Background: WA Verify and the Technology Acceptance Lens
Public health has increasingly turned to digital tools to protect communities, especially during the COVID-19 era. Washington State’s WA Verify system used the SMART Health Card framework to provide a mobile, paperless way to display vaccination status. Understanding how the public perceives such tools—and why some embrace them while others hesitate—requires a structured framework. The study draws on the Technology Acceptance Model (TAM), which links perceived usefulness and perceived ease of use to attitudes, intention, and actual use. It also considers external factors such as privacy concerns, trust in institutions, and technology readiness that can shape adoption of digital health solutions.
Who Was Most Likely to Use WA Verify?
From a statewide survey of 1,401 respondents with poststratification weighting to reflect Washington’s population, participants were categorized as users, potential users, or unlikely users of WA Verify. About a quarter identified as users, roughly half as potential users, and a little over a quarter as unlikely users. Across these groups, attitudes toward public health policies that require vaccination proof or negative tests varied markedly, underscoring how acceptance hinges on both system design and trust in public health authorities.
Perceived Usefulness and Ease of Use
Those who already used WA Verify or similar tools cited strong convenience: having vaccination cards on a phone was seen as quick and practical, and using the tool could speed entry to care settings. A large share of potential users also agreed with these benefits, suggesting that the perceived usefulness and ease of use were persuasive for many. By contrast, a sizable portion of unlikely users questioned whether they would personally benefit from carrying a digital vaccination record, highlighting how perceived usefulness can diverge across population subgroups.
External Factors and Tech Readiness
External variables—such as concerns about data security, fear of hacking, and worry about government access to personal data—emerged as primary barriers among unlikely users. The TAM framework posits that such concerns diminish perceived usefulness and ease of use, thereby dampening adoption. Additionally, tech readiness varied: roughly one in five people overall faced lower tech readiness, with the rate climbing to about one-third among unlikely users. Not owning a smartphone or limited comfort with devices were common obstacles that public health programs must address to avoid widening digital disparities.
Communication, Privacy, and Trust
Across user groups, healthcare providers were favored channels for information about WA Verify, followed by moments like vaccination appointments and news coverage. Yet a substantial share of unlikely users reported no preferred information source among the options presented, signaling the need for inclusive, multilingual, and multi-channel outreach. Privacy and data security remained central concerns; many respondents worried about who could access their health data and how it might be used or tracked. Addressing these fears through transparent data practices and clear protections is essential for broader acceptance of digital health tools.
Implications for Public Health Strategy
The findings illuminate practical steps for future digital health initiatives. First, design must emphasize ease of use and tangible benefits to reinforce usefulness. Second, outreach should be tailored to diverse audiences, with particular attention to groups with lower tech readiness or limited device access. Third, nondigital alternatives must be maintained to ensure equity, so no one is left behind by the shift to electronic records. Finally, communications should foreground data security, user control, and the safeguards that protect personal health information, building trust and encouraging adoption.
Future Directions and Equity Considerations
Washington’s public health program envisions expanding digital health capabilities—supporting broader sharing of immunization records, medications, and even advance directives through secure standards like SMART Health Links. To reach diverse populations, efforts must be multilingual and culturally responsive while proactively addressing privacy and security concerns. Bridging the digital divide will require both education and access initiatives to ensure that digital verification tools enhance, rather than hinder, health equity.
Conclusion
The WA Verify statewide survey highlights that while a substantial portion of Washington residents are ready to embrace digital public health tools, significant barriers persist—chief among them privacy concerns and uneven technology readiness. By aligning tool design with TAM insights, strengthening trust through transparent practices, and deploying inclusive outreach, public health authorities can advance adoption while safeguarding individual protections and health equity.
