Clinical usefulness of brief screening tool for activating weight management discussions in primary cARE (AWARE): A nationwide mixed methods pilot study

Evan Atlantis; James Rufus John; Paul Patrick Fahey; Samantha Hocking; Kath Peters

doi:10.1371/journal.pone.0259220

Peer Review History

Original SubmissionJuly 29, 2021
22 Sep 2021 Decision Letter - Sabine Rohrmann, Editor PONE-D-21-24511Clinical usefulness of brief screening tool for Activating Weight management discussions in primary cARE (AWARE): a nationwide mixed methods pilot studyPLOS ONE Dear Dr. Atlantis, 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.Besides comments with respect to content of the manuscript made by the reviewer, but also e thoroughly check the manuscript for grammatical errors and non-academic language. Please submit your revised manuscript by Nov 06 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. 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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. When reporting the results of qualitative research, we suggest consulting the COREQ guidelines or other relevant checklists listed by the Equator Network, such as the SRQR, to ensure complete reporting (http://journals.plos.org/plosone/s/submission-guidelines#loc-qualitative-research)." Do not ping with follow up, thanks! [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: Partly ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: 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 ****** 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: No ****** 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: Thankyou to the authors for the opportunity to review this manuscript. This study addresses a very important gap in knowledge and practice. The inclusion of both qualitative and quantitative data was great. I have made a number of suggestions for the authors to consider: Abstract: Please define EOSS prior to introducing EOSS-2 risk tool, and explain how it is derived. You have this information in the introduction (page 4 lines 84-87). Please consider rewriting lines 40-41 for clarity. Please consider 'Further research is required to assess feasibility and applicability'. Introduction: Are 2-17 years olds better described as children rather than young people? Do you need to provide contextual information re GPs, given the international audience? Methods: In general, I think the methods section could benefit from refining to reduce repetition, length and improve clarity. Please consider 'recruited via authors' professional networks, namely...' page 5, line 111 Were patients reimbursed for their time? Why was a patient living without overweight/obesity included in the study, presumably with weight related health concerns? Were GPS responsible for obtaining consent? Page 6, line 137, please consider 'to identify previously undiagnosed weight related complications' Page 7, line 144, is family history the most accurate term, or is this point about previously undiagnosed health concerns? Page 8, lines 179-182, please consider omitting Page 8 lines 182-184, these are results Page 8, line 187, page 9, line 197, could you say 'no more than 2 weeks apart'? Page 9, line 211, likely fits better in results Results: Could you state the % of participants who were categorised as EOSS 2,3 or 4 separately? Page 13, line 283: I would recommend removing the numerical assessment of the qualitative findings. I would argue that the quotes from patient 9 and 3 talk more about weight loss than health (page 14, lines 305-314). However, the quote from patient 6 on page 16 is a better example Discussion: Could the authors please clarify how their results address questions of accuracy? This needs to be addressed, particularly as the authors have identified this as a limitation later in the discussion. Page 20, line 471, I think that stating consensus with a sample of 5 GPs is over reaching. The manuscript needs to be thoroughly checked for grammatical errors and non-academic language. ****** 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 [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.0259220.r001
Revision 1
8 Oct 2021 Author Response Response to Reviewers 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. To our knowledge, the manuscript meets PLOS ONE's style requirements. 2. When reporting the results of qualitative research, we suggest consulting the COREQ guidelines or other Please see page 5: This manuscript conforms to reporting guidelines for diagnostic accuracy studies (19) and qualitative studies (20). 20. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349-57. Review Comments to the Author Reviewer #1: Thank you to the authors for the opportunity to review this manuscript. This study addresses a very important gap in knowledge and practice. The inclusion of both qualitative and quantitative data was great. I have made a number of suggestions for the authors to consider: Abstract: Please define EOSS prior to introducing EOSS-2 risk tool, and explain how it is derived. You have this information in the introduction (page 4 lines 84-87). We appreciate this suggestion and have revised the abstract accordingly. Please consider rewriting lines 40-41 for clarity. We have revised this sentence for clarity. Please consider 'Further research is required to assess feasibility and applicability'. We appreciate the suggestion and have revised this sentence accordingly. Introduction: Are 2-17 years olds better described as children rather than young people? We have revised this to read ‘children and adolescents’. Do you need to provide contextual information re GPs, given the international audience? We have added ‘worldwide’ and ‘primary care physician’ to provide the international context of the evidence. Methods: In general, I think the methods section could benefit from refining to reduce repetition, length and improve clarity. Please consider 'recruited via authors' professional networks, namely...' page 5, line 111 We have revised this section accordingly. Were patients reimbursed for their time? We have clarified that patients were not reimbursed for their participation in the study. Why was a patient living without overweight/obesity included in the study, presumably with weight related health concerns? We presume so as the GP’s were responsible for ‘selecting patients with suspected overweight or obesity who they believed would benefit from weight management during routine practice and/or through searching their patient database’. Were GPS responsible for obtaining consent? The selected patient participants received study information packs from their GP containing specific participant information and a consent form. The study GPs were asked to reiterate to the patient that study participation was entirely voluntary, and that any decision to participate or not would not harm their existing doctor-patient relationship. Due to travel restrictions and locality of study sites, participants were required to return the signed consent form via a reply-paid postage to the University research team. The research team then sent scanned copies of the signed consent forms to the study GPs by email advising them that they could schedule the first study visit. Given the above stated concern about the length of the method section, no changes were made. Page 6, line 137, please consider 'to identify previously undiagnosed weight related complications' We have revised this accordingly. Page 7, line 144, is family history the most accurate term, or is this point about previously undiagnosed health concerns? We retained the term used in the survey to develop the new tool and believe it is a proxy variable of genetic risk factors. Page 8, lines 179-182, please consider omitting We have omitted this sentence. Page 8 lines 182-184, these are results We agree and have deleted this sentence for being redundant. Page 8, line 187, page 9, line 197, could you say 'no more than 2 weeks apart'? We have revised these sections accordingly. Page 9, line 211, likely fits better in results We agree and have revised this accordingly. Results: Could you state the % of participants who were categorised as EOSS 2,3 or 4 separately? We have revised the table presenting proportions for EOSS 2, 3, and 4. Page 13, line 283: I would recommend removing the numerical assessment of the qualitative findings. We have revised this accordingly. I would argue that the quotes from patient 9 and 3 talk more about weight loss than health (page 14, lines 305-314). However, the quote from patient 6 on page 16 is a better example After carefully considering the reviewer’s interpretation, we reviewed this section again. While we appreciate the suggestion, we still believe that the selected quotes appropriately support the themes. Discussion: Could the authors please clarify how their results address questions of accuracy? This needs to be addressed, particularly as the authors have identified this as a limitation later in the discussion. We have revised this for clarity. Page 20, line 471, I think that stating consensus with a sample of 5 GPs is over reaching. We have moderated this sentence. Attachments Attachment Submitted filename: Response to Reviewers_2.docx https://doi.org/10.1371/journal.pone.0259220.r002
18 Oct 2021 Decision Letter - Sabine Rohrmann, Editor Clinical usefulness of brief screening tool for Activating Weight management discussions in primary cARE (AWARE): a nationwide mixed methods pilot study PONE-D-21-24511R1 Dear Dr. Atlantis, 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, Sabine Rohrmann Academic Editor PLOS ONE Additional Editor Comments (optional): 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 #1: All comments have been addressed ******** 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 #1: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes ****** 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 #1: No ****** 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 #1: 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 #1: Thankyou to the authors for their careful consideration of the suggestions. I wish the authors well for their research into the future ****** 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 #1: No https://doi.org/10.1371/journal.pone.0259220.r003
Formally Accepted
20 Oct 2021 Acceptance Letter - Sabine Rohrmann, Editor PONE-D-21-24511R1 Clinical usefulness of brief screening tool for Activating Weight management discussions in primary cARE (AWARE): a nationwide mixed methods pilot study Dear Dr. Atlantis: 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. Sabine Rohrmann Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0259220.r004

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