Challenges for Nontechnical Implementation of Digital Proximity Tracing During the COVID-19 Pandemic: Media Analysis of the SwissCovid App.
Challenges for Nontechnical Implementation of Digital Proximity Tracing During the COVID-19 Pandemic: Media Analysis of the SwissCovid App.
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DOI：
10.2196/25345
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发表时间：
2021-02-26
影响因子：
5
通讯作者：
von Wyl V
中科院分区：
文献类型：
--
作者：
von Wyl V
一些国家已经发布了数字近距离追踪 (DPT) 应用程序，以补充手动接触者追踪，以对抗 SARS-CoV-2 大流行。 DPT 旨在通知应用程序用户有关与 SARS-CoV-2 感染者的近距离接触情况，以便他们能够进行自我隔离。 DPT 应用程序的成功取决于用户的接受程度以及将 DPT 嵌入到流行病缓解策略中。通过检索 DPT 推出后前 3 个月内发表的媒体文章，对瑞士 DPT 的实施情况进行了评估，为其他国家的类似行动提供参考。该研究的第二个目的是在报告的 DPT 实施挑战与规划和优化复杂数字健康干预措施的标准化过程理论之间建立联系，这可以为 DPT 设计和实施的决策提供有用的指导。在瑞士媒体数据库中搜索了 2020 年 7 月 4 日至 10 月 3 日期间以德语或法语发表的瑞士 DPT 应用程序 (SwissCovid) 上的文章。在结构化过程中，从被认为相关的文章中手动提取主题并进行聚类。提取的主题被映射到四个 NPT 结构，反映了从规划、利益相关者加入、执行到批判性评估的干预开发流程。连贯性构建描述了利益相关者的意义建构，认知参与构建反映了参与者为建立干预参与而做出的努力，集体行动是指干预执行和利益相关者为使干预发挥作用而做出的共同努力，反思性监控是指集体风险效益评估以创造改进。在 94 篇被认为相关并被选择进行仔细检查的文章中，有 38 篇提供了有关实施挑战的独特信息。确定了五个挑战领域：沟通挑战、DPT 与其他流程交互的挑战、担心与既定的流行病缓解措施发生资源竞争、DPT 有效性不明确以及扩大用户覆盖范围和合规性的障碍。具体来说，几篇文章提到了不明确的 DPT 好处，这会影响承诺并引起不同卫生系统参与者对资源竞争的担忧。此外，媒体报道指出了流程界面的挑战，例如通知级联中的延迟或责任不明确，以及卫生系统参与者的误解和未满足的沟通需求。最后，报告指出，激励措施不一致，不仅针对公众的应用程序使用，而且针对应用程序通知级联中其他参与者的流程参与。 NPT 提供了一个非常合适的框架，可以将不同的 DPT 实施挑战结合起来，并强调改进策略，即更好地协调利益相关者的激励措施，或针对利益相关者进行特定的沟通，以解决他们对 DPT 的担忧。 DPT 首批采用者之一的早期经验表明，非技术实施挑战可能会影响 DPT 的有效性。 NPT 分析为 DPT 实施提供了新颖的视角，并强调利益相关者参与开发和运营的必要性。
Several countries have released digital proximity tracing (DPT) apps to complement manual contact tracing for combatting the SARS-CoV-2 pandemic. DPT aims to notify app users about proximity exposures to persons infected with SARS-CoV-2 so that they can self-quarantine. The success of DPT apps depends on user acceptance and the embedding of DPT into the pandemic mitigation strategy. By searching for media articles published during the first 3 months after DPT launch, the implementation of DPT in Switzerland was evaluated to inform similar undertakings in other countries. The second aim of the study was to create a link between reported DPT implementation challenges and normalization process theory for planning and optimizing complex digital health interventions, which can provide useful guidance for decision-making in DPT design and implementation. A Swiss media database was searched for articles on the Swiss DPT app (SwissCovid) published in German or French between July 4 and October 3, 2020. In a structured process, topics were extracted and clustered manually from articles that were deemed pertinent. Extracted topics were mapped to four NPT constructs, which reflected the flow of intervention development from planning, stakeholder onboarding, and execution to critical appraisal. Coherence constructs describe sense-making by stakeholders, cognitive participation constructs reflect participants’ efforts to create engagement with the intervention, collective actions refer to intervention execution and joint stakeholder efforts to make the intervention work, and reflexive monitoring refers to collective risk-benefit appraisals to create improvements. Out of 94 articles deemed pertinent and selected for closer inspection, 38 provided unique information on implementation challenges. Five challenge areas were identified: communication challenges, challenges for DPT to interface with other processes, fear of resource competition with established pandemic mitigation measures, unclear DPT effectiveness, and obstacles to greater user coverage and compliance. Specifically, several articles mentioned unclear DPT benefits to affect commitment and to raise fears among different health system actors regarding resource competition. Moreover, media reports indicated process interface challenges such as delays or unclear responsibilities in the notification cascade, as well as misunderstandings and unmet communication needs from health system actors. Finally, reports suggested misaligned incentives, not only for app usage by the public but also for process engagement by other actors in the app notification cascade. NPT provided a well-fitting framework to contextualize the different DPT implementation challenges and to highlight improvement strategies, namely a better alignment of stakeholder incentives, or stakeholder-specific communication to address their concerns about DPT. Early experiences from one of the first adopters of DPT indicate that nontechnical implementation challenges may affect the effectiveness of DPT. The NPT analysis provides a novel perspective on DPT implementation and stresses the need for stakeholder inclusion in development and operationalization.
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