How does a social norms-based intervention affect behaviour change? Interim findings from a cluster randomised controlled trial in Odisha, India
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Published version
Date
2022-07-08
Authors
Sedlander, Erica
Pant, Ichhya
Bingenheimer, Jeffrey
Yilma, Hagere
Patro, Lipika
Ganjoo, Rohini
Mohanty, Satyanarayan
Rimal, Rajiv
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Published version
OA Version
Citation
E. Sedlander, I. Pant, J. Bingenheimer, H. Yilma, L. Patro, R. Ganjoo, S. Mohanty, R. Rimal. 2022. "How does a social norms-based intervention affect behaviour change? Interim findings from a cluster randomised controlled trial in Odisha, India." BMJ Open.
Abstract
Background Behaviour change interventions targeting
social norms are burgeoning, but researchers have little
guidance on what they look like, and which components
affect behaviour change. The Reduction in Anaemia
through Normative Innovations (RANI) project designed an
intervention to increase iron folic acid (IFA) consumption in
Odisha, India.
Objective This paper examines the effect of the
intervention at midline to understand which components of
the RANI intervention affect uptake.
Methods Using a cluster randomised controlled design,
we collected baseline data and midline data 6 months
later from women of reproductive age in the control and
treatment arms (n=3800) in Angul, Odisha, India. Using
nested models, we analysed data from three different
intervention components, monthly community-based
testing for anaemia, participatory group education
sessions, and videos, to determine the extent to which
exposure to each of these components accounted for
the overall intervention effect on haemoglobin and self-reported
IFA use.
Results Overall, residing in a treatment as opposed to
control village had little effect on midline haemoglobin, but
increased the odds of taking supplements by 17 times.
Exposure to each of the intervention components had a
dose–response relationship with self-reported
IFA use. These
components, separately and together, accounted for most of
the overall effect of treatment assignment on IFA use.
Conclusions All intervention components increased
iron supplement use to differing degrees of magnitude.
It appears that a social norms-based
approach can
result in improving IFA uptake, though improvements in
haemoglobin counts were not yet discernible.
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License
© Author(s) (or their employer(s)) 2022. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the license is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.