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Lessons learned from using linked administrative data to evaluate the Family Nurse Partnership in England and Scotland.

Cavallaro, Francesca L, Cannings-John, Rebecca, Lugg-Widger, Fiona, Gilbert, Ruth, Kennedy, Eilis, Kendall, Sally, Robling, Michael, Harron, Katie L (2023) Lessons learned from using linked administrative data to evaluate the Family Nurse Partnership in England and Scotland. International journal of population data science, 8 (1). Article Number 2113. E-ISSN 2399-4908. (doi:10.23889/ijpds.v8i1.2113) (KAR id:102822)


"Big data" - including linked administrative data - can be exploited to evaluate interventions for maternal and child health, providing time- and cost-effective alternatives to randomised controlled trials. However, using these data to evaluate population-level interventions can be challenging. We aimed to inform future evaluations of complex interventions by describing sources of bias, lessons learned, and suggestions for improvements, based on two observational studies using linked administrative data from health, education and social care sectors to evaluate the Family Nurse Partnership (FNP) in England and Scotland. We first considered how different sources of potential bias within the administrative data could affect results of the evaluations. We explored how each study design addressed these sources of bias using maternal confounders captured in the data. We then determined what additional information could be captured at each step of the complex intervention to enable analysts to minimise bias and maximise comparability between intervention and usual care groups, so that any observed differences can be attributed to the intervention. Lessons learned include the need for i) detailed data on intervention activity (dates/geography) and usual care; ii) improved information on data linkage quality to accurately characterise control groups; iii) more efficient provision of linked data to ensure timeliness of results; iv) better measurement of confounding characteristics affecting who is eligible, approached and enrolled. Linked administrative data are a valuable resource for evaluations of the FNP national programme and other complex population-level interventions. However, information on local programme delivery and usual care are required to account for biases that characterise those who receive the intervention, and to inform understanding of mechanisms of effect. National, ongoing, robust evaluations of complex public health evaluations would be more achievable if programme implementation was integrated with improved national and local data collection, and robust quasi-experimental designs.

Item Type: Article
DOI/Identification number: 10.23889/ijpds.v8i1.2113
Additional information: For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission.
Uncontrolled keywords: early years, Scotland, cross-sectoral linkage, England, evaluation, Semantic Web, Humans, Child Health, adolescent motherhood, Child, Big Data, administrative data
Subjects: H Social Sciences
Divisions: Divisions > Division for the Study of Law, Society and Social Justice > School of Social Policy, Sociology and Social Research > Centre for Health Services Studies
Funders: National Institute for Health Research (
Wellcome Trust (
SWORD Depositor: JISC Publications Router
Depositing User: JISC Publications Router
Date Deposited: 08 Nov 2023 15:08 UTC
Last Modified: 08 Nov 2023 15:08 UTC
Resource URI: (The current URI for this page, for reference purposes)

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