# Privacy and Security in Digital Health Contact-Tracing: A Narrative Review
## 3 Results
### Trust
#### 3.3.2 Trust in Other Institutions  
This includes institutions associated with the digital contact-tracing process. Lack of trust in the public and private institutions was mentioned as a concern for not downloading the app [50]. Respondents expressed the least trust in private companies with their information [107]. Young adult respondents significantly distrusted sharing their data with private companies, including Google, Apple, Microsoft, or Facebook. Only 15.2% agreed to share their information with such entities. This substantial distrust among young adults could potentially interfere with the pandemic surveillance programs developed by these private companies [107]. In contrast, European participants expressed a higher level of trust in Google than in other companies [79]. Similarly, participants expressed a preference for a company known for protecting user data, and creating secure and private apps known to be susceptible to data breaches/leaks in the past [79]. In Germany, Austria, and Switzerland, distrust in authorities was particularly pronounced among Austrian participants, who consistently emphasised the need for more transparent communication about the contact-tracing app [90]. In the Republic of Ireland, a lack of trust in the Irish health service and distrust in major technology companies were reported as reasons for not downloading the contact-tracing app [20]. In the UK, respondents demonstrated strong trust in the NHS and less trust in the UK government, with the weakest trust towards private contractors [93]. Notably, trust in the NHS was significantly stronger than in any other institution, while trust in private contractors was significantly lower than in any other institution. Individuals who did not plan to download the app exhibited significantly lower trust in the app compared to all other user groups. Additionally, those who initially downloaded but later deleted the contact-tracing app had significantly lower trust than individuals who currently had the app [93]. In the USA, reasons for the non-adoption of contact-tracing apps included low trust in Apple and Google [41]. According to a survey, medical providers (68%) were chosen as the most trusted group to protect the privacy of COVID-19 surveillance data. The second most trusted group was educational/non-profit bodies, and technology companies were considered the least trusted group. Respondents also reported low levels of trust in the government [121]. In the USA, mistrust in the government (82%), tech companies (59%), public health organisations (53%), and corporations (47%) were identified as barriers to the adoption of COVID-19 measures within their communities [42]. In the USA, a survey revealed that when asked about sharing personal information, 62.6% of young adults were willing to share information with their doctor or healthcare provider. Following closely, government agencies emerged as the next-most trusted option, with a comparable number of individuals indicating their readiness to share data with local and federal government agencies and researchers [107]. Similarly, regarding trust in entities associated with tracking apps and tracing apps, users expressed the highest trust in medical providers, followed by health insurers, private companies, public research universities, private research universities, employers, non-profit organisations, local governments, state governments, and federal governments, respectively [96]. People generally expressed their lack of trust in the developers of the contact-tracing app [28,119]. In line with the above finding, a study conducted in European countries and the USA reported that people were reluctant to share their data with private businesses or foreign governments and more willing to share data with medical professionals and academic institutions [122]. It was evident that European participants were more aware of the workings of the contact-tracing apps currently using its data collection mechanism and storage.