PONE-D-23-05274School-based Physical Activity Interventions among Children and Adolescents in the Middle East and Arabic Speaking Countries: A Systematic ReviewPLOS ONE

Dear Dr. Alalawi,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript by May 07 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.

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Bojan Masanovic, Ph.D.

Academic Editor

PLOS ONE

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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

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

Reviewer #1: Yes

Reviewer #2: N/A

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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

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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: No

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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: Dear authors, the research topic is very current. The manuscript is methodologically very well written, in accordance with the guidelines for writing review research. The manuscript has some details that need fixing:

1. The first sentence in the Introduction requires a citation

2. in the section Selection of studies, it is unnecessary to state the author's initials, this part should be written without a specific indication of the author

3. In Figure 1, the number 1349 needs to be technically corrected

4. #the combined number of school-aged children who took part in the 17 studies was 15,551 with a mean sample size of 1,113" - I am not clear about this average? That is not correct information! And it is not necessary because each study has its own number of subjects.

Reviewer #2: Manuscript number: PONE-D-23-05274

Thank you for the opportunity to review the paper entitled: ‘School-based physical activity interventions among children and adolescents in the Middle East and Arabic speaking countries: a systematic review.

The manuscript addresses an important gap in the literature in relation to children’s physical activity in Arabic and Middle Eastern countries. The paper is reasonably well written but there are several typographical and grammatical errors throughout. It is not clear if all the PRISMA guidelines were adhered to, please see my comments in the methods section of this review. I have listed several suggestions below. I hope the authors find the comments helpful and wish them all the best with their future research.

Abstract

i) Page 3 – Conclusion- check grammar in section “multi-component includes education”

Introductory section

i) Please add references to all sentences which do not have a reference in the introduction section of the manuscript.

ii) I wonder, given that this article solely focuses on children, it might be better to acknowledge in one sentence the health impact of low levels of PA on the broader population (e.g., adults) but then focus more specifically on the health impact of low levels of PA in children, as there is quite a lot of literature in this area now.

iii) Start of second paragraph suggest using ‘increase’ rather than ‘raise’

iv) Some of the references used are quite old and should be updated – suggest reviewing all references that are older than 10 years.

v) Suggest indicating what the PA levels are in Arabic countries to provide more insight in the sentence: More specifically, the average level of PA is low in the Arabic speaking countries, compared with other countries [7].

vi) Last sentence of paragraph 2 - Suggest that exercise and physical activity are not used interchangeably, as people can still be physically active without exercising. Suggest checking the manuscript throughout and changing where necessary.

vii) Suggest that physical inactivity is not used interchangeably with sedentary behaviour. As being physically inactive means that someone is not doing enough physical activity and being sedentary means that they are sitting or lying down for long periods.

viii) Last sentence on page 5 - suggest changing the word ‘find’ to: understand

Methods

i) Did you use the PRISMA framework for systematic reviews? If you used the PRISMA guidelines, suggest that this be added to the methods and abstract.

ii) Page 7 - Add ‘the’ to the sentence commencing: Search parameters were limited to ‘the’ English language.

iii) In the section entitled: Search Strategy – I suggest combining individual sentences into one paragraph. I am just wondering why the Arabic studies data bases were not included in the search.

Selection of studies

iv) The study selection does not seem to have followed the PRISMA guidelines where 2 to 3 reviewers independently select relevant studies.

v) Was a referencing packaged used (e.g., Endnote)? Please describe how the references were managed.

vi) MENA should be written in full when first cited in the paper with MENA in brackets.

Study characteristics

vii) Page 10 second paragraph second sentence. Note: 8-year-olds are not generally considered adolescents – those 13 years and above are adolescents. Suggest revising this section

Risk of Bias

viii) Page 16 first sentence suggest adding ‘an’ to the following part of the sentence had ‘an’ unclear risk of bias.

ix) Page 16 first paragraph second last sentence: Suggest rewording this sentence to state that selective bias was low in ten trials and unclear in two trials …..

x) In relation to the above sentence – it seems that one trial is missing??

xi) Page 16 second paragraph. This paragraph includes one very long sentence – suggest revising to at least two sentences.

xii) Page 16 - suggest providing more details of the relevant studies in relation to the following sentence: Nonetheless, it is important to note that the outcomes seemed reliable judging by the number of raters and the intra-rater and inter-raters reliabilities where reported.

Data synthesis

xiii) Page 17 second sentence check grammar for ‘These includes’

xiv) Page 17 – need a full stop in this sentence: PA levels and social support differed significantly between males and females According to the research, during the intervention…

xv) Also suggest removing the word ‘an’ from this sentence: This study [27] reported an changes in knowledge..

xvi) Page 18 check grammar in this sentence: Engaging in PA, on the other hand, was used in only two study

And

Page 18 The two study focusing

xvii) I am not 100% sure of the journal formatting but suggest that the authors names should be referred to in sections on page 19 where it just uses numbers e.g., alone (22) reported….

xviii) Page 20 add ‘the’ to this sentence: In [17], both PA only

Discussion

i) Page 21 second paragraph of the discussion. It is unclear which studies are being referred to in this paragraph. Were the four remaining studies a part of the first study? Suggest revising and adding references to this paragraph.

ii) Also suggest adding more detail in relation to the following sentence from the above paragraph: related to factors such as the content and details of the school-based intervention programme.

iii) Page 22 suggest adding ‘the’ to the sentence: to consider potential for PA other times.

iv) Page 22 third paragraph suggest adding ‘that’ to the following sentence: schools have not been implemented to any extent

v) Page 23 first paragraph suggest adding ‘that’ to this sentence: strong evidence school-based PA interventions

vi) Page 23 paragraph 1 – Suggest revising the last sentence for grammar.

vii) Page 23 paragraph 2 -suggest revising this part of the sentence: ‘met inclusion criteria’ to read: that met the inclusion criteria

viii) Page 23 paragraph 2 Suggest expanding a little on the following sentence so that the reader understands the focus of these reviews in comparison to the current review in the section: These results align with those of Nash et al. and Benajiba et al., which recently focused on interventions to promote physical activity in the region [43,44].

Implications for research

i) Page 25 first paragraph: suggest revising this sentence: ‘have potential in increasing PA levels’ to read have the potential to increase PA levels

ii) Page 25 paragraph two suggest keeping the PA focus and stating: favourable benefits of PA on health in general

and

iii) Suggest removing capitalization on the word: Standardised.

Conclusion

Suggest revising the conclusion for grammatical errors.

i) Page 26: conclusion – check grammar in this section: ‘who increase participate in physical activity levels’.

And this section:

ii) To date, limited range of types few evaluations focused solely on assess PA specific interventions and most of the interventions were multi-component (includes education components on lifestyle, and diet, education).

And

iii) An ‘r’ is missing from this section: ‘have been effective in other egions’

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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: Yes: Dr Anne-Maree Parrish

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Attachments

Attachment

Submitted filename: Review paper Plos One (PONE-D-23-05274) 20.3.23.docx

PONE-D-23-05274R1School-based Physical Activity Interventions among Children and Adolescents in the Middle East and Arabic Speaking Countries: A Systematic ReviewPLOS ONE

Dear Dr. Alalawi,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript by Jul 07 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,

Bojan Masanovic, Ph.D.

Academic Editor

PLOS ONE

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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 #3: (No Response)

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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 #3: Partly

**********

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

Reviewer #1: Yes

Reviewer #3: 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

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 #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: All comments from the reviewers have been accepted and the manuscript has now been reconciled with the comments submitted.

Reviewer #3: This was an interesting review that explores physical activity interventions across Arabic-speaking countries. The manuscript is certainly unique in its own right, however, there are some major concerns worth raising.

My primary concern with this review involves the Methods section.

Firstly, the use of additional electronic academic databases would likely have added to the study in both complexity and sample size. If the scope of this study were expanded to use additional databases, more sources might have been identified and explored. For example, the following electronic databases could have been used for a more thorough and inclusive search;

“ArticleFirst; Biomed Central; BioOne; BIOSIS; EBSCOHost; JSTOR; ProQuest; SAGE Reference Online; ScienceDirect; SpringerLink; Taylor & Francis; and Wiley Online.” These databases would have likely added to the overall literature search in their academic rigor, aim, and biomedical scope. While PubMed/MEDLINE, Web of Science, Scopus and CINAHL is an excellent database, the use of more databases would have added to the study sample size. Also, I recommend adding French in the language search as well. Not using French would potentially neglect countries like Morocco, Tunisia, Algeria etc. as part of the search parameters.

Secondly, the Arab world (or the Middle east) should be clearly and expressly defined. I strongly suggest the authors review this article thoroughly and clearly define what ‘Arabic-speaking countries’ are. What defines the ‘Middle East’? Israel (Arabic is a recognized language in Israel), Iran, and Turkey may be argued as part of the Middle East…were those counted as part of the search parameters. I recommend using the Arab League member states as the definition. This should be written clearly in the methods section. I suggest citing the article too to improve the merit of this review.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3988371/

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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: Jovan Gardasevic, University of Montenegro

Reviewer #3: Yes: Basil H. Aboul-Enein

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[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.

School-based Physical Activity Interventions among Children and Adolescents in the Middle East and Arabic Speaking Countries: A Systematic Review

PONE-D-23-05274R2

Dear Dr. Alalawi,

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,

Bojan Masanovic, Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #3: All comments have been addressed

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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 #3: Yes

**********

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

Reviewer #1: Yes

Reviewer #3: 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

Reviewer #3: 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

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: All comments have been acknowledged by the authors, the manuscript has been revised and is now ready for publication.

Reviewer #3: thank you very much for addressing the recommendations and suggestions. the manuscript has been improved.

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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: Jovan Gardasevic

Reviewer #3: Yes: Basil H. Aboul-Enein

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