PONE-D-22-11199Examining Neighborhood-Level Hot and Cold Spots of Food Insecurity In Relation to Social Vulnerability in Houston, Texas

PLOS ONE

Dear Dr. Ramphul,

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 manuscript has been evaluated by four reviewers, and their comments are available below.

The reviewers have raised a number of  concerns regarding the methodology and reporting of this study.

Could you please revise the manuscript to carefully address the concerns raised?

Please submit your revised manuscript by Oct 09 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,

Johannes Stortz

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. We note that Figure 1 & 2 in your submission contain [map/satellite] images which may be copyrighted. All PLOS content is published under the Creative Commons Attribution License (CC BY 4.0), which means that the manuscript, images, and Supporting Information files will be freely available online, and any third party is permitted to access, download, copy, distribute, and use these materials in any way, even commercially, with proper attribution. For these reasons, we cannot publish previously copyrighted maps or satellite images created using proprietary data, such as Google software (Google Maps, Street View, and Earth). For more information, see our copyright guidelines: http://journals.plos.org/plosone/s/licenses-and-copyright.

We require you to either (1) present written permission from the copyright holder to publish these figures specifically under the CC BY 4.0 license, or (2) remove the figures from your submission:

1. You may seek permission from the original copyright holder of Figure 1 & 2 to publish the content specifically under the CC BY 4.0 license.  

We recommend that you contact the original copyright holder with the Content Permission Form (http://journals.plos.org/plosone/s/file?id=7c09/content-permission-form.pdf) and the following text:

“I request permission for the open-access journal PLOS ONE to publish XXX under the Creative Commons Attribution License (CCAL) CC BY 4.0 (http://creativecommons.org/licenses/by/4.0/). Please be aware that this license allows unrestricted use and distribution, even commercially, by third parties. Please reply and provide explicit written permission to publish XXX under a CC BY license and complete the attached form.”

Please upload the completed Content Permission Form or other proof of granted permissions as an "Other" file with your submission.

In the figure caption of the copyrighted figure, please include the following text: “Reprinted from [ref] under a CC BY license, with permission from [name of publisher], original copyright [original copyright year].”

2. If you are unable to obtain permission from the original copyright holder to publish these figures under the CC BY 4.0 license or if the copyright holder’s requirements are incompatible with the CC BY 4.0 license, please either i) remove the figure or ii) supply a replacement figure that complies with the CC BY 4.0 license. Please check copyright information on all replacement figures and update the figure caption with source information. If applicable, please specify in the figure caption text when a figure is similar but not identical to the original image and is therefore for illustrative purposes only.

The following resources for replacing copyrighted map figures may be helpful:

USGS National Map Viewer (public domain): http://viewer.nationalmap.gov/viewer/

The Gateway to Astronaut Photography of Earth (public domain): http://eol.jsc.nasa.gov/sseop/clickmap/

Maps at the CIA (public domain): https://www.cia.gov/library/publications/the-world-factbook/index.html and https://www.cia.gov/library/publications/cia-maps-publications/index.html

NASA Earth Observatory (public domain): http://earthobservatory.nasa.gov/

Landsat: http://landsat.visibleearth.nasa.gov/

USGS EROS (Earth Resources Observatory and Science (EROS) Center) (public domain): http://eros.usgs.gov/#

Natural Earth (public domain): http://www.naturalearthdata.com/

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. 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

Reviewer #3: Partly

Reviewer #4: Yes

**********

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

Reviewer #1: Yes

Reviewer #2: I Don't Know

Reviewer #3: Yes

Reviewer #4: 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

Reviewer #3: No

Reviewer #4: No

**********

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

Reviewer #3: Yes

Reviewer #4: 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: To know about neighborhood food insecurity authors geocoded food insecurity screening data provided by health provider, along with geospatial modeling, and Social Vulnerability Index. They found that hot spot tracts were having higher overall social vulnerability index scores, greater subdomain scores, and increased poverty, unemployment, limited English proficiency. Overall this is an interesting study. I think it is well written and properly explained but few minor suggestions are there to improve the paper:

When you say plethora of research …. and see last line in the para references provided same and only 1 in the whole paragraph. Better cite more literature here. See below

“A plethora of research suggests that food insecurity is not only highly prevalent but associated with several poor health outcomes. Regarding children, studies suggest that food insecurity is associated with an increased risk of birth defects, anemia, lower nutrient intake, cognitive problems, aggression, and anxiety (1). Research also indicates that food insecurity is associated with higher risks of children being hospitalized, having asthma, behavioral problems, depression, suicide ideation, poor oral health, and poor overall health (1). Regarding non-senior adults, studies show that food insecurity is associated with decreased nutrient intake, increased rates of mental health problems, diabetes, hypertension and hyperlipidemia, poor sleep outcomes, and poor overall health (1). Finally, studies indicate that food insecure seniors are more likely to be in poor health, depressed, and have limited daily activities compared to their food-secure peers (1).

In introduction I think extra details on food security outcomes are given than needed. Instead of three paragraphs on outcomes better be concise.

Last two Paragraphs of discussion section is about study limitation and strength, So better give a heading “The limitation and Strength.”

Literature and references are not sufficient give some more studies and literature.

Reference 20 is in the conclusion. Better put these lines in discussion/analysis section.

Reviewer #2: Thank you for allowing me to review this interesting manuscript called "Examining Neighborhood-Level Hot and Cold Spots of Food Insecurity In Relation to Social Vulnerability in Houston, Texas." It aimed to assess residential spatial patterns of Medicare and Medicaid beneficiaries who screened positive for food insecurity at health care locations in Harris County, Texas. Even though the study could contribute to the field, some aspects do not allow me to accept it in its current form.

1. The definition of food insecurity in the introduction lacks other essential elements such as food availability. Please, add the reference for the definition used.

2. I am not sure what the need for this study is. This should be stated clearly in the introduction.

3. Please, clarify the aim of the study in the abstract and the text.

4. The food insecurity information was collected during the pandemic. There is extensive evidence that food insecurity increased during the pandemic due to socioeconomic and health problems. How could this affect the results of this research? Is this a limitation of the study?

5. There are different levels of food insecurity. Why were they not considered in the analysis?

6. I suggest adding the definition of hot and cold spots in the methods section and removing it from the results.

7. The aim of the study should guide the conclusion. However, the authors conclude with ideas related to the healthcare system.

8. In the discussion section, the authors state: "Researchers used to postulate that food-insecure people resided in "food deserts" until a growing body of evidence suggested otherwise." Here, it is essential to re-review the definition of food insecurity because it includes the lack of economic and physical access to food.

9. Please, review the names of all tables and figures.

10. I suggest separating the results and discussion sections.

Reviewer #3: This was an interesting article and thank you for the opportunity to review this article. I have suggested a few revisions that could further improve this paper.

List of comments/suggestions:

Abstract: Please include the sample size. If word count permits, consider providing the p values for the significant differences mentioned in the abstract.

Introduction: A citation should be provided for the statement “Food insecurity is highly prevalent in the US”. If possible, provide the most recent statistics on food insecurity prevalence. Consider defining food desert area when it is first mentioned on page 3. In the introduction the importance of specifically using the address-level food insecurity screening data and the spatial clustering methods.

Materials and methods: This section could be clearer if you could break it into subsections under materials and methods. Provide a citation for the Hunger Vital SignTM screening tool. Consider using a flow diagram to show the participants' inclusion/exclusion. There is a typo on page 7, line 3. A citation is needed for the queen’s contiguity method. The second paragraph on page 7, requires a citation. Define the abbreviation SVI on page 8, the first line.

Results and discussion:

I believe you have mistakenly used “… in terms of HPV vaccine uptake” in the title of Table 2. Also, there is a typo in this title. Include the Mann-Whitney U test statistics with the p-values in the table.

I think it will be better if you could add a footnote to the Table 2 indicating what this p-value is. It is in the text but missing from the table.

Conclusion: I feel that except for the final sentence other statements in this section could not be considered as conclusions based on this study's findings. Please include only the conclusions that are based on your findings.

Reviewer #4: This paper provided a unique way to measure neighborhood food insecurity. There are some minor suggestions that would improve this paper:

Results and Discussion

• Stating that finding the prevalence of food insecurity to be 54% in this study compared to Greater Houston at 16.6% is due to comfort with answering food insecurity screening in this setting might be an overstatement. People that attend this clinic were on Medicaid or Medicare, suggesting a higher probability of lower/fixed income.

• Additionally, the method used to measure food insecurity in this study was the Hunger Vital Sign and the full USDA questionnaire may have been the method used to get the Greater Houston prevalence of food insecurity. Authors should report if this may have contributed to a difference in measurement for comparison.

• The title for Table 2 does not make sense and appears to be copied from a different study.

**********

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

Reviewer #3: No

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.

PONE-D-22-11199R1Examining Neighborhood-Level Hot and Cold Spots of Food Insecurity in Relation to Social Vulnerability in Houston, TexasPLOS ONE

Dear Dr. Ramphul,

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. Here are the comments from the reviewers that you should focus on:

The second paragraph indicates "a plethora of research..." and only one reference is cited in the text. The authors should revise this phrase to "A literature review..." instead of "A plethora of research.."

Please, revise all references cited in the text. When there are more than two references, the right way of citing is (3-6), not (3,4,5,6).

You should add that the study does not consider the different levels of Food insecurity as a limitation.

When reporting p values if the p =0.000 please indicate it as p< 0.001. In general p values smaller than 0.001 should be reported as p<0.001

The first paragraphs in material section and method section should come under the subheading "Data", as these two paragraphs explain the study sample or the data used.

You could have another subheading "Food insecurity" for the paragraphs that explain the tool used for measuring food insecurity.

All paragraphs explaining the statistical analysis conducted should be under the subheading "Statistical Analysis”.

Please submit your revised manuscript by Jan 18 2023 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,

Jim P Stimpson, PhD

Academic 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 #1: All comments have been addressed

Reviewer #2: All comments have been addressed

Reviewer #3: (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 #1: Yes

Reviewer #2: (No Response)

Reviewer #3: Yes

**********

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

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: No

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: 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: Thank you very much for the responses. They have provided sufficient revisions. this can be accepted in its present form

Reviewer #2: Thank you for allowing me to review this new version of the manuscript titled "Examining Neighborhood-Level Hot and Cold Spots of Food Insecurity in Relation to Social Vulnerability in Houston, Texas." All my comments have been addressed. However, some minor aspects still do not allow me to approve this new version, mainly in the introduction section.

The second paragraph indicates "a plethora of research..." and only one reference is cited in the text. I reviewed the answer to another reviewer's comment about this point. Even when the cited reference is a literature review, its use needs to be more coherent with the phrase at the beginning of the paragraph. The authors should use the original references or indicate "A literature review..." instead of "A plethora of research.."

Please, revise all references cited in the text. When there are more than two references, the right way of citing is (3-6), not (3,4,5,6).

Another limitation is that the study does not consider the different levels of Food insecurity. I suggest adding it.

Reviewer #3: The authors have addressed most of the comments provided in the previous review. However, I have two minor comments that could improve this paper before publishing.

1. When reporting p values if the p =0.000 please indicate it as p< 0.001. In general p values smaller than 0.001 should be reported as p<0.001

2. I think you can rearrange the materials and method section to make if flow better and easier to follow.

e.g. The first paragraphs in material section and method section should come under the subheading "Data", as these two paragraphs explain the study sample or the data used.

You could have another subheading "Food insecurity" for the paragraphs that explain the tool used for measuring food insecurity.

All paragraphs explaining the statistical analysis conducted should be under the subheading "Statistical Analysis"

**********

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: farooq

Reviewer #2: No

Reviewer #3: 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.

Examining Neighborhood-Level Hot and Cold Spots of Food Insecurity in Relation to Social Vulnerability in Houston, Texas

PONE-D-22-11199R2

Dear Dr. Ramphul,

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,

Jim P Stimpson, PhD

Academic Editor

PLOS ONE