# 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.

## Key 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.