“Alexa, Am I pregnant?”: A content analysis of a virtual assistant’s responses to prenatal health questions during the COVID-19 pandemic

Objective: To elucidate whether Amazon’s virtual assistant, Alexa, provides evidence-based support as a supplement to provider-facilitated prenatal care, during the COVID-19 pandemic.
Methods: Using a conceptual content analysis approach, a query of 40 questions, relating to all phases of pregnancy, was collected from Alexa by two independent investigators, using two unique devices, over a one-week period between May 20, 2020 and May 27, 2020. Alexa’s responses were matched to the evidence-based content from the American College of Obstetricians and Gynecologists (ACOG) and reviewed by a Certified Nurse Midwife for completeness and currency.
Results: Of the 40 questions asked of Alexa, it was unable to answer 14 questions (35%). A total of 21 out of the 40 responses (52%) were not evidence-based and three COVID-specific questions (about 1%) were answered incorrectly or insufficiently. Four questions (10%) were answered accurately.
Conclusion: Alexa was largely unable to provide evidence-based answers to commonly asked pregnancy questions and, in many cases, supplied inaccurate, incomplete, or completely unrelated answers that could further confuse health consumers.
Practice implications: Ensuring that mobile health (mhealth) tools, such as Amazon Alexa, are evidence-based and credible in answering common prenatal questions has important implications for this pandemic and future consumer needs.