Multilevel theorizing in health communication: Integrating the Risk Perception Attitude (RPA) framework and the Theory of Normative Social Behavior (TNSB)

Hagere Yilma; Rajiv N. Rimal; Manoj Parida

doi:10.1371/journal.pone.0271804

Peer Review History

Original SubmissionNovember 5, 2021
19 Apr 2022 Decision Letter - Lei Shi, Editor PONE-D-21-35351Multilevel theorizing in health communication: integrating the Risk Perception Attitude (RPA) framework and the Theory of Normative Social Behavior (TNSB)PLOS ONE Dear Dr. Hagere Yilma, 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 Jun 03 2022 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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If you have no competing interests, please state ""The authors have declared that no competing interests exist."", as detailed online in our guide for authors at http://journals.plos.org/plosone/s/submit-now This information should be included in your cover letter; we will change the online submission form on your behalf. 6. Please include your full ethics statement in the ‘Methods’ section of your manuscript file. In your statement, please include the full name of the IRB or ethics committee who approved or waived your study, as well as whether or not you obtained informed written or verbal consent. If consent was waived for your study, please include this information in your statement as well. [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 a well written manuscript and the statistical analyses approach in a stepwise fashion is routine for this type of question. The sample size is certainly adequate and the power needed to address the hypotheses may be adequate, although the investigators are counting on the original randomized trial to accommodate this concern. Admittedly the study is cross sectional. The limitations are well explained and the conclusions follow from the analyses provided. The investigators used hierarchical linear equations to analyze interactions between predictors at various levels and efficacy to predict behavioral intention. The moderators incorporated into the model are certainly reasonable. There is no mention of any fit statistics examining the appropriateness of the linear models unless this is already discussed in previous work and should be referenced if such is the case. Reviewer #2: This paper resorts the concept of efficacy to bring together normative factors at the social-level, specifically including descriptive norms, injunctive norms and collective norms, and risk perception at the individual-level, and analyzes data from the RANI project through hierarchical linear equations, and then examines the role of a series of predictors and efficacy on the intention to consume IFA. The main findings are the strength of the association between efficacy beliefs and intentions and the interaction effect involving efficacy beliefs. The literature review of this paper is well prepared, the hypotheses are natural and reasonable, and the conclusions are generally credible. It is an honor to read this paper, but there are still a few suggestions before publication: 1. It is suggested that the authors supplement the hierarchical linear equations used in this paper at appropriate place, and further enrich the summary statistics on measures; 2. It is suggested that the authors provide further explanations for “low reliability” and “exponentially iterative process” in Measures. 3. As the authors mention the relationship between efficacy and behaviors in Limitations, it is also recommended that they explore the self-efficacy and response efficacy separately; 4. The dependent variable in this paper is the intention to consume IFA, not the actuals. If permitted, it is recommended that the authors continue to track the behavioral performance of participants to better supplement and evaluate the conclusions involved in this paper. ****** 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 [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. Attachments Attachment Submitted filename: PONE-D-21-35351_reviewer comment.docx https://doi.org/10.1371/journal.pone.0271804.r001
Revision 1
8 Jun 2022 Author Response Dear Reviewers , Thank you for taking the time to thoroughly review our manuscript PONE-D-21-35351 Multilevel theorizing in health communication: integrating the Risk Perception Attitude (RPA) framework and the Theory of Normative Social Behavior (TNSB). I am delighted to share our response to each editorial and reviewer comment below, indicated in bold blue font within our attached letter (Response to reviewers. doc). Reviewer #1: This is a well written manuscript and the statistical analyses approach in a stepwise fashion is routine for this type of question. The sample size is certainly adequate and the power needed to address the hypotheses may be adequate, although the investigators are counting on the original randomized trial to accommodate this concern. Admittedly the study is cross sectional. The limitations are well explained and the conclusions follow from the analyses provided. The investigators used hierarchical linear equations to analyze interactions between predictors at various levels and efficacy to predict behavioral intention. The moderators incorporated into the model are certainly reasonable. There is no mention of any fit statistics examining the appropriateness of the linear models unless this is already discussed in previous work and should be referenced if such is the case. Thank you for your thoughtful review and summary of the strengths and limitations of our study. We report the adjusted R-square as the fit statistic for the model with the main effects, as well as changes in adjusted R-square with the addition of each moderator (page 15-16). We have now edited the manuscript so that this clearer. Reviewer #2: This paper resorts the concept of efficacy to bring together normative factors at the social-level, specifically including descriptive norms, injunctive norms and collective norms, and risk perception at the individual-level, and analyzes data from the RANI project through hierarchical linear equations, and then examines the role of a series of predictors and efficacy on the intention to consume IFA. The main findings are the strength of the association between efficacy beliefs and intentions and the interaction effect involving efficacy beliefs. The literature review of this paper is well prepared, the hypotheses are natural and reasonable, and the conclusions are generally credible. It is an honor to read this paper, but there are still a few suggestions before publication: 1. It is suggested that the authors supplement the hierarchical linear equations used in this paper at appropriate place, and further enrich the summary statistics on measures; Thank you for your thoughtful and careful review of our manuscript. We have not included hierarchical linear equations in our manuscript because we only present models with variables measured at a singular level (the individual level). Rather, the “hierarchical regressions” referred to in this paper is in reference to the step-wise fashion in which the interaction terms were included into the model. 2. It is suggested that the authors provide further explanations for “low reliability” and “exponentially iterative process” in Measures. Thank you for this note. We have edited the manuscript to reflect that we are referring to the low Cronbach’s alpha when we use claim the measure has low reliability, and that the iterative process used was Tukey’s ladder of powers. 3. As the authors mention the relationship between efficacy and behaviors in Limitations, it is also recommended that they explore the self-efficacy and response efficacy separately Thank you for this note. We have looked at efficacy as separate variables and have not found a difference in findings between the two. However, after much consideration, we have decided to report efficacy as a combination of self-efficacy and response-efficacy because the RPA framework indicates that it is the combination between the two that has the power to strengthen or attenuate the influence of risk perception on behavior intentions. 4. The dependent variable in this paper is the intention to consume IFA, not the actuals. If permitted, it is recommended that the authors continue to track the behavioral performance of participants to better supplement and evaluate the conclusions involved in this paper. We appreciate this comment and agree that behavior is important to track. We are delighted to share that the behavioral impact of the RANI Project will be reported in the intervention’s final impact paper. However, in terms of this particular paper, we have chosen to look at intention rather than behavior because 1) we wanted to stay true to the theories used; the TNSB and the RPA framework posit that risk perception, efficacy, and social norms predict intentions, which then subsequently impact behavior and 2) intention and behaviors are measured 6 to 12 months a part in subsequent rounds of the RANI Project’s data collection, therefore we do not report associations between intentions and behavior here due to the temporal distance between the two measures. However, we have added a statement under our description of the measurement of intentions that supports the association between intentions and behaviors. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0271804.r002
8 Jul 2022 Decision Letter - Lei Shi, Editor Multilevel theorizing in health communication: integrating the Risk Perception Attitude (RPA) framework and the Theory of Normative Social Behavior (TNSB) PONE-D-21-35351R1 Dear Dr. Hagere Yilma, 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, Lei Shi 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 #2: 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 #2: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #2: 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 #2: Yes ****** 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: (No Response) ****** 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 ******** https://doi.org/10.1371/journal.pone.0271804.r003
Formally Accepted
14 Jul 2022 Acceptance Letter - Lei Shi, Editor PONE-D-21-35351R1 Multilevel theorizing in health communication: integrating the Risk Perception Attitude (RPA) framework and the Theory of Normative Social Behavior (TNSB) Dear Dr. Yilma: 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. Lei Shi Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0271804.r004

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