This paper analyzes a randomized experiment that
uses novel strategies to promote handwashing with
soap at critical times in Peru. It evaluates a large-scale
intervention that includes a mass media provincial
campaign and a district-level community component.
The analysis finds that the mass media intervention alone
had no significant effect on exposure to the handwashing
promotion campaign messages, and therefore no effect
on handwashing knowledge or handwashing behavior.
In contrast, the community-level intervention, a more
comprehensive intervention that included several
community and school activities in addition to the
communications campaign, was successful in reaching
the target audience with handwashing promotion
messages and in improving the knowledge of the treated
population on appropriate handwashing behavior. Those
improvements translated into higher self-reported and
observed handwashing with soap at critical junctures.
However, no significant improvements in the health of
children under the age of five were observed. The results
are consistent with earlier literature, which indicates that
substantively changing behavior to improve health is a
complex task requiring intensive and more personalized
interventions.