Increasing SNAP Enrollment Among Eligible Medicaid Beneficiaries: A Randomized Controlled Trial of Informational Messaging and Application Assistance

Arm 1 (Control):
Participants receive standard communications from Connecticut Department of Social Services (DSS) and have access to all existing resources for learning about and applying for SNAP, but receive no study-specific interventions.


Arm 2 (Information):
Participants receive SMS text messages informing them of their likely SNAP eligibility which also provides information about how to apply and how to further determine their benefit eligibility. Connecticut Department of Social Services (DSS) staff operate the SMS messaging system and send messages using DSS's established text messaging platform to targeted participants. Messages are sent from official DSS phone numbers that Medicaid beneficiaries have agreed to receive communications from (by not opting out). Slight variations in messaging, timing and frequency will be tested to determine optimal content. Messages include:
- Statement that the recipient may be eligible for SNAP based on their current Medicaid enrollment and directions to DSS websites that can further verify benefit eligibility
- Brief explanation of SNAP benefits (nutritional assistance program)
- Information about how to apply (phone number, website, or instruction to visit local DSS office)
- Opt-out instructions (recipients can reply STOP to stop receiving messages)

Members will receive an initial message at normal hours of the day (8 AM through 8 PM) and may receive additional reminder text messages (at most 2 additional reminders) weekly thereafter. Messages are delivered via SMS text message to the mobile phone number registered in DSS Medicaid enrollment records. Each SMS message is brief (160-300 characters, approximately 25-50 words) and takes approximately 30 seconds to read. With reminders, participants will receiving fewer than 5 brief messages in total.



Arm 3 (Information + Assistance):
Participants receive SMS text messages identical or similar to Arm 2, plus direction to contact application assistance partners. This intervention is the same as the intervention above with the addition that individuals will be directed to voluntarily request application assistance from Connecticut Foodshare. Messages are still sent from Connecticut DSS Staff. Connecticut Foodshare is a non-profit member of Feeding America with trained staff and volunteers who specialize in SNAP application assistance. Staff complete training on SNAP eligibility rules, application procedures, confidentiality requirements, and cultural competency.

Participants who respond to messages expressing interest or who call the Connecticut Foodshare number are connected with trained assistance staff. For participants who request assistance, Connecticut Foodshare staff: (i) explain the application process and requirements, (ii) help gather required documentation (proof of identity, income, residency, household composition) (iii) complete application forms with the participant, and (iv) follow up on application status if needed. All assistance is provided in English or Spanish based on participant preference. Assistance is entirely voluntary; participants can decline at any time without consequences.

Connecticut Foodshare staff are available to provide assistance throughout the study period during normal business hours (Monday-Friday, 9am-5pm). If members voluntarily decide to obtain assistance, it typically takes 30-45 minutes per participant, though duration varies based on income complexity of the beneficiary.

2026-04-06

2026-08-31

SNAP enrollment within 6 months of randomized outreach

From administrative records we will identify whether the household enrolls in SNAP within 6 months of the intervention.

(1) Duration of SNAP enrollment within 12 months of randomization; (2) SNAP enrollment at alternative time points (3 months and 12 months post-randomization) measured as binary indicators; (3) enrollment outcomes stratified by message variations within treatment arms to identify optimal messaging strategies; and (4) cost per additional enrollment calculated by dividing total intervention costs by the number of additional SNAP enrollments attributable to each intervention arm.

The experimental design consists of three main arms.

Arm 1 - Control
Arm 2 - Information
Arm 3 - Information + Assistance

We will make comparisons across these aggregate arms to identify the impact of informational messaging and information messaging in conjunction with application assistance relative to a control group receiving no communications as part of this trial.

Within the Information and Information + Assistance arms we will vary message content to identify the most effective message framing and content to drive enrollment. We will make comparisons across these variants, within each arm, to identify the relative impact of different messages:

Arm 2 - Information
- Arm 2a: Message 1
- Arm 2b: Message 2
- Arm 2c: Message 3
- Arm 2d: Message 4

Not available

Computer generated randomization

Household

Yes

250,000 households

375,000 medicaid beneficiaries

10,000 households information arm 1
10,000 households information arm 2
10,000 households information arm 3
10,000 households information arm 4
5,0000 households information and assistance arm 1
5,0000 households information and assistance arm 2
200,000 households control

We can detect a 0.5 percentage point (10% relative MDE) change in "Any SNAP enrollment" in the aggregate information arm relative to the control arm, and a 0.9 percentage point (18% relative MDE) change in "Any SNAP enrollment" in the aggregate information + assistance arm relative to the control arm.