Embracing Contact Tracing
What is Contact Tracing?
In a bid to control the spread of Coronavirus, the UK government have initiated the development of ‘contact tracing’ technology. Those who become infected can report their diagnosis using a smartphone app, which will then notify anyone with whom they have had significant and recent contact. This technology is particularly useful because it uses mobile data to detect easily forgettable or unknown interactions – such as those in the supermarket or on public transport. By instructing people who have been near a suspected case of coronavirus to self-isolate, it is thought the app will limit further exposure to ultimately keep the R value down.
Contact tracing has been successfully applied in other locations to help ease Coronavirus-related restrictions. In South Korea, early-stage tracking of credit card transactions, CCTV and mobile data resulted in quickly flattened curve, pre-empting the need for lockdown. However, whilst statistical modelling suggests the app can help reduce infection if taken up by 50% of the UK population, and that even lower numbers could prevent intensive care units from becoming overwhelmed, it is estimated 80% of smartphone users will need to become app users for it to be truly effective. Given only 67% of UK smartphone users have downloaded WhatsApp, it is essential the general population are driven to act.
How Do We Achieve Success?
Three key behaviours are required: (1) large numbers of people will need to download the app, (2) report their symptoms, and (3) adhere to self-isolation advice if instructed. Issues of distrust, apathy, complacency or the desire to actually remain ignorant of one’s health status may impede this process. However, behavioural science, including the MINDSPACE toolkit, can be used to overcome these problems and instigate desired behaviour.
MINDSPACE describes nine evidence-based behavioural influencers which can prompt automatic, low-effort or habitual action. These influences often underlie many of the behaviours we make without thinking about them much beforehand:
- Messenger – we are heavily influenced by the people and platforms which communicate information.
- Incentives – rewards drive behaviour; their appeal is influenced by type, magnitude and timing
- Norms – the behaviour of other people has a significant effect on what we do
- Defaults – we automatically tend to ‘go with the flow’ of usual or standard options
- Salience – we pay the most attention to things that are novel, immediately visible, and relevant to us
- Priming –cues in the environment produce a subconscious influence on how we behave
- Affect – emotions (passion!) are powerful drivers of behaviour
- Commitment – we like to reciprocate the effort of others and be consistent with promises we make in public
- Ego – we seek to act in ways that promote our self-esteem
How to Drive Engagement
In tackling apathy or complacency, communication campaigns might combine some of the above factors to drive public engagement with a contact tracing app.
Affect
Affective reactions are more likely to instigate behaviour than complex cognitive information, and thus initiatives could focus on generating an emotional narrative around coming together to achieve a common goal. This includes Nostalgia – a sentimental longing for the past. It is an overwhelmingly positive emotion and can promote a sense of hope and social connectedness. Nostalgia can be experienced as an individual or as a group, given neighbourhoods, cities, and nations are often tied together through shared experiences and memories. For these reasons, evoking nostalgic experiences may motivate large groups of people to support covid-beating action, such as using the contact tracing app. Importantly, individuals are not required to have lived through an event in order to feel nostalgia for it.
Salience
At present, protecting the NHS is a highly salient topic, with immense public support. This means related material is likely to automatically grab the attention of many. We only have a limited capacity to process and remember the myriad information we are presented with each day, so it is essential to package information using concepts and platforms which help it stand out. One such example is the communication of contact tracing messages via NHS staff, which is discussed further below.
A second salient construct is freedom, as the lockdown has restructured both our personal autonomy and our greater sense of civic freedom. Paradoxically, in order to grant freedom, the Government must to some extent, restrict people’s liberty by tracking their movements. One tactic may therefore be to explicitly address this: whilst the app does track movement (anonymously), using it grants increased personal autonomy and freedom, and in so doing protects the NHS etc.
Incentives
We are compelled to seek rewards which satisfy some form of need, whether that be intrinsic or extrinsic. For example, we have an inherent drive for freedom, and using the app will allow us to experience this sooner. Alternatively, linking app use to other items of value, such as money or discounts, can also drive engagement. However, this latter use of extrinsic incentives is risky as it can damage pre-existing reasons to engage, such as the desire to support others. Importantly, incentives which can be enjoyed promptly are most persuasive, given we tend to devalue rewards the longer they take to receive.
Norms
Social norms have an incredibly powerful influence on our behaviour and can motivate action even if an individual has no personal desire to act. Publicising a consistent and compelling message (based on population behaviour) using an appropriate narrative will be most effective in driving momentum toward downloading and using the contact tracing app. Acknowledging the role of ego in human psychology (see below) can also support this process.
Ego
Appropriate action regarding lockdown restrictions has been a controversial and emotive topic. Given we are compelled to act in ways that make ourselves feel proud, positioning the contact tracing app as a way in which everyone can play a meaningful and easy role in beating Coronavirus capitalises on this human need and facilitates the development of social norms. Likewise, the public shaming of individuals who have broken lockdown rules also powerfully impacts their ego(as well as the perceptions others have of them and the risks to their own egos).
We need to trust what we’re being asked to do
Messenger
Choosing the right messenger and channel for different groups of people is essential for success. For example, celebrity role models on Tik Tok or Instagram appeal to younger generations, and well-established public figures on television or radio can appeal to older people. Whilst the content remains consistent, the form is adapted to suit specific populations for the greatest impact. Equally, the use of both gain-framed (help save lives) and loss-framed (your family might die) messages will appeal to different personalities.
Defaults
Current trials of the contact tracing app have been conducted with a ‘centralised’ version, which stores data in an anonymised form with the UK government. This allows the NHS extensive visibility on the wider spread of the virus, however early-stage testing has revealed individuals are extremely concerned about the protection of this data. Indeed, at a time when trust in the UK government appears to be falling, many people are particularly concerned about the monitoring of their movement. Promoting trust around this issue is core to achieving a high take-up rate.
An alternative strategy is to use the default technology of Apple and Google, which is the ‘decentralised’ model currently in use in other countries. Here, data is stored on a user’s phone rather than with the Government, which should naturally ease privacy concerns. Moreover, Apple and Google are powerful brands, reflecting lifestyle statements and ways of being, which almost all smartphone owners already buy into, and tend to respect. Here, individuals are more likely to be comfortable with the ‘default’ option, rather than placing their trust in a lesser known, less established or less respected version produced by the UK Gov.
Everyone needs to take ownership of their actions and consequences
Commitment
We are motivated to keep both public and personal promises, and so incorporating an element of commitment to the contact tracing app can ensure behaviour is instigated and maintained. For example, asking individuals to share a sign they have downloaded via the app on social media (similar to profile picture frames, or ‘I just bought…’ notices on Amazon) both publicises the app, and acts as a public commitment device for these individuals themselves. Likewise, wearing a badge or label to show that an individual ius using the app (which could then also produce a norming influence). Equally, embedding a pledge (personal commitment) to report symptoms and adhere to self-isolation instructions, if included in the app set-up process, can also increase the likelihood that users will follow-through with these actions, should they become necessary.
Priming
At present, there are many environmental cues which remind us of the threat coronavirus poses and the importance of social distancing. These cues subsequently influence how we behave. One such example is the use of floor tape to encourage keeping 2m apart in supermarkets, and in queues outside. Similar primes could be used to increase awareness and take-up of the contact tracing app, such as publicising the app in commonly frequented areas such as shops or garden centres, or using sponsored adverts on social media.
Going Forward
These examples provide illustration of how behavioural science can be used to promote a potentially life-saving resource. However, the same principles could be applied in multiple different ways to achieve success. Critically, it is essential to utilise incoming data on potential barriers to action, and think creatively on the development of public campaigns in tackling such issues in a dynamic way as time progresses. Ultimately, behaviour change is about both (1) promoting habits/ automaticity for desirable behaviours, and (2) inhibiting undesirable impulsive actions to allow meaningful deliberation about positive behaviours. Finally, given the evidence of significant asymptomatic cases of Covid-19, a contact tracing app will not in itself be sufficient and could give users a false sense of security. Indeed, these behaviour change tools areonly a subset of tactics available, and can only really work within a supportive context which includes appropriate regulation and Government support.