Social Factors Associated with Chronic Non-Communicable

BMJ Open: first published as 10.1136/bmjopen-2019-035590 on 28 June 2020. Downloaded from PEER REVIEW HISTORY

BMJ Open publishes all reviews undertaken for accepted manuscripts. Reviewers are asked to complete a checklist review form (http://bmjopen.bmj.com/site/about/resources/checklist.pdf) and are provided with free text boxes to elaborate on their assessment. These free text comments are reproduced below.

ARTICLE DETAILS

TITLE (PROVISIONAL) Social factors associated with chronic non-communicable disease and comorbidity with mental health problems in India: a scoping review AUTHORS M D, Saju; Benny, Anuja; Scaria, Lorane; Anjana, Nannatt; Fendt- Newlin, Meredith; Joubert, Jacques; Joubert, Lynette; Webber, Martin

VERSION 1 – REVIEW

REVIEWER Hoan Linh Banh University of Alberta, Canada REVIEW RETURNED 28-Nov-2019

GENERAL COMMENTS There is a major flaw with the search strategy. The authors did not include important databases such as PsycInfo and the Educational Resources Information Centre. Also, pubmed should have been used rather than medline. Finally, the authors did not even attempt to search google scholar for grey literature.

The the study only included 10 papers and 6 were on multiple countries which was one of the exclusion critera. http://bmjopen.bmj.com/

REVIEWER Graham Thornicroft KCL, UK REVIEW RETURNED 06-Dec-2019

GENERAL COMMENTS MJ Open: Social factors associated with chronic non-communicable disease and comorbidity with mental health problems in India: a scoping review on October 2, 2021 by guest. Protected copyright.

The aim of this paper is to examine the existing literature of the major social risk factors which are associated with diabetes, hypertension and the co- morbid conditions of depression and anxiety in India.

The strengths of this paper include: • The scoping review reveal very few (10) relevant studies on such comorbidities • The wider issues of comorbidities between physical and mental NCDs is increasingly appreciated and so this paper is timely • The review is very well conducted

The paper could be improved by: • Being much more explicit in the ‘more research is needed’ concluding sections on which important research questions remain

BMJ Open: first published as 10.1136/bmjopen-2019-035590 on 28 June 2020. Downloaded from unanswered • Making it clearer why data from multi-site studies (where this can be disaggregated) were excluded • Tidying up the fonts which vary a lot • Giving a clearer rationale for the selection of a single country for this review- are the factors expected to be associated with comorbidity different in India from other countries, and if so, why? • Making clear if any papers in non English languages were included • Saying why only papers from the last 10 years were included • Also justifying the selection of NCDs included and excluded for the review • Saying in some more details why there was no patient or public involvement of any kind in this review

VERSION 1 – AUTHOR RESPONSE

Reviewer 1 There is a major flaw with the search strategy. Firstly, we limited the search to peer reviewed The authors did not include important journal papers as a quality control databases such as PsycInfo and the mechanism. Therefore, we chose not to Educational Resources Information Centre. undertake a grey literature search. Secondly, Also, pubmed should have been used rather we have noted the limitation of searching only than medline. Finally, the authors did not 6 databases in the paper. However, it is even attempt to search google scholar for standard practice to select key databases in grey literature. the field for a scoping review, not all of them. MEDLINE is the primary component of PubMed, so we are unlikely to have missed any papers by searching MEDLINE. We included PsycINFO and the inclusion of Scopus and Web of Science

would have been likely to capture any http://bmjopen.bmj.com/ additional references. Finally, Educational Resources Information Centre is a database of education research and would have been unlikely to have returned any additional papers that met the inclusion criteria. A justification of the choice of the databases has been added to the methods section of the paper. The study only included 10 papers and 6 It was possible to disaggregate the data from on October 2, 2021 by guest. Protected copyright. were on multiple countries which was one of these 6 papers so they met the inclusion the exclusion criteria. criteria. Reviewer 2 Being much more explicit in the ‘more We have been much more explicit about research is needed’ concluding sections on future research which is required and added which important research questions remain this to the end of the paper. unanswered Making it clearer why data from multi-site We only excluded data where it could not be studies (where this can be disaggregated) disaggregated. Multi-site studies with were excluded disaggregated data were included. We have clarified this in the methods section. Tidying up the fonts which vary a lot The fonts have all been changed to Times New Roman. Giving a clearer rationale for the selection of a Cardiovascular disease is a significant public single country for this review- are the factors health concern in India. As it is important to expected to be associated with comorbidity ensure that interventions are socially and different in India from other countries, and if culturally appropriate, we need

BMJ Open: first published as 10.1136/bmjopen-2019-035590 on 28 June 2020. Downloaded from so, why? reliable data from India to fully understand underpinning social risk factors and their association with co-morbid mental health problems. These may be similar to other countries, but it is important not to assume universality. A review using data from many countries could be too large and unwieldy, so we decided to focus on India. We have clarified this in the methods section.

Making clear if any papers in non No papers in non-English languages were English languages were included included. This is clarified in the methods section. Saying why only papers from the last 10 This period was selected as it is when CVD years were included became a significant concern in India. It was also important to ensure that data were pertaining to contemporary social factors in order to inform future intervention development; social change may make older studies redundant. This clarification has been added to the methods section. Also justifying the selection of NCDs included Diabetes and hypertension are the two most and excluded for the review prevalent NCDs in India. Also, importantly, they are amenable to treatment. The review focused on these to provide the opportunity to intervene where the need is greatest and where there is the greatest likelihood of improving outcomes for people. We have included a justification for this in the methods section. Saying in some more details why there was This review was the first part of a multi- no patient or public involvement of any kind in method capacity building project. Although this review there was no patient and public involvement

in this review, as the literacy levels of the http://bmjopen.bmj.com/ target population were too low to facilitate a meaningful involvement, there was involvement of ASHA workers, local health workers and local officials throughout the remainder of the project. This has been clarified in the methods section.