# What Went Wrong? Predictors of Contact Tracing Adoption in Italy during COVID-19 Pandemic
## 4 Discussion and Conclusions  
This study aimed to investigate the predictors of contact tracing adoption during the COVID-19 pandemic on an Italian sample. To conduct a comprehensive analysis of Immuni adoption, we administered an online survey inspired by the most important psychological models for behavioral change and technological adoption [20; 21; 22; 23; 24; 25]. The participants were recruited through a voluntary census online during the second wave of the pandemic in Italy (from 23 October 2020 to 20 November 2020). Notably, during the data collection, new infections increased from 5901 to 37,242, and we also observed the second greatest increase in Immuni downloads after the initial release (Figure 10). In order to identify the characteristics of the person who downloaded and used the Immuni application, we proceeded with the analysis of sociodemographic dimensions that, according to literature and confirming our hypothesis (H1), resulted in having no influence on the download and use of contact tracing apps [27; 43]. Our study also provided evidence on the impact of factors that potentially affect technological adoption. In line with the literature, our results showed that people's perceived efficacy of CT systems influenced Immuni adoption (H2; [26; 27; 28]). \begin{table}
\begin{tabular}{c c c c c c c} \hline \hline
**Predictor** & \(\beta\) & **SE \(\beta\)** & **Wald \(\chi^{2}\)** & **df** & \(p\)**-Value** & **Odds Ratio** \\ \hline PANAS: Scared & 0.31 & 0.16 & 3.85 & 1 & 0.050 & 1.37 \\ \hline Immuni Efficacy & 0.49 & 0.14 & 11.91 & 1 & 0.001 & 1.62 \\ \hline Family member uses CT & 1.53 & 0.29 & 28.37 & 1 & \(<0.001\) & 4.62 \\ \hline Friend uses CT & 0.95 & 0.28 & 11.10 & 1 & 0.001 & 2.60 \\ \hline Acquaintance uses CT & 0.68 & 0.34 & 3.98 & 1 & 0.046 & 1.97 \\ \hline Risk Perception: & & & & & & \\ Likelihood of Infection & & & & & & \\ \hline ATCTS: Fear\({}^{(\text{log})}\) & \(-0.49\) & 0.18 & 7.18 & 1 & 0.007 & 0.61 \\ \hline ATCTS: Acceptance & 0.13 & 0.03 & 12.38 & 1 & \(<0.001\) & 1.14 \\ \hline \hline \end{tabular}
\end{table} 
Table 2: Logistic regression model for Immuni adoption. Other factors, like social influence, seemed to promote the adoption of the CT system. We hypothesized that individuals who know important others that have downloaded and installed the Immuni application would have a higher probability to download and use it (H3). The results showed that the strongest association related to the adoption of Immuni appeared to be having significant others (in particular family members or friends) who used the application. These results corroborated other studies [27] that found individuals as more inclined to adopt, in general, new technology systems if significant others use them [27]. Fear of COVID-19 appeared as an important factor in predicting the adoption of mobile applications to deal with the COVID-19 pandemic. Based on our findings, the participants that downloaded and used the Immuni application also had higher scores on risk perception (Perceived Severity and Likelihood of Infection) and experienced more fear compared to individuals that did not adopt the app (H4). Indeed, the literature shows that perception of severity and the likelihood of infection are factors that influence people's health behaviors [41; 42]. Furthermore, COVID-19 risk frightened people into adopting the app more [43]. People's attitudes towards technology appeared also related to acceptance of contact tracing apps [43]. In line with the literature, our study shows that both components of attitudes toward CT systems (i.e., fear and acceptance) influenced the download and use of Immuni (H5). Another factor that influences the usage of the CT system is the trust people have in the government (H6). Literature shows that willingness to use a contact-tracing application is associated with trust in the government [2]; in our research, a higher level of trust in government was associated with a higher probability of adopting the Immuni app.