Factors that influence the on-going retention of pre-school children aged 0-5 within Childsmile, the national oral health improvement programme for Scotland

Kidd, Jamie Brian Rutherford (2012) Factors that influence the on-going retention of pre-school children aged 0-5 within Childsmile, the national oral health improvement programme for Scotland. MSc(R) thesis, University of Glasgow.

Abstract

Evidence is abundant that oral health inequalities exist in Scotland. Poor oral health is associated with infrequent dental attendance. Those who need this care the most are the least likely to access it.

Childsmile Practice is an oral health improvement programme established in 2006 to improve child oral health and help reduce the oral health inequalities being experienced by children in Scotland. One aspect of the programme is the intervention of trained Dental Health Support Workers to facilitate children, aged from birth to five years, to attend dental practices where they will receive Childsmile prevention interventions.

The demonstration phase of Childsmile Practice was piloted in three NHS health boards between 2006 and 2009; Ayrshire and Arran, Greater Glasgow and Clyde, and Lanarkshire. Only 47% of children who first attended a Childsmile dental practice appointment during this period returned within twelve months of their initial appointment and retention rates have decreased each year since the programme started.

The aims of this study were to identify which factors were associated with retention in Childsmile Practice by developing a model which could be used to predict those children who had the highest probability of returning within twelve months of their first appointment. Univariately significant variables were analysed by multivariate logistic regression to create prediction models.

No individual variable was found to predict retention and although a combination of variables (outcome of last scheduled appointment, the age of the child, area-deprivation status, and factors related to the dental practice) could identify those children more likely to be retained, the predictability remained low (c-index = 0.61). Children aged under 6 months when they first attended were significantly the most likely to be retained (p<0.0001, OR = 1.44). The odds of retention were lower if the parent last visited a dentist for pain relief or smoked.

Although Childsmile is addressing oral health inequality, there remains inequality with regards to those accessing Childsmile Practice regularly. By tackling this problem, Childsmile has a further opportunity to decrease oral health inequalities in children in Scotland.

• Item Type: Thesis (MSc(R))
• Qualification Level: Masters
• Keywords: Dental Public Health, Childsmile, Oral Health, Retention, Child health, Scotland, Dental Caries, dental attendance, inequality
• Subjects: R Medicine > RK Dentistry; R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine; R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
• Colleges/Schools: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School
• Supervisor's Name: McMahon, Dr. Alex D. and Conway, Dr. David I.
• Date of Award: 2012
• Depositing User: MR Jamie Brian Rutherford Kidd
• Unique ID: glathesis:2012-3523
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 01 Aug 2012
• Last Modified: 10 Dec 2012 14:08
• URI: https://theses.gla.ac.uk/id/eprint/3523