Manaseki-Holland S, Manjang B, Hemming K, et al. - High rates of under-5 mortality from diarrhoea and pneumonia are reported in the Gambia; these rates peak during complementary-feeding age. Considering that Community-based interventions may allow reduction in complementary-food contamination and disease rates, researchers conducted a large cluster randomized controlled trial (RCT) to test a novel community-level campaign-like intervention in 15 intervention and 15 control villages in rural Gambia and evaluated outcomes at 6 and 32 months post-intervention. Identification of target behaviors was done via systematic assessment of motivational drivers for behavior change and critical control points (CCPs) for contamination in complementary-food preparation and handling practices recognized via a hazard analysis assessment. Implementation of the intervention was done at the community level focussing on mothers of young children. A combination of performing arts, public meetings, household visits, commitment ceremonies, and certifications of mothers and communities were involved to deliver the intervention. Adoption of behaviors was high at 6 months postintervention; there was reduction in child’s reported diarrhoea, hospital admission for diarrhoea, and respiratory disease by 60%, 60%, and 30%, respectively. At 32 months post-intervention, adoption of some of the behaviors promoted by the intervention was observed among the mothers in control villages (intervention ‘cross-contamination’), however, significantly higher practice of the behaviors remained among the intervention villages, with a 30% decrease in documented diarrhoea and a 40% decrease in hospital admissions for diarrhoea. Attainment of these outcomes was observed without further programmatic input after 5 months. They observed subsequent engagement of mothers without babies at the time of the programme by community members and adoption of the behaviors. Findings overall suggest that these low-cost, culturally embedded interventions are acceptable, adopted, and sustained at the community level, with high levels of behavior change and described decrease in diarrhoea and acute respiratory infection outcomes in the short term, and significant long-term effects.