Use of Digital COVID-19 Exposure Notifications at a Large Gathering: Survey Analysis of Public Health Conference Attendees

Caitlin M Drover; Adam S Elder; Brandon L Guthrie; Debra Revere; Nicole L Briggs; Laura M West; Amanda Higgins; William B Lober; Bryant T Karras; Janet G Baseman

doi:10.2196/50716

Use of Digital COVID-19 Exposure Notifications at a Large Gathering: Survey Analysis of Public Health Conference Attendees

JMIR Form Res. 2024 Mar 18:8:e50716. doi: 10.2196/50716.

Authors

Caitlin M Drover¹, Adam S Elder¹, Brandon L Guthrie^{1

2}, Debra Revere³, Nicole L Briggs¹, Laura M West⁴, Amanda Higgins⁴, William B Lober^{2

5

6}, Bryant T Karras⁴, Janet G Baseman¹

Affiliations

¹ Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, United States.
² Department of Global Health, School of Public Health, University of Washington, Seattle, WA, United States.
³ Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WA, United States.
⁴ Department of Health, Washington State, Tumwater, WA, United States.
⁵ Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, WA, United States.
⁶ Department of Biomedical Informatics and Medical Education, School of Medicine, University of Washington, Seattle, WA, United States.

PMID: 38498047
PMCID: PMC10953810
DOI: 10.2196/50716

Abstract

Background: WA Notify was Washington State's smartphone-based COVID-19 digital exposure notification (EN) tool, which was used to help limit the spread of COVID-19 between November 30, 2020, and May 11, 2023. Following the 2022 Washington State Public Health Association Annual Conference, attendees who had WA Notify activated began receiving ENs alerting them to a possible COVID-19 exposure during the conference. A survey was emailed to all conference attendees to measure WA Notify adoption, mechanisms through which attendees received ENs, and self-reported engagement in protective behaviors postexposure.

Objective: This study aimed to learn more about the experiences of WA Notify adopters and nonadopters who may have been exposed to COVID-19 at a large group gathering.

Methods: A web-based survey administered through REDCap (Research Electronic Data Capture; Vanderbilt University) was sent to all attendees of the Washington State Public Health Association conference. Self-reported demographic information and characteristics of respondents were summarized. Regression models were used to estimate relative risks to compare WA Notify adoption and testing behaviors between groups.

Results: Of the 464 total registered attendees who were sent the survey, 205 (44%) responses were received; 201 eligible attendees were included in this analysis. Of those, 149 (74%) respondents reported having WA Notify activated on their phones at the time of the conference. Among respondents with WA Notify activated, 54% (n=77) reported learning of their potential exposure from a WA Notify EN. Respondents who reported that they did not have WA Notify activated and learned of their potential exposure via the event-wide email from conference organizers were 39% less likely to test for COVID-19 compared to respondents with WA Notify activated who learned of their potential exposure from the email (relative risk 0.61, 95% CI 0.40-0.93; P=.02), and this gap was even larger when compared to respondents who learned of their exposure from a WA Notify EN. The most commonly cited reason for not having WA Notify activated was privacy concerns (n=17, 35%), followed by not wanting to receive ENs (n=6, 12%) and being unaware of WA Notify (n=5, 10%).

Conclusions: Digital EN systems are an important tool to directly and anonymously notify close contacts of potential exposures and provide guidance on the next steps in a timely manner. Given the privacy concerns, there is still a need for increasing transparency surrounding EN technology to increase uptake by the public if this technology were to be used in the future to slow the spread of communicable diseases.

Keywords: COVID-19; conference; contact tracing; digital public health tool; digital tool; exposure notification; online survey; public health; survey analysis.

©Caitlin M Drover, Adam S Elder, Brandon L Guthrie, Debra Revere, Nicole L Briggs, Laura M West, Amanda Higgins, William B Lober, Bryant T Karras, Janet G Baseman. Originally published in JMIR Formative Research (https://formative.jmir.org), 18.03.2024.