Artificial intelligence–enabled digital reproductive health education: corpus-based strategies for strengthening Spanish health communication capacity

This study examines how corpus-grounded artificial intelligence (AI) can strengthen Spanish reproductive health communication capacity within China's digital health ecosystem. A mixed-methods design was employed, combining corpus linguistics, AI-assisted message generation, expert-informed evaluation, and quantitative user assessment. A domain-specific Spanish reproductive health corpus was constructed from 3,052 documents, including clinical guidelines, patient education materials, and FAQs/user queries, yielding 1,065,110 tokens for linguistic analysis and AI grounding. Corpus-derived readability benchmarks, lexical simplification rules, and discourse patterns were integrated into an AI content generation pipeline to produce reproductive health messages, which were then compared with non-corpus-grounded AI outputs. The user evaluation phase was conducted among 240 Spanish-speaking or Spanish-proficient adults in selected Chinese metropolitan cities. Data were collected through a structured questionnaire measuring Corpus-Grounded AI Generation, Spanish Communication Quality, and Health Communication Capacity, and were analyzed using reliability testing, correlation analysis, and structural equation modeling. The findings showed that corpus-grounded AI significantly improved Spanish communication quality, while communication quality had the strongest effect on users' comprehension, confidence, and help-seeking intention. Mediation analysis further demonstrated that Spanish communication quality significantly mediated the relationship between corpus-grounded AI generation and health communication capacity. The study concludes that linguistically informed AI design can enhance the clarity, accessibility, and effectiveness of reproductive health education and offers a practical framework for multilingual digital health communication in sensitive healthcare contexts.