PONE-D-25-02270Health Care Professional’s Intention to Use Digital Health Data Hub Working in East Gojjam Hospitals, Northwest Ethiopia: Technology Acceptance ModelingPLOS ONE

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PLOS ONE

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Funding was obtained from Debre Markos University. This work would not be possible without the financial support of the Research and Technology Transfer Directorate (RTTD) under grant number 177/01/17.

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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: Yes

Reviewer #2: Yes

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

Reviewer #1: Yes

Reviewer #2: 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

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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

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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: In the Title, change "Professional’s" to "Professionals’" for grammatical accuracy. In the Abstract, the background section clearly explains the significance and knowledge gap, but the statement "health system has a unified digital health center" could be rephrased for clarity. The Methods section adequately describes the study design and analysis approach but could briefly explain why SEM was specifically chosen. In the Results, key findings are presented clearly with relevant statistics, but it would be helpful to specify the strength of influence for perceived usefulness (PU), perceived trust (PT), and attitude. The Conclusion is well-linked to the findings but could suggest practical interventions. In the Introduction, the background provides a comprehensive overview of digital health data hubs, global data trends, and the Ethiopian context. However, the first paragraph is too broad, and the historical context on data storage feels unnecessary. The flow of the introduction is somewhat disjointed, and better transitions are needed between global trends, the local context, and the study's relevance. Additionally, there is repetition of concepts, especially regarding perceived ease of use, which could be consolidated. In the Methods, the cross-sectional design is well-suited for the research objectives, offering a snapshot of healthcare professionals' intentions at a specific point in time. The sample size calculation is well-explained, using a robust method for structural equation modeling (SEM) with sufficient statistical power. The use of stratified sampling ensures that diverse healthcare facilities (specialized, general, primary hospitals) are represented. The pre-test and detailed quality assurance measures, such as training and supervisor oversight, demonstrate a thorough approach to ensuring data validity and consistency. SEM is a suitable choice for analyzing the complex relationships between multiple constructs and latent variables.

Reviewer #2: Overall, this manuscript presents valuable insights into healthcare professionals' intentions regarding digital health data hubs in Ethiopia. The topic of digital health data hubs is highly relevant, especially in the context of achieving Sustainable Development Goals (SDGs). Your focus on Ethiopia adds an important dimension to the global conversation about digital health. These merits contribute to making your manuscript a valuable addition to the literature on digital health adoption among healthcare professionals, particularly in developing countries like Ethiopia.

General Feedback

1. Clarity and Conciseness:

a. The abstract is informative but could be more concise. Aim to summarize key findings in fewer words while maintaining clarity

b. Some sentences are complex, consider breaking them into shorter sentences for better readability.

Example from the introduction

Original: "Gradually, more and more people are using mobile devices and the Internet and intend to use them for healthcare services, as digital health (DH) has significantly accelerated the achievement of the Sustainable Development Goals (SDGs) and strengthened healthcare systems in Africa."

Suggested Revision: "More people are gradually using mobile devices and the Internet for healthcare services. Digital health (DH) has significantly accelerated progress toward achieving the Sustainable Development Goals (SDGs) and strengthening healthcare systems in Africa."

Example from Background Section:

Original: "To date, it is of great importance to examine the emerging cloud-based adoption at the organizational level Healthcare organizations have continually recorded data over time for customers, suppliers, and stakeholders to analyze the data and derive insights."

Suggested Revision: "It is important to examine emerging cloud-based adoption at the organizational level. Healthcare organizations have continually recorded data over time for customers, suppliers, and stakeholders to analyze this information and derive insights."

2. Structure:

a. Ensure that each section flows logically into the next. For example, the transition from the introduction to methods could be smoother by summarizing how the background leads to your research questions or hypotheses.

b. Consider using subheadings within sections (e.g., "Methods," "Results") to improve navigation through the document.

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a. It might be helpful to provide more detail about how you ensured the validity and reliability of your survey instruments beyond mentioning pre-testing and PCA.

b. Clarify how you addressed potential biases in sampling or data collection.

4. Results Presentation:

a. Present results in a clear manner using tables or figures where appropriate (e.g., showing demographic data).

5. Discussion:

a. The discussion should connect back to your research questions/hypotheses more explicitly.

b. Consider discussing limitations earlier in this section rather than at the end; this can help contextualize your findings.

6. Conclusion:

Your conclusion summarizes findings well but could benefit from a stronger emphasis on implications for practice and future research directions.

Specific Feedback

Abstract:

a. The phrase "the health system has a unified digital health center" might need clarification - does it mean there is one central hub for all data?

b. Instead of stating "this study aims," use past tense since this is a completed study. "This study assessed..."

Introduction

a. The introduction provides good context but could be streamlined by focusing on key points relevant to your study's objectives.

b. Avoid excessive citations in introductory paragraphs; instead, synthesize information from multiple sources into cohesive statements.

Methods

a. Specify what type of healthcare professionals were surveyed (e.g., doctors, nurses) early on for context.

b. In describing SEM analysis, briefly explain why this method was chosen over others.

Results

a. Include descriptive statistics before diving into inferential statistics to give readers context about your sample.

b. Be cautious with terms like “significant” without specifying p-values initially; clarify what constitutes significance based on your analysis plan.

Discussion

a. Expand on how these findings relate to existing literature—what do they add or challenge?

b. Discuss practical applications of your findings more thoroughly—how can stakeholders implement changes based on this research?

Congratulations to the team on this great achievement.

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Reviewer #1: No

Reviewer #2: No

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<p>Health Care Professionals Intention to Use Digital Health Data Hub Working in East Gojjam Hospitals, Northwest Ethiopia: Technology Acceptance Modeling

PONE-D-25-02270R1

Dear Dr. Ayenew Sisay Gebeyew,

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.

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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,

Yibeltal Alemu Bekele, MpH

Academic Editor

PLOS ONE

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

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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: In the first round of the review, I provide extensive comments on the submitted manuscripts. Following the comments provided, the authors have gone ahead to review, update, and resubmit the updated version of their manuscript. After reviewing the latest version, the manuscript can now be accepted.

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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 #2: No

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