The relationship between trust and attitudes towards the COVID-19 digital contact-tracing app in the UK

Liz Dowthwaite; Hanne Gesine Wagner; Camilla May Babbage; Joel E. Fischer; Pepita Barnard; Elena Nichele; Elvira Perez Vallejos; Jeremie Clos; Virginia Portillo; Derek McAuley

doi:10.1371/journal.pone.0276661

Peer Review History

Original SubmissionJune 27, 2022
8 Aug 2022 Decision Letter - Mukhtiar Baig, Editor PONE-D-22-17800The Relationship between Trust and Attitudes towards the COVID-19 Digital Contact-Tracing App in the UKPLOS ONE Dear Dr. Dowthwaite, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please revise the manuscript as suggested by the reviewers. Please submit your revised manuscript by Sep 22 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. 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The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. In the ethics statement in the Methods, you have specified that verbal consent was obtained. Please provide additional details regarding how this consent was documented and witnessed, and state whether this was approved by the IRB. 3. You indicated that you had ethical approval for your interview study. Please clarify whether minors were involved in the interviews. If so, in your Methods section, please ensure you have also stated whether you obtained consent from parents or guardians of the minors included in the study or whether the research ethics committee or IRB specifically waived the need for their consent. 4. You indicated that you had ethical approval for your online survey study. In your Methods section, please ensure you have also stated whether you obtained consent from parents or guardians of the minors included in the study or whether the research ethics committee or IRB specifically waived the need for their consent. 5. Please include your full ethics statement in the ‘Methods’ section of your manuscript file. In your statement, please include the full name of the IRB or ethics committee who approved or waived your study, as well as whether or not you obtained informed written or verbal consent. If consent was waived for your study, please include this information in your statement as well. 6. Please include a caption for figure 2. Additional Editor Comments: Following are a few other observations sent by the third reviewer via email. Please reply to these comments as well. • Please write a clear justification for the work • No clear research question • No structure to the abstract • Chunks of the text in the Introduction belong in the Discussion • It needs a restructure • It also seems quite late in the day to be covering this topic • I’m not sure it adds significantly to the already published work • Referring to the attached paper might help the authors – it’s not in their reference list Jones K, Thompson R. To Use or Not to Use a COVID-19 Contact Tracing App: Mixed Methods Survey in Wales. JMIR mHealth and uHealth. 2021 Nov 22;9(11):e29181. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Partly ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: I Don't Know ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: This is a strong paper with some useful findings, and one which I read with interest as someone with similar data I am working on myself. I can therefore see that this is a well conducted piece and that the findings are useful, and with application to other public health situations in future, beyond Covid, potentially. The measures are sound, the analysis correct, and the writing clear. I have just one suggestion, which might be useful to make reference to in the latter part of the paper. It would have been useful to recognise that trust in apps, the government, and things in general, are usually underpinned by various psychological variables such as intolerance of uncertainty, authoritarianism, locus of control and attachment style. So, it would have been useful to measure one or more of these, and then partial out those variables in order to feel more sure that the findings are not polluted by such factors. It's not essential for publication, but I think it might strengthen the limitations/conclusions to recognise this. Reviewer #2: Thank you for asking me to review this interesting paper on public trust in the COVID-19 contact tracing apps. In this paper, the authors draw on semi-structured interviews with 12 people prior to the introduction of a contact tracing app in the UK, and a large scale questionnaire to highlight a number of key points. Most interesting (and novel at least in my opinion) are points 2 and 4 (noted on page 3 of the manuscript). I think there are some issues that the authors could address to further strengthen their paper. I have note these below. I find it hard to marry the two data sets and I think more work is needed to make it clear that the combination is meaningful. 12 semi-structured interviews prior to seeing a contact tracing app (and reflecting on their use in other countries) seems rather divorced from data once a formal contact tracing app had been introduced and means the comparison is between the hypothetical and the real. In the discussion of trust, I think it’s important to also note and learn from accounts of civic participation (in health), accounts of altruism and participation in other activities that supporting the NHS, for example, blood donation (and rationales for doing so). Titmuss’s work on blood is donation is a good starting point here (reference from a reprint - it was originally published in the 70s) Titmuss, R. (2018). The Gift Relationship: From Human Blood to Social Policy. Bristol University Press. Linked to these points about civic participation, there is also substantial work on the concept of solidarity which appears to me as something that should be noted and could help develop your discussion (particularly in relation to key findings 2 and 4.). Barbara Prainsack’s work is crucial here. She was also involved in a large pan Europe project on covid-19 with two papers that are linked to covid-19 apps that are currently not covered. These papers might help further develop your discussion of your findings. Federica Lucivero, Luca Marelli, Nora Hangel, Bettina Maria Zimmermann, Barbara Prainsack, Ilaria Galasso, Ruth Horn, Katharina Kieslich, Marjolein Lanzing, Elisa Lievevrouw, Fernandos Ongolly, Gabrielle Samuel, Tamar Sharon, Lotje Siffels, Emma Stendahl & Ine Van Hoyweghen (2022) Normative positions towards COVID-19 contact-tracing apps: findings from a large-scale qualitative study in nine European countries, Critical Public Health, 32:1, 5-18, DOI: 10.1080/09581596.2021.1925634 Zimmermann BM, Fiske A, Prainsack B, Hangel N, McLennan S, Buyx A Early Perceptions of COVID-19 Contact Tracing Apps in German-Speaking Countries: Comparative Mixed Methods Study J Med Internet Res 2021;23(2):e25525 doi: 10.2196/25525 Finally, I’m a little perplexed by finding 1 (from page 3). To me this appears pretty obvious and I wonder whether there is more nuance that could be teased out from the data. For example, does the data allow the authors to say anything about other rationales for adopting, adopting and abandoning or avoiding the Contact Trace App? Is trust the highest scoring rationale (in relation to other rationales - like civic duty, trust in the NHS as opposed to the app etc and could these also be noted so it’s clear that the finding is important and contributes meaningfully to our knowledge. Data Availability: I've noted that data has been made available above (which I realise is incorrect based on the authors' statements) - this is just to note that the rationale for not making qualitative data available is sound to me (and common practice). ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. 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Revision 1
28 Sep 2022 Author Response Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone /s/file?id=wjVg/ PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone /s/file?id=ba62/ PLOSOne_formatting_sample_title_authors_affiliations.pdf - Files renamed as requested In the ethics statement in the Methods, you have specified that verbal consent was obtained. Please provide additional details regarding how this consent was documented and witnessed, and state whether this was approved by the IRB. - Clarified that this was in addition to the online consent form, and was approved You indicated that you had ethical approval for your interview study. Please clarify whether minors were involved in the interviews. If so, in your Methods section, please ensure you have also stated whether you obtained consent from parents or guardians of the minors included in the study or whether the research ethics committee or IRB specifically waived the need for their consent. - Clarified that no minors were involved in the study You indicated that you had ethical approval for your online survey study. In your Methods section, please ensure you have also stated whether you obtained consent from parents or guardians of the minors included in the study or whether the research ethics committee or IRB specifically waived the need for their consent - Clarified that no minors under 16 were involved in the study, and those under 18 did not require additional consent Please include your full ethics statement in the ‘Methods’ section of your manuscript file. In your statement, please include the full name of the IRB or ethics committee who approved or waived your study, as well as whether or not you obtained informed written or verbal consent. If consent was waived for your study, please include this information in your statement as well. - Information provided as requested Please include a caption for figure 2. - Figure 2 was mislabelled as figure 1 in the manuscript Reviewer 1 This is a strong paper with some useful findings, and one which I read with interest as someone with similar data I am working on myself. I can therefore see that this is a well conducted piece and that the findings are useful, and with application to other public health situations in future, beyond Covid, potentially. The measures are sound, the analysis correct, and the writing clear. - We thank the reviewer for this response I have just one suggestion, which might be useful to make reference to in the latter part of the paper. It would have been useful to recognise that trust in apps, the government, and things in general, are usually underpinned by various psychological variables such as intolerance of uncertainty, authoritarianism, locus of control and attachment style. So, it would have been useful to measure one or more of these, and then partial out those variables in order to feel more sure that the findings are not polluted by such factors. It's not essential for publication, but I think it might strengthen the limitations/conclusions to recognise this. - Thank you. We have added this consideration to the limitations of the paper. Reviewer 2 Thank you for asking me to review this interesting paper on public trust in the COVID-19 contact tracing apps. In this paper, the authors draw on semi-structured interviews with 12 people prior to the introduction of a contact tracing app in the UK, and a large scale questionnaire to highlight a number of key points. Most interesting (and novel at least in my opinion) are points 2 and 4 (noted on page 3 of the manuscript). - Thank you for this comment I find it hard to marry the two data sets and I think more work is needed to make it clear that the combination is meaningful. 12 semi-structured interviews prior to seeing a contact tracing app (and reflecting on their use in other countries) seems rather divorced from data once a formal contact tracing app had been introduced and means the comparison is between the hypothetical and the real. - We have added further justification at strategic places throughout the text, and added to limitations. This includes clarifying that we are looking at how the hypothetical (ie how people felt about the idea of the app and how they thought they’d feel about it’s release) relates to the real (how they actually felt when it was used ‘in the wild’) – rather than a comparison of the two. In the discussion of trust, I think it’s important to also note and learn from accounts of civic participation (in health), accounts of altruism and participation in other activities that supporting the NHS, for example, blood donation (and rationales for doing so). Titmuss’s work on blood is donation is a good starting point here (reference from a reprint - it was originally published in the 70s) Titmuss, R. (2018). The Gift Relationship: From Human Blood to Social Policy. Bristol University Press. - We thank the reviewer for this useful reference and have added it to the Discussion Linked to these points about civic participation, there is also substantial work on the concept of solidarity which appears to me as something that should be noted and could help develop your discussion (particularly in relation to key findings 2 and 4.). Barbara Prainsack’s work is crucial here. She was also involved in a large pan Europe project on covid-19 with two papers that are linked to covid-19 apps that are currently not covered. These papers might help further develop your discussion of your findings. - Federica Lucivero, Luca Marelli, Nora Hangel, Bettina Maria Zimmermann, Barbara Prainsack, Ilaria Galasso, Ruth Horn, Katharina Kieslich, Marjolein Lanzing, Elisa Lievevrouw, Fernandos Ongolly, Gabrielle Samuel, Tamar Sharon, Lotje Siffels, Emma Stendahl & Ine Van Hoyweghen (2022) Normative positions towards COVID-19 contact-tracing apps: findings from a large-scale qualitative study in nine European countries, Critical Public Health, 32:1, 5-18, DOI: 10.1080/09581596.2021.1925634 - Zimmermann BM, Fiske A, Prainsack B, Hangel N, McLennan S, Buyx A Early Perceptions of COVID-19 Contact Tracing Apps in German-Speaking Countries: Comparative Mixed Methods Study J Med Internet Res 2021;23(2):e25525 doi: 10.2196/25525 - Thank you for these points, we have added the suggested references to the Discussion Finally, I’m a little perplexed by finding 1 (from page 3). To me this appears pretty obvious and I wonder whether there is more nuance that could be teased out from the data. For example, does the data allow the authors to say anything about other rationales for adopting, adopting and abandoning or avoiding the Contact Trace App? Is trust the highest scoring rationale (in relation to other rationales - like civic duty, trust in the NHS as opposed to the app etc and could these also be noted so it’s clear that the finding is important and contributes meaningfully to our knowledge. - We have demoted point 1 to the final point, focussing on the lack of trust as one of the strongest reasons for not downloading, so that the summary focuses on the most interesting points Reviewer 3 Please write a clear justification for the work - Edited the Introduction to make the aims clearer No clear research question - Clarified the exploratory and descriptive nature of the paper No structure to the abstract - We have edited the abstract to make it clearly structured as background, method, results and implications. There is no requirement from PLOS One to use a specific (headered) structure Chunks of the text in the Introduction belong in the Discussion - Everything included in the Introduction was from previous studies rather than our own so we wanted to highlight them early on. We have added parts to the discussion which reflect back on these previous studies. It also seems quite late in the day to be covering this topic - Whilst this pandemic is on the way out, this paper gives insight into how members of the public may react to future interventions designed to tackle issues of public health. The lessons learnt are transferrable to future situations and we have made this clearer in the Discussion I’m not sure it adds significantly to the already published work - This paper includes a thematic analysis of data that has not appeared before, as well as many new tests of the relationship of trust to other factors. The previous paper did not look at the relationships between different factors at all. The inclusion of trust in the app as a scale to compare to other factors is entirely new. The vast majority of statistical analysis is new, but we had to re-report things like mean scores to contextualise these results. Referring to the attached paper might help the authors – it’s not in their reference list Jones K, Thompson R. To Use or Not to Use a COVID-19 Contact Tracing App: Mixed Methods Survey in Wales. JMIR mHealth and uHealth. 2021 Nov 22;9(11):e29181. - Thank you for the addition of this useful reference. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0276661.r002
12 Oct 2022 Decision Letter - Mukhtiar Baig, Editor The Relationship between Trust and Attitudes towards the COVID-19 Digital Contact-Tracing App in the UK PONE-D-22-17800R1 Dear Dr. Dowthwaite, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Mukhtiar Baig, Ph.D. Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0276661.r003
Formally Accepted
19 Oct 2022 Acceptance Letter - Mukhtiar Baig, Editor PONE-D-22-17800R1 The Relationship between Trust and Attitudes towards the COVID-19 Digital Contact-Tracing App in the UK Dear Dr. Dowthwaite: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Professor Mukhtiar Baig Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0276661.r004

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