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. 2023 Oct 20:25:e45549.
doi: 10.2196/45549.

Smartphone Apps for Containing the COVID-19 Pandemic in Germany: Qualitative Interview Study With Experts Based on Grounded Theory

Dennis Krämer  1 , Elisabeth Brachem  2 , Lydia Schneider-Reuter  2 , Isabella D'Angelo  3 , Jochen Vollmann  2 , Joschka Haltaufderheide  4
Affiliations

Smartphone Apps for Containing the COVID-19 Pandemic in Germany: Qualitative Interview Study With Experts Based on Grounded Theory

Dennis Krämer et al. J Med Internet Res. .

Abstract

Background: Smartphone apps, including those for digital contact tracing (DCT), played a crucial role in containing infections during the COVID-19 pandemic. Their primary function is to generate and disseminate information to disrupt transmissions based on various events, such as encounters, vaccinations, locations, or infections. Although the functionality of these apps has been extensively studied, there is still a lack of qualitative research addressing critical issues.

Objective: We will demonstrate that the use of DCT presents a challenge due to the tension between continuous health monitoring and uncertainties related to transparency and user sovereignty. On one hand, DCT enables the monitoring of various risk factors, including data-based calculations of infection probabilities. On the other hand, continuous risk management is intertwined with several uncertainties, including the unclear storage of personal data, who has access to it, and how it will be used in the future.

Methods: We focus on the German "Corona-Warn-App" and support our argument with empirical data from 19 expert interviews conducted between 2020 and 2021. The interviews were conducted using a semistructured questionnaire and analyzed according to the principles of grounded theory.

Results: Our data underscores 3 dimensions: transparency, data sovereignty, and the east-west divide. While transparency is considered an essential foundation for establishing trust in the use of DCT by providing a sense of security, data sovereignty is seen as a high value during the pandemic, protecting users from an undesired loss of control. The aspect of the east-west divide highlights the idea of incorporating sociocultural values and standards into technology, emphasizing that algorithms and data-driven elements, such as distance indicators, encounters, and isolations, are also influenced by sociocultural factors.

Conclusions: The effective use of DCT for pandemic containment relies on achieving a balance between individual control and technological prevention. Maximizing the technological benefits of these tools is crucial. However, users must also be mindful of the information they share and maintain control over their shared data.

Keywords: COVID-19 pandemic; Corona-Warn-App; Germany; eHealth; health technology; mobile phone; qualitative research; sovereignty; transparency.

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Conflict of interest statement

Conflicts of Interest: DK, JH, and JV are guest editors of the theme issue “The Present and Future of Pandemic Technologies” in the Journal of Medical Internet Research at the time of this publication. They were not involved in any editorial decisions with regard to this manuscript.

Figures

Figure 1
Figure 1
Overview of the Corona-Warn-App.
Figure 2
Figure 2
Steps of the empirical analysis.
Figure 3
Figure 3
Overview of the meta- and subcategories.
Figure 4
Figure 4
Overview of different dimensions of transparency.
See this image and copyright information in PMC

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