Messages on COVID-19 Prevention in India Increased Symptoms Reporting and Adherence to Preventive Behaviors Among 25 Million Recipients with Similar Effects on Non-recipient Members of Their Communities

This large randomized controlled trial in West Bengal investigated the effectiveness of messaging videos that were 2.5-minutes long and delivered by West Bengal native Abhijit Banerjee, Nobel prize laureate in economics and the chair of the West Bengal government’s COVID-19 advisory board. All messages encouraged reporting symptoms to the local public health worker and emphasized one health-preserving behavior (distancing or hygiene) and one motivation for action (effects on everyone or just on self). Messages were randomized at the PIN code level, with the control group receiving a message pointing participants to government information. Findings of this campaign depict a doubling in the reporting of health symptoms to community health workers, a decrease in travel beyond one’s village in the last two days by 20%, and an increase in estimated handwashing when returning home by 7%. Behavior change was evident by both message recipients and nonrecipients in the same community in areas not mentioned in the message – mask-wearing, physical distancing and hygiene practices. Recommendations are to disseminate messages broadly across many communities, rather than using the same budget to target key communities; and there is an important role in messaging by credible individuals and/or celebrities.