PONE-D-24-08327Australian Communities That Care (CTC) intervention: Benefit-cost analysis of a community-based youth alcohol prevention initiativePLOS ONE

Dear Dr. Abimanyi-Ochom,

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 [Bosco Rowland, John W Toumbourou and Rob Carter received funding from The National Health and Medical Research Council (APP1087781) and Australian Research Council (LP100200755).].  

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[Bosco Rowland, John W Toumbourou and Rob Carter received funding from the National Health and Medical Research Council (APP1087781) and Australian Research Council (LP100200755).]

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  [Bosco Rowland, John W Toumbourou and Rob Carter received funding from The National Health and Medical Research Council (APP1087781) and Australian Research Council (LP100200755).].  

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Additional Editor Comments:

Despite a significant number of attempts, I haven't been able to secure 2 reviews. However, I agree with the review comments that I have received, and so as to not hold up the process any further, I am making my recommendation on the basis of the review that I have received.

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Reviewers' comments:

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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: No

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

Reviewer #1: I Don't Know

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

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

Reviewer #1: Yes

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

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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: Australian Communities that Care Intervention: B-C analysis of a community-based youth alcohol prevention initiative.

As the authors note adolescent and youth alcohol drinking is a public health concern. And evidence on what works and is cost-effective is valuable.

However despite being nicely written the underlying logic is not convincing, and in particular whether the trial outcomes that inform this B-C analysis are suitable to answer the research question.

A Cost - Benefit analysis relies entirely on the interpretation of reported outcomes, in this case of a CTC intervention in 5 localities. As such it would be useful to restate the key outcomes being draw on and what they mean. As I understand the outcomes from the Toumbourou et al 2019 paper as reported, the key question related to alcohol assumption was about number of drinks a year 8 student had even consumed - defined as more than a few sips of an alcoholic beverage ever – dichotomised into ever vs never. It is not self-evident that this would be a useful descriptor of alcohol consumption from which to model impacts of alcohol consumption on ED attendance, criminal behaviour etc – which might rather have been related more to intoxication. If this is a mis-interpretation please describe more clearly the trial data on which the modelling is based. But if correct, greater attention as to why this outcome is considered sound for assessing the impacts of alcohol needs to be made. The B-C analysis rests on this.

In particular, given the vast majority of benefits were from a modelled crime reduction, evidence to support the plausibility of the assumptions here are crucial. For example does a PAF for alcohol related youth crime, necessarily translate into what would be avoided if alcohol consumption was reduced – is the PAF is based on an association or a causal link. Further in terms of evidence from this study, perhaps explain why a 1%pa reduced likely of ever having a drink in year 8 in a community is linked to the number of adolescents who might get intoxicated and perhaps more likely to participate in crime. There seems to be a few logic steps missing.

The survey on which the CTC evaluation was based did include questions on anti-social behaviour including involvement in criminal activity – but it appears this wasn’t used in the C-B analysis. It is not clear why not?

Finally, ensuring the intervention is fully costed is clearly important. I could not locate the details on how the costing was done. Specifically what was the source of the costing data, do costs reflect a full cost,for example if office space were made available at below-market rate – how was that treated? It is unclear what is covered under salary costs – does it include wage on-costs and salary overheads (eg for HR, financial services, IT other agency costs).

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Reviewer #1: No

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PONE-D-24-08327R1Australian Communities That Care (CTC) intervention: Benefit-cost analysis of a community-based youth alcohol prevention initiativePLOS ONE

Dear Dr. Abimanyi-Ochom,

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 Nov 15 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,

Daryl Higgins, PhD

Academic Editor

PLOS ONE

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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.

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Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #2: Partly

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

Reviewer #2: Yes

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

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Reviewer #2: 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

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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: The key areas for improvement are suggested below, I have attached a more detailed feedback in the track-changed Word document.

1. Assumptions: Oversimplification of the relationship between alcohol use and health outcomes (e.g., proportional reductions in adverse events). The assumption of confounding variables not being controlled needs to be addressed (e.g., socioeconomic status, mental health conditions).

2. Methodology: Limiting analysis to the first cycle of the intervention may underestimate long-term costs. Clarification on long-term benefits in the discussion is required. Confounding factors like varying levels of alcohol reduction are not accounted for (e.g., small vs large reductions in consumption).

3.Definitions: Expanding on definitions (e.g., examples of crimes attributed to alcohol use) to aid non-expert readers.

4.Future Recommendations: Suggestion to include a cost-effectiveness analysis in future research. Highlighting the limitations of self-reported data (e.g., potential response bias).

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Reviewer #2: Yes: Dhatsayini Rattambige

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Attachments

Attachment

Submitted filename: Comments_DR.docx

Australian Communities That Care (CTC) intervention: Benefit-cost analysis of a community-based youth alcohol prevention initiative

PONE-D-24-08327R2

Dear Dr. Abimanyi-Ochom,

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.

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Daryl Higgins, PhD

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

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

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #2: Yes

**********

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

Reviewer #2: Yes

**********

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

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

Reviewer #2: 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

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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: Thank you for addressing all the comments and for providing more clarity. There are no further comments from my end.

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Reviewer #2: Yes: Dhatsayini Rattambige

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