journal article·2025-01-16Open access

Privacy and Security in Digital Health Contact-Tracing: A Narrative Review

Shehani Pigera, Paul van Schaik, Karen Renaud, Miglena Campbell, Petra Manley, Pierre Esser

Applied Sciences· Volume 15· Issue 2

Abstract

(1) Background: Contact-tracing apps only achieve their aims if the majority of the population installs and actively engages with them. Such acceptance depends on public perceptions and are likely influenced by privacy and security concerns. Therefore, this review evaluates public perceptions towards the privacy and security of contact-tracing apps used during the recent COVID-19 pandemic, with a focus on identifying factors that influence acceptance. (2) Methods: A systematic literature review was performed. A total of 114 articles were retained as per the inclusion criteria, which included quantitative, qualitative, and mixed-methods studies. The data were analysed using thematic analysis. (3) Results: Eight main themes were derived: privacy, data protection and control, trust, technical issues, perceived benefit, knowledge and awareness, social influence, and psychological factors. (4) Conclusions: Improving privacy standards and the awareness of the digital contact-tracing process will encourage the acceptance of contact-tracing apps.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: COVID-19 Digital Contact Tracing · Privacy, Security, and Data Protection · Privacy-Preserving Technologies in Data

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Department of Psychology, School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough TS1 3BA, UK

Department of Computer and Information Sciences, University of Strathclyde, Glasgow G1 1XQ, UK

UK Health Security Agency, London E14 4PU, UK

References (100+)

Show source-provided references
1. Contact-tracing and disease control10.1098/rspb.2003.2554 ↗
2. Digital contact-tracing for COVID-1910.1503/cmaj.200922 ↗
3. Public Health Measures to Control the Spread of the Severe Acute Respiratory Syndrome during the Outbreak in Toronto10.1056/NEJMoa032111 ↗
4. Swanson, K.C., Altare, C., Wesseh, C.S., Nyenswah, T., Ahmed, T., Eyal, N., Hamblion, E.L., Lessler, J., Peters, D.H., and Altmann, M. (2018). Contact-tracing performance during the Ebola epidemic in Liberia, 2014–2015. PLoS Neglected Trop. Dis., 12.10.1371/journal.pntd.0006762 ↗
5. Digital contact-tracing technologies in epiDemics: A rapid review
6. Best Practice Guidance for Digital Contact-tracing Apps: A Cross-disciplinary Review of the Literature10.2196/27753 ↗
7. How ‘big data’ can make big impact: Findings from a systematic review and a longitudinal case study10.1016/j.ijpe.2014.12.031 ↗
8. Quantifying SARS-CoV-2 transmission suggests epidemic control with digital contact-tracing10.1126/science.abb6936 ↗
9. Gillmor, D.K. (2020). Principles for Technology-Assisted Contact-Tracing, American Civil Liberties Union. ACLU White Paper.
10. An effective approach to mobile device management: Security and privacy issues associated with mobile applications10.1016/j.digbus.2020.100001 ↗
11. Vaughan, A. (2023, November 10). There Are Many Reasons Why COVID-19 Contact-Tracing Apps May Not Work|New Scientist. Available online: https://www.newscientist.com/article/2241041-there-are-many-reasons-why-covid-19-contact-tracing-apps-may-not-work/.
12. Chang, S. (2023, November 10). COVID-19 Contact-Tracing Apps Reach 9% Adoption in Most Populous Countries. Available online: https://sensortower.com/blog/contact-tracing-app-adoption.
13. (2023, November 10). NHS COVID-19 App: Isle of Wight Pilot Evaluation Report NHS Test and Trace Programme; NHS: UK, Available online: https://assets.publishing.service.gov.uk/media/606de293e90e076f54661429/IoW_EA_report_April_2020.pdf.
14. Farronato, C. (2023, November 10). How to Get People to Actually Use Contact-Tracing Apps. Available online: https://hbr.org/2020/07/how-to-get-people-to-actually-use-contact-tracing-apps.
15. Privacy versus safety in contact-tracing apps for coronavirus disease 201910.1177/2055207620941673 ↗
16. Belief of having had unconfirmed COVID-19 infection reduces willingness to participate in app-based contact-tracing10.1038/s41746-020-00357-5 ↗
17. Böhm, V., Wolff, C., Geiselhart, C., Karl, E., and Kleindienst, N. (2021). Investigating Barriers for the Adoption of the German Contact-Tracing App and the Influence of a Video Intervention on User Acceptance. Proceedings of Mensch und Computer, ACM.10.1145/3473856.3474017 ↗
18. Gao, G., Lang, R., Oxoby, R.J., Mourali, M., Sheikh, H., Fullerton, M.M., Tang, T., Manns, B.J., Marshall, D.A., and Hu, J. (2022). Drivers of downloading and reasons for not downloading COVID-19 contact-tracing and exposure notification apps: A national crosssectional survey. PLoS ONE, 17.10.1371/journal.pone.0269783 ↗
19. Predictors to Use Mobile Apps for Monitoring COVID-19 Symptoms and Contact-tracing: Survey among Dutch Citizens10.2196/28416 ↗
20. Public opinion of the Irish “COVID Tracker” digital contact-tracing App: A national survey
21. Oyibo, K., and Morita, P.P. (2022). COVID Alert: Factors Influencing the Adoption of Exposure Notification Apps Among Canadian Residents. Front. Digit. Health, 4.10.3389/fdgth.2022.842661 ↗
22. Concerns and misconceptions about the australian government’s COVIDsafe app: Cross-sectional survey study10.2196/23081 ↗
23. Drivers of Acceptance of COVID-19 Proximity Tracing Apps in Switzerland: Panel Survey Analysis10.2196/25701 ↗
24. User Experiences of the NZ COVID Tracer App in New Zealand: Thematic Analysis of Interviews10.2196/26318 ↗
25. Bosco, C., Cvajner, M., and ACM (2021, January 11–13). A qualitative analysis of users’ attitudes towards the Italian contact-tracing app. Proceedings of the 14th Biannual Conference of the Italian Sigchi Chapter (Chiitaly 2021), Bolzano, Italy.10.1145/3464385.3464732 ↗
26. App use and usability of a barcode-based digital platform to augment COVID-19 contact-tracing: Postpilot survey and paradata analysis10.2196/25859 ↗
27. Osmanlliu, E., Paquette, J., Duarte, M.A.R., Bédard, S., de Marcellis-Warin, N., Zhegu, M., Régis, C., Bouthillier, M.-E., Grenier, A.-D., and Lewis, P. (2022). Public Perspectives on Exposure Notification Apps: A Patient and Citizen Co-Designed Study. J. Pers. Med., 12.10.3390/jpm12050729 ↗
28. Public adoption of and trust in the nhs COVID-19 contact-tracing app in the united kingdom: Quantitative online survey study10.2196/29085 ↗
29. Critical Appraisal Skills Programme (2018). CASP (Cohort Study, Randomised Controlled Trial, Qualitative) Checklist, Critical Appraisal Skills Programme. Available online: https://casp-uk.net/casp-tools-checklists/.
30. Using thematic analysis in psychology10.1191/1478088706qp063oa ↗
31. An Investigation of Perceived Risk at the Brand Level10.1177/002224377601300210 ↗
32. Factors Influencing Intention to use the COVID-19 Contact-tracing Application10.3844/jcssp.2022.453.462 ↗
33. Duan, S.X., and Deng, H. (2022). Exploring privacy paradox in contact-tracing apps adoption. Internet Res.10.1108/INTR-03-2021-0160 ↗
34. Business as usual through contact-tracing app: What influences intention to download?10.1080/0267257X.2021.2017323 ↗
35. Perceptions of users and non-users of an early contact-tracing mobile application to fight COVID-19 spread: A value-based empirical investigation10.1108/ITP-01-2021-0026 ↗
36. One for all, all for one: Social considerations in user acceptance of contact-tracing apps using longitudinal evidence from Germany and Switzerland10.1016/j.ijinfomgt.2022.102473 ↗
37. Dooley, S., Turjeman, D., Dickerson, J.P., and Redmiles, E.M. (May, January 29). Field Evidence of the Effects of Privacy, Data Transparency, and Pro-Social Appeals on COVID-19 App Attractiveness. Proceedings of the 2022 CHI Conference on Human Factors in Computing Systems, New Orleans, LA, USA.10.1145/3491102.3501869 ↗
38. Alkhalifah, A., and Bukar, U.A. (2022). Examining the Prediction of COVID-19 Contact-Tracing App Adoption Using an Integrated Model and Hybrid Approach Analysis. Front. Public Health, 10.10.3389/fpubh.2022.847184 ↗
39. Exploring User Acceptance Determinants of COVID-19-Tracing Apps to Manage the Pandemic
40. Adoption of a contact-tracing app for containing COVID-19: A health belief model approach10.2196/20572 ↗
41. A learning health system approach to COVID-19 exposure notification system rollout10.1002/lrh2.10290 ↗
42. Equity and Accessibility of Washington State’s COVID-19 Digital Exposure Notification Tool (WA Notify): Survey and Listening Sessions Among Community Leaders10.2196/38193 ↗
43. Who does or does not use the “Corona-Warn-App” and why?10.1093/eurpub/ckaa239 ↗
44. Investigating factors that affect the adoption of COVID-19 contact-tracing apps: A privacy calculus perspective
45. A privacy calculus model for contact-tracing apps: Analyzing the use behavior of the German Corona-Warn-App with a longitudinal user study10.1016/j.cose.2023.103338 ↗
46. Utilizing health behavior change and technology acceptance models to predict the adoption of COVID-19 contact-tracing apps: Cross-sectional survey study10.2196/25447 ↗
47. “To our health!” Perceived benefits offset privacy concerns in using national contact-tracing apps10.1108/LHT-12-2021-0461 ↗
48. Navigating privacy concerns through societal benefits: A case of digital contact-tracing applications10.1002/cb.2029 ↗
49. Citizen’s adoption intention toward contact-tracing apps: An analysis using innovation resistance theory10.1002/pa.2844 ↗
50. Understanding the perceptions of UK COVID-19 contact-tracing app in the BAME community in Leicester10.1108/JICES-06-2021-0071 ↗
51. Individual costs and societal benefits: The privacy calculus of contact-tracing apps
52. Where horizontal and vertical surveillances meet: Sense-making of US COVID-19 contact-tracing apps during a health crisis10.1177/20501579221078674 ↗
53. Ready or Not for Contact-tracing? Investigating the Adoption Intention of COVID-19 Contact-Tracing Technology Using an Extended Unified Theory of Acceptance and Use of Technology Model10.1089/cyber.2020.0483 ↗
54. Farrell, W., Pammer, M., and Drebert, J. (2021). COVID Contact-Tracing App Technology Acceptance among Students, Management Center International, Department of Business Administration Online.10.1109/ICTE51655.2021.9584605 ↗
55. Tomczyk, S. (2022). Appsolutely secure? Psychometric properties of the German version of an app information privacy concerns measure during COVID-19. Front. Psychol., 13.10.3389/fpsyg.2022.899092 ↗
56. I use a COVID-19 contact-tracing app. Do you? Regulatory focus and the intention to engage with contact-tracing technology
57. Explaining citizens’ resistance to use digital contact-tracing apps: A mixed-methods study10.1016/j.ijinfomgt.2021.102468 ↗
58. Adoption and continued use of mobile contact-tracing technology: Multilevel explanations from a three-wave panel survey and linked data10.1136/bmjopen-2021-053327 ↗
59. Analysis of the factors affecting the adoption and compliance of the NHS COVID-19 mobile application: A national cross-sectional survey in England10.1136/bmjopen-2021-053395 ↗
60. Trestian, R., Celeste, E., Xie, G., Lohar, P., Bendechache, M., Brennan, R., and Ta, I. (2022, January 16–18). The Privacy Paradox-Investigating People’s Attitude Towards Privacy in a Time of COVID-19. Proceedings of the 14th International Conference on Communications, COMM 2022-Proceedings, Bucharest, Romania.10.1109/COMM54429.2022.9817170 ↗
61. To Use or Not to Use a COVID-19 Contact-tracing App: Mixed Methods Survey in Wales10.2196/29181 ↗
62. Expert insights on digital contact-tracing: Interviews with contact-tracing policy professionals in New Zealand10.1093/heapro/daac059 ↗
63. An analysis of the COVID-19 contact-tracing App in South Africa: Challenges experienced by users10.1080/20421338.2022.2043808 ↗
64. How optimistic do citizens feel about digital contact-tracing?—Perspectives from developing countries10.1108/IJPCC-10-2020-0166 ↗
65. Padyab, A., and Kävrestad, J. (2021). Perceived Privacy Problems Within Digital Contact-Tracing: A Study Among Swedish Citizens, University of Skövde.10.1007/978-3-030-78120-0_18 ↗
66. Reasons for Nonuse, Discontinuation of Use, and Acceptance of Additional Functionalities of a COVID-19 Contact-tracing App: Cross-sectional Survey Study10.2196/22113 ↗
67. Privacy concerns with COVID-19 tracking apps: A privacy calculus approach10.1108/JCM-03-2021-4510 ↗
68. Benham, J.L., Lang, R., Burns, K.K., MacKean, G., Léveillé, T., McCormack, B., Sheikh, H., Fullerton, M.M., Tang, T., and Boucher, J.-C. (2021). Attitudes, current behaviours and barriers to public health measures that reduce COVID-19 transmission: A qualitative study to inform public health messaging. PLoS ONE, 16.10.1371/journal.pone.0246941 ↗
69. Modeling Adoption, Security, and Privacy of COVID-19 Apps: Findings and Recommendations From an Empirical Study Using the Unified Theory of Acceptance and Use of Technology10.2196/35434 ↗
70. Coronalert, H.F. (2021). To Download, or Not to Download, That Is the Question: Investigating Belgian Residents’ Motivation to Download or Not Download the COVID-19 Contact-Tracing App, Univeristy of Salzburg, Vrije Universiteit Brussel, EMJMD DCLead.
71. Impact of Privacy Messaging on COVID-19 Exposure Notification App Downloads: Evidence From a Randomized Experiment10.1016/j.focus.2022.100059 ↗
72. Perception and Use of COVID Contact-tracing Mobile Applications in New York State (NYS)10.1002/pra2.746 ↗
73. Barriers to the large-scale adoption of a COVID-19 contact-tracing app in germany: Survey study10.2196/23362 ↗
74. Citizens’ Attitudes to Contact-tracing Apps10.1017/XPS.2020.30 ↗
75. Privacy at risk? Understanding the perceived privacy protection of health code apps in China10.1177/20539517221135132 ↗
76. One-time decision or continual adjustment? A longitudinal study of the within-person privacy calculus among users and non-users of a COVID-19 contact-tracing app10.1080/15213269.2022.2092750 ↗
77. Understanding Trust and Changes in Use After a Year With the NHS COVID-19 Contact-tracing App in the United Kingdom: Longitudinal Mixed Methods Study10.2196/40558 ↗
78. Seberger, J.S., and Patil, S. (2021). Us and Them (and It): Social Orientation, Privacy Concerns, and Expected Use of Pandemic-Tracking Apps in the United States, Indiana University Bloomington.10.1145/3411764.3445485 ↗
79. COVID-19 Contact-tracing and Privacy: A Longitudinal Study of Public Opinion10.1145/3480464 ↗
80. Digital contact-tracing in France: Uptake by COVID-19 risk factor and by exposure risk10.1093/pubmed/fdab349 ↗
81. Oyibo, K., and Morita, P.P. (2022). The Role UX Design Attributes Play in the Perceived Persuasiveness of Contact-tracing Apps. Multimodal Technol. Interact., 6.10.3390/mti6100088 ↗
82. Should Digital Contact-tracing Technologies be used to Control COVID-19? Perspectives from an Australian Public Deliberation10.1007/s10728-021-00441-1 ↗
83. Ye, C., Yang, J., Zheng, M., and Cao, C. (2022, January 12–14). Research on the Willingness of Users’ Privacy Concerns To Use Epidemic Prevention Technology Under the Background of the New Coronavirus Epidemic. Proceedings of the 15th IADIS International Conference Information Systems 2022, Online.
84. Factors impacting the use of the NZ COVID Tracer application in New Zealand10.1016/j.smhl.2022.100278 ↗
85. Xie, G., Lohar, P., Florea, C., Bendechache, M., Trestian, R., Brennan, R., Connolly, R., and Tal, I. (2021). Privacy in Times of COVID-19: A Pilot Study in the Republic of Ireland, Adapt Centre Dublin City University.10.1145/3465481.3470096 ↗
86. Widening or narrowing inequalities? The equity implications of digital tools to support COVID-19 contact-tracing: A qualitative study
87. User Privacy, Surveillance and Public Health during COVID-19—An Examination of Twitterverse10.1007/s10796-022-10247-8 ↗
88. The insufficiency of the Malaysian contact-tracing app from the perspective of Chinese tourists: Preparing for international tourism in the post-COVID-19 world10.1016/j.heliyon.2022.e12154 ↗
89. Alsyouf, A., Lutfi, A., Al-Bsheish, M., Jarrar, M., Al-Mugheed, K., Almaiah, M.A., Alhazmi, F.N., Masa’deh, R., Anshasi, R.J., and Ashour, A. (2022). Exposure Detection Applications Acceptance: The Case of COVID-19. Int. J. Environ. Res. Public Health, 19.10.3390/ijerph19127307 ↗
90. Early perceptions of COVID-19 contact-tracing apps in German-speaking countries: Comparative mixed methods study10.2196/25525 ↗
91. From Shadow Profiles to Contact-tracing: Qualitative Research into Consent and Privacy10.5204/lthj.1874 ↗
92. Understanding ‘passivity’ in digital health through imaginaries and experiences of coronavirus disease 2019 contact-tracing apps10.1177/20539517221091138 ↗
93. Dowthwaite, L., Wagner, H.G., Babbage, C.M., Fischer, J.E., Barnard, P., Nichele, E., Vallejos, E.P., Clos, J., Portillo, V., and McAuley, D. (2022). The relationship between trust and attitudes towards the COVID-19 digital contact-tracing app in the UK. PLoS ONE, 17.10.1371/journal.pone.0276661 ↗
94. Ethical Perspectives in Sharing Digital Data for Public Health Surveillance Before and Shortly After the Onset of the COVID-19 Pandemic10.1080/10508422.2021.1884079 ↗
95. Determinants of the acceptance and adoption of a digital contact-tracing tool during the COVID-19 pandemic in Singapore10.1017/S0950268822000401 ↗
96. Enabling User-centered Privacy Controls for Mobile Applications: COVID-19 Perspective10.1145/3434777 ↗
97. Attitudes Towards COVID-19 Contact-tracing Apps: A Cross-National Survey10.1109/ACCESS.2021.3136649 ↗
98. To disclose or not to disclose? Factors related to the willingness to disclose information to a COVID-19 tracing app10.1080/1369118X.2022.2050418 ↗
99. The more the merrier! Barriers and facilitators to the general public’s use of a COVID-19 contact-tracing app in New Zealand10.1080/17538157.2021.1951274 ↗
100. Health care students’ knowledge of and attitudes, beliefs, and practices toward the french COVID-19 app: Cross-sectional questionnaire study10.2196/26399 ↗