How strong is the evidence that the Calendar intervention can be effective in bringing about behavior change?
Efficacy = Whether the intervention “works” under ideal (research) conditions
We cannot say with certainty what the outcomes would be under these conditions as an entirely controlled-environment experiment has never been performed that exactly matches these circumstances.
Effectiveness = Whether the intervention “works” under real-life conditions
Yes, we have seen evidence that the calendar interventions would work. A higher proportion of intervention than of control babies were up to date at the end of a 9-month enrollment period (82% vs 65%, P < .001) and at age 24 months (66% vs 47%, P < .001). The younger the baby’s age at enrollment in the program, the greater was the intervention effect. Since the study was taken place in real life conditions in urban areas of St. Louis, Missouri, the intervention proved to work in real-life conditions.
Evidence based = Is there evidence to suggest the intervention should work
Yes, this real-life study was also performed in a metropolitan/urban environment (St. Louis, MO). Calendar interventions did not target all high-risk groups, it targeted one group who were users of public health systems. However, users of public health systems do
have a higher proportion of minority, low socioeconomic individuals than users of private systems. This intervention could work with new mothers but it has only been shown effective with certain populations.