Community-led change: Progress toward policy, systems, and environmental impacts through the Catalyzing Communities initiative

Travis R. Moore; Yuilyn A. Chang Chusan; Emily Sanderson; Larissa Calancie; Erin Hennessy; Julia M. Appel; Mary Ulseth; Christina D. Economos

doi:10.1371/journal.pone.0336482

Peer Review History

Original SubmissionApril 12, 2025
7 Oct 2025 Decision Letter - Alon Harris, Editor Dear Dr. Moore, 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 21 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. 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'. 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If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? Reviewer #1: Yes Reviewer #2: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? -->?> Reviewer #1: Yes Reviewer #2: I Don't Know ****** 3. Have the authors made all data underlying the findings in their manuscript fully available??> The PLOS Data policy Reviewer #1: Yes Reviewer #2: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English??> Reviewer #1: Yes Reviewer #2: Yes ****** Reviewer #1: This is a well-structured and important study that explores how the Catalyzing Communities initiative, guided by the Stakeholder-Driven Community Diffusion (SDCD) theory, supported community-led efforts to implement policy, systems, and environmental (PSE) changes. The authors used a mixed-methods approach (surveys and interviews) across eight U.S. communities to evaluate the implementation, capacity building, and contextual influences of these interventions. The manuscript addresses a timely and critical topic: community-driven, equity-focused change in public health. The explanatory sequential design (quantitative then qualitative) is well-executed and enhances the depth of understanding. Integration of intensity scoring provides a meaningful way to assess the impact of community actions. The authors did a great job of detailing community-specific differences, especially across Cohort 1 (C1) and Cohort 2 (C2) sites. They account for contextual challenges (e.g., COVID-19, organizational infrastructure) that affect real-world implementation. Areas for Improvement: 1. Clarity in Writing- Consider streamlining sections of the Results and Discussion for better flow and readability. In particular, tables with large amounts of data (e.g., Tables 2–6) could be supplemented with clearer summaries or synthesis in the text. 2. Despite the paper’s focus on policy, systems, and environmental change, few concrete policy-level impacts were observed or described. A discussion of why policy progress was limited (e.g., timeline, governance barriers) would strengthen the analysis. 3. The communities involved are diverse, but the sample size of changemakers (n=14 surveys, 10 interviews) is relatively small. The authors might consider discussing limits to generalizability or transferability of findings. 4. The manuscript uses “changemakers,” “community leaders,” “committee members,” and “partners” somewhat interchangeably. For clarity, please standardize terminology throughout the manuscript. Consider abbreviating lengthy phrases like “community-led actions” after the first use. This is a solid and well-designed manuscript. With some editorial tightening, clarification of methodology, and more critical reflection on limitations, it will make a valuable contribution to public health and implementation science literature. Reviewer #2: Thank you for the opportunity to review this manuscript. The study addresses an important and timely topic, and I commend the authors for their community-engaged approach and clear commitment to equity. I have just a few suggestions that I believe could strengthen the paper: 1. A shorter summary of key findings and simplified tables/figures would help readers quickly understand the main results. 2. Since most findings are based on changemakers’ self-reports, it would be helpful to highlight this more clearly in the limitations and discuss how future work might incorporate more objective measures. 3. Some tables are difficult to follow due to formatting and length. Consider streamlining or supplementing with simple visuals (charts or infographics) to make findings more accessible. 4. The discussion could acknowledge challenges (e.g., partial reach, incomplete actions, COVID-19 disruptions) more explicitly to provide a balanced picture alongside the successes. Good luck! ****** 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? 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Revision 1
10 Oct 2025 Author Response Reviewer 1 1. Clarity in Writing- Consider streamlining sections of the Results and Discussion for better flow and readability. In particular, tables with large amounts of data (e.g., Tables 2–6) could be supplemented with clearer summaries or synthesis in the text. a. We thank the reviewer for this helpful suggestion. We have revised the Results and Discussion sections to improve readability and flow. Specifically, we streamlined descriptions of the quantitative results and added concise synthesis paragraphs summarizing key findings from Tables 2–6. In addition, we included explicit summary statements (or table legends, following style requirements) after each table to help readers quickly grasp the major takeaways from the detailed data presented in the tables. 2. Despite the paper’s focus on policy, systems, and environmental change, few concrete policy-level impacts were observed or described. A discussion of why policy progress was limited (e.g., timeline, governance barriers) would strengthen the analysis. a. We agree that while our data show meaningful progress toward systems and environmental changes, fewer policy outcomes at the local or state levels were observed. To address this, we have expanded the Discussion section to explicitly discuss potential reasons for limited policy progress, including the relatively short implementation timeline for Cohort 2 communities, the community-led prioritization of actions that focused on visible systems or environmental outcomes, and governance barriers such as limited authority or alignment among community partners; all reflecting the complexity of policy processes at local and state levels We have also highlighted how these contextual challenges shape expectations for policy outcomes in community-based PSE initiatives. b. Revisions were made in the Discussion to clarify that limited policy progress does not reflect lack of success but rather structural and temporal realities of community-driven change efforts. 3. The communities involved are diverse, but the sample size of changemakers (n=14 surveys, 10 interviews) is relatively small. The authors might consider discussing limits to generalizability or transferability of findings. a. While the number of participating changemakers was necessarily limited due to the structure of the Catalyzing Communities initiative (where each community designates a small number of key leaders) we agree that this limits the generalizability of findings. To address this, we have expanded the Limitations discussion to explicitly acknowledge the small sample size and note that our findings are best understood as contextually grounded insights into community processes rather than statistically generalizable results. We have also clarified that the study’s strength lies in its depth of engagement and cross-community comparison, which enhances the transferability of findings to similar community-based, systems-oriented initiatives. b. Revisions were made in the Discussion section. 4. The manuscript uses “changemakers,” “community leaders,” “committee members,” and “partners” somewhat interchangeably. For clarity, please standardize terminology throughout the manuscript. Consider abbreviating lengthy phrases like “community-led actions” after the first use. a. We appreciate the reviewer’s attention to terminology and clarity. We have reviewed the manuscript carefully to ensure consistent and precise use of terms. We intentionally use “changemakers,” “committee members,” and “community partners” to reflect distinct but complementary roles within the Catalyzing Communities initiative. i. Changemakers refer to designated community leaders who co-led the Catalyzing Communities initiative alongside researchers.. ii. Committee members represent the broader local champions engaged in planning and implementing community-led actions. iii. The term ‘Community partners’ is used as an umbrella term when referring collectively to changemakers and committee members. b. To improve clarity, we added brief definitional statements when these groups are first introduced in the Introduction and ensured consistent usage throughout. We also abbreviated community-led actions as CLAs after the first use, as suggested. Reviewer 2 1. A shorter summary of key findings and simplified tables/figures would help readers quickly understand the main results. a. We appreciate this helpful suggestion. In response to a similar comment from another reviewer, we revised the Results section to include concise summary statements that introduce each table, as well as table legends,, highlighting key findings from Tables 2–6. We also streamlined the tables by refining headers and reducing redundant information to improve readability. These changes make the main results easier to interpret at a glance while preserving the richness of the mixed-methods findings. 2. Since most findings are based on changemakers’ self-reports, it would be helpful to highlight this more clearly in the limitations and discuss how future work might incorporate more objective measures. a. We have added text in the Discussion section to acknowledge that the findings are primarily based on changemakers’ self-reported data and therefore may reflect subjective perspectives. We also note that future studies could complement these insights with more objective or externally validated measures of community progress, such as document reviews, policy audits, or independent assessments of PSE change. 3. Some tables are difficult to follow due to formatting and length. Consider streamlining or supplementing with simple visuals (charts or infographics) to make findings more accessible. a. We appreciate this suggestion and agree that clarity in presentation is important. To improve readability, we adjusted the formatting of longer tables (particularly Tables 3–6) by refining headers, adding spacing for visual separation between entries, and ensuring consistent labeling of cohorts and communities. We also added brief introductory sentences before several tables to orient readers to their purpose and key takeaways. b. Given that these tables capture rich qualitative data that substantively illustrate the diversity and nuance of changemakers’ experiences, we retained their level of detail to preserve analytic depth. To further enhance accessibility, we have also included brief summary statements and references to figures summarizing overarching findings across communities. 4. The discussion could acknowledge challenges (e.g., partial reach, incomplete actions, COVID-19 disruptions) more explicitly to provide a balanced picture alongside the successes. a. We agree with the reviewer that a balanced discussion should include both accomplishments and challenges experienced by communities during implementation. We have expanded the Discussion to explicitly acknowledge barriers such as limited reach among target populations, incomplete or ongoing actions at the time of data collection, and disruptions caused by the COVID-19 pandemic. https://doi.org/10.1371/journal.pone.0336482.r002
28 Oct 2025 Decision Letter - Alon Harris, Editor Community-led change: Progress toward policy, systems, and environmental impacts through the Catalyzing Communities initiative PONE-D-25-18403R1 Dear Dr. Moore, 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. For questions related to billing, please contact billing support . 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, Alon Harris Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 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??> Reviewer #1: Yes Reviewer #2: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? -->?> Reviewer #1: Yes Reviewer #2: I Don't Know ****** 4. Have the authors made all data underlying the findings in their manuscript fully available??> The PLOS Data policy Reviewer #1: Yes Reviewer #2: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English??> Reviewer #1: Yes Reviewer #2: Yes ****** Reviewer #1: The authors have been highly responsive to reviewer feedback, resulting in a significantly strengthened and more coherent manuscript. The integration of quantitative and qualitative findings is now clearer. The revisions improve both methodological transparency and interpretive depth. The study offers a meaningful contribution to the literature on community-led, systems-oriented public health initiatives and illustrates the practical application of the SDCD framework. The work’s emphasis on context, capacity building, and community agency provides valuable insights for both researchers and practitioners. Reviewer #2: (No Response) ****** 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: Yes: Anna Fabczak-Kubicka Reviewer #2: No ******** https://doi.org/10.1371/journal.pone.0336482.r003
Formally Accepted
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