The Effects of the RANI Project on 6-Month Physical Activity Among Women Living in Rural India: A Randomized-Controlled Trial

TL;DR

This study tested a social norms-based intervention to reduce anemia and increase physical activity among women in rural India, but found no significant changes in anemia or overall activity, though steps per day increased.

Contribution

The study evaluates a novel social norms-based intervention for improving anemia and physical activity in rural Indian women.

Findings

No significant differences in hemoglobin levels between treatment and control groups after 6 months.

Steps per day were significantly higher in the treatment group compared to the control group.

Overall physical activity levels did not change significantly between the groups.

Abstract

Anemia is associated with fatigue, low physical activity, and poor quality of life. The purpose of this study was to determine the effects of a field trial on 6-month change in anemia and physical activity among nonpregnant women living in rural India.

The Reduction in Anemia through Normative Innovations (RANI) Project is a cluster randomized controlled trial of a social norms-based intervention to reduce anemia among women (15–49 years). Participants (n = 292) performed a modified Queen's College Step Test (QCST) and wore an ActivPAL accelerometer for 3 days. Hemoglobin concentrations (g/dL) were determined using a HemoCue 301 photometer. Linear regression tested the effects of the intervention on 6-month change in hemoglobin and physical activity, while adjusting for age, body mass index, education, parity, and predicted VO2max.

We observed no differences in hemoglobin (11.8 ± 1.2 vs.11.6 ± 1.4 g/dL) or overall physical activity (36.6 ± 2.1 vs. 35.3 ± 5.8 metabolic equivalent of task-hours/day) at 6 months between the treatment and control groups, respectively. In contrast, steps/day was significantly higher in the treatment, compared with the control group (β = 1353.83; 95% confidence interval: 372.46, 2335.31), independent of other covariables.

The potential to modify walking and other health-seeking behaviors using a social norms approach is worthy of further investigation among women living in rural India.

Clinical Trial Registry – India: CTRI/2018/10/016186.