The Impact of Individuals' Social Environments on Contact Tracing App Use: Survey Study.

Background: The German Corona-Warn-App (CWA) is a contact tracing app to mitigate the spread of SARS-CoV-2. As of today, it has been downloaded approximately 45 million times.

Objective: This study aims to investigate the influence of (non)users' social environments on the usage of the CWA during 2 periods with relatively lower death rates and higher death rates caused by SARS-CoV-2.

Methods: We conducted a longitudinal survey study in Germany with 833 participants in 2 waves to investigate how participants perceive their peer groups' opinion about making use of the German CWA to mitigate the risk of SARS-CoV-2. In addition, we asked whether this perceived opinion, in turn, influences the participants with respect to their own decision to use the CWA. We analyzed these questions with generalized estimating equations. Further, 2 related sample tests were performed to test for differences between users of the CWA and nonusers and between the 2 points in time (wave 1 with the highest death rates observable during the pandemic in Germany versus wave 2 with significantly lower death rates).

Results: Participants perceived that peer groups have a positive opinion toward using the CWA, with more positive opinions by the media, family doctors, politicians, and virologists/Robert Koch Institute and a lower, only slightly negative opinion originating from social media. Users of the CWA perceived their peer groups' opinions about using the app as more positive than nonusers do. Furthermore, the perceived positive opinion of the media (P=.001) and politicians (P<.001) was significantly lower in wave 2 compared with that in wave 1. The perceived opinion of friends and family (P<.001) as well as their perceived influence (P=.02) among nonusers toward using the CWA was significantly higher in the latter period compared with that in wave 1. The influence of virologists (in Germany primarily communicated via the Robert Koch Institute) had the highest positive effect on using the CWA (B=0.363, P<.001). We only found 1 decreasing effect of the influence of politicians (B=-0.098, P=.04).

Conclusions: Opinions of peer groups play an important role when it comes to the adoption of the CWA. Our results show that the influence of virologists/Robert Koch Institute and family/friends exerts the strongest effect on participants' decisions to use the CWA while politicians had a slightly negative influence. Our results also indicate that it is crucial to accompany the introduction of such a contact tracing app with explanations and a media campaign to support its adoption that is backed up by political decision makers and subject matter experts.