Analysis of the Factors Affecting the Adoption and Compliance of the NHS COVID-19 Mobile Application

ObjectivesTo conduct an independent study investigating how adults perceive the usability, and functionality of the "NHS COVID-19" app. This study aims to highlight strengths, and provide recommendations to improve adoption of future contact tracing developments. Design, Setting, and Participants1036 adults in England and Wales completed a 60-item, web-based observational survey. This survey was disseminated through social media outlets and email-lists. Primary Outcome MeasuresTo evaluate the compliance and public attitude towards the "NHS COVID-19" app, regarding its functionality and main features. This included whether participants expectations were met, and their thoughts on the privacy and security of app data. Furthermore, to distinguish how usability, perception, and adoption differed with varying demographics and user values. ResultsFair rates of app compliance were identified across participants, with the app meeting the expectation of 59.7% of participants who downloaded it. However, participants finding the interface challenging were less likely to read information in the app and had a lesser understanding of its functionality. Furthermore, lack of understanding regarding the apps functionality and privacy preserving features were behind the reasons why users did not download it. A readability analysis of the text revealed that the information of the app was conveyed at a level which might only be accessible to under 60% of the population. The study highlighted issues related to the high probability of false positives caused by the design choices in the "Check-In" feature. ConclusionThis study showed that while the "NHS COVID-19" app was viewed positively, however, there remained issues regarding participants perceived knowledge of the app with privacy and functionality, which appeared to affect compliance. Therefore, we have recommended improvements regarding the delivery and presentation of the apps information, and highlighted the potential need for the ability to check out of venues to reduce the number of false positive contacts. Strengths and LimitationsO_LIThis is the first study assessing the perceived usability and functionality of the "NHS COVID-19" app directly from app users. C_LIO_LIDiverse sample size, with representation from all major regions of England. C_LIO_LIStatistical analysis to compare perceived app usability and functionality across demographics and the participants values regarding privacy and information. C_LIO_LIStudy was conducted during lockdown where app use may have been minimal. C_LIO_LIStudy may have missed potential participants who were not active on the relevant social media channels and email mailing lists which were used to disseminate the survey. C_LI