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A community-engaged implementation mapping approach to increase SNAP participation in a diverse Latine community
Elena Byhoff1, Rebecca K Rudel2, Rachel Burgun3
1Department of Medicine, University of Massachusetts Chan Medical School, 55 North Lake Avenue, Worcester, MA 01655, USA.
Background:
The Supplemental Nutrition Assistance Program (SNAP) is an underutilized program. SNAP uptake is limited in Latine households in particular due to concerns about immigration eligibility, even when there are SNAP-eligible household members. Implementation strategies are urgently needed to increase SNAP participation rates among those who are eligible.
Purpose:
We used collaborative planning and implementation mapping to design implementation strategies to increase SNAP participation.
Methods:
Collaborative planning and implementation mapping included: (i) identify a shared priority; (ii) review relevant data to identify determinants of SNAP participation; (iii) design strategies to accomplish the priority goal; (iv) reach consensus and pilot-chosen strategies and workflows; and (v) evaluate implementation success based on chosen outcomes. Using the Practical Robust Implementation and Sustainability Model, we identified two implementation strategies, a community and a policy strategy, to pilot from January to December 2023.
Results:
The community strategy leveraged an existing food program to identify participants who were not already enrolled in SNAP. This resulted in 69 referrals and 4 new SNAP enrollees. The policy strategy leveraged the existing policy context to link SNAP enrollment with Medicaid insurance reenrollment at the end of the COVID-19 public health emergency protections. This resulted in an unknown number of referrals due to data workflow barriers.
Conclusions:
Despite considering context in the design and piloting of two implementation strategies, success was limited. Future success will require including the perspectives of those with lived experience to inform processes to identify eligible individuals without creating additional stigma or furthering distrust among those who may be ineligible.
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