Performance of family health teams for tackling chronic diseases in a state of the Amazon

Kelly Cristina Gomes Alves; Rafael Alves Guimarães; Marta Rovery de Souza; Otaliba Libânio de Morais Neto

doi:10.1371/journal.pone.0241765

Peer Review History

Original SubmissionDecember 29, 2019
15 Jun 2020 Decision Letter - Nelly Oelke, Editor PONE-D-19-35881 Performance of the family health teams for tackling chronic diseases in a state of the Amazon. PLOS ONE Dear Dr. Gomes Alves, 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. Please address the changes recommended by the reviewers. In addition, please address the following: Page 13: Lines 110-111 - Please clarify the following statement: “The state is divided into eight health regions (Fig. 1) that were instituted after meeting the following inclusion criteria… I would assume that the health regions exist despite the study, so not sure how the inclusion criteria were used to develop the 8 regions? Page 14: Lines 130-131 - Can you describe these 3 phases? Page 15: Line 144- logical should be changed to logic I believe. As noted by both reviewers, I would also strongly recommend that you include more information on the strategy itself as well as a description of the Family Health Teams. Furthermore, I would ask that you carefully review the manuscript for minor edits such as spelling, use of words, and other errors. Please submit your revised manuscript by August 13, 2020. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols We look forward to receiving your revised manuscript. Kind regards, Nelly Oelke Academic Editor PLOS ONE Journal Requirements: When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. We note that you have stated that you will provide repository information for your data at acceptance. Should your manuscript be accepted for publication, we will hold it until you provide the relevant accession numbers or DOIs necessary to access your data. If you wish to make changes to your Data Availability statement, please describe these changes in your cover letter and we will update your Data Availability statement to reflect the information you provide. [Note: HTML markup is below. Please do not edit.] 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 ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 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: This is an important evaluation of the performance of the Brazilian primary care in light of the Chronic Care Model and recent national reforms aimed at controlling non-communicable diseases. The study utilized existing data and subjected it to a robust analysis. A minor limitation in the report is a lack of detail in describing the "Family Health Strategy" and the "Family Health Teams". These are the focus of the research and warrant more detailed description since these are not generic to other health systems. Currently the discussion is of a higher order and does not adequately describe these well enough for readers not familiar with the Brazilian primary care reforms. The principal components which constitute the data gives the reader a sense of what Family Health Teams do. However, other details such as the level of training (cadre) about these health care providers are lacking. It would be worth citing literature about Family Health Teams. A few typographical errors are present in the manuscript and would need attention through further proofreading. Reviewer #2: The aim of the study was to evaluate the adequacy of the work process among family health teams and to compare regional adequacy differences in the state of Tocantins, in Amazonian Region, Brazil. A cross-sectional study was conducted to evaluate the adequacy of the work process among family health teams and compare regional adequacy differences in the state of Tocantins, in Amazonian Region, Brazil. It was carried out a cross-sectional using the PMAQ-AB secondary database. The method is described with rigor and details. The results and discussions answered adequately the study’s aim. The methodology evaluation of the family health teams for tackling NCDs is innovative in the Family Health Strategy, in Brazil. It was possible to determine six PC associated with the family health teams' work process adequacy in the Tocantins health regions and to compare the findings among these regions. My recommendation for the authors is to include in the introduction more information related to the work process and the composition of the family health teams. It is important because the variables selected from the PMAQ-AB national database concerned the family health teams' work process. In addition, it is important to highlight the specifics of work process and family health teams in primary care in Brazil. ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: Yes: José Luís Guedes dos Santos [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0241765.r001
Revision 1
22 Aug 2020 Author Response Page 13: Lines 110-111 - Please clarify the following statement: “The state is divided into eight health regions (Fig. 1) that were instituted after meeting the following inclusion criteria… I would assume that the health regions exist despite the study, so not sure how the inclusion criteria were used to develop the 8 regions? Page 14: Lines 130-131 - Can you describe these 3 phases? Page 15: Line 144- logical should be changed to logic I believe. As noted by both reviewers, I would also strongly recommend that you include more information on the strategy itself as well as a description of the Family Health Teams. Furthermore, I would ask that you carefully review the manuscript for minor edits such as spelling, use of words, and other errors. Reviewer #1: This is an important evaluation of the performance of the Brazilian primary care in light of the Chronic Care Model and recent national reforms aimed at controlling non-communicable diseases. The study utilized existing data and subjected it to a robust analysis. A minor limitation in the report is a lack of detail in describing the "Family Health Strategy" and the "Family Health Teams". These are the focus of the research and warrant more detailed description since these are not generic to other health systems. Currently the discussion is of a higher order and does not adequately describe these well enough for readers not familiar with the Brazilian primary care reforms. The principal components which constitute the data gives the reader a sense of what Family Health Teams do. However, other details such as the level of training (cadre) about these health care providers are lacking. It would be worth citing literature about Family Health Teams. A few typographical errors are present in the manuscript and would need attention through further proofreading. Reviewer #2: The aim of the study was to evaluate the adequacy of the work process among family health teams and to compare regional adequacy differences in the state of Tocantins, in Amazonian Region, Brazil. A cross-sectional study was conducted to evaluate the adequacy of the work process among family health teams and compare regional adequacy differences in the state of Tocantins, in Amazonian Region, Brazil. It was carried out a cross-sectional using the PMAQ-AB secondary database. The method is described with rigor and details. The results and discussions answered adequately the study’s aim. The methodology evaluation of the family health teams for tackling NCDs is innovative in the Family Health Strategy, in Brazil. It was possible to determine six PC associated with the family health teams' work process adequacy in the Tocantins health regions and to compare the findings among these regions. My recommendation for the authors is to include in the introduction more information related to the work process and the composition of the family health teams. It is important because the variables selected from the PMAQ-AB national database concerned the family health teams' work process. In addition, it is important to highlight the specifics of work process and family health teams in primary care in Brazil. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0241765.r002
2 Sep 2020 Decision Letter - Nelly Oelke, Editor PONE-D-19-35881R1 Performance of family health teams for tackling chronic diseases in a state of the Amazon. PLOS ONE Dear Dr. Gomez Alves, 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. Please attend to the minor revisions requested. All revisions are required for consideration of this manuscript for publication. Please submit your revised manuscript by October 29, 2020. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols We look forward to receiving your revised manuscript. Kind regards, Nelly Oelke Academic Editor PLOS ONE Additional Editor Comments (if provided): Minor revisions requested: • Final sentence in the abstract is not clear. As it currently stands, it does not make sense. Please revise. Would also suggest breaking up into two sentences. • Line 67, delete “in order.” Not necessary. • Lines 80-81, “reduce the population's health indicators” is not clear. • Line 117, remove the first “the.” • Line 137, suggest capitalizing “Indigenous.” • Line 169, “adherence to family health,” change the “to” to “of” • Line 210: “other NASF professionals nonphysicians,” this is not clear. Also need to spell out acronym. • Review manuscript for consistency in capitalization of “Regions” when referring to a specific numbered region. They should all be capitalized. [Note: HTML markup is below. Please do not edit.] [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0241765.r003
Revision 2
15 Oct 2020 Author Response RESPONSE TO EDITOR: Comment: Dear Dr. Gomes Alves, 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. Please attend to the minor revisions requested. All revisions are required for consideration of this manuscript for publication. Response from the authors: Thank you for your careful review and comments on our manuscript submitted to PlosOne. We are submitting the manuscript which was reviewed according to Editor’ comments and recommendations. In addition, this letter presents the responses of every note made by the Editor. The manuscript was revised with track changes. We certify that our article meets the standards of the journal. In addition, the manuscript was revised in English by the American Journal Experts. Comment: Final sentence in the abstract is not clear. As it currently stands, it does not make sense. Please revise. Would also suggest breaking up into two sentences. Response from the authors: Thank you for your careful review. We broke up the final sentence into two sentences to make it more clear. Comment: Line 67, delete “in order.” Not necessary. Response from the authors: Thank you for your comment. We deleted “in order”. Comment: Lines 80-81, “reduce the population's health indicators” is not clear. Response from the authors: Thank you for your comment. We rewrote the sentence to make it clearer. Comment: Line 117, remove the first “the.” Response from the authors: Thank you for your comment. We removed the first “the”. Comment: Line 137, suggest capitalizing “Indigenous.” Response from the authors: Thank you for your suggestion. We capitalize “Indigenous”. Comment: Line 169, “adherence to family health,” change the “to” to “of” Response from the authors: Thank you for your comment. We made that change. Comment: Line 210: “other NASF professionals nonphysicians,” this is not clear. Also need to spell out acronym. Response from the authors: Thank you for your comment. We rewrote the sentence to make it clearer. Comment: Review manuscript for consistency in capitalization of “Regions” when referring to a specific numbered region. They should all be capitalized. Response from the authors: Thank you for your comment. We made all the capitalized to refer to specific “Region”. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0241765.r004
21 Oct 2020 Decision Letter - Nelly Oelke, Editor Performance of family health teams for tackling chronic diseases in a state of the Amazon PONE-D-19-35881R2 Dear Dr. Gomes Alves, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Nelly Oelke Academic Editor PLOS ONE Additional Editor Comments (optional): Thank you for making the final revisions to your manuscript. Reviewers' comments: https://doi.org/10.1371/journal.pone.0241765.r005
Formally Accepted
27 Oct 2020 Acceptance Letter - Nelly Oelke, Editor PONE-D-19-35881R2 Performance of family health teams for tackling chronic diseases in a state of the Amazon. Dear Dr. Alves: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Nelly Oelke Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0241765.r006

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