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Abstract
Objective To conduct a process evaluation of a national programme distributing free fluoride toothpaste and toothbrushes to all 8-month-old children, and targeted distribution to high caries risk 1–3-year-old children in Scotland.
Design Telephone interview with a local co-ordinator in each NHS Board and postal questionnaire to health visitors in four Boards, to explore distribution methods, dissemination of information to distributors, satisfaction levels with the distribution process and methods of monitoring packs issued to children. Results Main distributors of packs to 8-month-olds were health visitors. A wider variety of outlets was used for targeted distribution to 1–3-year-olds, including playgroups/nurseries, pharmacies and dental practices. Ninety-six per cent of health visitors reported involvement in the programme with proportions indicating receipt of information specific to the distribution to 8-month-olds and 1–3-year-olds being 97 and 69 per cent respectively. A positive association was found between level of information received by health visitors and level of satisfaction with the distribution process, for both age groups (p< 0.001). Satisfaction levels with distribution to 8- month-olds were high but for 1–3-year-olds, distribution and monitoring difficulties were reported. The majority of Boards had no robust system of recording distribution of packs to individual children and major discrepancies were seen between recorded number of packs sent to distributors and those distributed to children.
Conclusion Co-ordinators and health visitors were positive about the distribution programme but reported difficulties accessing high-risk 1–3-year-olds. For monitoring purposes, a minimum data set should be agreed. The results highlight the need for good communication at all levels in a programme of this type.