Physical and Mental Health of Informal Carers from Culturally and Linguistically Diverse (CALD) and Non-CALD Groups in Australia
Round 1
Reviewer 1 Report
Comments and Suggestions for AuthorsThe English abstract is too long to be less than 250 words
The references are old please update.
Summarize the procedure. The tool section has many explanations
There are many explanations above the tables. Only 3 lines above each table are enough
In the results section, the percentages should be written in parentheses in the text and in the tables, not N.
In the discussion section, the first 4 lines of the discussion should be deleted
Limits are long to be reduced
The conclusion should be summary and based on the results
Comments on the Quality of English LanguageThe English text should be read again and written more fluently
Author Response
We thank the reviewers for their constructive feedback and for allowing us to revise the manuscript based on their insightful comments.
Please see attachment for authors' response.
Author Response File: 
Author Response.pdf
Reviewer 2 Report
Comments and Suggestions for AuthorsGeneral comment
Very pertinent article about the reality of different caregivers in Australia, namely with regard to their physical and mental health and to socio cultural conditions. The struture, presentation and contents addressed meet the criteria to consider it an article with scientific robustness. I recommend, however, small revisions that I put for your consideration.
It will be interesting to disseminate it to the international community. Regarding the struture,
Specific comments and suggestions
Title - Objetive and appropriate
Abstract - Organized and clear, it provides a summary of the most importants parts of the article.
line 23 - change 650 para 649 participants.
Introduction - well strutured. It contextualizes and delimits the study carried out. It refers to the main objetive substantianting its relevance. It provides reasons that justify the need to investigate the theme. It presents the conceptual and theoretical framework that underlies the study and refers the different existing evidences on the subjet.
Materials and Methods - The study design reveals concern with the recruitment of participants. It as a population base, however, the sample was ocassional and not representative. The protocol of investigation was defined with detail regarding the different steps necessary to carry out data collection. the materials and methods are judicious and are proprely described as to thus psichometrics characteristics, wich gives scientific robustness to the study. The descriptive statistics and data analysis are adequate.
point 2.3. line 186 - describe de acronym - HREC
point 2.4. line 215 - put value - %
Results - presented in a clear, objetive and well- sistematized way. Tables and graphs support better understanding of results.
Discussion - Inferences consistents with the results obtained and with well-founded discussion both by the interpretation made by the authors as well as the conceptual and theoretical framework. The inclusions of limitations values the discussion and demonstrates the critical evaluation carried out by the authors themselves, evidencing honesty and seriouness in the work.
In the lines 404 e 405 order reference to authors
line 414 insert % - 80%
Conclusions - congruent with the results of the work and the outliened objetive. Interesting and well thought-out.
References - I suggest revision as to the form. althout you use alphabetical order by authors and acronyms for the references organizations, there are some lapses and inconsistencies. For example: some publication date do not match the reference in the text. I did not find throughout the article reference to the author Pinquart - lines 599 - 600.
I enphasize that you have current references and within the scope of the subject studied.
Ethical principles and procedures are duly ensured.
Good Work.
Author Response
We thank the reviewers for their constructive feedback and for allowing us to revise the manuscript based on their insightful comments.
Please see attachment for authors' response.
Author Response File: Author Response.pdf
Reviewer 3 Report
Comments and Suggestions for Authors
The article provides some background on the context of informal carers but could benefit from a more comprehensive review of existing literature. Specifically, while Australian and international sources are mentioned, there is a lack of depth in the comparison between existing findings and the study’s outcomes.
The authors state that there is a lack of comparative studies between CALD and non-CALD groups, but this claim is not sufficiently substantiated with references to the broader body of existing research. Including more studies from other multicultural societies would enrich the discussion.
The article includes 650 participants, but there is limited discussion on how representative this sample is of the larger carer population in Australia, particularly when it comes to subgroups within CALD communities. This is especially important since the paper notes the heterogeneity within CALD populations.
The underrepresentation of non-CALD respondents (46.6% of the sample) is not thoroughly addressed. The authors do not discuss potential selection bias or whether the sampling methods may have disproportionately favored CALD respondents.
While the methodology section outlines the basic approach, some aspects remain unclear:
The pilot testing details are minimal, and the authors do not explain why specific questions were removed or simplified during the pilot phase. This raises questions about how much potential data may have been lost in the process.
The recruitment strategy mentions different approaches but does not clarify how effectively the digital versus in-person methods worked or the challenges in reaching certain populations.
The multivariable regression analysis results are presented, but the interpretation of interaction effects between demographic and health variables is vague. More emphasis on explaining why certain variables were included or excluded in the stepwise regression models would be beneficial.
The limitations section could be expanded to acknowledge the cross-sectional nature of the study more explicitly. The authors only briefly mention that causality cannot be inferred, but this limitation needs to be discussed further given the focus on physical and mental health outcomes over time.
The authors should have explored more confounding variables, particularly when discussing the impact of chronic health conditions. The differentiation between pre-existing health conditions and those developed due to caregiving responsibilities is not well defined.
Comments on the Quality of English Languageminor editing
Author Response
We thank the reviewers for their constructive feedback and for allowing us to revise the manuscript based on their insightful comments.
Please see attachment for authors' response.
Author Response File: Author Response.pdf
Reviewer 4 Report
Comments and Suggestions for AuthorsSubject of this article is highly actual. The manuscript’s results are reproducible based on the details given in the methods section after minor revisions.
The article has inaccuracies in author references:
- the author is incorrectly listed in the text (407) Wega, 2021 in the references (639) WGEA, 2021
-also incorrectly listed (457) Bergland et al., 2015 and in the references (551) Berglund et al., 2015.
Some references listed are not relevant because they are not from the last 5 years (19 references).
Related Citation is omitted in the article:
ABS (Australian Bureau of Statistics). (2021). Population: Census. URL: 537 https://www.abs.gov.au/statistics/people/population/population-census/latest-release. 538
ABS (Australian Bureau of Statistics). (2016). Census Household Form. URL: 539 https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/2901.0Main%20Features802016/$FILE/2016%20 540 Census%20Sample%20Household%20Form.pdf
FECCA (Federation of Ethnic Community Councils of Australia). (2020). Annual Report. URL: https://fecca.org.au/wp-content/up-562 loads/2021/01/FECCA-Annual-Report-2019_20.pdf
IBM Corp. (2020). IBM SPSS Statistics for Windows (Version 27.0) [Computer software]. IBM Corp
Pinquart, M., Sörensen, S. Differences between caregivers and non-caregivers in psychological health and physical health: A meta-599 analysis. Psychology and Aging 2003;18(2):250-67.
Wee CC, Davis RB, Hamel MB. Comparing the SF-12 and SF-36 health status questionnaires in patients with and without obesity. 630 Health and Quality of Life Outcomes 2008; 6, 11, https://doi.org/10.1186/1477-7525-6-11
A related citation is omitted from the references:
ABS, 2015 (72)
ABS, 1999 (86)
ABS, 2014 (90)
AIHW, 2023 (81)
AIHW, 2022 (106)
Standards for Statistics on Cultural and Language Diversity, 1999 (93)
Author Response
We thank the reviewers for their constructive feedback and for allowing us to revise the manuscript based on their insightful comments.
Please see attachment for authors' response.
Author Response File: Author Response.pdf
Reviewer 5 Report
Comments and Suggestions for AuthorsThank you for sending me the manuscript titled "Physical and Mental Health of Informal Carers from Culturally and Linguistically Diverse (CALD) and Non-CALD Groups in Australia" by Hussain and co-authors. This study explores demographic and health differences between informal carers from CALD and non-CALD backgrounds in Australia, highlighting that both groups are predominantly women, with CALD carers being younger and more educated, and non-CALD carers providing more care hours. Despite no significant differences in physical or mental health scores, non-CALD carers reported higher levels of depressive symptoms. The findings underscore the need for culturally tailored support systems for carers. The paper is well written, the methodology is clearly outlined, and the discussion is appropriate. While the study's limitations are acknowledged by the authors, the topic is both relevant and important, particularly regarding cultural and linguistic differences in healthcare.
Please consider a shorter abstract section
Author Response
We thank the reviewers for their constructive feedback and for allowing us to revise the manuscript based on their insightful comments.
Please see attachment for authors' response.
Author Response File: Author Response.pdf
Round 2
Reviewer 1 Report
Comments and Suggestions for AuthorsThanks
Author Response
We appreciate your comments.
Reviewer 3 Report
Comments and Suggestions for AuthorsSome p-values ​​were left as 0.000 and these values ​​should always be expressed as <0.001. Otherwise, it is ready for publication.
Author Response
Comment: Some p values need review.
Response: P values have been reviewed. Revisions have been highlighted. See Abstract and Tables.
