An individual's trust in government is a major determinant in the decision to voluntarily join a public health initiative.

backgroundRecently, there has been a growing trend of incorporating technology using health applications by official organizations such as health organizations and governmental bodies. In response to the COVID-19 pandemic, Israel implemented a health application to be voluntarily downloaded by citizens (VA). Additionally, the Israeli authorities used mandatory mobile tracking to monitor citizens' movements (GT). The current study aims to identify the factors associated with individuals' decisions to download the voluntary contact-tracing app. We hypothesized that (a) attitudes toward GT will mediate the relations between trust in the healthcare system and downloading VA, and (b) attitudes toward GT will mediate the relations between the perceived COVID-19 threat and downloading VA.

methodsData were collected among 741 respondents who completed an online survey on July 19-21, 2020. The survey was designed to represent the diversity of the Israeli population. A logistic regression was calculated with downloading VA as the dependent variable and trust in the healthcare system, perceived threat and attitudes toward GT as independent variables. Then, the extent to which attitudes toward GT mediated the associations between trust in the healthcare system and downloading VA and between the perceived threat and downloading the voluntary app was assessed using the Process procedure.

resultsThe findings reveal that 47.1% of respondents perceive governmental tracing as an invasion of privacy, while 24.4% report that it increased their sense of security. About a third report having downloaded the voluntary app. Both research hypotheses were supported; attitudes played a mediating role in the relationship between an individual's level of trust and an individual's level of perceived threat and behavior, i.e., higher trust and higher perceived COVID-19 threat were associated with more favorable attitudes towards GT, which was associated with more substantial odds of downloading VA.

conclusionsThe results emphasize the crucial importance of public trust. Building trust with the public is essential to encourage voluntary actions that ultimately benefit public health. Achieving and maintaining the public's trust requires addressing concerns about the potential misuse of government power and fostering an environment that promotes voluntary participation and engagement.