Practice Interaction

These ten covariates were grouped together as they described the interactions between the participants and the dental practices. These covariates were analysed to determine if the interactions between the participants and the practices

significantly influenced retention.

Unless stated otherwise, data for covariates in this group were from the ‘Record of Child/Parent Contact’ and ‘GP17’ forms.

4.7.2.1 Fluoride Varnish Application at First Kept Appointment

This covariate indicates whether or not a child received a FVA when they attended their first Childsmile appointment. As dental practices were eligible to claim a fee for a FVA, it would be expected that the number of FVAs recorded would be highly accurate.

4.7.2.2 Supplementary Contact

Although Childsmile Practice is normally delivered by a trained Childsmile dental nurse, there may be instances where the patient also received supplementary contact with either a dentist or dental hygienist. This data were only collected on the ‘Record of Child/Parent Contact’ form and therefore it is unknown whether or not a child received supplementary contact with a dentist or dental hygienist once Childsmile dental practice data were recorded on the ‘GP17’ form. Because of this, it was unknown for the majority of Childsmile appointments if supplementary contact was provided.

4.7.2.3 Toothbrushing Advice Given at First Kept Appointment

This covariate indicates whether or not a child was given toothbrushing and fluoride advice when they attended their first Childsmile appointment. Whilst this intervention was to be delivered at all first appointments (unlike FVAs), there was no financial incentive to record this intervention and it is therefore possible that practices did not claim for this intervention.

4.7.2.4 Dietary Advice Given at First Kept Appointment

This covariate indicates if a child was given dietary advice when they attended their first Childsmile appointment. Whilst this intervention should be delivered at all first appointments (unlike FVAs), there was no financial incentive to record this intervention and it is therefore possible that practices did not claim for this

intervention, although as this intervention was recorded in 93% of cases it would indicate that the data for this covariate is highly accurate.

4.7.2.5 Year of First Appointment

The year of the first appointment was the year Childsmile dental practice activity was first recorded for an individual child, regardless of whether or not the

appointment was kept or not. If the appointment was kept, it would initiate the first instalment of an annual fee being paid to the dental practice for the child. Therefore it would be expected that this covariate would be highly accurate. It is possible however that a practice may not have completed a form if the first appointment was not attended as this would not have generated a payment for them.

4.7.2.6 Year of First Kept Appointment

The year of the first kept appointment was the year that an individual child first attended a Childsmile appointment. As the payment of an annual fee to the dental practice is initiated when a patient first attends a Childsmile appointment, it would be expected that this covariate would be highly accurate.

4.7.2.7 Result of First Scheduled Appointment

This is the result of the first recorded Childsmile appointment at a Dental Practice. The result is either that the child attended their first Childsmile appointment or that they FTA it. Due to the financial incentive for a dental practice to indicate that a child attended their first scheduled appointment it would be expected that

this covariate would be accurate although is it possible that a practice may not have completed a form is the first appointment was not attended as this would not generate a fee.

4.7.2.8 Result of Last Scheduled Appointment

This is the result of the last recorded Childsmile appointment at a Dental Practice. The result is either that the child attended their last scheduled Childsmile

appointment or that they FTA it. From 2009 onwards, a child must have attended an appointment at least once within a twelve month period for the dental practice to continue receiving an annual fee. This therefore provided a financial incentive to record all kept appointments. As there was no financial incentive to record a FTA it is possible that practices did not always complete a form for these appointments.

4.7.2.9 Year of first appointment (Outcome ‘Failed to Attend’)

This is the year of a child’s first appointment that resulted in a FTA. As a FTA appointment has no financial bearing for a dental practice, there is a possibility that some FTAs were not recorded. As there were low number of patients whose first FTA appointment was in the early years of Childsmile, data from 2006 and 2007 were pooled as one category for the analysis.

4.7.2.10 Data-zone (Child Versus Practice)

This covariate indicates whether or not a child lives within the same data-zone as the dental practice that they attended. A data-zone is a geographical area that consists of between 500 to 1000 persons which represents local boundaries and neighbourhoods based on the 2001 Census [Scottish Government, 2005]. The data- zone was known for each child and practice in this study.

Data for this covariate were available by linking the Record of Child/Parent Contact form and the GP17 form with the SIMD lookup file.