# Exploring the Utility of Digital Voice Assistants for Primary Care Patients, Including Those With Physical and Visual Disabilities: Cross-Sectional Study

## TL;DR

This study explores how digital voice assistants are used by primary care patients, including those with physical and visual disabilities, and finds mixed usage and privacy concerns.

## Contribution

The study provides insights into DVA usage patterns and barriers among patients with disabilities in primary care settings.

## Key findings

- Most participants have used a DVA before, and many are willing to use them in the future.
- Participants with visual disabilities are less likely to have used a DVA compared to those without.
- Privacy, security, and confidentiality concerns are moderately to highly reported among users.

## Abstract

Today, most smartphones provide a digital voice assistant (DVA) for their user, and it is estimated that about 91% of adults report owning and operating a smartphone. A DVA is an automated system preinstalled on technological devices, such as smartphones, computers, tablets, and speakers, which serves to aid users in performing tasks like answering questions, managing smart devices at home, playing music, managing schedules, sending messages, and more. Research with DVA is emerging, and its applicability to health and health care needs to be elucidated.

The objective of this study was to describe the use of DVAs among primary care patients, as well as purposely sampled clinics including patients with visual and physical disabilities.

A convenience sample of adult participants was recruited to complete a needs assessment survey to ascertain the interest and possible utility of DVAs to promote and enhance health from among three populations at an academic medical center: (1) general primary care patients recruited from a primary care clinic, (2) patients with visual disabilities recruited from a low vision clinic, and (3) patients with physical disabilities recruited from a physical medicine and rehabilitation clinic. The survey used in this study was a 46-item investigator-developed instrument administered to participants assessing knowledge, use, and perceptions of DVAs, participant interest to participate in related future studies, and demographics.

The results of the survey showed that the majority of participants have used a DVA before (69.7%, 152/218) and were or might be willing to use them in the future (84.0%, 178/212). Participants reported moderate to high concern about the privacy (47.8%, 97/203), security (54.5%, 110/202), and confidentiality (51.7%, 105/203) of DVAs. A greater proportion of those with visual disabilities reported having never used DVA than those without visual disabilities (39.0% vs 24.6%, P=.03). There was no significant difference in reliance on DVAs for participants with and those without physical disabilities (45.0% vs 34.9%, P=.31), indicating that they do not require it for everyday needs.

DVA use remains low among the surveyed participants with physical and visual disabilities. For those with visual disabilities, DVA use was seen to be advantageous in everyday life for tasks such as answering questions and seeking information, but not for those with physical disabilities. However, further research should be conducted that focuses on the use of DVAs by accessing data that represent an individual’s DVA use without being biased by knowledge of a research study. In addition, research is needed on DVA use that includes diverse samples of participants with physical and visual disabilities, which address the barriers to using DVAs for these adult populations.