Title: Factors influencing the healthcare transition in Chinese adolescents with inflammatory
bowel disease: A multi-perspective qualitative study
Version: 1 Date: 01 Oct 2023
Reviewer's report:
Thank you for the opportunity to review this important manuscript. Overall, this article is well
written and methodologically sound. There are some minor grammatical and spelling errors
noted throughout the paper and tables. This study adds value to the transition literature because
it focuses on the Chinese context.
Abstract: Results section – I suggest to identify barriers found to influence transition.
Background: It may be helpful to provide a few sentences on the IBD transition process within
China. Are youth patients automatically referred to an adult provider once they age-out of
pediatric care? When reading the findings related to the Chinese environment, I understand there
are some inadequacies with the system, but I can’t fully understand the results because I need
a bit more information about the Chinese healthcare setting and ways in which transitions are
managed within it.
Methods: Participant section – it is unclear what is meant by ‘we maintained a one-to-one
relationship between the patient and their parents’. I would suggest to add some clarification to
this sentence. It is unclear if the caregivers/parent participants were matched with the adolescent
participants. For example, did both the adolescent and the caregiver dyad need to participate?
I suggest a sentence to clarify if this was a requirement or not. It is not clear exactly how
study participants were recruited. The authors mention that recruitment occurred at IBD centres
and through China Crohn’s and Colitis Foundation, but how exactly was recruitment material
and information distributed to potential participants? I suggest greater clarity is needed on the
recruitment process. Data collection – I suggest adding a clarification stating that the interviews
were 1:1 interviews and not group interviews. Data collection and analysis was described and
conducted appropriately based on what was described in the manuscript.
Results: The constructed framework developed by the researchers is illustrative of the key
themes, is novel, and is easy to understand. Well done. On page 8, the heading is ‘transition
awareness’, should it read ‘transition consciousness’ to be consistent with the model? Also
within the model, under the provider section, there is ‘transition consciousness’, I suggest to
explain what type of transition consciousness is required by the providers within the body of
the manuscript. It may be helpful to add a new heading in the body of the text to introduce the
next outer ring in the figure (i.e. parent-child separation and communication) to better guide
the reader.
Discussion: I believe it would add value to the manuscript to add a paragraph of suggestions for
providers, patients, parents, communities, or health systems on how the newly developed model
and findings can be integrated at each level.
Title: Factors influencing the healthcare transition in Chinese adolescents with inflammatory
bowel disease: A multi-perspective qualitative study
Version: 1 Date: 01 Oct 2023
Reviewer's report:
Thank you for the opportunity to review this important manuscript. Overall, this article is well
written and methodologically sound. There are some minor grammatical and spelling errors
noted throughout the paper and tables. This study adds value to the transition literature because
it focuses on the Chinese context.
Abstract: Results section – I suggest to identify barriers found to influence transition.
Background: It may be helpful to provide a few sentences on the IBD transition process within
China. Are youth patients automatically referred to an adult provider once they age-out of
pediatric care? When reading the findings related to the Chinese environment, I understand there
are some inadequacies with the system, but I can’t fully understand the results because I need
a bit more information about the Chinese healthcare setting and ways in which transitions are
managed within it.
Methods: Participant section – it is unclear what is meant by ‘we maintained a one-to-one
relationship between the patient and their parents’. I would suggest to add some clarification to
this sentence. It is unclear if the caregivers/parent participants were matched with the adolescent
participants. For example, did both the adolescent and the caregiver dyad need to participate?
I suggest a sentence to clarify if this was a requirement or not. It is not clear exactly how
study participants were recruited. The authors mention that recruitment occurred at IBD centres
and through China Crohn’s and Colitis Foundation, but how exactly was recruitment material
and information distributed to potential participants? I suggest greater clarity is needed on the
recruitment process. Data collection – I suggest adding a clarification stating that the interviews
were 1:1 interviews and not group interviews. Data collection and analysis was described and
conducted appropriately based on what was described in the manuscript.
Results: The constructed framework developed by the researchers is illustrative of the key
themes, is novel, and is easy to understand. Well done. On page 8, the heading is ‘transition
awareness’, should it read ‘transition consciousness’ to be consistent with the model? Also
within the model, under the provider section, there is ‘transition consciousness’, I suggest to
explain what type of transition consciousness is required by the providers within the body of
the manuscript. It may be helpful to add a new heading in the body of the text to introduce the
next outer ring in the figure (i.e. parent-child separation and communication) to better guide
the reader.
Discussion: I believe it would add value to the manuscript to add a paragraph of suggestions for
providers, patients, parents, communities, or health systems on how the newly developed model
and findings can be integrated at each level.
Please review this paper.
user
Title: Factors influencing the healthcare transition in Chinese adolescents with inflammatory
bowel disease: A multi-perspective qualitative study
Version: 1 Date: 01 Oct 2023
Reviewer's report:
Thank you for the opportunity to review this important manuscript. Overall, this article is well
written and methodologically sound. There are some minor grammatical and spelling errors
noted throughout the paper and tables. This study adds value to the transition literature because
it focuses on the Chinese context.
Abstract: Results section – I suggest to identify barriers found to influence transition.
Background: It may be helpful to provide a few sentences on the IBD transition process within
China. Are youth patients automatically referred to an adult provider once they age-out of
pediatric care? When reading the findings related to the Chinese environment, I understand there
are some inadequacies with the system, but I can’t fully understand the results because I need
a bit more information about the Chinese healthcare setting and ways in which transitions are
managed within it.
Methods: Participant section – it is unclear what is meant by ‘we maintained a one-to-one
relationship between the patient and their parents’. I would suggest to add some clarification to
this sentence. It is unclear if the caregivers/parent participants were matched with the adolescent
participants. For example, did both the adolescent and the caregiver dyad need to participate?
I suggest a sentence to clarify if this was a requirement or not. It is not clear exactly how
study participants were recruited. The authors mention that recruitment occurred at IBD centres
and through China Crohn’s and Colitis Foundation, but how exactly was recruitment material
and information distributed to potential participants? I suggest greater clarity is needed on the
recruitment process. Data collection – I suggest adding a clarification stating that the interviews
were 1:1 interviews and not group interviews. Data collection and analysis was described and
conducted appropriately based on what was described in the manuscript.
Results: The constructed framework developed by the researchers is illustrative of the key
themes, is novel, and is easy to understand. Well done. On page 8, the heading is ‘transition
awareness’, should it read ‘transition consciousness’ to be consistent with the model? Also
within the model, under the provider section, there is ‘transition consciousness’, I suggest to
explain what type of transition consciousness is required by the providers within the body of
the manuscript. It may be helpful to add a new heading in the body of the text to introduce the
next outer ring in the figure (i.e. parent-child separation and communication) to better guide
the reader.
Discussion: I believe it would add value to the manuscript to add a paragraph of suggestions for
providers, patients, parents, communities, or health systems on how the newly developed model
and findings can be integrated at each level.
assistant