Factors Influencing the Adoption of Voluntary Nonpharmaceutical Interventions to Control COVID-19 in Japan: Cross-sectional Study

Background: Trust in government is seen to facilitate crisis management and policy instrument adoption across numerous studies. However, in Japan, public support for government handling of the COVID-19 pandemic and trust in the government is low, yet the adoption of voluntary nondigital nonpharmaceutical interventions (NPIs) is high. This is an important tension this study seeks to unravel. Objective: The aim of this study is to understand the antecedents of nondigital NPI and tracking app adoption in the COVID-19 pandemic in Japan. Methods: A commercial company was contracted to deliver an online survey of 1248 Japanese citizens in December 2020. A quota technique was used to deliver a sample representative in terms of gender, age, residence, income, and education. Results: The adoption of voluntary nondigital NPIs is predicted by confidence in public health scientists and a favoring of infection control over reducing economic and social costs. A novel and unexpected finding is that trust in government does not predict nondigital NPI use. Perceived risk and knowledge of infection did not increase the use of nondigital NPIs. Education and income were not significant factors, although female and older respondents demonstrated greater compliance. For the adoption of a phone tracking app, trust in government is important, as is urban residence, albeit with a lower use of the app compared to nondigital NPIs. Conclusions: Voluntary compliance in the adoption of nondigital NPIs-if skillfully led by trusted scientific experts and in accord with societal norms-can be effectively achieved. We provide evidence that trust in government is effective in encouraging the use of the Japanese tracking app. Moreover, the technical efficacy of digital initiatives and perceptions of such will unsurprisingly affect citizen support and use of digital tools.