PONE-D-21-33135Alcohol use among Congolese Babembe refugees in Tarrant County: A qualitative studyPLOS ONE

Dear Dr. Baker,

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 may inform you that the reviewers have several important points that needs the authors' systematic response. However, your submission of the manuscript  after due revision does not guarantee an acceptance of the manuscript for publication. 

Please submit your revised manuscript by Feb 24 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,

Subhendu Kumar Acharya, 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. We note that the grant information you provided in the ‘Funding Information’ and ‘Financial Disclosure’ sections do not match.

When you resubmit, please ensure that you provide the correct grant numbers for the awards you received for your study in the ‘Funding Information’ section.

3. Thank you for stating the following financial disclosure:

“No. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript”

At this time, please address the following queries:

a)        Please clarify the sources of funding (financial or material support) for your study. List the grants or organizations that supported your study, including funding received from your institution.

b)        State what role the funders took in the study. If the funders had no role in your study, please state: “The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.”

c)        If any authors received a salary from any of your funders, please state which authors and which funders.

d)        If you did not receive any funding for this study, please state: “The authors received no specific funding for this work.”

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

4. In your Data Availability statement, you have not specified where the minimal data set underlying the results described in your manuscript can be found. PLOS defines a study's minimal data set as the underlying data used to reach the conclusions drawn in the manuscript and any additional data required to replicate the reported study findings in their entirety. All PLOS journals require that the minimal data set be made fully available. For more information about our data policy, please see http://journals.plos.org/plosone/s/data-availability.

Upon re-submitting your revised manuscript, please upload your study’s minimal underlying data set as either Supporting Information files or to a stable, public repository and include the relevant URLs, DOIs, or accession numbers within your revised cover letter. For a list of acceptable repositories, please see http://journals.plos.org/plosone/s/data-availability#loc-recommended-repositories. Any potentially identifying patient information must be fully anonymized.

Important: If there are ethical or legal restrictions to sharing your data publicly, please explain these restrictions in detail. Please see our guidelines for more information on what we consider unacceptable restrictions to publicly sharing data: http://journals.plos.org/plosone/s/data-availability#loc-unacceptable-data-access-restrictions. Note that it is not acceptable for the authors to be the sole named individuals responsible for ensuring data access.

We will update your Data Availability statement to reflect the information you provide in your cover letter.

5. 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: Partly

**********

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

Reviewer #1: N/A

Reviewer #2: N/A

**********

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 purpose of this study is to explore the determinants and practises that contribute to alcohol use among one of the world's most vulnerable populations. While this work has major implications for public health, it should clarify or address the following points.

The title of the article is 'Alcohol usage among Congolese Babembe refugees in Tarrant County: A qualitative study.' Kindly include among male refugees, as this study is mostly focused on male participation.

Abstract: Indicate in approach which approach you used, such as phenomenology, ethnography, or narrative. Similarly, make reference to the analysis method of 'thematic content analysis.'

Introduction: There are no comments.

Methods:

It stated unequivocally that 19 individuals were chosen using snow-ball sampling. How many focus groups were held by the authors? Each FGD recorded the number of participants. I believe that facilitating 19 participants in a single FGD is tough. How the author dealt with it. All of these approaches put limits on your data collection procedures. Alternatively, the author may refer to 19 interviews conducted with semi-structured open-ended questions.

How many individuals did you approach? And how many are unwilling to participate, and what are their reasons? Are there any additional non-participants present during the FGDs?

Kindly include one sentence describing each author's educational background and professional experience in qualitative research, as well as how their multidisciplinary backgrounds help to extend the scope of the findings' interpretation. You may mention investigator triangulation here.

Results:

The participants characteristics you can move to methods section. Since it is only 19 participants instead of table you may summarize the key participants characteristics.

In each quotation mention the age and years lived in refugees camp of the participant.

In Subtheme 2: Alcohol abuse in refugee camps. Reduce the quotation length and describe the content in detail.

The ‘Subtheme 5: America has destroyed our culture, and Subtheme 6: Loss of traditional ways to control alcohol abuse’ may be combined.

Similarly, sub-theme 8 to 11 may be classified as two broad sub-themes.

There is need of table on coding tree. Example of coding tree given below.

Themes

Sub-themes

Codes

Discussion:

Mention one paragraph on ‘Implication for policy and practice’

Instead of limitations, put the heading as ‘Methodological considerations’ and discus both strength and limitations of the study.

Conclusion section is missing.

Reviewer #2: The central contribution of the manuscript is to help the reader understand the factors contributing to alcohol abuse among the Babembe refugees who are originally from Congo. While the empirical material and analysis indicate the relationship between the refugee status and alcohol abuse, it may require more nuanced analysis of the data to present the argument better. The connection between the theoretical argument and the empirical material needs to be strengthened

Some specific comments:

1. The authors should include a justification of why FGD was conducted with 19 members in the methods section. While they discuss this in the limitations, it may help the reader to contextualise the results if it is mentioned upfront.

2. FGD using a semi-structured guide make better sense than mentioning ‘semi-structured FGD’.

3. The analysis section should be strengthened by including a description of the analysis process and epistemological stance of the researchers in choosing thematic content analysis. They should also provide a reference for the analysis framework.

4. Use of identifiers that do not reveal the identities of the respondents along with the quotations is important.

5. For the subtheme 2, the quote on TKK does not seem to fit into the theme of alcohol abuse. The quote could be used to substantiate the existing efforts to tackle the alcohol abuse problem and the community participation.

6. Subtheme 4 indicates ease of access and low cost of alcohol. The theme can be rephrased to effectively communicate to the reader

7. Under theme 2, all the subthemes are overlapping. There has to be more nuanced presentation of the data in this theme.

8. Are the themes and subthemes based on the verbatim from the FGD?

9. Theme 3 and the sub themes need to be rephrased.

10. Sub-theme 10 is misleading about empowerment. The statement and the quote convey that beating wife is empowerment for men. I’m sure that that the community and the researchers do not subscribe to this!!

11. The discussion could be have been more effective if discussion around larger social determinants, issues around racism shape the experience of the refuges in US.

12. The manuscript should have included some discussion around how these factors were dealt with among other refugees or could be dealt with through appropriate interventions among the Babembe.

**********

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: Yes: Krushna Chandra Sahoo

Reviewer #2: Yes: Nanda Kishore Kannuri

[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.

Alcohol use among Congolese Babembe male refugees in Tarrant County: A qualitative study

PONE-D-21-33135R1

Dear Dr. Baker,

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. We apologize for the delay incurred on your submission. 

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,

Dario Ummarino, PhD

Senior 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: N/A

**********

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: 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 #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: In the manuscript 'Alcohol use among Congolese Babembe male refugees in Tarrant County: A

qualitative study' thanks for addressing all the comments.

**********

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: Yes: Dr. Krushna Chandra Sahoo

**********