Supporting families to protect child health: Parenting quality and household needs during the COVID-19 pandemic

Leslie E. Roos; Marlee Salisbury; Lara Penner-Goeke; Emily E. Cameron; Jennifer L. P. Protudjer; Ryan Giuliano; Tracie O. Afifi; Kristin Reynolds

doi:10.1371/journal.pone.0251720

Peer Review History

Original SubmissionSeptember 21, 2020
29 Jan 2021 Decision Letter - Kyoung-Sae Na, Editor PONE-D-20-29512 Supporting families to protect child health: Parenting quality and household needs during the COVID-19 pandemic PLOS ONE Dear Dr. Roos, 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. I agree with the reviewers' comments that this study is very interesting and dealing with one of the important issues of COVID-19. I expect that the reviewers' suggestion would greatly increase the impact of this paper. Please submit your revised manuscript by Mar 15 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, Kyoung-Sae Na, M.D. 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 noted in your submission details that a portion of your manuscript may have been presented or published elsewhere. ["Results on the prevalence of maternal mental health have been published elsewhere (Journal of Affective Disorders)."] Please clarify whether this publication was peer-reviewed and formally published. If this work was previously peer-reviewed and published, in the cover letter please provide the reason that this work does not constitute dual publication and should be included in the current manuscript. 3. 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 Reviewer #3: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: 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: No Reviewer #2: Yes Reviewer #3: 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 Reviewer #3: 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 a very interesting paper regarding parenting and parental mental health during Covid-19 in a cross sectional online survey. A great advantage is that the authors have used several interesting validated questionnaires and add qualitative data. The introduction is well written. However, I do have some concerns that should be clarified: • Could you add psychometrics of the used questionnaires? • You have assessed academic background, which is known to be highly important for parenting and stress coping. Why haven’t you included this important factor into regression analyses • Same for age and gender of parents and children – this could be important family characteristics and predict parenting • You mention SES as important factor and that usually, sample in online surveys have a higher SES compared to the general public. To get a better idea on the representativeness of your sample, it would be good to have a comparison with e.g. SES of the general public of parents in Canada • It is surprising that based on all reports on economic hardship and parenting during times of e.g. recession, this was not a significant predictor of parenting. Could you discuss this? • Limitations section: Majority of participants were females – please discuss how this can decrease the external validity of the study Reviewer #2: It’s a very interesting and important work! The paper is well written with key points made easy to find. The methods and study design are clear, thoroughly described, and well-matched to answer the stated research questions. Here are some concerns: Introduction “Families are coping with numerous challenges including unmet childcare needs, crisis schooling, low resource access, and financial strain.” Citations are needed. Also, may consider including the impact of social distancing and quarantine. For example, authors may find evidence and strategies from some recent articles: Janssen, Loes HC, Marie-Louise J. Kullberg, Bart Verkuil, Noa van Zwieten, Mirjam CM Wever, Lisanne AEM van Houtum, Wilma GM Wentholt, and Bernet M. Elzinga. "Does the COVID-19 pandemic impact parents’ and adolescents’ well-being? An EMA-study on daily affect and parenting." PloS one 15, no. 10 (2020): e0240962. Ye J. Pediatric mental and behavioral health in the period of quarantine and social distancing with COVID-19. JMIR pediatrics and parenting. 2020;3(2):e19867. Methods It’s not clear why the authors chose 1.5-8 years old children for this study. Any evidence for this range? Did this study get IRB approval? If so, please include this information in the main text. There was missing data based on the results Table 1. The missing rates in some variables were pretty high. How did you handle missing data in your statistical analyses? How to interpret Table 2 in terms of its relationship with your primary aim? More explanations are needed to help the readers understand this table. Results It will be helpful to link the quantitative and qualitative results, and give some feasible interventions from the family-level based on your findings. The interventions that authors mentioned in the discussion may not be generalizable in other countries or settings. Reviewer #3: dear Author I Congratulate you on the submission, the work is good and well conducted. the tools used are appropriate. I would like to point out to the authors that there can be a section that gives the teachers and professionals involved in managing the children a recommendation to manage and anticipate the needs post the COVID-19 Crisis thus enabling them better management of the children's need. ****** 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: No Reviewer #3: Yes:** Deblina Roy [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.0251720.r001
Revision 1
19 Mar 2021 Author Response 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 -- We have reviewed the style templates and adjusted the manuscript. 2. We noted in your submission details that a portion of your manuscript may have been presented or published elsewhere. ["Results on the prevalence of maternal mental health have been published elsewhere (Journal of Affective Disorders)."] Please clarify whether this publication was peer-reviewed and formally published. If this work was previously peer-reviewed and published, in the cover letter please provide the reason that this work does not constitute dual publication and should be included in the current manuscript. -- This is the second publication from a large online convenience sample. The current study highlights novel findings relevant to factors associated with parenting quality, while the previously published solely examined maternal mental health status and protective factors. 3. 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. -- No changes at this time, we will update Data Availability upon acceptance Response to Reviewers Reviewer #1: This is a very interesting paper regarding parenting and parental mental health during Covid-19 in a cross sectional online survey. A great advantage is that the authors have used several interesting validated questionnaires and add qualitative data. The introduction is well written. However, I do have some concerns that should be clarified: • Could you add psychometrics of the used questionnaires? -- We have ensured that psychometrics are included for each questionnaire used in the methods (pp. 8-9). • You have assessed academic background, which is known to be highly important for parenting and stress coping. Why haven’t you included this important factor into regression analyses -- We appreciate the attention to the relevance of parent education to parenting stress and coping. However, bivariate correlations (Table 2.) indicated that parent education was not associated with any of the parenting measures in our sample, so was not brought into multivariate analyses, consistent with our analytic plan. • Same for age and gender of parents and children – this could be important family characteristics and predict parenting -- We agree that child age and gender would be important predictors of parenting to include in analyses. However, the survey design did not allow for data on these specific demographics for the child considered in parent’s responses. Parents reported gender and age of all children but were advised to only think about their most challenging child when responding to relevant questionnaires. Because the majority of families reported having more than one child, we are unable to determine the exact age and gender of each child considered in the parenting questionnaires responses. This procedure is described on pp 6-7. • You mention SES as important factor and that usually, sample in online surveys have a higher SES compared to the general public. To get a better idea on the representativeness of your sample, it would be good to have a comparison with e.g. SES of the general public of parents in Canada -- We have now included 2018 census data describing the median annual family income in Canada as a comparison to our sample (p. 25). • It is surprising that based on all reports on economic hardship and parenting during times of e.g. recession, this was not a significant predictor of parenting. Could you discuss this? -- Although economic hardship has been previously reported to impact parenting, it is possible we did not find this effect because of our relatively high SES sample in which financial strain during the pandemic may be less impactful. We have now discussed this further on pp. 25-26. • Limitations section: Majority of participants were females – please discuss how this can decrease the external validity of the study -- Thank you for pointing out this limitation of our sample. We have provided a discussion of this limitation and its relevance to family life on p.26. Reviewer #2: It’s a very interesting and important work! The paper is well written with key points made easy to find. The methods and study design are clear, thoroughly described, and well-matched to answer the stated research questions. Here are some concerns: Introduction “Families are coping with numerous challenges including unmet childcare needs, crisis schooling, low resource access, and financial strain.” Citations are needed. Also, may consider including the impact of social distancing and quarantine. For example, authors may find evidence and strategies from some recent articles: Janssen, Loes HC, Marie-Louise J. Kullberg, Bart Verkuil, Noa van Zwieten, Mirjam CM Wever, Lisanne AEM van Houtum, Wilma GM Wentholt, and Bernet M. Elzinga. "Does the COVID-19 pandemic impact parents’ and adolescents’ well-being? An EMA-study on daily affect and parenting." PloS one 15, no. 10 (2020): e0240962. Ye J. Pediatric mental and behavioral health in the period of quarantine and social distancing with COVID-19. JMIR pediatrics and parenting. 2020;3(2):e19867. -- Thank you for pointing out our oversight in referencing the relevant literature. We have now included three relevant citations pertinent to our child age group that support this statement on p.3, including the Ye (2020) article. Methods It’s not clear why the authors chose 1.5-8 years old children for this study. Any evidence for this range? -- We have provided justification for using this age range on pp 7-8. Briefly, we wanted to distinguish our sample from the postpartum period, when parent-child interactions may differ from those during early childhood. As well, early childhood is generally considered to be until age 8, during which children are highly susceptible to environment influence including parenting factors. Citations are included to support this decision-making. Did this study get IRB approval? If so, please include this information in the main text. -- Yes it did. This is now included in the main text (p.11) There was missing data based on the results Table 1. The missing rates in some variables were pretty high. How did you handle missing data in your statistical analyses? -- Missing data was handled in Mplus with Maximum Likelihood approaches. We have now described this procedure on p. 10. How to interpret Table 2 in terms of its relationship with your primary aim? More explanations are needed to help the readers understand this table. -- We have now more clearly explained the variables included in Table 2 in the results section (pg. 12). Results It will be helpful to link the quantitative and qualitative results, and give some feasible interventions from the family-level based on your findings. The interventions that authors mentioned in the discussion may not be generalizable in other countries or settings. -- Thank you for this recommendation to provide more discussion on effective evidenced-based interventions that can support families during the pandemic. We have included this in our discussion on p.28. Reviewer #3: dear Author I Congratulate you on the submission, the work is good and well conducted. the tools used are appropriate. I would like to point out to the authors that there can be a section that gives the teachers and professionals involved in managing the children a recommendation to manage and anticipate the needs post the COVID-19 Crisis thus enabling them better management of the children's need. -- Thank you for this suggestion. We have now included some recommendations in consideration of educators and clinical professionals on p.28-29. Attachments Attachment Submitted filename: CV19ParentingQuality_ResponsetoReviewers_031521.docx https://doi.org/10.1371/journal.pone.0251720.r002
6 Apr 2021 Decision Letter - Kyoung-Sae Na, Editor PONE-D-20-29512R1 Supporting families to protect child health: Parenting quality and household needs during the COVID-19 pandemic PLOS ONE Dear Dr. Roos, 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. ============================== The reviewer raised one minor issue. ============================== Please submit your revised manuscript by May 21 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. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Kyoung-Sae Na, M.D. Academic Editor PLOS ONE Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. [Note: HTML markup is below. Please do not edit.] 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) ******** 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: (No Response) ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #2: (No Response) ****** 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: (No Response) ****** 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: (No Response) ****** 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: Thank you for addressing the comments. One additional suggestion is to add a conclusion section and summarize your key findings and recommendations. ****** 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. https://doi.org/10.1371/journal.pone.0251720.r003
Revision 2
12 Apr 2021 Author Response In response to reviewer comments, “Thank you for addressing the comments. One additional suggestion is to add a conclusion section and summarize your key findings and recommendations.” we have organized a conclusion section and summarized our findings to provide concluding recommendations for supporting families of young children during and after the COVID-19 pandemic. https://doi.org/10.1371/journal.pone.0251720.r004
3 May 2021 Decision Letter - Kyoung-Sae Na, Editor Supporting families to protect child health: Parenting quality and household needs during the COVID-19 pandemic PONE-D-20-29512R2 Dear Dr. Roos, 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, Kyoung-Sae Na, M.D. Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0251720.r005
Formally Accepted
14 May 2021 Acceptance Letter - Kyoung-Sae Na, Editor PONE-D-20-29512R2 Supporting families to protect child health: Parenting quality and household needs during the COVID-19 pandemic Dear Dr. Roos: 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. Kyoung-Sae Na Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0251720.r006

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