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Helms YB, Stein ML, Hamdiui N, van der Meer A, Ferreira JA, Crutzen R, Timen A, Kretzschmar MEE. Determinants of Dutch public health professionals' intention to use digital contact tracing support tools: A cross-sectional online questionnaire study. PLOS DIGITAL HEALTH 2024; 3:e0000425. [PMID: 38354119 PMCID: PMC10866487 DOI: 10.1371/journal.pdig.0000425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/02/2023] [Indexed: 02/16/2024]
Abstract
Contact tracing (CT) can be a resource intensive task for public health services. To alleviate their workload and potentially accelerate the CT-process, public health professionals (PHPs) may transfer some tasks in the identification, notification, and monitoring of contacts to cases and their contacts themselves, using 'digital contact tracing support tools' (DCTS-tools). In this study, we aimed to identify determinants of PHPs' intention to use DCTS-tools. Between February and April 2022, we performed a cross-sectional online questionnaire study among PHPs involved in CT for COVID-19 in the Netherlands. We built three random forest models to identify determinants of PHPs' intention to use DCTS-tools for the identification, notification, and monitoring of contacts, respectively. The online questionnaire was completed by 641 PHPs. Most respondents had a positive intention towards using DCTS-tools for the identification (64.5%), notification (58%), and monitoring (55.2%) of contacts. Random forest models were able to correctly predict the intention of 81%, 80%, and 81% of respondents to use DCTS-tools for the identification, notification, and monitoring of contacts, respectively. Top-determinants of having a positive intention are the anticipated effect of DCTS-tools on the feasibility and efficiency of CT (speed, workload, difficulty), the degree to which PHPs anticipated that cases and contacts may find it pleasant and may be willing to participate in CT using DCTS-tools, and the degree to which PHPs anticipated that cases and contacts are sufficiently supported in CT when using DCTS-tools. Most PHPs have a positive intention to involve cases and their contacts in the identification, notification, and monitoring stages of the CT-process through DCTS-tools. The identified top-determinants should be prioritized in the (future) development and implementation of DCTS-tools in public health practice. Citizens' perspectives on the use of DCTS-tools should be investigated in future research.
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Affiliation(s)
- Yannick B. Helms
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Mart L. Stein
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Nora Hamdiui
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Akke van der Meer
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - José A. Ferreira
- Department of Statistics, Informatics and Modelling, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Rik Crutzen
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Aura Timen
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Mirjam E. E. Kretzschmar
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Baron R, Hamdiui N, Helms YB, Crutzen R, Götz HM, Stein ML. Evaluating the Added Value of Digital Contact Tracing Support Tools for Citizens: Framework Development. JMIR Res Protoc 2023; 12:e44728. [PMID: 38019583 PMCID: PMC10719815 DOI: 10.2196/44728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic revealed that with high infection rates, health services conducting contact tracing (CT) could become overburdened, leading to limited or incomplete CT. Digital CT support (DCTS) tools are designed to mimic traditional CT, by transferring a part of or all the tasks of CT into the hands of citizens. Besides saving time for health services, these tools may help to increase the number of contacts retrieved during the contact identification process, quantity and quality of contact details, and speed of the contact notification process. The added value of DCTS tools for CT is currently unknown. OBJECTIVE To help determine whether DCTS tools could improve the effectiveness of CT, this study aims to develop a framework for the comprehensive assessment of these tools. METHODS A framework containing evaluation topics, research questions, accompanying study designs, and methods was developed based on consultations with CT experts from municipal public health services and national public health authorities, complemented with scientific literature. RESULTS These efforts resulted in a framework aiming to assist with the assessment of the following aspects of CT: speed; comprehensiveness; effectiveness with regard to contact notification; positive case detection; potential workload reduction of public health professionals; demographics related to adoption and reach; and user experiences of public health professionals, index cases, and contacts. CONCLUSIONS This framework provides guidance for researchers and policy makers in designing their own evaluation studies, the findings of which can help determine how and the extent to which DCTS tools should be implemented as a CT strategy for future infectious disease outbreaks.
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Affiliation(s)
- Ruth Baron
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Nora Hamdiui
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Yannick B Helms
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Rik Crutzen
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Hannelore M Götz
- Department of Public Health, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, Netherlands
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Mart L Stein
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
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van der Meer A, Helms YB, Baron R, Crutzen R, Timen A, Kretzschmar MEE, Stein ML, Hamdiui N. Citizen involvement in COVID-19 contact tracing with digital tools: a qualitative study to explore citizens' perspectives and needs. BMC Public Health 2023; 23:1804. [PMID: 37716982 PMCID: PMC10504771 DOI: 10.1186/s12889-023-16664-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 08/30/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND Contact tracing (CT) is a key strategy when dealing with outbreaks of infectious diseases such as COVID-19. The scale of the COVID-19 pandemic has often left public health professionals (PHPs), who are responsible for the execution of CT, unable to keep up with the rapid and largescale spread of the virus. To enhance or support its execution, and potentially lower the workload for PHPs, citizens may be more actively involved in CT-tasks that are commonly executed by PHPs (referred to as 'self-led CT'). There is limited insight into citizens' perspectives on and needs for self-led CT for COVID-19. This study aims to explore the perspectives and needs of Dutch citizens on taking more responsibilities in the execution of CT for COVID-19, potentially through the use of digital tools. METHODS An exploratory qualitative study was performed, in which online semi-structured interviews were conducted. Questions were based on the Reasoned Action Approach and Health Belief Model. Interviews were audio-recorded and transcribed verbatim. A thematic analysis was conducted to identify citizens' perspectives and needs to participate in self-led CT. RESULTS We conducted 27 interviews with Dutch citizens. Seven main themes were identified from the interviews: 1) 'Citizens' perspectives on self-led CT are influenced by prior experiences with regular CT', 2) 'Citizens' felt responsibilities and the perceived responsibilities of the PHS in CT shape their perspectives on self-led CT', 3) 'Anticipated impacts of self-led CT on the CT-process', 4) 'Citizens' attitude towards the application of self-led CT depends on their own perceived skills and the willingness and skills of others', 5) 'Shame and social stigma may hamper participation in self-led CT', 6) 'Concerns about privacy and data security: a barrier for self-led CT', and 7) 'Citizens' perspectives and anticipated needs for the implementation and application of self-led CT in practice'. CONCLUSIONS Most interviewees hold a positive attitude towards self-led CT and using digital tools for this purpose. However, their intention for self-led CT may depend on various factors, such as prior experiences with regular CT, and their perceived self-efficacy to participate. Perspectives and needs of citizens should be considered for the future implementation of self-led CT in practice.
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Affiliation(s)
- A van der Meer
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
| | - Y B Helms
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - R Baron
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - R Crutzen
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - A Timen
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - M E E Kretzschmar
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - M L Stein
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - N Hamdiui
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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Dutch public health professionals’ perspectives and needs regarding citizen involvement in COVID-19 contact tracing through digital support tools: an exploratory qualitative study. BMC Health Serv Res 2022; 22:1378. [DOI: 10.1186/s12913-022-08764-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 10/31/2022] [Indexed: 11/21/2022] Open
Abstract
Abstract
Background
Contact tracing (CT) is an important, but resource-intensive tool to control outbreaks of communicable diseases. Under pandemic circumstances, public health services may not have sufficient resources at their disposal to effectively facilitate CT. This may be addressed by giving cases and their contact persons more autonomy and responsibility in the execution of CT by public health professionals, through digital contact tracing support tools (DCTS-tools). However, the application of this approach has not yet been systematically investigated from the perspective of public health practice. Therefore, we investigated public health professionals’ perspectives and needs regarding involving cases and contact persons in CT for COVID-19 through DCTS-tools.
Methods
Between October 2020 and February 2021, we conducted online semi-structured interviews (N = 17) with Dutch public health professionals to explore their perspectives and needs regarding the involvement of cases and contact persons in CT for COVID-19 through DCTS-tools, in the contact identification, notification, and monitoring stages of the CT-process. Interviews were audio recorded and transcribed verbatim. A thematic analysis was performed.
Results
Four main themes related to Dutch public health professionals’ perspectives and needs regarding involving cases and contact persons in CT for COVID-19 through DCTS-tools emerged from the data: ‘Distinct characteristics of CT with DCTS-tools’; ‘Anticipated benefits and challenges of CT for COVID-19 with DCTS- tools’; ‘Circumstances in CT for COVID-19 that permit or constrain the application of DCTS-tools’; and ‘Public health professionals’ needs regarding the development and application of DCTS-tools for CT’. Public health professionals seem to have a positive attitude towards involving cases and contact persons through DCTS-tools. Public health professionals’ (positive) attitudes seem conditional on the circumstances under which CT is performed, and the fulfilment of their needs in the development and application of DCTS-tools.
Conclusions
Dutch public health professionals seem positive towards involving cases and contact persons in CT for COVID-19 through DCTS-tools. Through adequate implementation of DCTS-tools in the CT-process, anticipated challenges can be overcome. Future research should investigate the perspectives and needs of cases and contact persons regarding DCTS-tools, and the application of DCTS-tools in practice.
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Strengthening the Trialability for the Intention to Use of mHealth Apps Amidst Pandemic: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052752. [PMID: 35270445 PMCID: PMC8910131 DOI: 10.3390/ijerph19052752] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/05/2022] [Accepted: 02/05/2022] [Indexed: 12/28/2022]
Abstract
Recent advancements in mHealth apps and services have played a vital role in strengthening healthcare services and enabling their accessibility to marginalized people. With the alarming rise in COVID-19 infection rates around the world, there appears to be an urgent call to modernize traditional medical practices to combat the pandemic. This study aims to investigate the key factors influencing the trialability of mHealth apps/services and behavioral intention to adopt mobile health applications. The study also examines the moderating effects of self-discipline motivation, knowledge, and attitude on the relationship between trialability and behavioral intention to use. The deductive reasoning approach was followed in a positivism paradigm. The study used convenience sampling and collected responses from 280 Generation Y participants in Bangladesh. Partial least square-based structural equation modeling was employed. The results revealed that relative advantage (β = 0.229, p < 0.05), compatibility (β = 0.232, p < 0.05), complexity (β = −0.411, p < 0.05), and observability (β = 0.235, p < 0.05) of mHealth apps influence the trialability of mHealth apps and services among users. Trialability compatibility (β = 0.425, p < 0.05) of mHealth was positively related to the behavioral intention to use these mobile apps. The study found no moderating effects of attitude (β = 0.043, p > 0.05) or self-discipline motivation (β = −0.007, p > 0.05) on the hypothesized relationships. The empirical findings of this study may facilitate the development, design process, and implementation of mHealth applications with improved features that can lead to high user acceptance among Generation Y during future health crises.
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