Rosie en Español, a Chatbot-Delivered Intervention for Spanish-Speaking, US-Based Latina Mothers: Pilot Randomized Controlled Trial
4 affiliations
- 1Department of Behavioral and Community Health, University of Maryland, 4200 Valley Drive, Suite 2242, College Park, MD, 20742, United States
- 2National Institute of Nursing Research, National Institutes of Health, 31 Center Drive, Room 5B03, Bethesda, MD, 20892, United States, 1 3014354322
- 3Department of Epidemiology and Biostatistics, University of Maryland, College Park, MD, United States
- 4Department of Computer Science, UMIACS, University of Maryland, College Park, MD, United States
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. 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: We aimed to evaluate the feasibility, acceptability, and preliminary outcome changes of Rosie, a Spanish-language AI-powered chatbot designed with and for Latina mothers, on maternal mental health and healthcareuse 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 6 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 3-month follow-up assessed depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), perceived stress (Perceived Stress Scale), and health care use. Quantitative analyses examined within- and between-group changes, and qualitative feedback assessed acceptability and user experience.
Results: Baseline mental health scores were low in both groups; however, several baseline demographic differences were observed between study arms, including age, pregnancy vs parenting status, marital status, education, and country of origin. Over 3 months, participants in the Rosie group demonstrated statistically significant within-group reductions in anxiety (mean baseline 3.27, SD 2.89; mean change −2.00, SD 2.94; P=.02) and perceived stress (mean baseline 30.00, SD 5.53; mean change −12.20, SD 12.99; P=.003). Depression scores declined modestly in both groups, with no significant between-group differences. No significant differences were observed in maternal emergency department use 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 and acceptable among Latina mothers during the perinatal period. Although anxiety and perceived stress decreased within the Rosie group, no significant between-group differences were observed. Within-group reductions in anxiety and perceived stress among Rosie participants are preliminary and should be interpreted cautiously because the trial was not powered to detect between-group effects and no statistically significant between-group differences were observed. Larger, adequately powered trials are needed to evaluate effectiveness.
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BibTeX
@article{norell2026rosie,
title = {{Rosie en Español, a Chatbot-Delivered Intervention for Spanish-Speaking, US-Based Latina Mothers: Pilot Randomized Controlled Trial}},
author = {Elizabeth M Norell and Francia Ximena Marin Gutierrez and Daniel Smolyak and Heran Mane and Xiaohe Yue and Neha Srikanth and Xin He and Thu T Nguyen and Jordan Boyd-Graber and Pankaj Dipankar and Quynh C Nguyen},
journal = {JMIR Formative Research},
year = {2026},
month = oct,
doi = {10.2196/101898},
url = {https://doi.org/10.2196/101898},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Rosie en Español, a Chatbot-Delivered Intervention for Spanish-Speaking, US-Based Latina Mothers: Pilot Randomized Controlled Trial
AU - Elizabeth M Norell
AU - Francia Ximena Marin Gutierrez
AU - Daniel Smolyak
AU - Heran Mane
AU - Xiaohe Yue
AU - Neha Srikanth
AU - Xin He
AU - Thu T Nguyen
AU - Jordan Boyd-Graber
AU - Pankaj Dipankar
AU - Quynh C Nguyen
PY - 2026
DA - 2026/10/22
JO - JMIR Formative Research
DO - 10.2196/101898
UR - https://doi.org/10.2196/101898
AB - 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. 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: We aimed to evaluate the feasibility, acceptability, and preliminary outcome changes of Rosie, a Spanish-language AI-powered chatbot designed with and for Latina mothers, on maternal mental health and healthcareuse 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 6 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 3-month follow-up assessed depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), perceived stress (Perceived Stress Scale), and health care use. Quantitative analyses examined within- and between-group changes, and qualitative feedback assessed acceptability and user experience. Results: Baseline mental health scores were low in both groups; however, several baseline demographic differences were observed between study arms, including age, pregnancy vs parenting status, marital status, education, and country of origin. Over 3 months, participants in the Rosie group demonstrated statistically significant within-group reductions in anxiety (mean baseline 3.27, SD 2.89; mean change −2.00, SD 2.94; P=.02) and perceived stress (mean baseline 30.00, SD 5.53; mean change −12.20, SD 12.99; P=.003). Depression scores declined modestly in both groups, with no significant between-group differences. No significant differences were observed in maternal emergency department use 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 and acceptable among Latina mothers during the perinatal period. Although anxiety and perceived stress decreased within the Rosie group, no significant between-group differences were observed. Within-group reductions in anxiety and perceived stress among Rosie participants are preliminary and should be interpreted cautiously because the trial was not powered to detect between-group effects and no statistically significant between-group differences were observed. Larger, adequately powered trials are needed to evaluate effectiveness.
SN - 2561-326X
ER -