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Objectives: Our study investigates the extent to which uptake of a COVID-19 digital contact-tracing (DCT) app among the Dutch population is affected by its configurations, its societal effects, and government policies toward such an app. Methods: We performed a discrete choice experiment among Dutch adults including 7 attributes, that is, who gets a notification, waiting time for testing, possibility for shops to refuse customers who have not installed the app, stopping condition for contact tracing, number of people unjustifiably quarantined, number of deaths prevented, and number of households with financial problems prevented. The data were analyzed by means of panel mixed logit models. Results: The prevention of deaths and financial problems of households had a very strong influence on the uptake of the app. Predicted app uptake rates ranged from 24% to 78% for the worst and best possible app for these societal effects. We found a strong positive relationship between people's trust in government and people's propensity to install the DCT app. Conclusions: The uptake levels we find are much more volatile than the uptake levels predicted in comparable studies that did not include societal effects in their discrete choice experiments. Our finding that the societal effects are a major factor in the uptake of the DCT app results in a chicken-or-the-egg causality dilemma. That is, the societal effects of the app are severely influenced by the uptake of the app, but the uptake of the app is severely influenced by its societal effects., Transport and Logistics

Objectives: To obtain public support for the active disinvestment (i.e. policy decision to stop reimbursement) of healthcare interventions, it is important to have insight in what the public thinks about disinvestment and which considerations they find relevant in this context. Currently, evidence on relevant considerations in the disinvestment context is limited. Therefore, this study aimed to explore the societal views in the Netherlands on the active disinvestment of healthcare interventions and obtain insight into the considerations that are relevant for those holding the different views. Methods: A Q-methodology study was conducted among a purposively selected sample of citizens (n = 43). Data were collected in June and July 2019. Participants individually ranked a set of 43 statements broadly covering the issues that participants could consider relevant in the disinvestment context, from ‘least agree’ to ‘most agree’. Qualitative feedback on the statement ranking was collected from each participant using a questionnaire. Principal component analysis followed by oblimin rotation was used to identify clusters of participants with similar statement rankings. These clusters/factors were interpreted as distinct viewpoints using the factor arrays and qualitative questionnaire responses of participants. Results: Four viewpoints were identified. People holding viewpoint I believe that reimbursement of necessary healthcare should be maintained, irrespective of its costs. People holding viewpoint II agree with viewpoint I, although they believe that necessity should be objectively determined. People holding viewpoint III think that unnecessary, ineffective and inefficient healthcare should be disinvested. People holding viewpoint IV, consider it most important that disinvestment decision-making processes are transparent and consistent. Conclusion: Insight in the distinct viewpoints identified in this study contributes to a better understan

De overheid wil een corona-app introduceren. Met keuze-experimenten onderzoeken we de voorkeuren van Nederlanders voor de inrichting van deze app. Beleidsmakers kunnen de uitkomsten gebruiken om het draagvlak voor de app en het aantal mensen dat deze installeert te vergroten. IN HET KORT: ●●Een op de drie Nederlanders zegt de corona-app sowieso te zullen installeren, een op de drie sowieso niet en een op de drie twijfelt. ●●Voorstanders vertrouwen de overheid bij de omgang met de data, terwijl tegenstanders de overheid wantrouwen. ●●Het advies dat Nederlanders aan de overheid geven over de app verschilt nauwelijks van de beslissing die ze zelf zouden nemen., Transport and Logistics