Peer Review History

Original SubmissionApril 25, 2021
Decision Letter - Jamie Males, Editor

PONE-D-21-13590Applying Network Analysis to Assess the Development and Sustainability of Multi-Sector CoalitionsPLOS ONE

Dear Dr. Heeren,

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 reviewers have identified several important aspects of your study design that require further clarification and contextualisation. Please attend carefully to the each of the concerns they have raised when preparing your revisions.

Please submit your revised manuscript by Nov 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: 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,

Jamie Males

Staff 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. Please include additional information regarding the survey or questionnaire used in the study and ensure that you have provided sufficient details that others could replicate the analyses. For instance, if you developed a questionnaire as part of this study and it is not under a copyright more restrictive than CC-BY, please include a copy, in both the original language and English, as Supporting Information. Moreover, please include more details on how the questionnaire was pre-tested, and whether it was validated.

3. Please provide additional details regarding participant consent. In the ethics statement in the Methods and online submission information, please ensure that you have specified (1) whether consent was informed and (2) what type you obtained (for instance, written or verbal, and if verbal, how it was documented and witnessed). If your study included minors, state whether you obtained consent from parents or guardians. If the need for consent was waived by the ethics committee, please include this information.

If you are reporting a retrospective study of medical records or archived samples, please ensure that you have discussed whether all data were fully anonymized before you accessed them and/or whether the IRB or ethics committee waived the requirement for informed consent. If patients provided informed written consent to have data from their medical records used in research, please include this information.

Once you have amended this/these statement(s) in the Methods section of the manuscript, please add the same text to the “Ethics Statement” field of the submission form (via “Edit Submission”).

For additional information about PLOS ONE ethical requirements for human subjects research, please refer to http://journals.plos.org/plosone/s/submission-guidelines#loc-human-subjects-research.

4. 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.

5. 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.

6. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information: http://journals.plos.org/plosone/s/supporting-information.

[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: I Don't Know

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: I enjoyed reading this paper. It is clearly and succinctly written and reports from an interesting study. I am not equipped to interrogate all of the methods but overall my sense is that the analyses are robust.

The study design matches its aims, and I particularly liked the attempt to measure relationships pre- and post the initiative. The paper reports some important findings, especially re the limitations of such funding approaches when relationship-building requires a longer view.

I think the exclusively quantitative design is a limitation as the tendency is to over-simplify complex social and organisational variables. Some qualitative insights might have added nuance here.

My only suggestion for amending the paper is to elaborate a little on its contribution. The authors talk about ‘refining’ understanding but this could be tied to a prior assessment of limitations/gaps in the literature.

Reviewer #2: This is a very interesting paper, but I would urge you all to go back and think about why you are doing this study, motivate with theory, what are you are capturing in the “networks” and justify your dyadic measures more.

There is no theoretical motivation for this research provided. Secondly, what are the networks you are trying to examine? How is each network bounded? Please explanation what the networks are, at least in theory. And what is the rationale for the dyad level measures? Please explain/give more motivation. Can we assume that most of the organizations have dyadic relationships? What about triads? Or clique structures?

Please explain the creation of the dyad-level covariate which is the absolute difference in closeness centrality, thus capturing pairwise similarity in centrality of

network position. There are many centrality measures. Why is closeness centrality of theoretical or empirical importance herein?

What was the extent of the missing data? Please elaborate on this.

**********

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.

Revision 1

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: I enjoyed reading this paper. It is clearly and succinctly written and reports from an interesting study. I am not equipped to interrogate all of the methods but overall my sense is that the analyses are robust.

The study design matches its aims, and I particularly liked the attempt to measure relationships pre- and post the initiative. The paper reports some important findings, especially re the limitations of such funding approaches when relationship-building requires a longer view.

I think the exclusively quantitative design is a limitation as the tendency is to over-simplify complex social and organisational variables. Some qualitative insights might have added nuance here.

Author response: Additional qualitative content added to provide additional context and illustrate motivation for network analysis methodology.

My only suggestion for amending the paper is to elaborate a little on its contribution. The authors talk about ‘refining’ understanding but this could be tied to a prior assessment of limitations/gaps in the literature.

Author response: A summary of contributions to documented gaps in literature have been added.

Reviewer #2: This is a very interesting paper, but I would urge you all to go back and think about why you are doing this study, motivate with theory, what are you are capturing in the “networks” and justify your dyadic measures more.

There is no theoretical motivation for this research provided. Secondly, what are the networks you are trying to examine? How is each network bounded? Please explanation what the networks are, at least in theory. And what is the rationale for the dyad level measures? Please explain/give more motivation. Can we assume that most of the organizations have dyadic relationships? What about triads? Or clique structures?

Author response:

More explicit definition of network boundaries and membership added (formal membership in health coalitions).

Underlying theory expounded upon (including structural holes, functional ties, and sustaining system change). Also referenced influencing implications from practical applications.

Theoretical justification for examining dyad-level measures and network density were added (focus on referral network connectivity between organizations and overall were of primary interest related to research question)

Triads were measured via network transitivity, but wasn’t expounded upon in discussion, as results were not integral to hypothesized outcomes

Please explain the creation of the dyad-level covariate which is the absolute difference in closeness centrality, thus capturing pairwise similarity in centrality of network position. There are many centrality measures. Why is closeness centrality of theoretical or empirical importance herein?

Author response:

Added theoretical content justifying the applied function of closeness centrality in a referral network (e.g. indicates capacity to connect efficiently with each actor in the network)

What was the extent of the missing data? Please elaborate on this.

Author response: Table 1 revised to include % of missing edges

Attachments
Attachment
Submitted filename: Response to Reviewers Heeren et al.docx
Decision Letter - Cynthia Lakon, Editor

PONE-D-21-13590R1Applying Network Analysis to Assess the Development and Sustainability of Multi-Sector CoalitionsPLOS ONE

Dear Dr. Heeren,

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.

As you can see, both reviewers suggest relatively minor changes.  Please respond to these comments in your revised manuscript, including the suggestion of adding one more model indicated by Reviewer 4. 

Please submit your revised manuscript by Aug 19 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,

Cynthia Lakon, PhD, MPH

Guest 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 #3: All comments have been addressed

Reviewer #4: (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 #3: Yes

Reviewer #4: Yes

********** 

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

Reviewer #3: Yes

Reviewer #4: 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 #3: Yes

Reviewer #4: 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 #3: Yes

Reviewer #4: 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 #3: This paper reports on an inter-organizational analysis relationship formed within the context of a state-wide granting mechanism in response to field reports on the challenges of creating and sustaining cross-sector collaborations. A few comments to improve the study.

The one glaring issue, which is certainly not amenable is the reliance on one time period to measures pre-SIM, during SIM, and projected sustainment. Although I am not immediately aware of any such studies I am certain there are other studies which have assessed networks at multiple time points at one time. I would encourage the authors to find such studies, reference, and see how they describe this limitation. Moreover, I wonder if the authors can explore any ways in which they can “validate” these reports.

Second, the authors make no mention of who specifically, within each organization, completed the survey. Presumably each organization has multiple hierarchical levels ranging from CEO, Director, program manager, staff, research assistant, etc. Who was responsible for providing this information can have implications for what they can report. Indeed, a CEO is likely to have quite a different perception of the working relationships than a program manager. This should be analyzed as it might be that the integrator organization consisting of health service agencies may have delegated reporting (survey completion) differently than other organizations.

Line 107: A roster of all possible collaborators was roved to minimize recall error and strengthen the equity of reporting, a

“roved”? -> “provided

Line 120: For instance, some tasks require mutual trust and investment (e.g. data sharing) while execution of other activities (e.g. co-serving on an advisory board) are less intensive.(18)

Should this be “ … less interactive.”?

Line 147: you should cite Freeman, 1979 on closeness centrality and report which variant you use.

Lines 196-197: as per comment 2 above, was there only one individual reporting for each organization?

Lines 220-223: “Contrary to the hypothesis that organizations with more similar centrality in the preexisting network were more likely to form stimulated edges with one another, there was a significant positive effect of the absolute difference in closeness centrality between the organizations (OR = 1.10, 95% CI = [1.04, 1.16]).”

Lines 224-225: “Meaning, organizations with dissimilar centralities (i.e. pairs comprised of one core and one periphery organization) were more likely to form connections.”

Make a visual inspection to be certain these are new core-periphery ties, just because they closeness centrality differences are associated with new ties does not necessarily imply that.

But I would think that organizations with high and similar closeness centrality scores would already be connected. Is this controlled for? At the very least they would have a shared partner thus more likely to become connected.

It might be worth noting if these 7 sites were the 7 largest municipalities in Iowa (or not).

Lines 124-125: “For each collaboration, respondents indicated: “little trust/new relationship,” “some trust/developing relationship,” or “high trust/strong relationship.”

You might note as a limitation that trust and duration of relationship are not synonymous.

Reviewer #4: One suggestion I had is that in the “likely sustained” model, you might add an additional model that only includes the variables in the “stimulated” model. This would allow you to assess the degree to which these added variables (including strength of ties) might moderate the effects of your ACH structure variables. This potentially could provide additional insights.

********** 

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 #3: Yes: Thomas W Valente

Reviewer #4: 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.

Revision 2

6. Review Comments to the Author

Reviewer #3: This paper reports on an inter-organizational analysis relationship formed within the context of a state-wide granting mechanism in response to field reports on the challenges of creating and sustaining cross-sector collaborations. A few comments to improve the study.

☒The one glaring issue, which is certainly not amenable is the reliance on one time period to measures pre-SIM, during SIM, and projected sustainment. Although I am not immediately aware of any such studies I am certain there are other studies which have assessed networks at multiple time points at one time. I would encourage the authors to find such studies, reference, and see how they describe this limitation. Moreover, I wonder if the authors can explore any ways in which they can “validate” these reports.

The reviewer is correct, in both that this is a major limitation and one which due to study constraints we were unable to avoid. If the reviewer can point us to specific papers we would take them into consideration; however, we are unaware of any papers that investigate the potential ramifications of this study design. The rationale behind perceptions of predicted sustainment as a valid assessment is based in the Theory of Planned Behavior, which states that behavioral intention (in this case, sustaining a relationship) is associated with behavioral achievement (Azjen, 1991). Several prior studies investigating network change over time have called for additional research with longitudinal analysis including variables like trust, stage of relationship, collaborative task, and network size (Bryson, 2015; Provan 2012; Varda, 2008) The Provan 2012 study used longitudinal data, but noted this did not mitigate all the complexities of interpreting network change over time, “First, despite use of longitudinal data, we were unable to develop a full understanding of how network ties evolved. For example, more in-depth qualitative data might have enabled us to examine the impact of [Value Option, a behavioral health network] VO’s contract rules on the evolution of the network as a whole… we did not know how many relationships were already in place when the VO system first was established. Thus, while the VO system was new, many relationships among providers may have predated VO.”(p.373).

As a small step in this direction, we ran a simulation study, replicating the analysis for stimulated connections. In this study, we simulated 100 datasets that, in order to emulate recall error, we randomly deleted 10% of the pre-existing edges. We then, for each simulated dataset, computed the estimated odds ratio and confidence intervals. We found remarkably little variation in the estimates, as can be seen in the figure below, which shows the boxplots of the 100 simulations for the lower bound and upper bound of the confidence intervals as well as for the point estimate of the odds ratio. The original CI bounds and point estimates are superimposed in red asterisks. It is clear that even if there is poor recall in pre-existing connections between organizations, we are still able to obtain accurate inference.

Regarding the analysis of sustained edges, since we were unable to confirm whether or not a connection was in fact sustained, it might be better to interpret our results in terms of intent to sustain. We have changed the Limitations Section to reflect all these points.

☒Second, the authors make no mention of who specifically, within each organization, completed the survey. Presumably each organization has multiple hierarchical levels ranging from CEO, Director, program manager, staff, research assistant, etc. Who was responsible for providing this information can have implications for what they can report. Indeed, a CEO is likely to have quite a different perception of the working relationships than a program manager. This should be analyzed as it might be that the integrator organization consisting of health service agencies may have delegated reporting (survey completion) differently than other organizations.

Surveys were completed by the staff designated as primary contact(s) representing the organization in the ACH network. In cases in which multiple staff from a single organization were involved, survey responses were aggregated at the organization level. The survey sample was largely comprised of practitioner roles (as opposed to formal leadership roles in each organization), for example, primary care providers, local public health department staff, hospital clinic managers, behavioral health providers, school nurses, law enforcement staff (e.g. sheriff), community members, transportation providers, faith-based organization staff, pharmacists, health coaches, care coordinators, case managers, benefits program administrators (e.g. WIC), non-profit staff, local government representatives (e.g. city managers), community group leaders (e.g. local NAACP chapters), and program managers.

This phrase was added to line 136

Other stakeholders in Iowa’s ACHs included local representatives from hospitals, primary care providers, other healthcare providers (e.g., behavioral health, pharmacy, dental), insurers, community action organizations, governmental entities, and social service providers. Surveys were completed by the staff designated as primary contact(s) representing the organization in the ACH network. In cases in which multiple staff from a single organization were involved, survey responses were aggregated at the organization level. These representatives comprised the survey sample, which was largely practitioner perspectives (as opposed to formal leadership e.g., CEOs)

☒Line 139: A roster of all possible collaborators was roved to minimize recall error and strengthen the equity of reporting, a

“roved”? -> “provided

Line 139, previously corrected in November 2021 revision response

☒Line 153: For instance, some tasks require mutual trust and investment (e.g. data sharing) while execution of other activities (e.g. co-serving on an advisory board) are less intensive.(18)

Should this be “ … less interactive.”?

Line 153, changed to interactive

☒Line 179: you should cite Freeman, 1979 on closeness centrality and report which variant you use.

Freeman 1978 citation added to line 201, in addition to the phrase below, added to line 202

Closeness centrality was calculated as the sum of the inverse distances and measures how close..

This method of calculating closeness centrality is sometimes called “harmonic centrality,” a type of relative measure (as described in Freeman 1979). The specific variant employed was not described in the Freeman paper.

☒Lines233-234: as per comment 2 above, was there only one individual reporting for each organization?

No, see response to second comment RE sample

Lines262-263: “Contrary to the hypothesis that organizations with more similar centrality in the preexisting network were more likely to form stimulated edges with one another, there was a significant positive effect of the absolute difference in closeness centrality between the organizations (OR = 1.10, 95% CI = [1.04, 1.16]).”

☒Lines 264-265: “Meaning, organizations with dissimilar centralities (i.e. pairs comprised of one core and one periphery organization) were more likely to form connections.”

Make a visual inspection to be certain these are new core-periphery ties, just because they closeness centrality differences are associated with new ties does not necessarily imply that.

We acknowledge that our original language was too strong regarding stimulated edges between core and peripheral organizations. We have changed the text now to read,

“This statistically significant positive effect implies that organizations with more dissimilar centralities were more likely to form connections, such as a stimulated connection between a central hub and a peripheral organization.”

☒But I would think that organizations with high and similar closeness centrality scores would already be connected. Is this controlled for? At the very least they would have a shared partner thus more likely to become connected.

The analysis for stimulated connections was implicitly conditioning on the non-existence of the edge; that is, we are considering only dyads without a connecting edge, and seeing which factors predict a new connection being formed (if the reviewer is familiar with STERGM, this is akin to the “relational formation” half of the separable likelihood). In the analysis for sustained connections, we are implicitly conditioning on the edge existing (again, akin to the “relational dissolution” half of the STERGM likelihood), and we are also including as a covariate whether or not the edge was originally connected or newly stimulated.

☒It might be worth noting if these 7 sites were the 7 largest municipalities in Iowa (or not).

This phrase has been added to line 127 –

The seven ACH sites in the state were a mix of single county (urban) and multi-county (rural) sites, with the intention of developing models for future replication for both settings.

☒Lines156-157: “For each collaboration, respondents indicated: “little trust/new relationship,” “some trust/developing relationship,” or “high trust/strong relationship.”

You might note as a limitation that trust and duration of relationship are not synonymous.

In pilot survey testing, items were specific only to level of trust. Test respondents reported they were hesitant to rate collaborative relationships as lacking trust. While trust and duration of relationship are not synonymous, alternative language describing the stage of the relationship (i.e., new, developing, strong) was included to mitigate social desirability bias.

☒Reviewer #4: One suggestion I had is that in the “likely sustained” model, you might add an additional model that only includes the variables in the “stimulated” model. This would allow you to assess the degree to which these added variables (including strength of ties) might moderate the effects of your ACH structure variables. This potentially could provide additional insights.

We appreciate the suggestion from Reviewer 4. We have rerun the analysis for the sustained connections model, and our results are consistent with previously reported findings (see table below). Analysis was completed, results consistent with original findings, suggesting that there are not moderation effects. Because these results are consistent, i.e., there does not appear to be moderation effects to report on, for the sake of brevity we have opted for omitting this additional analysis in the manuscript.

Stimulated Likely Sustained Likely Sustained (reviewer #4)

Variable Odds Ratio (OR) 95% confidence Interval (CI) for OR P-value Odds Ratio (OR) 95% confidence Interval (CI) for OR P-value Odds Ratio (OR) 95% confidence Interval (CI) for OR P-value

Autoregressive measures

Sum of node degree 1.157 (1.097, 1.221) <0.01 1.062 (1.010, 1.116) 0.0192 1.097 (1.049, 1.147) <0.01

Similarity = abs diff in closeness cent 1.092 (1.034, 1.154) <0.01 1.054 (0.954, 1.165) 0.3038 1.041 (0.951, 1.140) 0.3843

Same sector indicator 1.259 (0.767, 2.065) 0.3625 1.440 (0.873, 2.377) 0.1531 1.744 (1.104, 2.754) 0.0171

ACH structure

Integrator org 2.715 (1.248, 5.909) 0.0118 1.217 (0.557, 2.658) 0.6222 1.626 (0.805, 3.286) 0.1756

Both members of steering committee 13.860 (6.305, 30.469) <0.01 0.887 (0.347, 2.269) 0.8023 0.824 (0.385, 1.765) 0.6182

One member of steering committee 3.226 (1.999, 5.206) <0.01 1.230 (0.688, 2.200) 0.4852 0.886 (0.527, 1.490) 0.6480

Average strength of relationship 1.881 (1.377, 2.569) <0.01

Stimulated by SIM 0.695 (0.411, 1.173) 0.1729

Collaboration types

Advisory 1.534 (0.859, 2.739) 0.1486

Care coordination 1.264 (0.763, 2.095) 0.3630

Data sharing 2.129 (1.265, 3.585) <0.01

Resource sharing 2.164 (1.321, 3.546) <0.01

________________________________________

Attachments
Attachment
Submitted filename: Response to Reviewers Heeren et al 8.26.22.docx
Decision Letter - Cynthia Lakon, Editor

Applying Network Analysis to Assess the Development and Sustainability of Multi-Sector Coalitions

PONE-D-21-13590R2

Dear Dr. Heeren,

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,

Cynthia Lakon, PhD, MPH

Guest Editor

PLOS ONE

Additional Editor Comments (optional):

Thank you for your revisions, they have addressed the remaining comments.

Reviewers' comments:

Formally Accepted
Acceptance Letter - Cynthia Lakon, Editor

PONE-D-21-13590R2

Applying Network Analysis to Assess the Development and Sustainability of Multi-Sector Coalitions

Dear Dr. Heeren:

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. Cynthia Lakon

Guest Editor

PLOS ONE

Open letter on the publication of peer review reports

PLOS recognizes the benefits of transparency in the peer review process. Therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. Reviewers remain anonymous, unless they choose to reveal their names.

We encourage other journals to join us in this initiative. We hope that our action inspires the community, including researchers, research funders, and research institutions, to recognize the benefits of published peer review reports for all parts of the research system.

Learn more at ASAPbio .