COVID-19 Contact Tracing Application in Qatar

The study aimed at analyzing the publics attitude towards EHTERAZ using a mixed-method approach. Mixed method research is a study that employs both qualitative and quantitative methods to answer the research questions (Anguera et al., 2018). Researchers utilize mixed-method approaches to validate qualitative findings using quantitative methods, explore quantitative results, augment quantitative data using qualitative methods, develop survey instruments, or involve community-based stakeholders (Wisdom & Creswell, 2013). The primary benefits of mixed-method research include the ability to compare qualitative and quantitative data, reflect participants viewpoints, collect flexible data, and promote scholarly interaction (Shorten & Smith, 2017). The mixed-method approach best fits the purpose of this paper, as the qualitative approach could expand the understanding of participants attitudes towards contact tracing in general and EHTERAZ in particular. Additionally, the research design favored data type flexibility. This was crucial as information on the specifics of EHTERAZ was protected by privacy laws.

Sampling

For the quantitative part, the population under analysis was Qatar residents, including Qatar and non-Qatar citizens. Simple random sampling was used to provide all members of the population with an equal chance to participate in the survey (Shabbir et al., 2020). The sampling method is associated with decreased bias compared to other sampling methods, simplicity, and low cost (Etikan, & Bala, 2017). Questionnaires were distributed to the public through WhatsApp groups and social media platforms, including Twitter and Instagram. The questionnaire was also shared with famous social media influencers in Qatar to ensure that the survey was highly distributed. Even though the distribution of questionnaires through e-mail is considered the most effective method, using social media and messengers is also considered an appropriate distribution method in scientific research with questionnaires (Grossmann et al., 2018). A total of 884 questionnaires were distributed with a response rate of 45%. The final sample size 404 respondents, 76.2% were male, and 23.8% were female. The collected data were analyzed using statistical analysis in SPSS and discussed using the findings of qualitative data analysis.

The purpose of the qualitative part of the research was to fill the gaps from the literature and expand the quantitative findings. A focus group was created in one of the departments in the Ministry of Interior (MOI) that answered nine interview questions. Additionally, a semi-structured interview was conducted with a Network Security Expert from MOI. The qualitative questions are provided in Appendix A.

Instrument, Variables, and Data Analysis

A unique quantitative instrument was developed to answer the research question. The survey included 21 questions divided into three sections and four demographic questions. The questionnaire is provided in Appendix B. The quantitative data analysis was conducted using Statistical Package for Social Sciences (SPSS).The first section aimed at examining the factors that affected the attitude of Qatar citizens towards EHTERAZ, which was the first research question. The literature review revealed that awareness, trust, privacy, uptake issues, and application quality had a significant impact on the attitude toward contact tracing applications (Braithwaite et al., 2020; Hassandoust et al., 2021; Jansen-Kosterink et al., 2020; Williams et al., 2020). Attitudes towards EHTERAZ was measured with Question 7 in Section A, awareness was measured using Questions 1 and 2, in Section A, trust was measured by Question 5, privacy concerns were measured by Question 4, uptake concerns were measured by Question 6, and perceived quality of the application was measured using Question 3. The collected data was used to create a multiple regression model.

The regression model had five independent variables (the factors), one dependent variable (attitude towards EHTERAZ), and four control variables (demographic variables). The demographic variables included age, gender, education level, and nationality. The multiple regression model is provided below:

Research Questions 2 and 3 were answered using descriptive statistics. In particular, survey questions from Section B were analyzed to understand the perceived benefits of EHTERAZ of Qatar residents. A total of seven possible benefits were examined. A mean score of 3.5 and above was considered a significant perceived benefit of the program. Data variability was also included in the discussion of the perceived benefits of the application. Questions from Section C were used to examine the drivers and barriers of the public in using EHTERAZ. Two drivers and five barriers were assessed using descriptive statistics. A mean score of 3.5 and above was considered a significant barrier/driver of the public in using the contact tracing app. The discussion of data variability was also included in the analysis. According to Kaur et al. (2018), descriptive statistics are crucial for research as they enable data-driven decision-making. Thus, the selection of the data analysis methods was considered appropriate.

The quantitative data was collected by sending a request to MOI to conduct interviews with representatives from the organization. A list of questions was attached to the request send by e-mail. The reply to the request was concise answers to the interview questions, which were the focus group discussion results. The interview with the Network Security Expert from MOI was transcribed and analyzed using thematic analysis. The received results were juxtaposed with quantitative research findings.

References

Anguera, M. T., Blanco-Villaseñor, A., Losada, J. L., Sánchez-Algarra, P., & Onwuegbuzie, A. J. (2018). Revisiting the difference between mixed methods and multimethods: Is it all in the name?. Quality & Quantity, 52(6), 2757-2770.

Braithwaite, I., Callender, T., Bullock, M., & Aldridge, R. W. (2020). Automated and partly automated contact tracing: a systematic review to inform the control of COVID-19. The Lancet Digital Health, 2(11), e607-e621. Web.

Etikan, I., & Bala, K. (2017). Sampling and sampling methods. Biometrics & Biostatistics International Journal, 5(6), 00149.

Grossmann, S. D. M. C., Moura, M. D. G., Matias, M. D. P., Paiva, S. M., & Mesquita, R. A. (2018). The use of social networks in scientific research with questionnaires. Brazilian Journal of Oral Sciences, 17, e18162-e18162.

Hassandoust, F., Akhlaghpour, S., & Johnston, A. C. (2021). Individuals privacy concerns and adoption of contact tracing mobile applications in a pandemic: a situational privacy calculus perspective. Journal of the American Medical Informatics Association, 28(3), 463-471. Web.

Jansen-Kosterink, S. M., Hurmuz, M., den Ouden, M., & van Velsen, L. (2020). Predictors to use mobile apps for monitoring COVID-19 symptoms and contact tracing: A survey among Dutch citizens. MedRxiv. Web.

Kaur, P., Stoltzfus, J., & Yellapu, V. (2018). Descriptive statistics. International Journal of Academic Medicine, 4(1), 60-63.

Shabbir, J., Gupta, S., & Masood, S. (2020). An improved general class of estimators for finite population mean in simple random sampling. Communications in Statistics-Theory and Methods, 1-13.

Shorten, A., & Smith, J. (2017). Mixed methods research: expanding the evidence base. Evidence-Based Nursing, 20, 74-75.

Williams, S. N., Armitage, C. J., Tampe, T., & Dienes, K. (2020). Public attitudes towards COVID-19 contact tracing apps: A UK based focus group study. Health Expectations, 2021(24), 377-385. Web.

Wisdom, J., & Creswell, J. W. (2013). Mixed methods: integrating quantitative and qualitative data collection and analysis while studying patient-centered medical home models. Rockville: Agency for Healthcare Research and Quality. Web.

Appendices

Appendix A: Interview and Focus Group Questions

Research Question 1: What are the publics attitudes toward Qatars COVID-19 contact tracing application (EHTERAZ)?

What do you believe the general public in Qatar thinks about EHTERAZ as a contact tracing application?
How do you think this attitude can be improved?
What is being done by the ministry to make sure citizens use EHTERAZ to its full potential? For example: adds, awareness sessions etc.
What kind of collaboration is between MOI and the Ministry of Public Health when it comes to EHTERAZ?

Research Question 2: What are the perceived benefits of using EHTERAZ to mitigate the spread of COVID-19?

What do you think are the central benefits of using EHTERAZ for reducing the spread of COVID-19?
How do you think EHTERAZ affects the notification speed of possible contaminations?
How do you think EHTERAZ affects the accuracy of data collection about possible contacts?

Research Question 3: What are the drivers and barriers of the public in using EHTERAZ?

What do you believe are the central drivers that encourage the adoption of EHTERAZ in Qatar?
What do you think are the central barriers to the adoption of EHTERAZ in Qatar?
Do you think that the drivers outweigh the barriers? Why?

Appendix B. Quantitative Questionnaire

Research Question 1: What are the publics attitudes toward Qatars COVID-19 contact tracing application (EHTERAZ)?

The following seven questions are designed to answer the first research question. In particular, the questions aimed at examining the level of satisfaction and awareness with different aspects of EHTERAZ.

Instructions: For the following seven statements, please rate how much you agree with them. Use the following scale:

disagree;
disagree to a certain extent;
neither agree nor disagree;
agree to a certain extent;
agree.

	Questions	(1)	(2)	(3)	(4)	(5)
1	I have been using EHTERAZ for enough time to evaluate it.
2	I am aware of how EHTERAZ works to the extent that I need to know.
3	I think that the design of EHTERAZ and its functionality is of high quality.
4	I think that EHTERAZ manages my private data carefully and uses it only for the described purposes.
5	I fully trust the developer of EHTERAZ.
6	I think that the current level of adoption (uptake) of EHTERAZ among citizens of Qatar is high enough to contribute to limiting the spread of COVID-19.
7	In general, I am fully satisfied with EHTERAZ.

Research Question 2: What are the perceived benefits of using EHTERAZ to mitigate the spread of COVID-19?

The following seven questions are designed to answer the second research question. In particular, the questions aimed at examining how the general population thinks EHTERAZ can be useful for mitigating the spread of COVID-19 in Qatar.

Instructions: For the following seven statements, please rate how much you agree with them. Use the following scale:

disagree;
disagree to a certain extent;
neither agree nor disagree;
agree to a certain extent;
agree.

	Questions	(1)	(2)	(3)	(4)	(5)
1	In general, I believe that EHTERAZ brings significant benefits to the citizens of Qatar by helping to limit the spread of COVID-19.
2	I think that EHTERAZ is beneficial for timely notifications of possible contaminations.
3	I believe that EHTERAZ helps to accumulate relevant data to plan measures for mitigation of the spread of COVID-19.
4	I believe that EHTERAZ is more effective than standard methods for contact tracing (i.e. manual checking or interviewing of affected people to pinpoint their whereabouts, who they engaged with, etc.)
5	I think that the ability of EHTERAZ to automatically collect and store data about the locations a person has visited is crucial for mitigating the spread of COVID-19.
6	I believe that EHTERAZ is more precise than paper-based contact tracing.
7	I think that EHTERAZ is a healthy alternative to lockdown measures.

Research Question 3: What are the drivers and barriers of the public in using EHTERAZ?

The following seven questions are designed to answer the third research question. In particular, the questions aimed at examining what the perceived barriers and drivers for the wide adoption of EHTERAZ are.

Instructions: For the following seven statements, please rate how much you agree with them. Use the following scale:

disagree;
disagree to a certain extent;
neither agree nor disagree;
agree to a certain extent;
agree.

	Questions	(1)	(2)	(3)	(4)	(5)
1	I think that the lack of knowledge about the existence of contact tracing applications and their benefits is a significant barrier to the adoption of EHTERAZ among citizens of Qatar.
2	I believe that the lack of information about the technical characteristics of EHTERAZ is a significant barrier to the adoption of EHTERAZ among citizens of Qatar.
3	I believe that the lack of information about what data is collected and how it is used is a significant barrier to the adoption of EHTERAZ among citizens of Qatar.
4	I believe that trust in Qatars government is a significant driver to the adoption of EHTERAZ among citizens of Qatar.
5	I think that privacy concern is one of the central barriers to the adoption of EHTERAZ among citizens of Qatar.
6	I think that the effectiveness of the application is one of the central drivers to the adoption of EHTERAZ among citizens of Qatar.
7	I think that the lack of participation is one of the central barriers to the adoption of EHTERAZ among citizens of Qatar.