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Systematic proactive outreach has potential to improve FIM program enrollment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Determine the effectiveness of two outreach strategies (letter\u2009+\u2009telephone (higher intensity) and letter only (lower intensity)) compared to usual care on enrollment into a Medicaid FIM program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Three-arm randomized controlled trial conducted at one ACO in eastern Massachusetts between August 2023 and May 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Adults and children eligible for Flexible Services (Flex) nutrition services (Medicaid ACO insurance, food insecurity identified on two-item primary care-based screener, eligible diagnosis).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>The higher intensity group received a letter, followed by telephone outreach, offering Flex enrollment; the lower intensity group received a letter only. The usual care group received no outreach and could be referred by the clinical team.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Measures<\/jats:title>\n                    <jats:p>The primary outcome was the proportion of participants enrolled into Flex within 90\u00a0days of initial letter outreach, comparing each intervention group vs. usual care and higher vs. lower intensity groups. A secondary outcome was documented receipt of Flex services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Results<\/jats:title>\n                    <jats:p>\n                      A total of 255 individuals were randomized. Mean (SD) age was 33 (20) years, with 86 (34%) children; 131 (51%) were female. Compared to usual care, a larger proportion of intervention participants were enrolled in Flex in both the higher intensity (78% vs. 6% [\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001]) and lower intensity (39% vs. 6% [\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001]) groups. Higher intensity was more effective than lower intensity outreach (adjusted difference 39.0%; 95% CI 25.6%, 52.4%). Results were similar in comparisons of receipt of Flex services.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Proactive outreach increased enrollment into a Medicaid FIM program. Results suggest higher intensity outreach is most effective, but further research is needed to assess cost-effectiveness to guide implementation in other health systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>NIH Trial Registry Number (if Applicable)<\/jats:title>\n                    <jats:p>n\/a<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trials Registration Number<\/jats:title>\n                    <jats:p>NCT05972421<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11606-026-10558-5","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:19:17Z","timestamp":1790007557000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Higher and Lower Intensity Outreach to Increase Enrollment in a Medicaid Food Is Medicine Program: A Randomized Controlled Trial"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8138-1826","authenticated-orcid":false,"given":"Sarah","family":"Matathia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saja","family":"Alani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Regan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caylin","family":"Marotta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen","family":"Risley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexy","family":"Arauz Boudreau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Brodney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne N.","family":"Thorndike","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"10558_CR1","unstructured":"US Dept of Agriculture Economic Research Service. 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