PONE-D-24-31629Nurses' Perspectives on Using mHealth Apps in a Developing Country: Awareness, Attitude, and ObstaclesPLOS ONE

Dear Dr. Alipour,

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• Study limitations were provided. Any strengths for the study?

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Ibrahim Jahun, MD, MSc, PhD

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PLOS ONE

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This study was supported by the Vice Chancellor for Research and Technology of Zahedan University of Medical Sciences (No: 10494).

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The authors thank the Vice Chancellor for Research and Technology of Zahedan University of Medical Sciences for supporting the project. They also thankful to the nurses who participated in this study for sharing their valuable experiences.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

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

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

Reviewer #1: Yes

Reviewer #2: Partly

Reviewer #3: Yes

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

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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

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

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: 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:  I consider the abstract to be technically sound and even more as a Nigerian, living in this time of coming of age of technology and given recent boom in mHealth technologies in developing nations, I consider it even more timely and apt. As a leader in the health informatics field, developing some of the mHealth innovations, I often stop to consider the impact of the many mHealth tools and solutions we churn out every now and then, targeting either the clinician or the patient. My understanding is that the author who I have worked with in the past, have decided to do more fundamental study to figure out this question around 'impact' and 'effectiveness'.

The studies have shown with clear and yet rigorous statistical analysis, following sound research methodology, what the answer to the question is by identifying critical variables of awareness, attitude, and obstacles and measuring their mean scores. Which anyone can attempt to reproduce if they wish. The Manuscript is easy to understand in first reading because of the authors have deployed intelligible straight-forward English narratives in their writing.

Reviewer #2:  The manuscript raises important problem of mobile applications suitability for nurses and medical workers

Overall, information is too limited. It is restricted to the study at one city. It should be generalized to whole region, to developing countries.

The presentation material itself is too limited. The manuscript has only tables, no figures.

One large figure – scheme of experiment – will improve the material presentation

In the Abstract:

mHealth Apps – should be commented. It is any mobile application, in general, or program by some manufacturer?

“Android operating system installed (82%)”

Don’t use passive voice in English (“were used”, “was done”). Write directly.

Results section shows rather common statistics. Conclusion is not complete.

The term “the digital health literacy” should be commented. It is kind of science jargon,

“Mobile Health”, “Obstacle” are not appropriate as keywords.

In the text “The estimate made in 2018…” - old data.

The term ‘mHealth’ refers to the paper in Persian. Need cite available literature, add references.

Please not use bulk citations – 3 or more references together, like “(15, 18-20)”, “(21-23)”. Separate phrases into parts, add detail.

Tables 3 and 4 – the results should be highlighted, show most interesting result, discuss it. Maybe present it in other visual form (like a histogram, heatmap).

Conclusion should have general interest. Phrase like “The majority of nurses use smartphones (86%) and Android operating systems (82%)” gives no information. Nurses where?

Reviewer #3:  Some Concerns:

1. The authors indicated in the limitation section that the study was conducted in one city in the southeast of Iran therefore the results cannot be generalized to the whole country not to talk of several developing countries. So, the geographical coverage, sample size and the findings in this paper does not aligning with title of the paper. Therefore, the author should consider narrowing the title to reflect the locations/region where the study was conducted. Example “Nurses' Perspectives on Using mHealth Apps in Southeastern Iran: Awareness, Attitude, and Obstacles”.

2. The purpose of the discussion section is to interpret results and justify conclusion. The discussion section seems to be too long, citing lots of works done in other countries, I suggest that some of those literatures should be moved to introduction section where past related works were quoted. You need to restate your key results in this section.

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Reviewer #1: Yes:  Emeka Christian Madubuko

Reviewer #2: No

Reviewer #3: Yes:  Mukhtar Liman Ahmed

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Nurses' perspectives on using mobile health applications in southeastern Iran: Awareness, attitude, and obstacles

PONE-D-24-31629R1

Dear Dr. Alipour,

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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Kind regards,

Ibrahim Jahun, MD, MSC, 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 #3: All comments have been addressed

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

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

Reviewer #3: Yes

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

Reviewer #3: 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 #3: Yes

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

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #3: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #3: The authors have reflected my review comments in the revised copy of the paper. I have no further comments.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean? ). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy .

Reviewer #3: Yes:  Mukhtar Liman Ahmed

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