PONE-D-21-31405Battling the obesity epidemic with a school-based intervention: Long-term effects of a quasi-experimental studyPLOS ONE

Dear Dr. Willeboordse,

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 apologize again for the delay in coming to a decision. The good news is that the reviewers see merit in your work. They came up with some comprehensible questions that mainly are requests for additional information, which you should be able to answer satisfactorily.

Please submit your revised manuscript by May 01 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.

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: https://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,

Clemens Fürnsinn, Ph.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. Thank you for stating the following in the Acknowledgments/ Funding Section of your manuscript: 

This study was funded by the Limburg provincial authorities (www.limburg.nl), Project Number 200130003 (received by CvS), by Maastricht University (www.maastrichtuniversity.nl), Project Number 200130003 (received by MJ) and by FrieslandCampina (www.frieslandcampina.nl) (received by MW), Project Number LLMV00. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Please note that funding information should not appear in the Acknowledgments section or other areas of your manuscript. We will only publish funding information present in the Funding Statement section of the online submission form. 

Please remove any funding-related text from the manuscript and let us know how you would like to update your Funding Statement. Currently, your Funding Statement reads as follows: 

This study was funded by the Limburg provincial authorities (www.limburg.nl), Project Number 200130003 (received by CvS), by Maastricht University (www.maastrichtuniversity.nl), Project Number 200130003 (received by MJ) and by FrieslandCampina (www.frieslandcampina.nl) (received by MW), Project Number LLMV00. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Please include your amended statements within your cover letter; we will change the online submission form on your behalf. 

3. We noted in your submission details that a portion of your manuscript may have been presented or published elsewhere. 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.

4. 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.

5. 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.

6. You indicated that ethical approval was not necessary for your study. We understand that the framework for ethical oversight requirements for studies of this type may differ depending on the setting and we would appreciate some further clarification regarding your research. Could you please provide further details on why your study is exempt from the need for approval and confirmation from your institutional review board or research ethics committee (e.g., in the form of a letter or email correspondence) that ethics review was not necessary for this study? Please include a copy of the correspondence as an ""Other"" file.

[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: Partly

********** 

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

Reviewer #1: N/A

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: The presented study reports on a real life intervention in schools. The results are important and highly valuable to policy maker, also in other countries than The Netherlands.

The authors have adressed all questions of other reviewers. Nothing to add. The only remark I want to make - it might be of interest for the non-Dutch reader to learn more about the the school environment for example - are materials from food companies as teaching materials used/allowed, participation in the school milk school fruit Programm ...

I agree with the authors, we need more of this kind of evaluated interventions.

Reviewer #2: Review Comments

PONE-D-21-31405 Battling the obesity epidemic with a school-based intervention: Long-term effects of a quasi-experimental study

Major comments:

1. Power calculations justifying sample size are not presented, as well as justification for the effect size included in the calculation. Have they been published elsewhere? A brief description in this paper would be helpful.

2. The rate of attrition (drop out) could be clarified. What was the rate of attrition by the study arms? What was the attrition rate assumed for power calculations? Is attrition randomly distributed? If there is non-random attrition, what statistical techniques are used to identify and adjust for the attrition bias?

3. Any comments on spill-overs? How is the contamination controlled for (e.g. the participation of three comparison schools with the European School Fruit and Vegetables Scheme)?

4. For a combined table on baseline characteristics, the last column usually gives the p value for the comparison between study groups. Why is the p value on baseline differences not presented and only the mean difference is reported?

5. Can the authors report both adjusted and unadjusted models, to avoid reporting bias? Do both adjusted and unadjusted analyses yield the same results?

6. “Comparison schools” instead of “control schools” as this is not an RCT?

7. Can the authors comment on food waste in this 4-year intervention? Food waste in school nutrition programs has received increasing attention.

Minor comments:

Introduction

8. Reference is missing for this statement: Current evidence suggests that school-based interventions show small favourable effects in terms of body mass index (BMI), and dietary and physical activity (PA) behaviours.

9. For L109-L113, is there any particular reason why result on BMIz in the short term evaluation is not reported? It would appear that effects on BMIz only started to show after two years, while effects on BMIz was significant from E1 to E4 as reported in the Results section. This could be clarified.

10. The statement “We hypothesise that improvements in dietary and PA behaviours will improve after one year of exposure…” (L117) could be clarified. Does it refer to an increasing intervention effect?

Study design

11. The numbers reported in L153-L157 are not lined up with numbers on E0-E4 in Participation expressed in exposure (in years) (Figure 1). This could be clarified.

Results

12. Was the stratification by gender specified in the pre-analysis plan? (L269-L270)

13. Results on PA behaviors at E4 appears to be counter-intuitive (L294-L295). This could be commented on in the Discussion section.

14. How are Figure 3 & Figure 4 referenced in the text?

Discussion

15. On L390, “water and dairy consumption instead of soft drinks” is stated. Is a decrease in soft drinks detected to support the statement? This could be reported as in the current study, the greatest effect was found in children’s water consumption.

********** 

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: Plos One Review comments 20220119.docx

Battling the obesity epidemic with a school-based intervention: Long-term effects of a quasi-experimental study

PONE-D-21-31405R1

Dear Dr. Willeboordse,

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,

Clemens Fürnsinn, Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: