 how clients opt for control to guide access of information,Citation36 and how the permission requirements of an app reduce the intention of installation.Citation37,Citation38

Since issues of privacy are significant obstacles for app approval,Citation31 it remains that the privacy design of an app influences its adoption. For contact tracing to function, the app should access and analyze confidential information. A citizen’s decision to install an app would rely on how the app’s privacy is designed based on the sensitivity (for example, GPS tracing vs Bluetooth tracing) and monitoring (eg, centralized vs decentralized data processing; restricted vs extended data usage). It is upon the policymakers to decide on the specification of privacy design that optimizes acceptance.

Voluntariness and Incentive

The least agreement in this study was if this technology should be obligatory (48.1%). The perfect circumstance would be the voluntary downloading of the app and a significant extent of a voluntary uptake of the app. This may be because it is assumed that acceptance of under 50% would still-combined with other methods-suffice in producing a significant effect.Citation39 There are various reasons why smartphone users will be highly motivated to take up the app. First, it would eventually imply that smartphone users and everybody else will quickly and safely emerge from the curfew. Secondly, by accepting the app, they will participate in saving the lives of other people, especially those at risk, and those providing care, both locally and internationally.

When the app’s adoption levels did not succeed, some authorities began using laws to mandate technology or making them a prerequisite for an individual to participate in public life fully. In the recent past, it may not be legally mandated to install an app and still consent-based,Citation40,Citation41 but consent will be meaningless if the benefit is too high for individuals to have the right to decide on using the app. Although international laws provide restrictions to civil rights during a public health emergency and privacy rights, it further explicitly defines how authorities should enforce such restrictions to harmonize privileges and avert misuses.

Currently, it is unclear whether implementing the suggested tools directly or indirectly would survive legal tests. Moreover, an approach that coerces is challenging if it does not recognize that many individuals may not access the internet or smartphones as assumption one shows. Despite these issues, India’s government made their contact COVID-19 tracing-contact technology compulsory for employees in the country and everyone in selected cities (this led to 90 million downloads, which accounted for less than 7% of the population). The quarantine app is compulsory despite its privacy issues.Citation42

In Singapore and Italy,Citation43 calls for mandatory use of technology are gaining momentum Baharudin.Citation44 In South Korea, foreigners are required to install a COVID-19 tracing-contact technology when they visit the country.Citation45 In Russia, Kazakhstan, and the Gulf states, while leaving the house during curfew, installing tracing technology is a prerequisite requirement.Citation46 It is crucial to evaluate the implementation of actors and practices to understand the real meaning of mandating in the lives of people. The police in India and Poland are tasked with implementing tools through fining or even sentencing to jail. In Russia, the quarantine app has inbuilt enforcement: failure to obey the app’s instructions automatically leads to a fine, also if a virus in the bug causes this failure.Citation40,Citation41

Furthermore, there are significant concerns about how individuals who do not own phones or the internet to abide by will perceive enforcement or how individuals whose economic circumstances compel them to leave their houses will view implementation.Citation40 Using incentives to increase the use of this technology educe may be valid if there were insufficient acceptance and that evidence existence that greater acceptance would protect more individuals. The kind of these incentives would call for keen evaluation through case-by-case. These may be some probable examples: donating to a selected charity or free credit for mobile phones.

A multiple regressions test was conducted to determine the predictors of acceptability and use of tracing technology. The results showed that only income and living areas were predictors for predictors of acceptability and use of tracing technology. This is expected since people living in cities are richer and open for technology and its implications compare to people living in rural areas.Citation18

Limitations

There are many limitations in this study. In the web-based surveys, there is uncertainty over the validity of the data collected and sampling. Moreover, the opinions of illiterate people or those who had no internet cannot be cast. Finally, some of the terms used in the questionnaire such as “private sector” might be vague and thus may have biased the responses.

Conclusion

The contribution to the understanding of technology adoption offer benefits at both personal and societal levels using COVID-19 contact-tracing technology. However, the implementation of such technology may raise many ethical concerns including privacy, beneficence and voluntariness. The acceptability to use contact-tracing technology for COVID-19 infection was high; yet, the actual use of the technology was comparably less. The results also showed that only income and living area were predictors of acceptability and use of tracing technology. Thus, healthcare providers and the government need to put more effort to promote actual use of tracing-contact technology for COVID-19 infection.

Author Contributions

All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agree to be accountable for all aspects of the work”.

Disclosure

The authors report no conflict of interests for this work.

Additional information

Funding

This project was carried out as part of “The Research Ethics Education Program in Jordan” and has been supported by NIH grant number (1R25TW010026-01). The funder support data collection and fees for publication. All authors have read and approved the manuscript”, and ensure that this is the case.

References

  • COVID-19 dashboard by the center for systems science and engineering (CSSE) at Johns Hopkins University (JHU). 2020. Available from: https://coronavirus.jhu.edu/map.html. Accessed May 10, 2020.
  • Dunford D, Dale B, Stylianou N, Lowther E, Ahmed M, De la Torre Arenas I. The world in lockdown in maps and charts. BBC News. 2020. Available from: https://www.bbc.com/news/world-52103747. Accessed April 30, 2020.
  • Chen S, Yang J, Yang W, Wang C, Bärnighausen T. COVID-19 control in China during mass population movements at New Year. Lancet. 2020;395(10226):764–766. doi:10.1016/S0140-6736(20)30421-9
  • Cho H, Ippolito D, Yu YW. Contact tracing mobile apps for COVID-19: privacy considerations and related trade-offs. ArXiv200311511 Cs. 2020.
  • omas N. Israel passes emergency law to use mobile data for COVID-19 contact tracing | techCrunch. In: tech crunch. 2020. Available from: https://techcrunch.com/2020/03/18/israel-passes-emergency-law-to-use-mobile-data-for-covid-19-contact-tracing/. Accessed May 19, 2020.
  • Mayor S. Covid-19: researchers launch app to track spread of symptoms in the UK. BMJ. 2020;368:m1263. doi:10.1136/bmj.m1263
  • Davalbhakta S, Advani S, Kumar S, et al. A systematic review of smartphone applications available for corona virus disease 2019 (COVID19) and the assessment of their quality using the mobile application rating scale (MARS). J Med Syst. 2020;44(164). doi:10.1007/s10916-020-01633-3
  • Lang M. Heart rate monitoring apps: information for engineers and researchers about the new European medical devices regulation 2017/745. JMIR Biomed Eng. 2017;2(1):e2. doi:10.2196/biomedeng.8179
  • Lang M. Beyond Fitbit: a critical appraisal of optical heart rate monitoring wearables and apps, their current limitations and legal implications. Albany Law J Sci Technol. 2017;28(1):39.
  • Food and Drug Administration. Examples of mobile apps for which the FDA will exercise enforcement discretion. 2016. Available from: https://www.fda.gov/MedicalDevices/DigitalHealth/MobileMedicalTechnology/ucm368744.htm.
  • FDA. Examples of mobile apps for which the FDA Will exercise enforcement discretion. 2016. Available from: https://www.fda.gov/MedicalDevices/DigitalHealth/MobileMedicalTechnology/ucm368744.htm. (WebCite Cache).
  • Food and Drug Administration. Regulations for digital health. 2018. Available from: https://www.fda.gov/medicaldevices/digitalhealth/. Accessed September 8, 2020. (WebCite Cache)
  • American Psychiatric Association. Mental Health Apps. 2017. Available from: https://www.psychiatry.org/psychiatrists/practice/mental-health-apps. Accessed 2017.
  • White K, Peloza J. Self-benefit versus other-benefit marketing appeals: their effectiveness in generating charitable support. J Mark. 2015;73(4):109–124. doi:10.1509/jmkg.73.4.109
  • Briz-Ponce L, García-Peñalvo F. An empirical assessment of a technology acceptance model for technology in medical education. J Med Syst. 2015;39(11):176. doi:10.1007/s10916-015-0352-x
  • Kim J, Park H-A. Development of a health information technology acceptance model using consumers’ health behavior intention. J Med Internet Res. 2015;14(5):e133. doi:10.2196/jmir.2143
  • Morley J, Cowls J, Taddeo M, Floridi L. Ethical guidelines for COVID-19 tracing technology. 2019;29–31.
  • Hui M. Singapore wants all its citizens to download contact tracing apps to fight the coronavirus. Quartz 2020. Available from: https://qz.com/1842200/singapore-wants-everyone-to-download-covid-19- contact-tracing-apps/. Accessed May 8, 2020.
  • Mello MM, Wang CJ. Ethics and governance for digital disease surveillance. Science. 2020;368:951–954.
  • Lenert L, McSwain BY. Balancing health privacy, health information exchange, and research in the context of the COVID-19 pandemic. J Am Med Inform Assoc. 2020;27(6):963–966. doi:10.1093/jamia/ocaa039
  • HIPAA Privacy Rule. December 2000. ( Online). Available from: https://www.hhs.gov/hipaa/forprofessionals/privacy/index.html.
  • Trinckes J, John J. The Definitive Guide to Complying with the HIPAA/HITECH Privacy and Security Rules. CRC Press; 2012.
  • Gupta R, Ibraheim MK, Doan HQ. Teledermatology in the wake of COVID-19: advantages and challenges to continued care in a time of disarray. J Am Acad Dermatol. 2020;83(1):168–169. doi:10.1016/j.jaad.2020.04.080
  • Salathé M, Althaus CL, Neher R, et al. COVID-19 epidemic in Switzerland: on the importance of testing, contact tracing and isolation. Swiss Med Wkly. 2020;150(11–12):w20225.
  • White K, Simpson B. When do (and don’t) normative appeals influence sustainable consumer behaviors? J Mark. 2013;77(2):78–95. doi:10.1509/jm.11.0278
  • Blau PM. Exchange and Power in Social Life. John Wiley & Sons; 1964.
  • Hinch R, Probert W, Nurtay A, et al. Effective configurations of a digital contact tracing app: a report to NHSX. en. In:(Apr. 2020). May, 2020. Available from: https://github. com/BDI-pathogens/covid-19_instant_tracing/blob/master/Report.
  • Venkatesh V, Aloysius JA, Hoehle H, Burton S. Design and evaluation of auto-ID enabled shopping assistance artifacts in customers’ mobile phones: two retail store laboratory experiments. Mis Q. 2017;41(1):83–113. doi:10.25300/MISQ/2017/41.1.05
  • Nov O, Arazy O, Anderson D. Technology-mediated citizen science participation: a motivational model. In Fifth International AAAI Conference on Weblogs and Social Media; 2011.
  • Raddick MJ, Bracey G, Gay PL, et al. Galaxy zoo: exploring the motivations of citizen science volunteers. arXiv Preprint arXiv:0909 2925. 2009.
  • Dinev T, McConnell AR, Smith HJ. Research commentary—informing privacy research through information systems, psychology, and behavioral economics: thinking outside the “APCO” box. Inf Syst Res. 2015;26(4):639–655. doi:10.1287/isre.2015.0600
  • Childress JF, Beauchamp TL. Principles of Biomedical Ethics. New York: Oxford University Press; 2001.
  • Belanger F, Crossler RE. Dealing with digital traces: understanding protective behaviors on mobile devices. J Strateg Inf Syst. 2019;28(1):34–49.
  • Cavoukian A. Privacy by Design: The 7 Foundational Principles.Vol. 5. Canada: Information and Privacy Commissioner of Ontario; 2009.
  • Malhotra NK, Kim SS, Agarwal J. Internet users' information privacy concerns (IUIPC): The construct, the scale, and a causal model. Information systems research. 2004 Dec;15(4):336–55
  • Sadeh N, Hong J, Cranor L, et al. Understanding and capturing people’s privacy policies in a mobile social networking application. Pers Ubiquit Comput. 2009;13(6):401–412. doi:10.1007/s00779-008-0214-3
  • Gu J, Xu YC, Xu H, Zhang C, Ling H. Privacy concerns for mobile app download: an elaboration likelihood model perspective. Decis Support Syst. 2017;94:19–28. doi:10.1016/j.dss.2016.10.002
  • Ferretti L, Wymant C, Kendall M, et al. Quantifying SARS-CoV-2 transmission suggests epidemic control with digital contact tracing. Science. 2020;368(6491). doi:10.1126/science.abb6936
  • Ahmed N, Michelin RA, Xue W, et al. A survey of covid-19 contact tracing technology. arXiv Preprint arXiv:2006 10306. 2020.
  • Abeler-Dörner L, Bonsall D, Parker M, Fraser C. The ethics of instantaneous contact tracing using mobile phone technology in the control of the COVID-19 pandemic. J Med Ethics.
  • Parker MJ, Fraser C, Abeler-Dörner L, Bonsall D. Ethics of instantaneous contact tracing using mobile phone technology in the control of the COVID-19 pandemic. J Med Ethics. 2020.
  • Singh RP, Chauhan A. Impact of lockdown on air quality in India during COVID-19 pandemic. Air Qual Atmos Health. 2020;13:921–928.
  • Perez-Pena R. Virus hits Europe harder than China. Is that the price of an open society? The New York Times (Internet). 2020.
  • Baharudin H. Coronavirus: S’pore Government to make its contact-tracing app freely available to developers worldwide. The Straits Times. 2020.
  • Normile D. Coronavirus cases have dropped sharply in South Korea: what’s the secret to its success? 2020.
  • YouGov. A plurality of americans believe covid-19 smartphone technology are an invasion of privacy. YouGov PLC; 2020. Available from: https://today.yougov.com/topics/technology/articles-reports/2020/04/27/covid-smartphone-app-poll. Accessed September 8, 2020. (Google Scholar).