PONE-D-19-16818

Social and structural factors associated with substance use within the support network of adults living in precarious housing in a socially marginalized neighborhood of Vancouver, Canada

PLOS ONE

Dear Dr. Rutherford,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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ACADEMIC EDITOR: Please insert comments here and delete this placeholder text when finished. Be sure to:

• Both reviewers found this to be a well-written and informative study.  However, Reviewer 1 recommended expansion o the introduction if this is to be accepted as a regular research article, and Reviewer 2 recommended expansion of the discussion of implications for interventions.  The editor is in agreement with these two recommendations. 

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Lawrence Palinkas

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

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Reviewer #1: No

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: In general this is a well-written and clear paper with interesting and meaningful results. In particular the authors do an excellent job of describing their methods and results in a way that will be understood by a broad audience. Any suggestions for edits are only relevant if this paper is not meant to be published as a brief report.

If this paper is not a brief report, then the introduction needs to be expanded to further explore how existing literature frames the current study. This should include literature that is specific to substance use in networks, homelessness/housing, and the assortativity characteristics you assess. If the introduction is expanded, it would also be helpful to articulate a set of research questions that clearly lead to your analytic plan.

Methods are extensive, appropriate for the study, and clearly described. The authors do a nice job outlining rigorous methods in a way that will be understandable to a broad audience.

The discussion is concise, but provides a nice, comprehensible overview of findings and implications. If the paper is expanded, I would like to see more specific recommendations for intervention, housing, and/or practice from the perspective of the authors.

Reviewer #2: This paper provides a valuable exploration into how the structure of networks and peer relationships impact the substance using behavior of precariously housed individuals recruited single room occupancy hotels in Vancouver. Overall the paper is quite excellent. The methods are well described and the social network analysis is appropriate to the questions raised by the authors.

My only minor criticism is with the discussion section. The authors make a point in both the abstract and the introduction of framing the importance of this work around the potential to inform interventions. Yet, the discussion of intervention direction is very superficial. Essentially, they say in one sentence on p. 20 line 370-371 “Concurrent use of substances creates complex phamacologies that may be of interest as clues to developing substitution therapies, or novel treatments.” This is really insufficient given the frame of the paper. I would recommend several citations below by Rice and his colleagues which explore similar network issues among homeless youth and provide more rigorous direction for interventions.

Rice, E., & Rhoades, H. (2013). How should network-based prevention for homeless youth be implemented?. Addiction (Abingdon, England), 108(9), 1625.

Rice, E., Barman-Adhikari, A., Milburn, N. G., & Monro, W. (2012). Position-specific HIV risk in a large network of homeless youths. American journal of public health, 102(1), 141-147.

Barman-Adhikari, A., Rice, E., Winetrobe, H., & Petering, R. (2015). Social network correlates of methamphetamine, heroin, and cocaine use in a sociometric network of homeless youth. Journal of the Society for Social Work and Research, 6(3), 433-457.

Rhoades, H., La Motte-Kerr, W., Duan, L., Woo, D., Rice, E., Henwood, B., ... & Wenzel, S. L. (2018). Social networks and substance use after transitioning into permanentsupportive housing. Drug and alcohol dependence, 191, 63-69.

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Reviewer #1: Yes: Harmony R Rhoades

Reviewer #2: Yes: Eric Rice

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Social and structural factors associated with substance use within the support network of adults living in precarious housing in a socially marginalized neighborhood of Vancouver, Canada

PONE-D-19-16818R1

Dear Dr. Rutherford,

We are pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it complies with all outstanding technical requirements.

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With kind regards,

Lawrence Palinkas

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

The revised manuscript is responsive to the suggestions provided by the viewers. This should make for a fine contribution to the literature.

Reviewers' comments: