Consumer Views on Using Digital Data for COVID-19 Control in the United States | Public Health | JAMA Network Open | JAMA Network
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    Original Investigation
    Public Health
    May 19, 2021

    Consumer Views on Using Digital Data for COVID-19 Control in the United States

    Author Affiliations
    • 1Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia
    • 2Division of General Internal Medicine, University of Pennsylvania, Philadelphia
    • 3Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia
    • 4Department of Emergency Medicine, University of Pennsylvania, Philadelphia
    • 5Center for Digital Health, University of Pennsylvania, Philadelphia
    • 6Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia
    • 7Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia
    JAMA Netw Open. 2021;4(5):e2110918. doi:10.1001/jamanetworkopen.2021.10918
    Key Points

    Question  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?

    Findings  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.

    Meaning  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.


    Importance  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.

    Objective  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.

    Results  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.