Facilitators and barriers to the adoption of mHealth apps for COVID-19 contact tracing: a systematic review of the literature

Background: Despite the enormous potential of mobile health (mHealth) apps for COVID-19 contact tracing, the adoption rate in most countries remains low. Thus, the objective of the current study is to identify facilitators and barriers of mHealth apps adoption for COVID-19 contact tracing based on existing studies. Methods: We conducted a systematic review of mHealth studies before December 2021 that evaluate facilitators and barriers associated with the adoption of mHealth apps for COVID-19 contact tracing. We assessed the risk of bias for all included studies using the Cochrane tool. We based our narrative synthesis on the facilitators-barriers to the adoption of mHealth framework comprising seven key factors. Results: A total of 27 articles were reviewed from 16 countries representing high income countries (France, German, Italy, United Kingdom, United States, Australia, Singapore, Belgium, Republic Ireland, Netherland, Poland, and Japan), middle-income countries (Fiji), and low-middle income countries (India). We identified the main facilitators of mHealth adoption: perceived risks to COVID-19, trust, perceived benefit, social norm, and technology readiness. The main barriers of mHealth adoption were data privacy/security concerns. Among sociodemographic factors, females, lower education, lower-income, and older individual are barriers to adoption in low-middle income countries, while most of those factors were not significantly associated with adoption in a high-income country. Conclusion: The findings imply that resolving data privacy/security issues while developing trust, perceived benefits, social norms, and technology preparedness could be effective strategies for increasing adoption intentions and app use among the general public. In low-middle-income countries, addressing digital divide is critical to the app’s adoption. Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=249500, identifier RD42021249500 (PROSPERO).