PONE-D-20-14440

Parental migration and psychological well-being of left-behind adolescents in Western Nepal

PLOS ONE

Dear Dr. Ong,

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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The reviewers have requested further details regarding the statistical analysis and requested the further variables be included in your analysis. You should consider the requests made by the reviewers to ensure that the data presented in the manuscript support the conclusions drawn.

Please submit your revised manuscript by Oct 22 2020 11:59PM. 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.

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We look forward to receiving your revised manuscript.

Kind regards,

George Vousden

Senior 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: Partly

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

Reviewer #1: Yes

Reviewer #2: No

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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: No

Reviewer #2: Yes

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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

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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: Many thanks for the opportunity to review this paper on the mental well-being of left-behind adolescents in Nepal. I apologise for the delay in submitting my review.

The research has been carried out to a high standard. The paper covers an important topic which has not received much attention to date in Nepal. The methods are rigorous and the authors have described them in detail. The conclusions are sound and of interest to a wide, global health audience.

I have some minor comments below for the authors' consideration.

Results, 1st paragraph: It may be clearer if you state that all children present on the days of the surveys completed the questionnaire. However, for analysis, those with divorced/deceased parents were excluded. At the moment it is slightly unclear from the way you have described it.

Results, Table 1. I would find it helpful to see these demographic characteristics according to parental migrant status. Would it be possible to add to this table (or in an additional table) the distribution of these characteristics by (a) whole sample; (b) one-parent migrant; (c) both parent migrants; (d) non-migrant?

Results, Table 3. It is interesting that you chose 1-migrant-parent as the reference group. PLease can you explain rationale for this? I would imagine it would make more sense to use non-migrant parent group as the reference, because it is the largest group and also it is most relevant to the overall research question - i.e. do children with migrnat parents have worse outcomes than those with no migrant parents. It is slightly more difficult to interpret when the reference category is 1-parent, and you are comparing those to either no-migrant or 2-parents.

Results, Table 3. I also cannot understand why in the simple linear regression, the order of scores changes. In Table 2, 1-parent group has the lowest SDQ scores, followed by non-migrant, and finally 2-parents. In Table 3, this has changed to lowest risk in non-migrant, followed by 1-parent, followed by 2-parents. What has changed, given that in the simple regression model you are (presumably) not controlling for any other factors yet?

Reviewer #2: Dear Authors,

I read your work with great interest and I commend you on focusing on left behind children on Nepal. Your study has a lot of potential to provide more insights into the existing literature on the psychological well-being left behind children. Below I provide you with comments to improve your work.

1. On page 4, line7, your paper argues that most studies focus on the left behind children in China in an internal migration context. However, there are now more studies on the psychological well-being of left behind children in Africa, Latin America and other parts of Asia (the Philippines, Indonesia). It is important that you acknowledge and get insights from these quantitative studies, which will help you in improving the choice of variables for your analysis and improving the key conclusions you can draw from this analysis.

2. In the Methods section,

a. the use of psychological data on the African adolescents is neither properly explained nor very well justified. It is not particularly clear for what purpose you use this data and what insight it can bring to the study, as well on what basis Nepalese and African Adolescents can be compared. Note: it is very important that you mention the exact country in Africa that this data represents as Africa is a continent covering many countries. If you are comparing continental average data, it is important to explicit about that.

b. The methods section should be explicit about what kind of information were collected in the survey.

c. It is important to add a supplementary table on the coding of the socioeconomic and demographic variables.

d. Because you are focusing on the left behind children, it is crucial that you account for the characteristics of the caregiver: is the caregiver employed, other than relationship with the caregiver. It is also important to control for the economic activities of these children (see #3 comment for more explanation). Please also consider variables such as household size if it is available.

e. In the analyses strategy, it is important to conduct further analyses to check the robustness of your results. Contrary to findings for Ghanaian and Angolan left behind children, your study finds that adolescents living with both their parents have lower psychological well-being. I suggest you conduct separate analyses for girls and boys to see whether this result persists. You can also conduct separate analyses for early adolescent and late adolescent groups as the effect of parental migration could differ between these groups.

3. To explain the results you find, it might be wise to look into childhood and youth studies, which study these groups in non-migratory contexts. It is also worthwhile to include some background information about Nepal’s socioeconomic and adolescent labor conditions to understand the emigration context better. That could for instance help to nuance why adolescents living with both parents could be in a worse situation. It could be that they may themselves need to work to support their families’ livelihood.

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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.

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Reviewer #1: No

Reviewer #2: No

[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.

PONE-D-20-14440R1

Parental migration and psychological well-being of left-behind adolescents in Western Nepal

PLOS ONE

Dear Dr. Ong,

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 submit your revised manuscript by Jan 09 2021 11:59PM. 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,

Gracia Fellmeth

Academic Editor

PLOS ONE

Additional Editor Comments (if provided):

Dear Associate Professor Ong,

Many thanks for submitting your revised manuscript. I have taken on the role of editor for your manuscript, having previously reviewed your original submission (my comments were those of "Reviewer 1" in the original submission).

I have now had a chance to read your revised version and feel it is much improved. Thank you for addressing the points raised by myself and the second reviewer. Both the second reviewer and I feel there are still some issues remaining which need to be addressed before this is suitable for publication. Please see these listed below.

We look forward to receiving another revised version.

Sincerely,

Dr Gracia Fellmeth

(Guest Editor)

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: (No Response)

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2. 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 #2: Partly

**********

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

Reviewer #2: (No Response)

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4. 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 #2: Yes

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5. 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 #2: Yes

**********

6. 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 #2: Dear Authors,

In general the motivation for such kind of research is nicely presented. The text is written in a clear and precise way.

Having said this, there are four major issues that need your attention.

1. It is not clear why you call Table 3 a simple linear regression analyses and Table 4 a multiple linear regression analyses. A simple linear regression is when you only have one variable in your analyses. By this logic, Table 3 is rather a multiple linear regression table. It is also not clear why and how Table 3 and Table 4 differ. I can see that the regression results on the parental migration status variable are not the same in the two tables even though the control variables used are the same. Table 4 shows that children living with both parents in Nepal have a higher SDQ compared to those with one of their parents abroad whereas Table 3 shows that an increased SDQ for children with both parents abroad. What is your explanation for these two opposite findings?

2. It might be worth discussing whether adolescents girls' and boys' SDQs respond differently due to their parent(s)' migration. To do that my suggestion is to run separate regressions for the girls' and boys' sub-samples. Alternatively, you may choose to see the interaction effect of gender and the parental migration status variable. This could give your analyses more nuance.

3. Your conclusion focuses a lot on general discussions on other control variables. It is best if your conclusion dedicates more time contemplating on the result on the parental migration status variable by using some contextual information to explain the result.

4. Suggestion: if you make the conclusion section succinct, then you can have more space to include some background information about parental migration in Nepal either in the introduction section or as a separate section and come back to this in the conclusion section.

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7. 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 #2: No

[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.

PONE-D-20-14440R2

Parental migration and psychological well-being of left-behind adolescents in Western Nepal

PLOS ONE

Dear Dr. Ong,

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 submit your revised manuscript by Feb 19 2021 11:59PM. 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,

Gracia Fellmeth

Academic Editor

PLOS ONE

Additional Editor Comments (if provided):

Dear Authors,

Many thanks for submitting your revised manuscript. I am happy that you have addressed all of the reviewers' comments. However, I ask if you can make one final change: in response to one of the reviewer comments, you removed what was previously Table 3 (simple linear regression). In the previous version, it was not clear that Table 3 was indeed a simple regression as it appeared that other factors were being controlled for. However, given your response and clarification, I feel it is important to include the simple regression as well as the multiple regression results. I would be very grateful if you could re-instate the deleted Table 3.

I sincerely apologise for any confusion caused by the reviewer comment - I think it was clarification that was sought, rather than removal of the table.

Many thanks for your understanding and I look forward to seeing your resubmission.

With best wishes,

Gracia Fellmeth

(Guest editor)

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[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.

Parental migration and psychological well-being of left-behind adolescents in Western Nepal

PONE-D-20-14440R3

Dear Dr. Ong,

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.

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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,

Gracia Fellmeth

Guest Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: