Self-identity explains better breastfeeding intention of ethnic pregnant mothers of Western Nepal: Extending the theory of planned behavior

Chiranjivi Adhikari; Rojana Dhakal; Kapil Giri; Biddhya Bhandari; Rameshwor Baral; Krishna Prasad Pathak; Lal Bahadur Kunwar; Poshan Thapa; Yadu Ram Upreti; Khem Narayan Pokharel; Chhabi Lal Ranabhat

doi:10.1371/journal.pone.0312010

Peer Review History

Original SubmissionFebruary 12, 2023
19 Feb 2024 Decision Letter - Abel Fekadu Dadi, Editor PONE-D-23-04076Self-identity explains better breastfeeding intention of ethnic pregnant mothers: Extending the theory of planned behaviorPLOS ONE Dear Dr. Adhikari, 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 address the comments' raised by the reviewers annexed below and submit your revision. ============================== Please submit your revised manuscript by Apr 04 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. 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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. Please note that funding information should not appear in any 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. 3. Thank you for providing the following Funding Statement: "This research was conducted with partial financial support from School of Health and Allied Sciences (SHAS) of Pokhara University, Nepal, however, the authorities had no role in design, data collection, analysis and manuscript preparation. CA and RD are permanent faculty members of SHAS, and were benefitted for a week-long leave for data collection and study related management. 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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: Partly Reviewer #2: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: No ****** 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: Thank you for sending this paper. This paper reads well. Following points for further revision. 1. Title- this study was conducted in Nepal, reader should know from the title, and they start to assume the context. Currently, I knew it was about Nepal when I reached to mid of introduction section. 2. Brief context ( one sentence) is needed about the problem in the abstract section. 3. Readers are left to assume many thing in the introduction section- please elaborate it contextualizing breast feeding, and available literature in the topic in Nepal, culture, practices, and trends on it. Secondly, it is necessary to detailed in PTB, thirdly, research gaps, significance and objective. Elaborate it to at least two pages. 4. Methods section also needs more detail explanation- research context, selection of participants, variables, data analysis model, results section reported beta coefficient but that was not described in the methods section. Very importantly, there is no data how four constructs- BFA, PBFC, BFSI, and BFSN were created (as these were presented quantitatively). 5. Table can be included in the findings section- that reads easy with the text. 6. Discussion section lacks contextualities of findings relating with policy and programs of Nepal. Interpretation should be focused comparing with other studies in Nepal. Reviewer #2: The document is informative and original. It has an ethical statement clearly stated. It is better if the document adds operational definitions and discusses all possible reasons for an association. ****** 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. 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Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0312010.r001
Revision 1
3 Apr 2024 Author Response Response to Editor Q Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. RE Thank you! We reviewed main-text, funding statement, CoI, Acknowledgement and revised as per ‘Title’ and ‘Body formatting guidelines’ of the PLOS ONE. Q Please note that funding information should not appear in any 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. RE Funding information has been removed from the manuscript part. Q We note that one or more of the authors is affiliated with the funding organization, indicating the funder may have had some role in the design, data collection, analysis or preparation of your manuscript for publication; in other words, the funder played an indirect role through the participation of the co-authors. If the funding organization did not play a role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript and only provided financial support in the form of authors' salaries and/or research materials, please review your statements relating to the author contributions, and ensure you have specifically and accurately indicated the role(s) that these authors had in your study in the Author Contributions section of the online submission form. Please make any necessary amendments directly within this section of the online submission form. Please also update your Funding Statement to include the following statement: “The funder provided support in the form of salaries for authors [insert relevant initials], but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section.” RE ▪Funding statement is revised as: “This research was funded from School of Health and Allied Sciences (SHAS) of Pokhara University, Nepal (Faculty Research Grant no. 650-2074/2075), The funder provided a support in the form of paid leaves of two weeks for data collection [CA], but did not have any additional role in the study design, data analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section.” ▪Author contribution revised as Conceptualization (CA, YRU, RD, KG); Data Curation (CA, KG, BB, RB); Formal Analysis (CA, KG, CLR, LBK, PT, YRU);Fund Acquisition (CA); Investigation (CA, KG, BB, RB); Methodology (CA, RD, PT, CLR), Project Administration (CA, KG, RB); Resources (CA, KG, RB); Software (CA, KG, LBK); Supervision (RD, CA); Validation (CLR); Visualization (CA); Writing- Original Draft Preparation (All Authors); Writing- Review & Editing (CA, RD, CLR, PT) ▪Funding organization’s role is included in the funding statement ▪Competing interest is updated as: CA and RD are faculty members under SHAS. KG, BB and RB were undergraduate final semester research students under CA. This does not alter our adherence to PLOS ONE policies on sharing data and materials. Q Please provide a complete Data Availability Statement in the submission form, ensuring you include all necessary access information or a reason for why you are unable to make your data freely accessible. If your research concerns only data provided within your submission, please write "All data are in the manuscript and/or supporting information files" as your Data Availability Statement. RE ▪Revised as “All data are in the manuscript and supporting information files.” REVIEWER # 1 Q Title- this study was conducted in Nepal, reader should know from the title, and they start to assume the context. Currently, I knew it was about Nepal when I reached to mid of introduction section. RE We are thankful to the reviewer. The title is revised as “Self-identity explains better breastfeeding intention of ethnic pregnant mothers of Western Nepal: Extending the theory of planned behavior” Q Brief context (one sentence) is needed about the problem in the abstract section. RE Sorrily I would like to reiterate that it has been mentioned as “…Although effects of additional theoretical constructs like self-identity, moral norm, and descriptive norm, and socio-demographic variables have been explored in the literature, their roles are not clear. Similarly, such exploration among the ethnic and low-income mothers are even scarce…” Kindly suggest further if not sufficient. Q Readers are left to assume many things in the introduction section- please elaborate it contextualizing breast feeding, and available literature in the topic in Nepal, culture, practices, and trends on it. Secondly, it is necessary to detailed in PTB, thirdly, research gaps, significance and objective. Elaborate it to at least two pages RE ▪Thank you for this comment, especially, the need of theoretical explanation of TPB, it is found elsewhere (Ajzen I. The theory of planned behavior. Organizational behavior and human decision processes. 1991 Dec 1;50(2):179-211.), including its evidence synthesis in breast feeding (https://link.springer.com/article/10.1007/s10995-018-2453-x), and BF testing in TPB rather than theoretical description, is our study aim. ▪We agree that culture is obviously related to the constructs and practices of BF intention and behavior, however, this will be out of the scope of our study. Moreover, we are concerned only with cross-sectional empirical evidence, the trend, we assume, would also be out of the scope of this study. However, agreed these are important, we included in limitations: The trend and cultural influences … ▪PLOS guideline does not intricate the limitations regarding number of words or pages for chapters/headings provided that the research gap, objectives and significance are clearly mentioned (https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf). ▪Sorrily, we have clearly mentioned the BF and BFI, their theoretical and empirical gaps, including in Nepalese contextual practices as… “Breastfeeding (BF) promotion is the most cost-effective intervention to advance mother-child health(1). BF, including early initiation of it (EIBF), not only reduces infant and under-five mortalities but also plays key roles in maternal health promotion by protecting mothers against postpartum bleeding, breast and ovarian cancer, and osteoporosis (2,3). BF should be initiated as early as and beneficial when continued as long as possible, for which a mother should be prepared before a child is delivered, when only a breastfeeding intent (BFI), not the actual behavior, can be assessed. Even more importantly, mothers, mainly nulliparous, do not adhere to BF, mainly EIBF(4). In the same predicament, only 80% of newborn babies were found to be breastfed within one hour of delivery in the Nepalese context (5).”…. ▪Kindly, we wanted to clarify in the study that we were more concerned towards the cognitive and social process (social psychological) variables of BFI and more delineated towards this. Q Methods section also needs more detail explanation- research context, selection of participants, variables, data analysis model, results section reported beta coefficient but that was not described in the methods section. Very importantly, there is no data how four constructs- BFA, PBFC, BFSI, and BFSN were created (as these were presented quantitatively) RE ▪We are thankful for this comment. We added the context, selection of pregnant mothers who completed their first trimesters. ▪ Thnak you for the comment. For this, we added a Supplemental file (S1. Table 1-16_Constructs and measurement). We also added in the manuscript, with a separate sub-heading, Scoring of constructs, and added text “We assessed BFA with 12 statements, BFSN with two, PBFC with three, BFI with five, BFSI with four, BFK with seven, and BFDN and BFMN each with three statements. All the statements were assessed in 5-point Likert scales, except for BFK and BFDN, with possible value ranges of 12-60, 2-10, 3-15, 5-25, 4-20, and 3-15 for BFA, BFSN, PBFC, BFI, BFSI, and BFMN, respectively. BFK had seven statements with value ranges of 0-1 and 1-3 (possible range; 2-11), whereas BFDN had three statements with value ranges of 0-3, 1-3 and 1-5. Possible values of both BFK and BFDN were 2-11. We dummied the variables with median values for modelling (S1.Table 1-16).” ▪ Kindly would like to reiterate that we have mentioned the stepwise logistic regression model and various related parameters. Q Table can be included in the findings section- that reads easy with the text RE Thank you for this comment, will be managed further. Q Discussion section lacks contextualities of findings relating with policy and programs of Nepal. Interpretation should be focused comparing with other studies in Nepal. RE Dear Reviewer, thank you for the comment. We added five more recent refs (including in limitations), after which there are 23 refs in discussion, which clearly shows the direct and mediating effects of theoretical constructs including the additional-BFSI and income, we have enriched the discussion. Since this is more a theory testing the mediating effects of BFSI and income, in all the theoretical constructs of TPB in breastfeeding (as we have already mentioned also) rather than directly related with a policy or program, and contextualizing. The study findings would possibly guide the policy or program. If you want to make it differently with policy or program to be related, we request to further clearance in this regard. Moreover, since this is a theory-driven research, and local and contextualized researches are very scarce in Nepalese context. REVIEWER #2 Q It has an ethical statement clearly stated RE Thank you for your complement. Q It is better if the document adds operational definitions and discusses all possible reasons for an association. RE Thanks for this comment. We have added with a separate sub-heading under “Scoring of constructs” and added the text, as mentioned above (Reviewer #1, Comment 4) https://doi.org/10.1371/journal.pone.0312010.r002
9 Jul 2024 Decision Letter - Jennifer Yourkavitch, Editor PONE-D-23-04076R1Self-identity explains better breastfeeding intention of ethnic pregnant mothers in western Nepal: Extending the theory of planned behaviorPLOS ONE Dear Dr. Adhikari, 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. I have reviewed your responses to the reviewers. Some responses were not adequate. Please see my requests and provide responses to them. Please submit your revised manuscript by Aug 23 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, Jennifer Yourkavitch Academic Editor PLOS ONE Journal Requirements: Additional Editor Comments: Thank you for this re-submission. This manuscript needs a thorough editing for English grammar. In addition, please address the following points (from the academic editor): 1. As the reviewer suggested, please develop the Introduction more. You can create at least three paragraphs from what you currently have to address: 1) the topic of predictors of BFI and related literature; 2) BFI in Nepal and especially among the populations of interest (ethnic and low-income), citing related literature; and 3) the purpose of this manuscript. 2. Methods: how did you choose the facilities for this study? Please explain. 3. Did you enroll all pregnant women who presented after their first trimester in the timeframe Dec 2018 - Nov 2019? How were the specific participants enrolled? 4. Please describe more about the sample size calculation. What is p? Is it the prevalence of pregnant women after the first trimester who have a BFI? 5. For scoring the constructs, were standard tools used? If so, please provide references. If not, please justify why standard measures were not used. It looks like you determined "good" and "bad" based on the median scores from this sample. Please justify that approach. It's not clear why the median of this sample would be used to make that judgment. 6. To determine predictors or potential confounders to include in multivariable models, typically a higher p-value is used during bivariate analysis (e.g., p<0.20). Have you considered that approach? 7. The Discussion needs more development. For example, in the last paragraph (before Limitations), you should discuss how your findings were similar or different from the studies you cited. 8. Tables: Define joint and nuclear family in Table 1. 9. Figure 1--you identify betas but I think those values are the aORs. [Note: HTML markup is below. Please do not edit.] [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.0312010.r003
Revision 2
28 Aug 2024 Author Response 1. As the reviewer suggested, please develop the Introduction more. You can create at least three paragraphs from what you currently have to address: 1) the topic of predictors of BFI and related literature; 2) BFI in Nepal and especially among the populations of interest (ethnic and low-income), citing related literature; and 3) the purpose of this manuscript. Response: Thank you! We included 15 more references (now 29, including 14 previous) and updated the chapter —Introduction—with three different paragraphs, considering your valuable suggestions: i) Theoretical constructs and influence on BFI, ii) Other factors including the self-identity, moral and descriptive norms, health belief, and the sociodemographic factors; and iii) BFI in Nepal and the paucity of evidence regarding BFI, and the purpose of the manuscript. Comment 2:How did you choose the facilities for this study? Please explain. Res: We selected six health care facilities (HCFs) (Kaski-2, Tanahu-4) in Gandaki province. We selected the health facilities purposively considering higher the attendance of ethnic pregnant mothers. Obviously this may limit the generalizability and so, mentioned in the limitations, too. Comment3:Did you enroll all pregnant women who presented after their first trimester in the timeframe Dec 2018 - Nov 2019? How were the specific participants enrolled? Res: We appreciate this important question. In Nepal, the majority of pregnant women (85.8%) receive the first ANC services within four months of pregnancy. As mothers come generally to the HCFs several weeks after their amenorrhea, it is difficult to get enrolled before their first trimester. we enrolled conveniently among from those who completed their first trimester. This has been described briefly in methods section. Comment 4: Please describe more about the sample size calculation. What is p? Is it the prevalence of pregnant women after the first trimester who have a BFI? Res: Yes, the 'p' is the prevalence (proportion) of high intent of mothers for exclusive breastfeeding (EBF)—29.8%. This gives the high intention of mothers to breastfeed in Odissa State of India. Moreover, among the BF indicators, EBF is found with lowest proportion in Nepal, and that was 70% in 2011. Coincidently, these (both) data give a similar size of sample to obtain. Comment 5: For scoring the constructs, were standard tools used? If so, please provide references. If not, please justify why standard measures were not used. It looks like you determined "good" and "bad" based on the median scores from this sample. Please justify that approach. It's not clear why the median of this sample would be used to make that judgment. Res: ▪Most of the tools of knowledge, constructs of TPB, and extended variables were adapted and modified according to the Nepalese context, this was pretested, however, with a low sample size, and revised in the final tool. Researchers reviewed the tools and some of the researchers of the team were expert in this field. (Pls refer to Supplemental file (S1. Table 1-16_Constructs and measurement). We also described the measurement and scoring of the constructs in the manuscript, with a separate sub-heading, "Scoring of constructs". ▪ We applied the median cut-offs for fair and poor, positive and negative, and other categorization/dummy of variables, although it is less robust, we applied for multiple logistic regression arbitrarily, and also mentioned in limitations. We also checked for multicollinearity with VIF and Tolerance, which showed no multicollinearity (values of VIF and tolerance given below). Variables Collinearity statistics Tolerance VIF Breast Feeding Behavioral Attitude .917 1.091 Subjective Norm .899 1.113 Perceived Behavioural Control .956 1.046 Descriptive Norm .889 1.125 Moral Norm .935 1.070 Self'-Identity .953 1.049 Parity .950 1.053 Annual Income in $US .973 1.028 Comment 6: To determine predictors or potential confounders to include in multivariable models, typically a higher p-value is used during bivariate analysis (e.g., p<0.20). Have you considered that approach? Res: ▪We are thankful for your concern. However, having more variables in explanatory categories, we pick-up with a p-value of maximum of 0.06, so that most of the variables could be filtered for stepwise LR. We believe this didn’t miss the important variables. Comment 7: The Discussion needs more development. For example, in the last paragraph (before Limitations), you should discuss how your findings were similar or different from the studies you cited. Res: Thank you for the suggestion. We have added and covered the issues you have raised. We added three more paragraphs with 22 citations and references further added, totaling of 52 references (from 30 earlier). We also checked and revised discussion. (Kindly refer to track-changed file for reference) Comment 8: Tables: Define joint and nuclear family in Table 1. Res: Thank you for this comment. Added accordingly in the table legend. Comment 9: Figure 1--you identify betas but I think those values are the aORs Res: Thank you for your complement. Both β's and aORs maintained. Also the figures are slightly modified. Attachments Attachment Submitted filename: Response to reviewers_old.docx https://doi.org/10.1371/journal.pone.0312010.r004
4 Sep 2024 Decision Letter - Jennifer Yourkavitch, Editor PONE-D-23-04076R2Self-identity explains better breastfeeding intention of ethnic pregnant mothers in western Nepal: Extending the theory of planned behaviorPLOS ONE Dear Dr. Adhikari, 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 Oct 19 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, Jennifer Yourkavitch 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. Additional Editor Comments: Thank you! Please check again for correct English grammar throughout the manuscript. For example, in the Methods section of the Abstract, you want to say "six purposively selected..." rather than the current phrasing. In the Methods section, please spell out all of the acronyms at the first usage (under "Scoring of Constructs"). Please also put the footnote about family type in Table 1, where the distinction first appears. [Note: HTML markup is below. Please do not edit.] [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.0312010.r005
Revision 3
25 Sep 2024 Author Response Dear Editor, thank you for your inputs Here, we keep the comments and the responses: 1. Journal requirement 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. Response Thank you, for making aware about the journal requirement. We checked all the references, 1-52, for completeness. For retraction check, we visited The Retraction Watch Database (http://retractiondatabase.org/RetractionSearch.aspx?AspxAutoDetectCookieSupport=1#?AspxAutoDetectCookieSupport%3d1%26ttl%3dInfant%2bfeeding%2binformation%252c%2battitudes%2band%2bpractices%253a%2ba%2blongitudinal%2bsurvey%2bin%2bcentral%2bNepal) mainly, and also in the “PUBPEER” in some selected cases, and in some, when the ‘Watch database’ was not giving clear retraction. We did not find any of our references ‘retracted’. 2. Whole manuscript Please check again for correct English grammar throughout the manuscript. For example, in the Methods section of the Abstract, you want to say "six purposively selected..." rather than the current phrasing. Response Thank you for this point. We corrected this one, and again, for the whole document, we checked in online platform, for grammar check (https://quillbot.com/grammar-check), by each sentence. We also checked manually, line-by-line for the errors. 3. Methods Spell out all of the acronyms at the first usage (under "Scoring of Constructs"). Please also put the footnote about family type in Table 1, where the distinction first appears. Response Thank you for the comment! We have done with these all. women (85.8%) receive the first ANC services within four months of pregnancy. As mothers come generally to the HCFs several weeks after their amenorrhea, it is difficult to get enrolled before their first trimester. we enrolled conveniently among from those who completed their first trimester. This has been described briefly in methods section. 4. Methods Also put the footnote about family type in Table 1, where the distinction first appears. Response Sorry for this typo error, as earlier it was supposed to be done. Now addressed, and checked once again. 5.Figures Checking figures in the “PACE” platform for journal compatibilities. Response Thank you! We checked without any difficulty, and as suggested, we are now uploading the ‘produced’ ones. Comments on 24 and 25th Sep from Journal office 1.Files We note that several of your files are duplicated on your submission. Please remove any unnecessary or old files from your revision, and make sure that only those relevant to the current version of the manuscript are included. Response Thank you. I have removed the older correction/trackchanged and other files, and tetained the recent files. 2. Title Please amend the title either on the online submission form or in your so that they are identical. Response We are extremely sorry, to update in cover letter, now checked and corrected in online, manuscript and other submitted documents. It is consistent now as "“Self-identity explains better breastfeeding intention of ethnic pregnant mothers of Western Nepal: Extending the theory of planned behavior”. Kindly let us remind if still there is any discrepancy. 3. Figure Please remove your figures/ from within your manuscript file, leaving only the individual TIFF/EPS image files. Please include a separate legend for each figure in your manuscript. Response The figures that have been 'produced' from the PACE have been uploaded, and the legend has been been separated from the main figure and kept where they occur in the text (manuscript). Thank you for your inputs, comments, and scientific contributions! Attachments Attachment Submitted filename: Response to editor.CA_etal_SI.TPBinBFI.docx https://doi.org/10.1371/journal.pone.0312010.r006
30 Sep 2024 Decision Letter - Jennifer Yourkavitch, Editor Self-identity explains better breastfeeding intention of ethnic pregnant mothers of Western Nepal: Extending the theory of planned behavior PONE-D-23-04076R3 Dear Dr. Adhikari, 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, Jennifer Yourkavitch Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0312010.r007
Formally Accepted
4 Oct 2024 Acceptance Letter - Jennifer Yourkavitch, Editor PONE-D-23-04076R3 PLOS ONE Dear Dr. Adhikari, 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. Jennifer Yourkavitch Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0312010.r008

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