Intergenerationality Programs—Between Children and Older Adults—For Portuguese Population: A Scoping Review

Round 1

Reviewer 1 Report

1. Figure 1, can the authors elaborate on the reasons for “excluded records” and “excluded full-text studies”? It will help readers better understand the exclusion criteria.

2. Page 5, line 189, “So, the maximum age was considered 11 years old [26, 32], and 13 years old for [33]; see Table 2.” I think this sentence was not completed.

3. For the first column in Table 1 and Table 2, the authors may consider only keeping the information on authors and year (similar to the APA reference style for in-text citation). The current version is very crowded and hard to read.

4. In the “The evaluated dimensions in the older adults population during the implementation of these programs/projects” section of the Discussion, the authors may consider elaborating on the several parameters within each category of dimensions. Ideally, after the sentence, “Within each category, several parameters were evaluated.”

5. In the Discussion, the authors may consider organizing the section “The dimensions which relate to the Mental Health of the older adults population” base on the five categories of dimensions that they organized in the previous section.

Author Response

First of all, we thank you for the careful evaluation carried out, which has been an excellent contribution to improving the quality of the article. Regarding the comments, we respond below with a description of the changes made, which are marked in the manuscript:

1. Reviewer comment: Figure 1, can the authors elaborate on the reasons for “excluded records” and “excluded full-text studies”? It will help readers better understand the exclusion criteria.

Authors' response: The authors are grateful for the observation. Changes made according suggesting. Please see figure 1.

2. Reviewer comment: Page 5, line 189, “So, the maximum age was considered 11 years old [26, 32], and 13 years old for [33]; see Table 2.” I think this sentence was not completed.

Authors' response: We understand the reviewer's observation. The wording of the sentence was not perceptible, since the authors were not identified. The change was done. Please see lines 214 to 215.

3. Reviewer comment: For the first column in Table 1 and Table 2, the authors may consider only keeping the information on authors and year (similar to the APA reference style for in-text citation). The current version is very crowded and hard to read.

Authors' response: The authors are grateful for the observation. Changes were made according to suggestions.

Please see Table 2 and 3.

4. Reviewer comment: In the “The evaluated dimensions in the older adults population during the implementation of these programs/projects” section of the Discussion, the authors may consider elaborating on the several parameters within each category of dimensions. Ideally, after the sentence, “Within each category, several parameters were evaluated.”

Authors' response: The authors considered the observation. We added table 4 which describes Categories of evaluated dimensions in the applied programs/projects. And see line 233 to 238.

5. Reviewer comment: In the Discussion, the authors may consider organizing the section “The dimensions which relate to the Mental Health of the older adults population” base on the five categories of dimensions that they organized in the previous section.

Authors' response: We appreciate the observation and we reformulated the discussion, based on each of the categories presented. We chose not to create separate categories, but a descriptive narrative of all the categories presented in the studies, since we consider that this interconnection makes the discussion more perceptible and richer. Please see lines 278 to 369.

Reviewer 2 Report

Dear Editor,

I appreciate the opportunity to review the article "Intergenerationality programs - between children and older adults - for Portuguese population: a scoping review".

Some information in the article is unclear...

Introduction:

- Revise the introduction more focused on the issue of intergenerationality and its effect and less on the ageing dimension (which takes up most of the introduction). 

- Improve the connection between the two ideas that are not clear. Consistent well-being will result from balance when experiencing the transition, allowing the individuals to develop their physical and psychological capabilities [14, 15].  Nursing care for older adults should be based on a multidisciplinary and multidimensional perspective, considering multiple ageing dimensions, maximising their potential, diminishing dependencies and increasing quality of life [11].

Methodology

-The inclusion criteria for this ScR were based on the PCC mnemonic: Population, Concept and Context, being that i) the population corresponds to the people older than 60 years old (institutionalized or living in the community). Why 60 when it should be 65?

-Use PRisma 2020 (Figure 1)

-Table 3 replace Population by Sample. Add study design column. Add programme evaluation instruments. 

-In the methodology, explain the instruments of evaluation of the programmes. 

- Regarding the evaluation of the activities carried out, only three studies 190 applied satisfaction surveys at the end of their sessions, showing “interesting” or “very 191 interesting” results [26, 27, 29]. Other studies applied surveys and scales to assess different 192 dimensions, such as self-esteem, loneliness and self-worth. Which ones ??? Explain

. In the initial phase of the elaboration of this ScR, we only intended to include studies  that addressed programs/projects implemented within the scope of Intergenerationality. However, as we consider that they add relevant and pertinent results about the meaning that the older adult who participate in these programs (Humboldt et al., 2018) and that  the professionals who implement them attribute to the theme (Soares, 2018), we decided  to include the two studies presented then in the present research (Table 3).. It makes no sense! That would imply altering the whole purpose of the article. 

- The evaluated dimensions in the multiple programs/projects were organized into  five categories: emotional, motor, cognitive, communicational and interactional. Explain how this data emerges.- Conclusion

- You need to review based on the aim of the article (intergenerationality, not ageing)

- We note that there is already scientific evidence, albeit still very incipient, on the contribution and impact of implementing projects and programs within the scope of Intergenerationality, despite the methodological weaknesses of the studies developed. What methodological weaknesses ? Not explored in the article. 

What does this study contribute to research and clinical practice?

Author Response

Authors' response to Reviewer 2:

First of all, we thank you for the careful evaluation carried out, which has been an excellent contribution to improving the quality of the article. Regarding the comments, we respond below with a description of the changes made, which are marked in the manuscript.

1. Reviewer comment: Revise the introduction more focused on the issue of intergenerationality and its effect and less on the ageing dimension (which takes up most of the introduction). 

Authors' response: The authors considered the observation. Changes were made according to suggestions. Please see lines 70 to 90 and 110 to 122.

2. Reviewer comment: Improve the connection between the two ideas that are not clear. Consistent well-being will result from balance when experiencing the transition, allowing the individuals to develop their physical and psychological capabilities [14, 15].  Nursing care for older adults should be based on a multidisciplinary and multidimensional perspective, considering multiple ageing dimensions, maximising their potential, diminishing dependencies and increasing quality of life [11].

Authors' response: The authors are grateful for the observation.

Changes were made according to suggestions. Please see lines 70 to 74.

3. Reviewer comment: The inclusion criteria for this ScR were based on the PCC mnemonic: Population, Concept and Context, being that i) the population corresponds to the people older than 60 years old (institutionalized or living in the community). Why 60 when it should be 65?

Authors' response: The authors considered the observation. We considered the age of 60 from a perspective of greater inclusion of studies. Some studies, when referring to elderly people, end up including subjects under the age of 65. Marginal ages, that is, close to 65. In order not to lose studies, a wider range was considered.

4. Reviewer comment: Use PRisma 2020 (Figure 1).

Authors' response: The authors are grateful for the observation. Changes were made according to suggestions.

It was added the reference: Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., McGuinness, L. A., … Moher, D. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ (Clinical research ed.) 2021, 372, (71). https://doi.org/10.1136/bmj.n71.

5. Reviewer comment: Table 3 replace Population by Sample. Add study design column. Add programme evaluation instruments.

Authors' response: The authors are grateful for the observation. Changes made according suggesting in the Table 3.

6. Reviewer comment: In the methodology, explain the instruments of evaluation of the programmes.

Authors' response: The authors are grateful for the observation. Changes made according suggesting in the Table 4.

7. Reviewer comment: Regarding the evaluation of the activities carried out, only three studies 190 applied satisfaction surveys at the end of their sessions, showing “interesting” or “very 191 interesting” results [26, 27, 29]. Other studies applied surveys and scales to assess different 192 dimensions, such as self-esteem, loneliness and self-worth. Which ones ??? Explain

Authors' response: The authors considered the observation. Changes made according suggesting in the Table 4 and the line 233 to 238.

8. Reviewer comment: In the initial phase of the elaboration of this ScR, we only intended to include studies that addressed programs/projects implemented within the scope of Intergenerationality. However, as we consider that they add relevant and pertinent results about the meaning that the older adult who participate in these programs (Humboldt et al., 2018) and that the professionals who implement them attribute to the theme (Soares, 2018), we decided to include the two studies presented then in the present research (Table 3). It makes no sense! That would imply altering the whole purpose of the article.

Authors' response: The authors are grateful for the observation. In order to answer our review questions, namely the characteristics of these programs/projects and what’s perception of professionals and older adults about intergenerational programs/projects, we decided to include two studies we consider relevant that portray relevant and pertinent results about the meaning that the older adults who participate in these programs (Humboldt et al., 2018) and that the professionals who implement them attribute to the theme (Soares, 2018), that's why they were included. See line 224 to 226.

Reviewer comment: The evaluated dimensions in the multiple programs/projects were organized into five categories: emotional, motor, cognitive, communicational and interactional. Explain how this data emerges.

Authors' response: The authors considered the observation. Changes made according suggesting.

For a better understanding of the dimensions integrated for analysis of the study, Table 4 was added in the document. On the other hand, in the topic "The evaluated dimensions in the older adults population during the implementation of these programs/projects", the table 4 is theoretically supported, where a more exhaustive characterization of the dimensions studied is carried out.

Round 2

Reviewer 2 Report

Dear Editor,

I appreciate the promptness of the changes made by the authors that have greatly improved the quality of the article