|Year : 2022 | Volume
| Issue : 3 | Page : 163-167
Cross-sectional study on awareness and usage of Government COVID-19 mobile health applications among adult smartphone users of Assam
Madhur Borah, Chandana Deka
Department of Community Medicine, Jorhat Medical College, Jorhat, Assam, India
|Date of Submission||27-Apr-2022|
|Date of Decision||25-May-2022|
|Date of Acceptance||03-Jun-2022|
|Date of Web Publication||13-Jul-2022|
Department of Community Medicine, Jorhat Medical College, Jorhat - 785 001, Assam
Source of Support: None, Conflict of Interest: None
Background: As the COVID pandemic became an emergency situation in India, government COVID-19 mobile health (mHealth) apps through smartphones and mobile internet reached citizens across the country and catered to their health needs. Data available from Assam and North Eastern states of India regarding the COVID-19 mHealth apps Arogya Setu app and CoWIN portal, their awareness, usage, and its effectiveness among the general population were very less. Therefore, this study was done with the objectives to find out the awareness and usage of Government COVID-19 mHealth apps among the adult smartphone users of Assam. Methodology: The study was conducted through an online survey method using the Google forms. A total of 310 adult smartphone users from eight different districts of Assam were selected by the convenient sampling method. Data processing and statistical analysis was done using the MS Excel platform. Five-point Likert scale was used for the measurement of respondents' opinions. Results: The awareness level was found to be more than 90%. On user experience of the government mHealth apps, 70% of the respondents agreed that these apps were easy to use and navigate. The satisfaction level of the respondents regarding the apps was found to be high and 80% of study participants trusted the apps. Conclusion: Our study observed that awareness and usage of the government COVID-19 health applications were high among the study participants.
Keywords: Arogya Setu, awareness, COVID-19, CoWIN, mobile health, pandemic, smartphone, user-satisfaction
|How to cite this article:|
Borah M, Deka C. Cross-sectional study on awareness and usage of Government COVID-19 mobile health applications among adult smartphone users of Assam. Apollo Med 2022;19:163-7
|How to cite this URL:|
Borah M, Deka C. Cross-sectional study on awareness and usage of Government COVID-19 mobile health applications among adult smartphone users of Assam. Apollo Med [serial online] 2022 [cited 2022 Sep 29];19:163-7. Available from: https://apollomedicine.org/text.asp?2022/19/3/163/351226
| Introduction|| |
As the COVID pandemic became an emergency situation in India, the Central government and several state governments took help of smartphone technology and mobile Health (mHealth) applications to combat this pandemic. Smartphone mHealth apps are being used for counseling, training, education of people regarding the pandemic, and correct location of COVID-19 infected people., Among the many mHealth apps launched by the government of India, Arogya Setu app has become the most downloaded mHealth app. This mhealth application uses Bluetooth technology to trace and maintain the details of all the people the app user has come in contact with. If any one of them, at a later point in time, tests positive for COVID-19, the user is immediately informed and guidance is provided to take appropriate preventive measures. Arogya Setu app can be a very useful tool for containing the pandemic provided more people are aware of the app and use the app responsively.
As the COVID-19 vaccination was introduced in India, CoWIN portal was launched by the Indian government to enable the citizens to know about the vaccines and book vaccination slots through their mobile phones. Further different state governments also launched COVID-19 apps to enforce lockdown, spreading awareness among the general public and monitoring home isolation patients and quarantined individuals. These apps act as medium for the dissemination of health information on a large scale during the pandemic, digital tracing of infected persons and also helped in self-assessment of patients as visiting health facilities was difficult and testing facilities were less.
With an increasing trend of smartphone users in India and rural penetration of smartphones, the use of mHealth apps has been on the rise., However, still effective use of these mHealth apps is limited. The main barriers to mHealth app use are the lack of knowledge of health apps, how to access them, limited functionality of apps, privacy and security concerns of apps. There is a scarcity of data regarding the user feedback of government COVID-19 mHealth apps among smartphone users and their perception of these mHealth apps. Arogya Setu and CoWin are two most important COVID-19 mHealth applications launched by the government of India using the mobile phone technology to improve healthcare delivery and for health promotion during the pandemic time. However, limited data available from Assam and North Eastern states of India regarding awareness, usage, and effectiveness of these two COVID-19 m Health apps among the general population. Therefore, this study was planned as an online survey among the adult smartphone users of Assam.
The objectives of our study were as follows:
- To find out the awareness of Government COVID-19 mHealth apps among the adult smartphone users of Assam through an online survey
- To assess the usage of Government COVID-19 mHealth apps
- To know the level of satisfaction of the apps users regarding Government COVID-19 mHealth apps.
| Methodology|| |
It was a community-based cross-sectional online study conducted among adult smartphone users residing in the selected districts of the State of Assam.
The state of Assam has five regional divisions, each comprising a number of districts. For our study, we had selected two districts each from three larger regional divisions (Upper Assam, Lower Assam, and North Assam) and one district each from two smaller regional divisions (Barak valley and Hill region) [District selection flowchart in [Figure 1]]. A total of eight districts thus were chosen for our study. From each of the selected districts, we selected the respondents purposively according to the population of each district, so more responders were selected from districts with higher population. The total number of respondents selected from each district is in a purposive manner. Moreover, hence a total 310 respondents were selected from those districts by convenient sampling. The sample size of 310 was estimated using the formula 4pq/D2, taking prevalence (willingness to receive health information through mobile phone) from previous study conducted in India.
Method of data collection
An online questionnaire using the Google forms was prepared and distributed among the selected adult smartphone users residing in the selected districts of Assam through WhatsApp and E-mail. Among the study participants, 10% of the responses were validated by interviewing them over phone. This number is chosen as a convenient sample according to the feasibility of the study.
Smartphone users residing in selected districts of Assam who are 18 years or older and who have given informed consent to be part of our study.
Those who gave incomplete information and did not belong to our selected study area and age group (total of 28 responses were incomplete and after excluding the incomplete responses total 310 respondents were included in our study) were excluded from the study.
Out of several Government COVID-19 mHeath apps, we had considered Arogya Setu App and CoWIN portal application to be included in this study.
This study was approved by the Institutional Ethics Committee of the Institute (Reference number SMEJ/JMCH/MEU/841/pt-2/2011/4513).
Data collected through Google forms processed and subjected to the statistical analysis with the help of MS excel platform. Data presented as frequency and percentage. Five-point Likert scale was used for the measurement of respondents' opinions on awareness, usage, and level of satisfaction regarding mHealth apps.
| Results|| |
From our study on awareness and usage of Arogya Setu app and CoWin portal among smartphone users of Assam, we obtained some relevant and important information regarding mHealth and government COVID-19 initiatives.
It was found out that [Table 1] among 310 respondents of our study, 63% of adults belonged to the age group 18–30 years, 20.6% belonged to the 31–50 years age group, and the rest 15% were 51 years and above.
Among 310 smartphone users, 50.3% users were male and 49.7% users were female. Fifty-eight percentage people reside in the urban areas while 42% people reside in rural areas.
Of total 310 study participants, most (45%) were educated up to the graduation level followed by 31% studied up to postgraduation or above.
Out of total 310 smartphone users, 2.6% had been using them for <1 year, 13% had been using them for 1–3 years, and a maximum 85.5% had been using them for more than 3 years.
[Table 2] showed awareness, usage, and levels of user satisfaction of App users of our study. Among 310 study participants, we found that 95% of respondents were aware of the Arogya Setu app and 98% of respondents were aware of the CoWin application. On analysis of level of awareness on Likert scale, we found that most (47%) study participants were moderately aware of the Arogya Setu app and most app users (76%) were using the app occasionally. Similarly, 61% respondents were moderately aware of the CoWin portal and 68.7% users are occasionally using that app.
|Table 2: Level of awareness and usage of Arogya Setu app and CoWin portal among the study participants|
Click here to view
We asked the study participants about their user experience of these two government mHealth apps and we found that 68% of the respondents agreed that Arogya Setu app was easy to use and 74.4% users found CoWIN portal easy to use and navigate. However, 25% of respondents found these apps difficult to use. On analysis of the level of satisfaction with the apps in [Table 3], 82% Arogya Setu app users and 71% CoWin portal users were satisfied with the app while 12.4% respondents were unsatisfied with Arogya Setu and 26% CoWin portal users were unsatisfied.
|Table 3: Distribution of study participants according to their satisfaction level and trustworthiness of the apps (n=250)|
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As we analyzed the participants' answers (n = 250) to the question of trustworthiness of these two apps, we found out that 87% of users trusted the Arogya Setu app while 13% of the respondents answered that they did not trust the app. Similarly, 80% of the respondents trust the CoWin portal [Table 3].
| Discussion|| |
The study conducted on the awareness and usage of Government COVID-19 mHealth applications among adult smartphone users of Assam obtained certain important observations. As our study population represented all the regional sub divisions of the state and was composed of respondents of different age groups, gender, and educational backgrounds; therefore, our findings support the notion that the current COVID-19 pandemic is making a significant impact on awareness and usage of mHealth applications among adult smartphone users of Assam. In our study, we found that most of the study participants were using smartphones for more than 3 years who were from different age groups and occupational backgrounds. It indicated the widespread penetration of smartphone technology in the state of Assam. Smartphones have become useful tools to access health information and to meet the health needs of people in developing countries like India as found by previous study. Similarly, Mohan et al. in their study observed that access to phones among women in urban India was associated with increased utilization of health care services.
The study findings indicated that most of the respondents used smartphones for a significant duration of time; therefore, their awareness of Government COVID-19 mHealth applications was also found to be high (≥95%). As the second wave of the pandemic was ongoing during the data collection period; therefore, it might influence the awareness level of the respondents. Similarly, previous studies observed that the level of awareness of mHealth was high among smartphone users and they were using smartphones to manage their health conditions. The study by Kayyali et al. found that though mHealth apps are increasing in numbers their awareness is still low, the study also observed beneficial effects of mHealth to the app users.
In our study, we observed that the level of awareness of the respondents toward the COVID-19 mHealth app was mostly moderate. Among the study participants, 47% were moderately aware of Arogya Setu app and 61% were moderately aware about the CoWin portal. Therefore, more awareness needs to be generated among the general public for the effective use of these COVID-19 apps. Chidambaram et al. in their study similarly suggested the need for increased public awareness of digital solutions for COVID pandemic. As our study observed that most of the respondents used these apps occasionally and very few used them more often, it indicated limited functionality of the apps. Similarly, more than 20% of respondents found these two apps difficult to navigate. This finding might be in line with the previous study findings of regular use by the app users was influenced by the app design.
Trustworthiness of an online application is a very critical topic which influences the user acceptability and usage of the app. Various studies have raised the concern of data safety and privacy issues related to mHealth apps influencing the trustworthiness of the apps., In our study, we found that more than 80% of the respondents trusted these government COVID-19 mHealth apps. This high trust shown by the study participants reflected the acceptance of the apps as a necessity during the pandemic. On analysis of the level of satisfaction with the app, we found that 82% of study participants were satisfied with the Arogya Setu app and 70% of participants were satisfied with the CoWin portal. Slightly low satisfaction numbers for the CoWin portal might be because of limited vaccination slots made available during the initial months of the vaccination program. A study by Kodali et al. on Arogya Setu also found high acceptance of the app among the users. Overall COVID-19 mobile apps have proven to be of valuable assistance to common people to manage the pandemic.
Limitations of our study
The study had certain limitations. As it was an online study hence had respondent bias. The sample size was small and collected using a nonrandom method.
| Conclusion|| |
The introduction of applications such as Co-WIN portal and Arogya Setu applications has made the people aware and knowledgeable abmnout the COVID-19 disease and these government COVID-19 mHealth apps have contributed significantly in our fight against the pandemic. Although the onslaught of COVID-19 appears to be declining now, it is a major public health threat; therefore, the information obtained from this study will be helpful for mitigation of the pandemic in future. As our study showed high awareness and use of COVID-19 mHealth apps among smartphone users of the state of Assam, therefore mHealth applications have a great potential for the use in other public health problems of Assam and other North Eastern states of India as limited accessibility of health care services exist in the most parts of the region.
We would like to acknowledge the support and help from the College authority for conducting the study also all faculty members and students of department of community medicine for their support in the successful completion of the study.
Conflicts of interest
There are no conflicts of interest.
Author MB involved in the concept of the study, CD involved in manuscript design. MB and CD both involved in literature search, writing, editing, and drafting of the manuscript.
| References|| |
Iyengar K, Upadhyaya GK, Vaishya R, Jain V. COVID-19 and applications of smartphone technology in the current pandemic. Diabetes Metab Syndr 2020;14:733-7.
Wilson K. Mobile cell phone technology puts the future of health care in our hands. CMAJ 2018;190:E378-9.
Bassi A, Arfin S, John O, Jha V. An overview of mobile applications (apps) to support the coronavirus disease 2019 response in India. Indian J Med Res 2020;151:468-73.
] [Full text]
Chidambaram S, Erridge S, Kinross J, Purkayastha S, PanSurg Collaborative. Observational study of UK mobile health apps for COVID-19. Lancet Digit Health 2020;2:e388-90.
Reddy MM, Thekkur P, Majella MG, Selvaraj K, Jayalakshmy R, Kar SS. Use of mobile phone in healthcare: Readiness among Urban population of Puducherry, India. Int J Med Public Health 2016;6:94-7.
Wang X, Shi J, Lee KM. The digital divide and seeking health information on smartphones in Asia: Survey study of ten countries. J Med Internet Res 2022;24:e24086.
Mohan D, Bashingwa JJ, Tiffin N, Dhar D, Mulder N, George A, et al.
Does having a mobile phone matter? Linking phone access among women to health in India: An exploratory analysis of the National Family Health Survey. PLoS One 2020;15:e0236078.
Mehbodniya A, Suresh Kumar A, Rane KP, Bhatia KK, Singh BK. Smartphone-Based mHealth and internet of things for diabetes control and self-management. Journal of Healthcare Engineering, 2021, Article ID 2116647, 10. https://doi.org/10.1155/2021/2116647
Kayyali R, Peletidi A, Ismail M, Hashim Z, Bandeira P, Bonnah J. Awareness and use of mHealth apps: A study from England. Pharmacy (Basel) 2017;5:33.
Wang C, Qi H. Influencing factors of acceptance and use behavior of mobile health application users: Systematic review. Healthcare (Basel) 2021;9:357.
Tangari G, Ikram M, Ijaz K, Kaafar MA, Berkovsky S. Mobile health and privacy: Cross sectional study. BMJ 2021;373:n1248.
Binkheder S, Aldekhyyel RN, AlMogbel A, Al-Twairesh N, Alhumaid N, Aldekhyyel SN, et al.
Public perceptions around mHealth applications during COVID-19 pandemic: A network and sentiment analysis of tweets in Saudi Arabia. Int J Environ Res Public Health 2021;18:13388.
Kodali PB, Hense S, Kopparty S, Kalapala GR, Haloi B. How Indians responded to the Arogya Setu app? Indian J Public Health 2020;64:S228-30.
[Table 1], [Table 2], [Table 3]