PONE-D-23-21967Reaching adolescents with health services: systematic development of an adolescent health check-ups programme in Ghana (Y-Check, Ghana)PLOS ONE

Dear Dr. Weobong,

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.

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We look forward to receiving your revised manuscript.

Kind regards,

Yolanda Malele-Kolisa, BDS, MPH, MDent, PhD

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

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

Reviewer #1: No

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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: No

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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

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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: It is exciting to see a manuscript focused on the improvement of adolescent health in sub-Saharan Africa. Please, find the comments below.

Methods

• This is a huge study that covered different locations in Cape coast, Ghana. For clarity, the study setting should be separated from the design. This will enhance the appreciation of the uniqueness and content of the design.

• Details about the data analysis was inadequate despite the huge data used in this research. For example, for ‘Identification of key policies, programmes, and interventions‘ step, how were the analysis of the identified policies, programs and interventions carried out?

The same applies to ‘Understanding the school health system and school attendance’ step. How were the data and literature identified reviewed and how was school attendance and access evaluated?

Results:

• The presentation of the results is not following the sequence of the steps in the design. Presenting the results in the logical flow of the steps in the design will make the reading easier. For example, the third step in the design was to identify common adolescent health problems but this was the first result to be presented. It is confusing.

• It appears that the data for identification of the adolescent health problems were not analyzed. What were presented in tables 1 and 2 appears like data from a single study/document (which was not referenced in this section where it was mentioned). The data from the literature search and the key informant interviews should be correctly analyzed and presented clearly to answer this objective. The method of analysis should also be clearly spelt out.

• The description of the study settlements, school characteristics (lines 329-332) presented should have been under study settings. They are not part of the results.

• The description of the participants in lines 282-285 is difficult to comprehend. It should be made clear.

• Please, provide a reference for the definition of ‘adolescent friendly spaces’ (lines 479-481). It appears that the only question that adolescents ask there is only about sex. This is incorrect and misleading.

• The demographic characteristics of the Community Advisory Board should be added for better understanding of their contributions.

• Lines 361-363- This is discussion and should be deleted. All other discussions (e.g. Lines 389-401, 365-366) in this section should be transferred to discussion section.

General comments

• Some sentences are not clear- lines 223-226, 282-285

• Some sentences are also too long making comprehension difficult e.g., lines 239-245

• There was a mixture of British and American English. Please, stick to one.

Tables

• What does Y mean in Table 6? This should be defined.

Mid upper arm circumference is used for screening for malnutrition in early childhood. It has no place in adolescence.

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Reviewer #1: No

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PONE-D-23-21967R1Reaching adolescents with health services: systematic development of an adolescent health check-ups programme in Ghana (Y-Check, Ghana)PLOS ONE

Dear Dr. Weobong,

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 Feb 24 2024 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'. SEE ACADEMIC EDITOR COMMENTS TOWARS END OF LETTER!
• 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,

Yolanda Malele-Kolisa, BDS, MPH, MDent, PhD

Academic Editor

PLOS ONE

Additional Editor Comments :

The reviewers proposed significant changes to the manuscript to increase the scientific rigor of the methods. This is a standard requirement for the journal to comply with rigorous methodology.

Rev 2 suggested the following: PLEASE create a point-by-point response to the comments.

1. The methodology and results sections need major reframing particularly given that multiple forms of data were utilized.

2. On one of your diagrams, you clearly showed how the study involved three phases which included situation analysis, feasibility & acceptability assessments with participants and co-development of an intervention.

3. The methodology & results are read there is lack of coherence in terms of that illustration.

4. There are methodological gaps on who exactly the "key informants" comprised of?

5. lack of clarity on search strategy of undertaking literature review?

6. How did you analyze it?

7. What tools did you use for assessing feasibility and acceptability?

8. There is need for more details in the steps you took in your framework analysis, how did you ensure trustworthiness?

In summary, you need to be clear, what data you collected, tools for collecting that data, what information that data provided and how did you analyse it.

9. This all needs to be aligned with your three phrases.

10. Lastly your results are too detailed as you have incorporated elements of discussions in them. That needs to be ironed out.

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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 #2: (No Response)

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 #2: No

Reviewer #3: Yes

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

Reviewer #2: No

Reviewer #3: Yes

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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 #2: Yes

Reviewer #3: Yes

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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 #2: Yes

Reviewer #3: Yes

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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 #2: This is a very interesting and important study however the methodology and results sections need major reframing particularly given that multiple forms of data were utilized. On one of your diagrams you clearly showed how the study involved three phases which included; situation analysis, feasibility & acceptibility assessments with participants and co-development of an intervention. However, when the methodology & results are read there is lack of coherence in terms of that illustration.

There are methodological gaps on who exactly the "key informants" comprised of? lack of clarity on search strategy of undertaking literature review? How did you analyze it? What tools did you use for assessing feasibility and acceptability? There is need for more details in the steps you took in your framework analysis, how did you ensure trustworthiness?

In summary, you need to be clear, what data you collected, tools for collecting that data, what information that data provided and how did you analyse it. This all needs to be aligned with your three phrases.

Lastly your results are too detailed as you have incorporated elements of discussions in them. That needs to be ironed out.

Reviewer #3: The study conducted by the authors provides valuable insights into adolescent health and significantly contributes to the existing literature in the field. The methodology is robust, the results are well-supported, and the discussion is thought-provoking. The findings presented in the manuscript have the potential to make a meaningful impact and I am confident that it will be of interest to the journal's readership. I recommend this manuscript for publication without reservation.

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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 #2: Yes: Mpho Matlakale Molete

Reviewer #3: No

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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.

Reaching adolescents with health services: systematic development of an adolescent health and wellbeing check-ups programme in Ghana (Y-Check, Ghana)

PONE-D-23-21967R2

Dear Dr. Benedict Woebong

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.

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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,

Sogo France Matlala, PhD

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: