Currently submitted to: JMIR Formative Research
Date Submitted: May 20, 2026
Open Peer Review Period: May 21, 2026 - Jul 16, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Rosie en Español: a pilot randomized trial of an AI-enabled chatbot to reduce anxiety and stress in Latina mothers
ABSTRACT
Background:
Latina pregnant women and mothers of infants in the United States experience elevated risk for perinatal anxiety, stress, and depression alongside persistent barriers to culturally and linguistically responsive care. Artificial intelligence (AI)-powered digital health tools offer a potentially scalable approach to address these gaps, yet evidence on their acceptability and effectiveness for this population remains limited.
Objective:
To evaluate the feasibility, acceptability, and preliminary efficacy of Rosie, a Spanish-language AI-powered chatbot designed with and for Latina mothers, on maternal mental health and healthcare utilization outcomes.
Methods:
We conducted a mixed-methods pilot randomized controlled trial with 30 Spanish-speaking Latina participants who were pregnant or parenting an infant younger than six months. Participants were randomized 1:1 to the Rosie intervention or a comparison Book Club condition that provided monthly children’s board books. Surveys administered at baseline and three-month follow-up assessed depression (PHQ-9), anxiety (GAD-7), perceived stress (PSS), and healthcare utilization. Quantitative analyses examined within- and between-group changes, and qualitative feedback assessed acceptability and user experience.
Results:
Baseline demographic characteristics and mental health scores were generally comparable between groups. Over three months, participants in the Rosie group demonstrated statistically significant within-group reductions in anxiety (mean change -2.00, p = 0.02) and perceived stress (mean change -12.20, p = 0.003). Depression scores declined modestly in both groups, with no significant between-group differences. No significant differences were observed in maternal emergency room utilization or adherence to well-baby visits. Engagement with Rosie was high, and qualitative feedback indicated that participants found the chatbot useful and supportive.
Conclusions:
This pilot study suggests that a culturally and linguistically tailored AI-powered chatbot is feasible, acceptable, and shows preliminary promise for reducing anxiety and stress among Latina mothers during the perinatal period. Larger, adequately powered trials are needed to determine effectiveness and inform integration of AI-enabled tools into maternal and child health care to advance health equity.
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