Evaluating the validity and reliability of the Tswana adaptation of the MOS-HIV tool for health-related quality of life among HIV Sub-populations in Botswana: A study protocol

Mooketsi Molefi; Olanrewaju Oladimeji

doi:10.1371/journal.pone.0311904

Peer Review History

Original SubmissionSeptember 27, 2023
18 Dec 2023 Decision Letter - Richard Makurumidze, Editor PONE-D-23-31341Evaluating the validity and reliability of the Tswana adaptation of the Medical Outcome survey tool for health-related Quality of life among HIV sub-populations in Botswana: A study protocolPLOS ONE Dear Dr. Molefi, 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 02 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. 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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. Thank you for stating the following in the Funding Section of your manuscript: “The project will receive support from the University of Botswana's Office of Staff Development & Training. Additionally, publications and relevant workshops, including capacity enhancement training, will be subsidized by supervisor grants: National Research Foundation (NRF) Grant No. 132385 (Incentive Funding for Rated Researchers - IPRR) and Award Number D43 TW010543 from the Fogarty International Center and National Institute of Mental Health, of the National Institutes of Health.” We note that you have provided funding information that is not currently declared in your Funding Statement. However, funding information should not appear in the Acknowledgments section or other areas of your manuscript. We will only publish funding information present in the Funding Statement section of the online submission form. Please remove any funding-related text from the manuscript and let us know how you would like to update your Funding Statement. Currently, your Funding Statement reads as follows: “The author(s) received no specific funding for this work.” Please include your amended statements within your cover letter; we will change the online submission form on your behalf. 3. Please amend either the title on the online submission form (via Edit Submission) or the title in the manuscript so that they are identical Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions? The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field. Reviewer #1: Partly Reviewer #2: Yes Reviewer #3: Partly ******** 2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses? The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory. Reviewer #1: No Reviewer #2: Yes Reviewer #3: Partly ****** 3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable? Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible. Reviewer #1: No Reviewer #2: Yes Reviewer #3: No ****** 4. Have the authors described where all data underlying the findings will be made available when the study is complete? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. 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 Reviewer #2: 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 #2: Yes Reviewer #3: No ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics. You may also provide optional suggestions and comments to authors that they might find helpful in planning their study. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Dear authors, Thank you for submitting your research protocol for your study to PlosONE. Unfortunately, I found this manuscript to not meet the minimum quality standard for a study protocol. I can only advise to - consider using guidelines, e.g. the COSMIN guidelines for the development and validation of patient-reported outcome measures under www.cosmin.nl - consider accessing textbooks on the subject matter, whether by the COSMIN group (see "Measurement in Medicine" by Henrica De Vet and co-authors, 2011) or even good review articles in seminal journal (i.e., the Lohr/ISPOR guidelines), - consider using guidelines by the MAPI trust for the translation of the tool to your language/culture Just a few pointers: - Cronbach's alpha is NOT reliability. For reliability, you want to assess inter-rater or test-retest reliability or both. Both should be done using ICCs or kappa coefficients. - Cronbach's alpha without a hint as to the factor structure of the tool is unintelligible. Also, Cronbach's alpha is not defined for multidimensional scales (see Tenko Raykov's work). When adapting a well-known instrument, you at least want to confirm its factor structure, ideally using measurement invariance techniques. - Logistic regression analysis in a cross-sectional sample with an ill-specified sampling mechanism (what you do is not "systematic random sampling", by the way: "systematic random sampling" does not exist - please look into any textbook on sampling mechanisms) and formulating this as "predictors" is not an appropriate technique for a validation study. Please reconsider the definition and subtypes of construct validity, see the COSMIN guidelines on how this should be accomplished. - Presenting a study protocol for a validation study without describing the tool or the validation studies on the tool that have gone before is a feat in itself! I think I have never come across a validation study or protocol that has not described what the tool is actually measuring. You also would want to give a history of its validation journey and - in particular - where you see the main cultural issues when translating into sub-Saharan languages/culture. - For this part in particular, you would want to consider using cognitive interviewing techniques and most likely quite extensive qualitative techniques to make sure all items, the construct, and the measurement scales are understood the same or need adapting in your culture. As inspiration, I can highly recommend Eve Namisango's work from Uganda - please have a look into how she accomplished translation work in palliative care. Reviewer #2: This is a much needed study within the geographical area of Southern Africa where test translation and validation studies are not as prevalent. Much research is needed on psychological measures, as well as the neglected area of the well-being of those infected with HIV. The student and their promotor should be commended on this exciting proposed study. The document reads very well, and all the important points and considerations are covered, in my opinion. The projected sample sizes are also good. All I would suggest is that they add the full stops at the end of sentences (eg. lines 94, 161, 181, 253, 256, and 260). Apart from that I wouldn't change anything, as the protocol is specific enough, but allows adequate room for statistical exploration. Reviewer #3: Preamble The paper that has been submitted ia a protocol for a study to assess validity and reliability of a widely used tool taht assesses quality of life among peple living wit HIV. the study also aims to assess the predictors of quality of life in the same population. Major Comment The authors did not desribe whther they are going to adapt the tool or they are jsut translating the 35 item tool into Setswana and use it as it is. Overall, the authors did not describe their methodology fully for example, on assessment of face and content validity, who are the experts who will be involved. the steps for the translation is also not fully described. who are the experts to be involved. When calculating the sample size for the validation process, what was the rationale for using a Cronbach's alpha of 7.0 when the reccommended is 8.0. It will be good to itemise each validation step and then state the corresponding methods e.g. (I) translation (ii) reliability assessment (iii) validity assessment May you please refer to this document. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5463570/#:~:text=Saudi%20J%20Anaesth.,and%20Abdullah%20Sulieman%20Terkawi ****** 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: No Reviewer #2: No Reviewer #3: Yes: Nyaradzai Arster Katena ******** [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. https://doi.org/10.1371/journal.pone.0311904.r001
Revision 1
2 Apr 2024 Author Response Journal requirements comments 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 We note that you have provided funding information that is not currently declared in your Funding Statement. However, funding information should not appear in the Acknowledgments section or other areas of your manuscript. We will only publish funding information present in the Funding Statement section of the online submission form. Please remove any funding-related text from the manuscript and let us know how you would like to update your Funding Statement. Please amend either the title on the online submission form (via Edit Submission) or the title in the manuscript so that they are identical Reviewer’s comments Reviewer 1 Thank you for submitting your research protocol for your study to PlosONE. Unfortunately, I found this manuscript to not meet the minimum quality standard for a study protocol. I can only advise to - consider using guidelines, e.g. the COSMIN guidelines for the development and validation of patient-reported outcome measures under www.cosmin.nl - consider accessing textbooks on the subject matter, whether by the COSMIN group (see "Measurement in Medicine" by Henrica De Vet and co-authors, 2011) or even good review articles in seminal journal (i.e., the Lohr/ISPOR guidelines), - consider using guidelines by the MAPI trust for the translation of the tool to your language/culture Just a few pointers: - Cronbach's alpha is NOT reliability. For reliability, you want to assess inter-rater or test-retest reliability or both. Both should be done using ICCs or kappa coefficients. - Cronbach's alpha without a hint as to the factor structure of the tool is unintelligible. Also, Cronbach's alpha is not defined for multidimensional scales (see Tenko Raykov's work). When adapting a well-known instrument, you at least want to confirm its factor structure, ideally using measurement invariance techniques. - Logistic regression analysis in a cross-sectional sample with an ill-specified sampling mechanism (what you do is not "systematic random sampling", by the way: "systematic random sampling" does not exist - please look into any textbook on sampling mechanisms) and formulating this as "predictors" is not an appropriate technique for a validation study. Please reconsider the definition and subtypes of construct validity, see the COSMIN guidelines on how this should be accomplished. - Presenting a study protocol for a validation study without describing the tool or the validation studies on the tool that have gone before is a feat in itself! I think I have never come across a validation study or protocol that has not described what the tool is actually measuring. You also would want to give a history of its validation journey and - in particular - where you see the main cultural issues when translating into sub-Saharan languages/culture. - For this part in particular, you would want to consider using cognitive interviewing techniques and most likely quite extensive qualitative techniques to make sure all items, the construct, and the measurement scales are understood the same or need adapting in your culture. As inspiration, I can highly recommend Eve Namisango's work from Uganda - please have a look into how she accomplished translation work in palliative care . Reviewer 2 This is a much needed study within the geographical area of Southern Africa where test translation and validation studies are not as prevalent. Much research is needed on psychological measures, as well as the neglected area of the well-being of those infected with HIV. The student and their promotor should be commended on this exciting proposed study. The document reads very well, and all the important points and considerations are covered, in my opinion. The projected sample sizes are also good. All I would suggest is that they add the full stops at the end of sentences (eg. lines 94, 161, 181, 253, 256, and 260). Apart from that I wouldn't change anything, as the protocol is specific enough, but allows adequate room for statistical exploration Reviewer 3 The authors did not desribe whther they are going to adapt the tool or they are jsut translating the 35 item tool into Setswana and use it as it is. Overall, the authors did not describe their methodology fully for example, on assessment of face and content validity, who are the experts who will be involved. the steps for the translation is also not fully described. who are the experts to be involved. When calculating the sample size for the validation process, what was the rationale for using a Cronbach's alpha of 7.0 when the reccommended is 8.0. It will be good to itemise each validation step and then state the corresponding methods e.g. (I) translation (ii) reliability assessment (iii) validity assessment Authors' responses We have diligently formatted the body of the manuscript to adhere as closely as possible to the prescribed format provided by the PLOS One guidelines. We understand the importance of consistency and readability in scientific publications, and we have made every effort to ensure that our manuscript meets these standards OO’s research protected time was partly supported by the Incentive Funding for Rated Researchers' Grant from National Research Foundation (No:132385). Research reported in this publication was partly supported by the South African Medical Research Council (SAMRC) through its Division of Research Capacity Development under the Research Capacity Development Initiative from funding received from the South African National Treasury. The content and findings reported/illustrated are the sole deduction, view and responsibility of the researcher and do not reflect the official position and sentiments of the funders. Thank you for bringing this to our attention. We have rectified the inconsistency between the title on the online submission form and the title in the manuscript to ensure they are now identical. We appreciate your diligence in ensuring the accuracy and coherence of our submission Author’s responses We have considered COSMIN guidelines and it emerged that whereas COSMIN guidelines provided further elucidation on the distinction between validity and reliability and their measurements, we found a misfit in their relevance to(i) non-clinical trial settings (ii) for an already defined core outcomes set, therefore we incorporated a translation and validation process prescribed by the MAPI trust, as you advised. We also consulted other resources for guidance e.g. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5463570/#:~:text=Saudi%20J%20Anaesth.,and%20Abdullah%20Sulieman%20Terkawi] While we acknowledge your comment on Cronbach’s alpha, we have come across numerous statistical sources that identify Cronbach’s alpha as a measure of internal consistency reliability. Perhaps, we should have been more comprehensive an indicate that we would measure internal consistency reliability using Cronbach’s alpha.[ Here are a few sources to highlight this….. [Vaske JJ, Beaman J, Sponarski CC. Rethinking internal consistency in Cronbach's alpha. Leisure sciences. 2017;39(2):163-73.] Hajjar S. Statistical analysis: Internal-consistency reliability and construct validity. International Journal of Quantitative and Qualitative Research Methods. 2018;6(1):27-38. We will use “systematic sampling” to comply with your preference however, it is to be recognized that the two terms; systematic random sampling and systematic sampling refer to the same thing and often used interchangeably. In fact, the former is the more complete nomenclature to emphasize that the sampling technique belongs to the probabilistic or random class as opposed to the non-probabilistic/ non-random class. I refer you to the article by Peregrine at Lawrence University and Santa Fe Institute who provides further elucidation on this issue[ https://www.researchgate.net/profile/Peter-Peregrine/publication/247987195_Sampling_in_archaeology/links/5d9606a3299bf1c363f5708b/Sampling-in-archaeology.pdf , manual by Alvi, Mohsin (2016): A Manual for Selecting Sampling Techniques in Research. Herein, we cite a few books and articles in high impact journals that have used “systematic random sampling”. Books 1. A Sample of Sampling Definitions Philip Bobko,Shari Miller & Richard Tusing[Pages 157-159 \| Published online: 20 Nov 2009 2. (1) 1. Fuller WA. Sampling statistics: John Wiley & Sons; 2011. Articles N Engl J Med 1993; 329:661-663/ DOI: 10.1056/NEJM199308263290914 Breast Cancer Research and Treatment 1995 Vol. 36 Issue 1 Pages 55-60/DOI: 10.1007/BF00690185 https://doi.org/10.1007/BF00690185 J Neurosci Methods 2009 Vol. 180 Issue 1 Pages 77-81 Accession Number: 19427532 DOI: 10.1016/j.jneumeth.2009.03.001 https://www.ncbi.nlm.nih.gov/pubmed/19427532 Unless missed, we stated that beyond the validation process, we will apply logistic regression model where upon the HRQoL scores people will be dichotomized into “poor” or otherwise health related quality of life based on the scores and evaluate a set of independent variables as potential predictors of poor HRQoL. To make it clear, validation process, precedes regression modelling and the two are in different phases of the study. We have reconditioned the introduction to give a consolidated history of the tool’s validation journey, to capture the pertinent contextual nuances. Tool Description and Validation History: • We have included a thorough description of the MOS-HIV tool, its validation journey in various settings, and the cultural considerations relevant to its adaptation to the Setswana language and culture. • Additionally, we have incorporated insights from Eve Namisango's work in Uganda to inform our approach to translation and validation studies in palliative care. Statistical Techniques and Sampling Procedures: • We have addressed concerns regarding statistical techniques by ensuring that appropriate methods are employed for reliability and validity assessments, including inter-rater reliability, test-retest reliability, and confirmatory factor analysis. • Sampling procedures have been revised to clarify the rationale behind the selection methods and to ensure adequate representation of urban and rural populations. • Thank you very much for your constructive comments and compliments. We have incorporated your suggestions in the revised manuscript Thank you for your comments, and we acknowledge the suggestions, and have included more details on measurements on validity and reliability. We believe the details shared are now sufficient for comprehensives and reproducibility. We have further expounded on the translation process-the approach, whom it would involve etc We plan to adapt, and therefore we will assess the translated tool for its validity and reliability. Methodology Clarifications: • We have provided a more detailed description of the methodology, including the steps involved in the translation process, experts involved in face and content validity assessments, and the rationale behind sample size determination. • The validation steps have been itemized, and corresponding methods have been stated clearly to enhance transparency and clarity. Thanks for suggesting this article [ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5463570/#:~:text=Saudi%20J%20Anaesth.,and%20Abdullah%20Sulieman%20Terkawi ] which we have utilized to guide us through the process of translation and validation process of an existing questionnaire or tool Nunnally J. Psychometric Theory. New York: McGraw-Hill; 1978., referenced in the article above indicates that in practice a Cronbach’s alpha of at the least 0.7 has been considered adequate internal consistency. Attachments Attachment Submitted filename: Responses to reviewers_PLOS One_0224.docx https://doi.org/10.1371/journal.pone.0311904.r002
25 Jul 2024 Decision Letter - Richard Makurumidze, Editor PONE-D-23-31341R1Evaluating the Validity and Reliability of the Tswana Adaptation of the MOS-HIV Tool for Health-Related Quality of Life among HIV sub-populations in Botswana: A study protocolPLOS ONE Dear Dr. Molefi, 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 Sep 08 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'. 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, Richard Makurumidze 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. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions? The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field. Reviewer #4: Yes ******** 2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses? The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory. Reviewer #4: Yes ****** 3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable? Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible. Reviewer #4: Yes ****** 4. Have the authors described where all data underlying the findings will be made available when the study is complete? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. 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 #4: 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 #4: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics. You may also provide optional suggestions and comments to authors that they might find helpful in planning their study. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #4: Many thanks to the authors for this well thought out research protocol. This study is very much needed research not only in Botswana but in sub-Saharan Africa, and evidence generated will be useful for policy and practice to improve HRQoL among PLHIV. Having carefully read the manuscript and rebuttal to reviewers, authors have satisfactorily responded to all concerns raised in the initial review. However, I will suggest that authors check: Line 89: a bracket without content, probably authors missed a citation. Line 85-87: In addition to the citation, I will suggest that authors include the MOS-HIV tool as a supplementary file for easy referencing by readers Line 130: ….’’Understanding HRQoL changes during treatment, particularly for conditions like 130 cryptococcal meningitis, is crucial for improving patient care and outcomes’’ authors should consider inserting a citation to support this statement Study Design and settings - Study location: where is Princess Marina Hospital located in Botswana? Include the name of town and county or state ****** 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 #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. https://doi.org/10.1371/journal.pone.0311904.r003
Revision 2
9 Sep 2024 Author Response We have uploaded a detailed rebuttal letter addressing each of the reviewers’ comments point by point, along with a revised document with tracked changes and the final version labeled ‘manuscript__0824. Attachments Attachment Submitted filename: Response to Reviewers_II.docx https://doi.org/10.1371/journal.pone.0311904.r004
27 Sep 2024 Decision Letter - Richard Makurumidze, Editor Evaluating the Validity and Reliability of the Tswana Adaptation of the MOS-HIV Tool for Health-Related Quality of Life among HIV sub-populations in Botswana: A study protocol PONE-D-23-31341R2 Dear Dr. Molefi, 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 will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at Editorial Manager® and clicking the ‘Update My Information' link at the top of the page. If you have any questions relating to publication charges, 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, Richard Makurumidze Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0311904.r005
Formally Accepted
2 Oct 2024 Acceptance Letter - Richard Makurumidze, Editor PONE-D-23-31341R2 PLOS ONE Dear Dr. Molefi, I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now being handed over to our production team. At this stage, our production department will prepare your paper for publication. This includes ensuring the following: * All references, tables, and figures are properly cited * All relevant supporting information is included in the manuscript submission, * There are no issues that prevent the paper from being properly typeset If revisions are needed, the production department will contact you directly to resolve them. If no revisions are needed, you will receive an email when the publication date has been set. At this time, we do not offer pre-publication proofs to authors during production of the accepted work. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few weeks to review your paper and let you know the next and final steps. Lastly, 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 customercare@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. Richard Makurumidze Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0311904.r006

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