School of Medicine, Dentistry & Nursing

Aims
To understand and tackle the social determinants of childs oral health and reduce child oral health inequalities. 

Process evaluation
The in-depth, mixed-methods process evaluation assesses how closely the programme is operating according to how it was envisioned initially, ie whether the anticipated changes in service provision and behaviours, necessary for child oral health improvement, have occurred. This includes, for example: activity levels for fluoride varnish applications in education and dental practice settings; dental registration and attendance rates; toothbrushing activity; DHSW and other community-based early years’ activity. Where necessary, research is conducted to investigate the barriers and facilitators for the implementation of component parts of the programme. Identification of these factors can facilitate ongoing refinement to enhance programme delivery still further.

Outcomes
Outcomes from the programme are being investigated mainly via a pioneering big data linkage project. This involves linking multiple routine administrative national health and education datasets to create a birth cohort to evaluate the complex multiple interventions of Childsmile with a range of health and education outcomes.
An economic evaluation, investigating the cost-effectiveness of the programme and its components, accompanies this work. Furthermore, an embedded, randomized control trial of the nursery fluoride varnish programme – Protecting Teeth @ 3 trial10 – has recently been completed.

Evaluation is ongoing
The programme is a complex multifaceted programme delivering prevention interventions in multiple settings (through health visitors, in communities with dental health support workers, in nurseries/school settings, and in dental practices). The programme has not been a single fixed model but has been dynamic and evolving since its establishment. Part of its success of Childsmile has been the long- term vision and support from successive Scottish Governments (of differing political make-ups) since its inception in 2005/06. The ongoing evaluation of the programme has also been crucial to programme development and achievements. While there has been considerable success in improvement of child oral health in Scotland over this period, there remains substantial ongoing challenges including persistent inequalities in child oral health; and more recently, the COVID-19 pandemic has had a major impact on the Childsmile programme and stalled the trend of improving child oral health in Scotland. Ongoing monitoring and evaluation of the Childsmile programme is essential to meeting the challenge of child oral health and inequalities both in Scotland and globally.

Child Oral Health Data Lab

Our Child Oral Health Data Lab is hosted within the NHS Scotland National Safe Haven and links over one million individual child records across numerous routine administrative health and education datasets to answer key evaluation questions.

Full approval has been given by the Health and Social Care Public Benefit Privacy Panel (HSC-PBPP) and the Statistics Public Benefit Privacy Panel (S-PBPP) for this data linkage.

Privacy Notice for Evaluation of the Childsmile Programme

Public Health Scotland and the Scottish Ministers (Scottish Government) will be the ‘Data Controllers’ of personal data processed in relation to this study, which is performed in the public interest. This privacy notice will explain how your personal data will be processed by the University of Glasgow.

Study background

Childsmile is the national oral health improvement programme for children in Scotland, and aims to improve child oral health, reduce inequalities in outcomes and access to services. It is funded by the Scottish Government and delivered by the NHS to all children from birth to 17 years through a variety of educational (nurseries and schools) and community settings (dental practices, home visits). The programme started in the early 2000’s with various different pilot programmes running in different Health Boards from 2006 and was fully rolled out across the 14 Health Boards in Scotland from 2011.

Part of its success has been the long-term vision and support from successive Scottish Governments since 2005/06. 

The evaluation of the Childsmile programme is led by the University of Glasgow (Central Evaluation and Research Team) in partnership with NHS Scotland. The evaluation has received core funding from the Scottish Government alongside ongoing external grant funding.  The evaluation aims to find out if the Childsmile programme is reaching the children it should across Scotland and if it has improved oral (and general) health and reduced health inequalities. In addition, we wish to find out which components of the Childsmile programme seem to work best under which circumstances to help the Scottish Government and NHS Scotland prioritise prevention services. We worked with parents/carers, policy makers, education staff, social workers and dental teams to determine which outcomes we should be evaluating for the Childsmile programme. As well as oral health outcomes, our stakeholders identified other health and education outcomes that they believed should/could be impacted by the programme such as obesity, diabetes, multimorbidity (due to common risk factors), and school attendance (days absent due to dental problems).

Why we need your data

We are collecting basic personal data such as ethnicity, care status, additional support needs information, as well as family socioeconomic circumstances (occupational and educational), health record data (including mental health) and parental and household information that may be risk factors for tooth decay (such as parental smoking).

We are processing data from Public Health Scotland and the Scottish Government, including oral health data, hospital admission data, prescribing information, dental attendance and engagement with the Childsmile programme as well as school data to help us understand if the Childsmile programme is reaching and benefitting all children in society, and particularly those in greater need. We will be collecting these data for individuals in the general population from birth to 17 years (when children and families should have access to the Childsmile programme).

We are also collecting data on the operational activities of Childsmile staff for our economic and environmental sustainability evaluation – these data will include workplace postcodes in order to estimate travel costs and resource use to support Childsmile’s sustainability targets.

Legal basis for processing your data

Tooth decay affects almost half of all 5-year-old children in Scotland with those from more socioeconomically deprived areas experiencing a greater burden of disease. Tooth decay is the most common reason for children being admitted to hospital for general anaesthetic in the UK and costs the NHS millions of pounds each year in treatment costs.

Childsmile is the national child oral health improvement programme for Scotland and helps prevent tooth decay in children from birth and reduce inequalities in tooth decay and access to preventive services. It may also prevent other conditions that share common risk factors (i.e sugar consumption as a risk factor for both childhood tooth decay and obesity). Improving oral health and reducing inequalities is a top global public health challenge and is a priority of the Scottish Government. Therefore, the processing of these data is to perform a task which is in the public interest.

For personal data: Article 6(1)(e) Processing is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the controller.

For special category data: Article 9(2)(j) processing is necessary for archiving purpose in the public interest, scientific or historical research purposes or statistical purposes.

What we do with the data and who we share it with

All data are anonymised to researchers and stored within the National Safe Haven (https://www.isdscotland.org/products-and-services/edris/use-of-the-national-safe-haven/). All data will be analysed by members of the Childsmile Evaluation research team using a University of Glasgow Virtual Private Network to safely and securely link to the National Safe Haven. All of our researchers are “Approved Researchers” and undertake regular training in Information Governance (MRC course in Research, GDPR and confidentiality; University of Glasgow Research Integrity Training/ Research Data Management).

How long we keep data for

Data will be retained for 10 years. After this time, data will be securely deleted.

Further information

If you require further information about this study, or how we process personal data, please email; andrea.sherriff@glasgow.ac.uk or david.conway@glasgow.ac.uk . Full contact details are given below:

Professor Andrea Sherriff

Professor of Epidemiology and Statistics (Dental School)

Telephone: 0141 211 9750

Email: Andrea.Sherriff@glasgow.ac.uk

School of Medicine, Dentistry & Nursing, Level 9, L11, 378 Sauchiehall Street, Glasgow

Dental Hospital & School, Glasgow, G2 3JZ

Professor David Conway

Professor of Dental Public Health (Dental School)

Telephone: 0141 211 9750

Email: David.Conway@glasgow.ac.uk

School of Medicine, Dentistry & Nursing, R1012 Level 10, 378 Sauchiehall Street,

Glasgow Dental Hospital & School, Glasgow, G2 3JZ

Complaints

Should you wish to exercise your data rights and raise a complaint regarding our use of personal data in this study, you can contact the University of Glasgow Data Protection Office, who will investigate the matter. The Data Protection Office can be contacted at: dataprotectionofficer@glasgow.ac.uk.

If you are not satisfied with our response or believe we are not processing your personal data in accordance with the law, you can complain to the Information Commissioner’s Office

(ICO) https://ico.org.uk/