PONE-D-24-15124Staff, Resident and Care Partner Perceptions on the Use of a Personalized Tablet to Mitigate the Impact of Isolation in Long-Term Care ResidentsPLOS ONE

Dear Dr. Iaboni,

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Reviewers' comments:

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Comments to the Author

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Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: N/A

Reviewer #2: N/A

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The paper describes experiences with a tech intervention, DIT-Tech, which aims to enhance LTCH residents’ wellbeing by addressing social isolation. The presentation of the findings is clear and interesting. However, some details about the research are missing; this information may have implications for the interpretation of the findings and/or the limitations of the research.

Under “Setting and intervention”, it states that 7 “diverse” LTCHs participated in the research but no details are provided. How were the homes diverse? How were LTCHs recruited?

No information is provided on the characteristics of residents who used the tablets. Given the high proportion of LTCH residents living with dementia, it would be particularly important to know what proportion of residents who used the tablets had dementia. This information would provide important context for interpreting the findings. If this information is not available, the potential impacts should be discussed in the limitations section. It would also be important to know if any of the residents who were interviewed had dementia and what proportion of care partners had relatives with dementia. If there is not good representation of residents with dementia and/or care partners of relatives have dementia, then the impacts of this should be discussed in the discussion and/or the limitations section. For example, future research directions are discussed on page 25 but there’s no mention of ensuring research includes the perspectives and voices of people living with dementia. Their use, and perceptions of DIT-Tech may differ from residents without dementia.

No residents were interviewed individually – all were part of interviews with care partners. Were residents active participants in the interviews? On page 9 it states that “resident quotes were largely omitted from the excerpts”, stating that there was agreement between residents’ and care partners’ comments. Why were most resident quotes (vs. care partner quotes) omitted? The tablets are intended for LTCH residents, and the aim of the study is to examine perceptions of the tablets. Given this, the perceptions of residents and staff would be the most relevant. Yet the manuscript only includes one quote from a resident. Please consider the use of additional resident quotes. Also discuss, as appropriate, the limited input/data from residents in the discussion or limitations sections.

Was each tablet provided to a single resident for use? How did the personalization process work? Was it based on information provided by residents? care partners? And was this done through discussion, survey, interview or some other approach? If a tablet was provided to another resident, would it be re-programmed? Was the research team responsible for individualizing the tablet, or the staff?

For what period of time / how frequently were the tablets used by residents and relatives of care partners? Also, what role did interviewed staff members play in implementing/supporting residents’ use of the tablets. This information would provide important context for interpreting the findings.

The limitations identified in the limitations section should be expanded upon and the implication(s) of each limitation discussed.

Minor comments:

Under “Design” – there is only mention of understanding “staff” perspectives, not residents and care partners.

Table 1 is incomplete. Information regarding ethnicity is said to be “pending”.

Some rows in the tables include document line numbers.

DIT-Tech is sometimes written with a capital “I” and sometimes with a lower case “I”.

Line 454 – should this say “…differing from shared technology studies”?

Line 469 – there is a reference to “leisure wellbeing” but elsewhere well-being (hyphenated) was usually described as mental well-being.

Reviewer #2: Thank you for the opportunity to review this manuscript which aimed to develop an understanding of the staff, resident and care partner experiences, including barriers and facilitators, to the adoption of remote-access personal tablets in long-term care home.

Mayor Revision

• Abstract: Please explain the abbreviation LTCH.

• Setting and intervention: The description of the intervention and the setting is not very detailed. Please describe some typical characteristics of long-term care homes for an international readership (e.g. ownership, size related to resident places, implemented care concepts, qualification levels of staff).

• Setting and intervention: The intervention is a complex intervention. Please use the recommendations of the TiDier Guideline to describe the intervention. For example, it is currently unclear who used the tablets, when, how often and under what circumstances. It is also unclear what role and qualification the DIT Tech Coordinator had?

https://www.equator-network.org/reporting-guidelines/tidier/#:~:text=The%20TIDieR%20Checklist%20is%20available%20to%20download%20as%20a%20PDF

• Participants and Recruitment: What does tablet usage level mean? What was the distribution of the tablet usage level.? Please present the tablet usage level as a result in terms of the degree of implementation of your intervention.

• Resident participant characteristics: What were the reasons for the isolation of the residents? To what extent did the duration of isolation have an influence on the selection of residents?

• Staff participant characteristics: Please describe the qualifications and roles of the employees so that an international readership can categorise them (e.g. using an international qualification framework)

• Discussion: Please reflect on future scientific steps necessary for the development and evaluation of the analysed intervention? In particular, please reflect on the necessity of investigating the effectiveness in corresponding study designs.

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Reviewer #1: No

Reviewer #2: No

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Staff, Resident and Care Partner Perceptions on the Use of a Personalized Tablet to Mitigate the Impact of Isolation in Long-Term Care Residents

PONE-D-24-15124R1

Dear Dr. Iaboni,

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Sascha Köpke

Academic Editor

PLOS ONE