A community-engaged implementation mapping approach to increase SNAP participation in a diverse Latine community

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. Increasing Supplemental Nutrition Assistance Program enrollment requires an interdisciplinary implementation team that includes perspectives from all stakeholders. The Supplemental Nutrition Assistance Program (SNAP, formerly known as food stamps) is an evidence-based intervention to reduce food insecurity and improve health. Yet not all individuals who are eligible receive SNAP benefits. Latine individuals in particular are underenrolled in the SNAP program. Using a planning approach that included representatives from a health center, a local food bank, SNAP enrollment workers, and a researcher, we identified new outreach strategies to increase SNAP enrollment in a Latine community. One strategy conducted SNAP outreach to individuals already using a food bank-delivered program. Another strategy linked SNAP outreach to Medicaid enrollment. Success was limited due to issues surrounding identifying eligible individuals at the food program and difficulty with new documentation workflows in Medicaid enrollment. Our findings highlight the need to include end-users in design of implementation strategies.