ArticleJMIR mHealth and uHealth2025
The Effectiveness of an Artificial Intelligence-Based Gamified Intervention for Improving Maternal Health Outcomes Among Refugees and Underserved Women in Lebanon: Community Interventional Trial.
Article in JMIR mHealth and uHealth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Refugee-centered framework for design of digital health interventions: a qualitative study with Ukrainian refugee women in Norway.Frontiers in digital health · 2026Article
- Artificial Intelligence (AI) Implementation in Maternal and Child Health: A Scoping Review.Journal of multidisciplinary healthcare · 2026Review
- Evidence integration: The transformative role of artificial intelligence in maternal health.Digital healthArticle
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Authors and funding
8 authors.
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Abstract
backgroundIn Lebanon, disadvantaged pregnant women show poor maternal outcomes due to limited access to antenatal care (ANC) and a strained health care system, compounded by ongoing conflicts and a significant refugee population. Despite substantial efforts to improve maternal health, the provision of maternal health services in primary health care centers (PHCs) still faces significant challenges. Mobile health (mHealth) interventions, particularly those using artificial intelligence (AI) and gamification, are proving effective in addressing gaps in maternal health services by offering scalable and accessible care.
objectiveThis study aimed to evaluate the effects of an AI-based gamified intervention, Gamification and Artificial Intelligence and mHealth Network for Maternal Health Improvement (GAIN MHI), on maternal health outcomes and uptake of ANC services among disadvantaged populations in Lebanon.
methodsThe study was a community interventional trial with historical controls, conducted across 19 randomly allocated PHCs in 5 Lebanese governorates. Participants included pregnant women in their first trimester visiting PHCs. The intervention used mHealth tools, including educational mobile-based messages, appointment reminders, and the GAIN MHI app, which provided AI-driven and gamified learning for health care providers (HCPs). Data collected covered demographics, medical history, and maternal and neonatal health outcomes. Key outcome measures included uptake of health care services (eg, ANC visits, supplement intake, ultrasound completion, lab tests) and maternal and neonatal outcomes (eg, term delivery, normal delivery, abortion rate, neonatal morbidity, maternal complications).
resultsThis study included 3989 participants, divided between a control group (n=1993, 50%) and an intervention group (n=1996, 50%). Regression models adjusting for demographics, health, and obstetric characteristics showed significantly higher odds in the intervention group for completing 4 or more ANC visits (odds ratio [OR] 1.569, 95% CI 1.329-1.852, P<.05), completing lab tests (OR 1.821, 95% CI 1.514-2.191, P<.05), 2 or more ultrasound screenings (OR 7.984, 95% CI 6.687-9.523, P<.05), urine analysis (OR 4.399, 95% CI 3.631-5.330, P<.05), and supplement intake (OR 3.508, 95% CI 2.982-4.128, P<.05). Regarding outcomes, the intervention group had 29.5% increased odds of a term delivery (OR 1.295, 95% CI 1.095-1.532, P=.002) and 58% increased odds of avoiding neonatal morbidity (OR 1.580, 95% CI 1.185-2.108, P=.002). However, both groups showed decreased odds of normal delivery (intervention: OR 0.774, 95% CI 0.657-0.911; control: OR 0.823, 95% CI 0.701-0.964) and increased odds of maternal complications (intervention: OR 0.535, 95% CI 0.449-0.637; control: OR 0.586, 95% CI 0.474-0.723; P<.05).
conclusionsThe GAIN MHI intervention effectively improves uptake of ANC and maternal and neonatal outcomes. Our findings highlight the potential of mHealth interventions to enhance health care delivery. To sustain these improvements, future research should focus on integrating mHealth with other interventions that address socioeconomic and contextual factors. This approach will further optimize maternal and neonatal health outcomes among disadvantaged populations.
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