Experiences of Digital Transitions in Health and Social Care Services in Later Life: Findings and Reflections from a Collaborative, Interdisciplinary Exploratory Review

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Dear authors,

thank you for submitting your paper to Social Sciences. I have read the manuscript with interest and care. I think the topic you are dealing with, the support of older adults with digital services and how this can be integrated better into the design and research of digital health services, denotes an important topic that is worthy of publication. However, I have several concerns that should be tackled in a resubmission with major revisions. Below, I have compiled a number of comments that should guide your revision process.

1) I am missing a clear goal of this paper. In the introduction you state that at least part of your concern is a perceived lack of a shared language and interdisicplinary collaboration. In your abstract you say that you provide "reflections on the interdisciplinary and collaborative processes used to help ensure an inclusive, caring and human-centred approach." However, this never really concretises in your paper. You remain rather vague what interdisciplinarity means for you and where it is located (in the research you are reviewing, in your own research practice, in your approach to engaging older adults?). Also, you never explicate the "inclusive, caring and human-centred approach" you claim to contribute to. In your revision you need to clearly outline and explain the concern you have, and how your research is tackling it. In this context, I am also not sure what you mean by a "rapid feasability study." Feasability of what? Of doing a literature review? You mention in the abstract that you present "a snapshot of our findings to date." Sometimes your paper reads like an unfinished prototype of a paper. This requires more development of a concrete contribution to existing literature.

2) Similarly, you describe inequalities and how they have been excacerbated during COVID, and how marginilised people struggle especially to use the digital health services you speak of. However, your discussion of how inequalities impact the use of health services remains superficial. You mention that some studies talk about inequalities, others don't, but to me as a reader it is never explained what this means concretely. It rather remains an implicit goal of your design philosophy. Then, in your own study with stakeholders inequalities do not seem to play a role either. So, I'm puzzled by the fact that you bring up the concern of inequalities but do not consider it part of your own research.

3) Another concern is your research design. You go into very much detail regarding your literature review, to which I only have a few questions (see below). But then you barely say anything about the other part of the paper, the stakeholder interviews with older adults (how many? who are they? what methods did you use?). It also seems to me that these two parts and methodologies do not seem to hang well together as they are presented at the moment. Your discussion of your interactions with people from the Edinburgh region is mostly about challenging some assumptions that were never introduced previously (like the inherent goodness of digital health services). They do not speak to the literature review, or at least I do not see the link. I suggest you either drop one of the two and focus on one of them, or make clear the link and give the stakeholder study the same methodological attention as you do with the review.

4) Finally, I have two questions about the literature review, one minor, one major. First the minor one: I did not quite understand how you arrived from over 1.000 papers to only 18 included. Crucially, in the screening step you give no indication why more than 90% of studies were excluded (while you provide that information regarding the other steps). Please provide explanation for the screening step. My major question is a bit more difficult: It seems to me that your selection of keywords (off- and onboarding) is very narrow, and you run the risk of missing a lot about digital support and digital inclusion (for inspiration, see Brit Winthereik et al.'s latest book on the topic). I do not understand why you focus solely on on- and offboarding (the latter of which seems to play no role in the literature), and why, for example, support during use is excluded from your study. Regarding off-boarding, I suggest to include other keywords like non-use or exclusion to get to what you try to identify with 'offboarding'. You either have to come up with a really good explanation why you limit yourself so much to on- and offboarding, or expand your literature review and contextualise it within the broader concern of digital inclusion.

I hope you'll find these comments helpful, and I'm looking forward to reading a revision of this paper in the future!

Author Response

Thank you for your comments and feedback. We feel they have enhanced the quality of our paper. Please see the attachment for a detailed point-by-point response.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

It is a necessary and important research work. As the paper indicates, after the COVID-19 Pandemic it is a relevant topic. The databases are adequate and the search equations correct. The inclusion and exclusion criteria are well described and extensive. It uses the PRISMA method and offers an explanatory flow chart as a result. I would recommend that the authors also indicate some descriptive information about the articles found (for example, the journals of the results articles). For future similar works, I would recommend the authors use the CADIMA tool.

Author Response

Comment 1:

I would recommend that the authors also indicate some descriptive information about the articles found (for example, the journals of the results articles)

Response 1:

Thank you for your comments. We have agreed to include the suggestion to provide a descriptive information of the fields that the included papers covered (between lines 190 and 192). We believe this can provide a summarised view of the interdisciplinarity of this review.