A Trial of AI-Powered Text Message Outreach on Well-Child Visit Completion

The goal of this clinical trial is to evaluate whether conversational AI-powered text message outreach with appointment scheduling assistance improves well-child visit completion rates in Medicaid-enrolled children aged 0-21 years compared with automated text messages alone or traditional passive outreach. The main questions it aims to answer are: Does automated SMS outreach improve well-child visit completion rates compared to traditional passive outreach? Does conversational AI-powered scheduling assistance lead to higher completion rates than automated SMS alone? Researchers will compare three groups: Control Group: Participants receive traditional passive outreach (mailed reminders). Automated SMS Group: Participants receive standardized automated text message reminders. Automated SMS + Conversational AI Scheduling Assistance Group: Participants receive automated text messages plus AI-powered appointment scheduling assistance that contacts primary care providers directly to book appointments on behalf of families. Participants will: Be randomized into one of three study groups at the household level. Receive outreach from June 9-July 14, 2025. Have well-child visit completion ascertained through administrative claims through December 31, 2025. This study tests whether concrete scheduling support - rather than reminders alone - drives preventive care utilization in pediatric Medicaid populations.

Inclusion Criteria: 1. Medicaid beneficiary aged 0-21 years 2. Had not completed a well-child visit in 2025 3. Enrolled through the managed care organization with authorization for health plan outreach 4. Valid mobile phone number capable of receiving SMS Exclusion Criteria: 1. Do-not-contact designation 2. Inactive phone service 3. Documented request for no contact from healthcare provider or health plan 4. Prior SMS well-child visit outreach earlier in the 2025 measurement year