One year of digital contact tracing: Who was more likely to install the NHS COVID-19 app? Results from a tracker survey in England and Wales

<jats:sec><jats:title>Objective</jats:title><jats:p> To examine changes in the uptake of the National Health Service (NHS) COVID-19 proximity (contact) tracing application (‘app’) over one year, amongst smartphone users in England and Wales. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> We conducted a longitudinal survey between October 2020 and September 2021, amongst an online panel representative of smartphone users aged 18–79 and a purposeful sample from six of the largest minority ethnic groups. We fitted pooled logistic regression models to examine factors associated with app installation and a longitudinal logistic regression model to estimate factors associated with installing/uninstalling the app over time. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> Around 50% of respondents had the app installed at each time point. The majority of installations took place soon after its launch. The key reason for installing at launch was ‘civic, public or social responsibility’. Amongst those who installed the app later, it was ‘needed to scan NHS QR code’. Uptake was higher amongst individuals who considered themselves vulnerable to COVID-19 or were concerned about the risk COVID-19 posed, were more highly educated, of White ethnicity, and who reported higher levels of trust in government information. Factors associated with installing the app over time included becoming more concerned about the risk COVID-19 poses to the country, or perceiving that the crisis in their local area had worsened. </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> Despite changes in pandemic response and case numbers, app installation in England and Wales remained relatively stable after launch. If governments wish to increase app installation and use rates in future pandemics, they need to highlight those app features that encourage engagement, and take related action to allay privacy concerns and improve trust in government information sharing. </jats:p></jats:sec>