Understanding Smart Behavioral AI in Infectious Disease Prevention: A Review of Usability, Equity, and Local Adaptation

Background: Artificial intelligence (AI) has been applied to behavioral interventions for preventing infectious diseases. However, the usability, equity, and regional adaptation of these tools—especially in Arabic-speaking have been relatively unaddressed. Aim: To advance a systematic review of the usability, efficacy, and cultural adaptation of AI-facilitated behavioral interventions for infectious disease prevention in primary health care settings. Methods: The search was conducted for papers that written from 2010 to 2025 in top databases. Existing literature that uses AI-based tools like mobile reminders, chatbots, adaptive messaging, and predictive nudges were considered eligible studies. We assessed behavioral effectiveness and usability measures, as well as the risk of bias. A total of seven new original figures were used for visual synthesis. Results: A total of fifty studies were examined, with primary focus areas including vaccine uptake, hand hygiene practices, and symptom reporting behaviors. Personalized interventions were more effective than others. Arabic language tools had significantly higher completion rates (70%), lower dropout rates (10%), and higher satisfaction (mean score = 4.6 out of 5) than non-Arabic tools. The risk of bias in randomized trials was also low, which differed in observational formats. An exercise with a geographic element revealed the under-representation of Arabic-speaking and displaced groups. Conclusion: The review highlights that behavioral interventions supported by AI can play a meaningful role in preventing infectious diseases—especially when they are thoughtfully designed to reflect the unique needs, cultural context, and circumstances of the target population. However, there is a lack of long-term evaluation, clinical inclusion, and regional equity. Future research should consider bilingual, ethically designed tools that can be used as integrated tools in care systems.