Reviewer ’s report  
 
Title:  Factors Affecting Trust in Healthcare among Middle -Aged to Older Korean American 
Women  
 
Version: 0 Date: 27 Apr 2018 
 
Reviewer:  Tanya  Seshadri  
 
Reviewer’s report:  
 
Overall the paper is well written, and the language is easy to follow and without much technical 
jargon. This paper appears to address an important gap in available literature and attempts to 
explore factors that could influence trust in healthcare providers for a demographic minority. The 
details provided for the measures a nd findings are appreciated.  
 
However I feel that one section of the paper still requires significant effort and clarity. This is the 
methods section. The authors state that the method used is secondary analysis and refers to 
details of the methods in a p aper cited. However reviewing the references, it appears that the 
paper cited is a study conducted by the researcher which asked a similar question "Effects of 
Perceived Discrimination and Trust on Breast Cancer Screening among Korean American 
Women". The paper is behind a paywall, so I was able to go through the abstract alone, and the 
variables considered and the analysis plan appear quite similar. It is hence unclear if: a) this is 
another output of the same study since the authors are the same and facto rs considered overlap 
significantly  ("perceived discrimination, trust, acculturation, cultural beliefs, health care 
access"), or b) was a completely different research question asked to the data from the first study 
(primary paper), making this a secondar y analysis.  
 
If the first option is the case, then the method section needs to be revised to indicate this, and the 
findings need to build upon the first paper. However it also needs to be clarified what additional 
information or axis of inquiry of the st udy is dealt with in this paper that wasn't in the first. From 
my impression, this appears to be the case - another output of the same study. The details of the 
method are referred to in the first paper - but since it is behind a paywall and many readers l ike 
me cannot access it, perhaps a brief paragraph or figure outlining the method including sampling 
strategy could be added. If the second option is the case, then the authors need to clarify how this 
research question is different from the primary study,  and perhaps even discuss how these 
findings contrast to the findings from the primary study since they appear to be on similar lines.  
 
Whatever the case, since I was only able to review the abstract of the other paper, and the factors 
considered and obje ctives of both so similar, it is unclear if this paper is adding something 
different or new to an existing paper. This needs to be stated explicitly in this paper given the 
same authors conducted and published the primary study.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to asses s 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the autho rs. 
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the ed itors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relatin g to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
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below. If your reply is yes to any, please give details below.  
I declare that I have no competing interests  
 
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