PONE-D-24-21647Factors Influencing the Hidden Burden of Care for Older Adults, with Overweight and Obesity, in England: A Qualitative StudyPLOS ONE

Dear Dr. Ghosh,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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We look forward to receiving your revised manuscript.

Kind regards,

Anteneh Mengist Dessie, MPH

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

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

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

Reviewer #1: Yes

Reviewer #2: Yes

**********

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

Reviewer #1: N/A

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

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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

**********

5. Review Comments to the Author

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

Reviewer #1:  It is a very good attempt. I really like the way everything has been mentioned in detail. Methodology is extremely vigorous. Results have been explained very clearly. Results have been explained very clearly.

Reviewer #2:  Factors Influencing the Hidden Burden of Care for Older Adults, with Overweight and Obesity, in England: A Qualitative Study is an interesting topic and noble cause to find out the responsible factors for the caring older adults with obesity in Britain society. I will suggest few changes in the manuscript before publication. These changes are following: Write full spellings of abbreviations used in abstract and font issues, and repeated full stops (Mentioned with yellow highlight in the pdf file). Need to short and avoid repeating the methodology section.

Page # 02: full spellings of NHS.

Page # 02: were all older participants (male or female or both) in this study, have British background or immigrant to British from different nationalities? Mentioned in Abstract. As later on mentioned in Table 1.

Page # 14: Figure 1 is not shown in PDF file.

Table 2 can put all data in supplementary files.

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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

**********

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Attachments

Attachment

Submitted filename: PONE-D-24-21647_reviewer.pdf

PONE-D-24-21647R1Factors Influencing the Hidden Burden of Care for Older Adults, with Overweight and Obesity, in England: A Qualitative StudyPLOS ONE

Dear Dr. Ghosh,

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.

==============================

1. Objective of the Study: It is written as quantitative using verb “to examine the association between …” Qualitative studies are not intended for examining the association rather focus on exploration and understanding the phenomena. Revise the study objective to better align with qualitative research language.

2. Ethical Consideration: Simplify the ethical consideration section to retain essential details while reducing verbosity.

3. Abstract: Provide a concise background that highlights the research gap in 1-2 line.

4. Introduction: It is very lengthy and difficult to follow. Streamline the introduction by focusing on the key background, research gap, and objectives in a concise manner.

5. Methods: All sections are overly detailed, resembling a thesis. Please revise to present the content concisely, particularly in the ethical aspect and underpinning theory sections. Condense sections while maintaining clarity.

Underpinning Theory: Limit to 1–2 paragraphs with only relevant points for this study, omitting extensive theoretical details. Discussion of underpinning theory should be condensed into a few sentences that directly tie to the study.

Eligibility: Combine bullet points into a paragraph

Try to avoid using terms "measurement of variables" like quantitative study.

6. Conclusion: Focus on summarizing the study's findings and implications in a concise manner, avoiding unrelated comparisons (line 4) like discussion. Avoid using terms like "outcomes" in the context of qualitative research.

7. Overall Manuscript: Throughout the manuscript, prioritize brevity by including only key information directly relevant to the study. Remove excessive elaboration (e.g., thesis-level details). Ensure a clear flow by presenting information systematically, avoiding redundancy.

==============================

Please submit your revised manuscript by Feb 22 2025 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,

Dr Buna Bhandari

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:

1. Objective of the Study: It is written as quantitative using verb “to examine the association between …” Qualitative studies are not intended for examining the association rather focus on exploration and understanding the phenomena. Revise the study objective to better align with qualitative research language.

2. Ethical Consideration: Simplify the ethical consideration section to retain essential details while reducing verbosity.

3. Abstract: Provide a concise background that highlights the research gap in 1-2 line.

4. Introduction: It is very lengthy and difficult to follow. Streamline the introduction by focusing on the key background, research gap, and objectives in a concise manner.

5. Methods: All sections are overly detailed, resembling a thesis. Please revise to present the content concisely, particularly in the ethical aspect and underpinning theory sections. Condense sections while maintaining clarity.

Underpinning Theory: Limit to 1–2 paragraphs with only relevant points for this study, omitting extensive theoretical details. Discussion of underpinning theory should be condensed into a few sentences that directly tie to the study.

Eligibility: Combine bullet points into a paragraph

Try to avoid using terms "measurement of variables" like quantitative study.

6. Conclusion: Focus on summarizing the study's findings and implications in a concise manner, avoiding unrelated comparisons (line 4) like discussion. Avoid using terms like "outcomes" in the context of qualitative research.

7. Overall Manuscript: Throughout the manuscript, prioritize brevity by including only key information directly relevant to the study. Remove excessive elaboration (e.g., thesis-level details). Ensure a clear flow by presenting information systematically, avoiding redundancy.

[Note: HTML markup is below. Please do not edit.]

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 #1: All comments have been addressed

Reviewer #2: All comments have been addressed

**********

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 #1: Yes

Reviewer #2: Yes

**********

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

Reviewer #1: Yes

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 #1: Yes

Reviewer #2: 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

**********

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 #1: All the revisions have been done now. The paper is now good to be published. There is no problem whatsoever regarding the technical aspects of the paper. I would like to see the paper published as such.

Reviewer #2: I reviewed the revisions of article "Factors Influencing the Hidden Burden of Care for Older Adults, with Overweight and Obesity, in England: A Qualitative Study" and found authors have been addressed all comments.

**********

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

**********

[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.

A Qualitative study to examine hidden care burden for older adults with overweight and obesity in England

PONE-D-24-21647R2

Dear Dr. Ghosh,

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,

Dr Buna Bhandari

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: