BACKGROUND
The silent transmission of COVID-19 has led to an exponential growth of fatal infections. With over 4 million deaths world-wide, the need to control and stem transmission has never been more critical. New COVID-19 vaccines offer hope. However, administration timelines, long-term protection, and effectiveness against potential variants are still unknown. In this context, Contact Tracing, and digital Contact Tracing Apps (CTAs) continue to offer a mechanism to help contain transmission, keep people safe, and help kickstart economies. However, CTAs must address a wide range of often conflicting concerns which make their development/evolution complex: for example, the app must preserve citizens’ privacy whilst gleaning their close contacts and as much epidemiological information as possible.
OBJECTIVE
In this paper, we derive a compare-and-contrast evaluative framework for CTAs that integrates and expands upon existing works in this domain, with a particular focus on citizen adoption, we call this framework the Citizen-Focused Compare-and-Contrast Evaluation Framework (C3EF) for CTAs.
METHODS
The framework has been derived using an iterative approach. First, we reviewed literature on CTAs and mHealth app evaluations, from which we derived a preliminary set of attributes and organizing pillars. These attributes and the probing questions which we formulated, were iteratively validated, augmented, and refined by applying the provisional framework against a selection of CTAs. Each framework pillar was then subjected to internal cross-team scrutiny where domain experts cross-checked sufficiency, relevancy, specificity, and non-redundancy of the attributes, and their organization in pillars. The consolidated framework was further validated on the selected CTAs to create a finalized version of C3EF for CTAs which we offer in this paper.
RESULTS
The final framework presents seven pillars exploring issues related to CTA’s design, adoption, and use: (General) Characteristics, Usability, Data Protection, Effectiveness, Transparency, Technical Performance, and Citizen Autonomy. The pillars encompass attributes, sub-attributes, and a set of illustrative questions (with associated example answers) to support app design, evaluation, and evolution. An online version of the framework has been made available to developers, health authorities, and others interested in assessing CTAs.
CONCLUSIONS
Our CTA framework provides a holistic compare-and-contrast tool that supports the work of decision-makers in the development and evolution of CTAs for citizens. This framework supports reflection on design decisions to better understand and optimize the design compromises in play when evolving current CTAs for increased public adoption. We intend it to act as a foundation for other researchers to build on and extend, as the technology matures and new CTAs become available.
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