Analysis of the Factors Affecting the Adoption and Compliance of the NHS COVID-19 Mobile Application: A National Online Questionnaire Survey in England

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.DesignA 60-item, anonymous online questionnaire, disseminated through social media outlets and email-lists by a team from Imperial College London.SettingEnglandParticipantsConvenience sample of 1036 responses, from participants aged 18 and above, between December 2020 to February 2021.Primary Outcome MeasuresEvaluate the compliance and public attitude towards the “NHS COVID-19” app, regarding its functionality and features. This included whether participants expectations were met, and their thoughts on the app privacy and security. Furthermore, to distinguish how usability, perception, and adoption differed with varying demographics and user values.ResultsFair app compliance was identified, with the app meeting expectations of 62.1% of participants who stated they downloaded it after weighted analysis. 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 app’s functionality and privacy concerns were possibly reasons why users did not download it. A readability analysis of the text revealed that app information was conveyed at a level which might only be accessible to under 60% of the population. The study highlighted issues related to the potential 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, there remained issues regarding participants’ perceived knowledge of the app functionality, potentially affecting compliance. Therefore, we recommended improvements regarding the delivery and presentation of the app’s information, and highlighted the potential need for the ability to check out of venues to reduce the number of false positive contacts.Strengths and LimitationsThis is the first study assessing the perceived usability and functionality of the “NHS COVID-19” app directly from app users.Diverse sample size, with representation from all major regions of England.Statistical analysis to compare perceived app usability and functionality across demographics and the participants values regarding privacy and information.Study was conducted during lockdown where app use may have been minimal.Study 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.