[Responses of German-speaking voice assistants to questions about health issues]

In Germany, there is widespread use of smartphones that can be operated via voice assistants (VAs). Due to their increasing distribution, they hold the potential to influence health behavior at a population level.

This study examines the response behavior of German-speaking VAs to questions on mental and physical health as well as interpersonal violence.

Common VAs received nine standardized health questions. Responses were evaluated in terms of the categories "Recognizing the question," "Respectful responsiveness," and "Referring to support services."

Fifty-one VAs were tested on 44 devices. Mental health issues were mostly recognized and answered with respect. Regarding expressed suicidal thoughts, only one VA did not refer to a specific crisis line. With respect to "interpersonal violence," only one VA recognized the expressed problems. In terms of physical health, only one VA showed respectful responses in all three tested healthcare areas, leading help seekers to additional healthcare services (e.g., hospitals, pharmacies). For some complaints, the VAs gave behavioral advice.

VAs are able to recognize health issues, to respond respectably, and to guide those in need of care to specific healthcare and counselling services. However, responsiveness is insufficient and inconsistent. Future research should investigate how the responsiveness of VAs can be improved to provide the best possible support to people in crisis.