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.