Promoting Handwashing Behavior in Peru: The Effect of Large-Scale Mass-Media and Community Level Interventions
Last registered on June 03, 2014

Pre-Trial

Trial Information
General Information
Title
Promoting Handwashing Behavior in Peru: The Effect of Large-Scale Mass-Media and Community Level Interventions
RCT ID
AEARCTR-0000318
Initial registration date
June 03, 2014
Last updated
June 03, 2014 2:48 PM EDT
Location(s)
Region
Primary Investigator
Affiliation
University of Maryland
Other Primary Investigator(s)
PI Affiliation
Berkeley Haas School of Business
PI Affiliation
World Bank, WSP
Additional Trial Information
Status
Completed
Start date
2008-05-01
End date
2012-11-01
Secondary IDs
Abstract
This project 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.
External Link(s)
Registration Citation
Citation
Galiani, Sebastian, Paul Gertler and Alexandra Orsola-Vidal. 2014. "Promoting Handwashing Behavior in Peru: The Effect of Large-Scale Mass-Media and Community Level Interventions." AEA RCT Registry. June 03. https://www.socialscienceregistry.org/trials/318/history/1861
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Experimental Details
Interventions
Intervention(s)
80 provinces were randomly selected, with 40 provinces assigned to a first group and 40 provinces to a second.

Province Group 1: 40 districts (with between 1,500 and 100,000 inhabitants) were randomly chosen to receive the mass media province-level treatment.

Province Group 2: 85 districts (with between 1,500 and 100,000 inhabitants) were randomly selected, with 44 districts randomly assigned to receive the district-level community treatment and the other 41 randomly assigned to serve as control group for the mass media and community treatments. In addition, for the 44 districts that were randomly assigned to the community treatment, the main school in each district received the school treatment. To create a counterfactual for the subgroup of households with children attending the main school in the treated districts, we also chose a subsample clustered around the main schools in the districts of the control group to serve as a control group for the school intervention.
Intervention Start Date
2008-05-02
Intervention End Date
2011-06-01
Primary Outcomes
Primary Outcomes (end points)
child health, campaign effectiveness, behavior change
Primary Outcomes (explanation)
Secondary Outcomes
Secondary Outcomes (end points)
Secondary Outcomes (explanation)
Experimental Design
Experimental Design
The Global Scaling Up Handwashing Project in Peru intervention consisted of two main
components:
• a province-level mass media campaign; and
• a more comprehensive district-level community treatment that included, in addition to
the media campaign, training of community agents; capacity building of mothers,
caregivers, and children; and the inclusion of handwashing promotion as part of
primary school curricula.
Experimental Design Details
The targeted areas were districts with populations ranging from 1,500 to 100,000 inhabitants. Figure 1 shows the experiment’s design. First, Pisco and Lima were excluded from the 195 Peruvian provinces. From the 193 remaining provinces, 80 provinces were randomly selected, with 40 assigned to a first group and 40 to a second. From the first group of 40 provinces, 40 districts (with between 1,500 and 100,000 inhabitants) were randomly chosen to receive the mass media province-level treatment. From the second group of provinces, 85 districts (with between 1,500 and 100,000 inhabitants) were randomly selected, with 44 randomly assigned to receive the district-level community treatment and the other 41 randomly assigned to serve as control group for the mass media and community treatments. In addition, for the 44 districts that were randomly assigned to the community treatment, the main school in each district received the school treatment. To create a counterfactual for the subgroup of households with children attending the main school in the treated districts, we also chose a subsample clustered around the main schools in the districts of the control group to serve as a control group for the school intervention.
Randomization Method
Randomization done in office.
Randomization Unit
province, district
Was the treatment clustered?
Yes
Experiment Characteristics
Sample size: planned number of clusters
Province Group 1: 40 districts (mass media treatment)
Province Group 2: 85 districts (44 districts assigned to the district-level community treatment and the other 41 randomly assigned to serve as control group to both treatments).
Sample size: planned number of observations
The baseline survey was conducted to 3,576 households.
Sample size (or number of clusters) by treatment arms
Treatment:
- Province Group 1 (mass media): 40 districts; 717 treatment
- Province Group 2 (community treatment and school component): 85 districts; 763 community treatment, 705 school component treatment, 684 school component control.
Control:
- 41 districts; 707 control
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
IRB
INSTITUTIONAL REVIEW BOARDS (IRBs)
IRB Name
Western Institutional Review Board (WIRB)
IRB Approval Date
2008-02-28
IRB Approval Number
20072099
Post-Trial
Post Trial Information
Study Withdrawal
Intervention
Is the intervention completed?
No
Is data collection complete?
Data Publication
Data Publication
Is public data available?
No
Program Files
Program Files
Reports and Papers
Preliminary Reports
Relevant Papers