PONE-D-25-06987Policies for Healthy Ageing in Response to Climate Change: Protocol of a Systematic ReviewPLOS ONE

Dear Dr. Asiamah,

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions?

The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field.

Reviewer #1: Yes

Reviewer #2: Partly

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2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses?

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Reviewer #1: Yes

Reviewer #2: Partly

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3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable?

Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

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 and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics.

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(Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Well done on your Protocol of a Systematic Review. Please find below specific comments to address.

INTRODUCTION

1. Reference needed after first sentence

2. Reference needed second paragraph, third sentence

3. Insert "globally" to third paragraph sentence- Because of population ageing, the population of older adults aged 65 years or older "globablly" is expected to more than double by 2050.

4. Reference needed third paragraph, third sentence

5. Remove paragraph 4 related to people of all ages as unclear why this is needed?

6. Remove from healthy ageing paragraph sentence "Hence, the ideal policies for healthy ageing in response to climate change should be targeted at every ageing individual"

7. Include at end of healthy ageing paragraph "Research in the past decades shows increased advocacy for healthy ageing policies in response to climate change [14, 15]. While some studies report policies already developed for fostering healthy ageing in contexts experiencing climate change events, others have reported policies recommended by experts for the same purpose [14, 16]."

METHODS

8. Correct spelling "Meta-Analyses" in (Review protocol and registration)

9. Include "also" in (Types of studies)- Although systematic reviews may focus on peer-reviewed articles, we plan to "also" include grey literature

10. Provide exclusion criteria for (Types of studies)

11. Remove "global warming" as this is not mentioned in introduction

12. Unclear if the current search strategy will identify (Types of comparators)- barriers to adoption healthy ageing, please consider describing how this will be achieved

13. Include "people with a disability" (Types of outcome measures)- brackets in final sentence

14. (First stage screening)- Study participants= Remove "often people aged 18 years or older"

15. Include detail information about literature uses 50 years as the minimum old age in Introduction, as currently you talk about older adults as 65 years or older

16. Study Participants= Remove "will be potentially eligible. Such materials"

17. (Risk of Bias Assessment)= Ensure you write in full before using abbreviations e.g. Critical Appraisal Skills Programme (CASP) or Joanna Briggs Institute (JBI)

18. Include "either" to first sentence Risk of Bias Assessment- The risk of bias and quality of studies will be assessed with "either" the

DISCUSSION AND CONCLUSION

19. Keep consistent terminology throughout paper, change programmes in first sentence to "policies"

20. Unclear who the specific stakeholders are? (e.g. general population/individuals, parliament, organisations, academics etc)

21. Reword final sentence suggestion "Finally, this review will highlight areas where future research and policy dialogues are needed to foster successful implementation of healthy ageing policies."

Reviewer #2: 1. The introduction provides a partly valid rationale for the proposed study, clearly justifying research questions; however, some parts need more clarity:

- Some broad statements should be backed by specific examples/evidence. For example, "Research in the past decades shows increased advocacy for healthy ageing policies in response to climate change [14, 15]" should be more specific such as what kind of policies or frameworks have been developed and in which contexts (e.g., WHO frameworks, national-level policies).

- The phrase “climate change accompanies” is inappropriate. Climate change increases the frequency and intensity of extreme weather events rather than simply accompanying them.

- The pathways through which climate change affects health are not well defined. "It threatens biodiversity, increases the risk of mortality, and makes communities more vulnerable to respiratory diseases." The phrase “makes communities more vulnerable” is too broad and lacks specific mechanisms. Data should support the statement.

2. The search strategy is well-structured, but some important keywords are missing in the search strings.

In your appendix 2 "Search strings and strategy generated across key search databases" consider including the following terms:

- S1 (population): Add: older adults, elderly, aging population, successful aging, aged individuals, senior citizens, older people, late-life adults

- S2 (climate): environmental change, extreme weathers (may be specific to storms, floods, heatwaves, heat stress, rising temperatures, extreme heat, cyclones, disasters, cold waves, extreme cold, winter storms, urban heat islands, rising sea levels)

- S3 (policy): climate change adaptation, governance, intervention, strategy, climate mitigation, emergency preparedness, disaster risk reduction

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Reviewer #1: No

Reviewer #2: Yes:  Nu Quy Linh Tran

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Policies for Healthy Ageing in Response to Climate Change: Protocol of a Systematic Review

PONE-D-25-06987R1

Dear Dr. Asiamah,

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LS Katrina Li

Academic Editor

PLOS ONE

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