Stakeholder priorities and conceptualization of One Health: Insights from fuzzy cognitive mapping and grounded theory

Evan F. Griffith; Angela Opondoh; Catherine Kaluwa; Erenius Lochede Nakadio; Kipkorir Rotich; Job Ronoh Kipkemoi; Jonah Levin; Jacob Mutua; Siobhan M. Mor; Janetrix Hellen Amuguni

doi:10.1371/journal.pone.0338167

Peer Review History

Original SubmissionNovember 21, 2025
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If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references.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 If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. [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: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available??> The PLOS Data policy Reviewer #1: No Reviewer #2: No ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English??> Reviewer #1: Yes Reviewer #2: Yes ****** Reviewer #1: The manuscript presents an innovative approach combining fuzzy cognitive mapping and grounded theory to examine stakeholder conceptualizations of One Health. Integration of participatory system modeling with qualitative analysis was excellent and well aligned with the study objectives. Additionally, the manuscript is well written and makes a meaningful contribution. However, minor changes are needed. 1. The proposed theory is a valuable framework, but its novelty should be explicitly added. A short description would strengthen the manuscript. 2. There is a variation in the sample size. Could you please add some discussion how may small size affect the stability? of this study during comparison. 3. Add the limitations of this study more explicitly. 4. The manuscript is detailed and well organized, but reducing some repetition would increase the readability 5.Figures and Tables. Some figures (e.g., FCM visualizations) are dense and may be difficult for readers unfamiliar with FCM to interpret. Consider adding brief explanatory captions or references to supplementary material. Table numbering appears inconsistent in places (e.g., Table 5 vs. Table 6); please check carefully.I have not found table table 6 in the mansucript. 6. Reviewer #2: The study uses a validated instrument (Smartphone Addiction Scale – Short Version) to measure smartphone overuse and applies binary logistic regression to explore associations between overuse and self-reported physical and mental health outcomes. The sample size is adequate, and the statistical analyses are properly conducted. It would be helpful to expand slightly on the application of logistic regression—specifically, whether assumptions such as multicollinearity and goodness-of-fit were tested. Although the use of this method is appropriate, adding a short note on diagnostics would enhance transparency. Given the cross-sectional design, I recommend to avoid wording that implies causality (e.g., "smartphone use caused"). Instead, consider using terms like “associated with” or “linked to.” According to PLOS ONE policies, data underlying the findings should be openly accessible unless restricted. You currently state data are available upon request. Please consider depositing an anonymised version of the dataset in a recognised public repository to comply with open data practices. While the SAS-SV is clearly described, the manuscript would benefit from clarification on how physical (e.g., neck or back pain) and mental health outcomes (e.g., anxiety, depression) were assessed—i.e., whether validated instruments were used or whether these were self-reported perceptions. ****** 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.] To ensure your figures meet our technical requirements, please review our figure guidelines: https://journals.plos.org/plosone/s/figures You may also use PLOS’s free figure tool, NAAS, to help you prepare publication quality figures: https://journals.plos.org/plosone/s/figures#loc-tools-for-figure-preparation. NAAS will assess whether your figures meet our technical requirements by comparing each figure against our figure specifications. https://doi.org/10.1371/journal.pone.0338167.r001
Revision 1
11 Feb 2026 Author Response Manuscript ID: ONE-D-25-61857 Title: Stakeholder priorities and conceptualization of One Health: Insights from fuzzy cognitive mapping and grounded theory Dear Dr. Ogola, We sincerely thank you and the reviewer for your careful evaluation of our manuscript and for the constructive feedback. We have carefully addressed all comments and believe the manuscript has been strengthened as a result. Below, we provide a point-by-point response to your comments and Reviewer #1. As noted below, Reviewer #2’s comments appear to refer to a different manuscript. Academic Editor and Journal Requirements 1. Formatting Requirements We have revised the manuscript to ensure full compliance with PLOS ONE style and formatting guidelines. 2. Clarification of Verbal Consent Documentation We have updated the manuscript with the following changes (Page 14, lines 246-251): “Prior to each mapping session, participants were informed about the purpose, procedures, data handling, confidentiality, and the voluntary nature of participation. Verbal informed consent was obtained from all participants. Consent was documented by the research team at the time of data collection and witnessed by EFG or CK, in accordance with the approved Tufts IRB study protocol.” 3. Funding Information in Manuscript All funding information has been removed from the manuscript body and retained only in the Funding Statement section of the online submission form. 4. Grant Information Consistency We reviewed and confirmed that grant information is now consistent across all sections of the submission. 5. Role of the Funder Statement We included the following statement in the cover letter: “This research was funded by a Cummings Foundation grant (V710458) awarded to H.J.A. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.” 6. Copyrighted Map Image (Figure 1) We removed the original copyrighted basemap and replaced Figure 1 with a version that complies with CC BY 4.0 licensing requirements. 7. Removal of Figures from Manuscript File All figures have been removed from the manuscript file and uploaded separately as individual TIFF files. Figure legends remain in the manuscript. 8–9. Table Numbering Issues Table numbering has been corrected throughout the manuscript. Table 5 starting on page 16 is now references in the text. There is no Table 6. 10–11. Reference List Review The reviewer comments did not include recommendations to cite specific works. Reviewer #1 Comment 1: Clarify novelty of proposed theory (OHGT) We expanded the Discussion to more explicitly articulate the novelty and broader applicability of One Health Grounded Theory (OHGT), clarifying its theoretical contribution beyond the immediate case study (Page 28, lines 543-559). Comment 2–3: Sample size variation and limitations We revised the Study Limitations section to explicitly address how sample size variation may affect concept saturation, centrality analysis, and structural stability across stakeholder maps (Pages 33-34, lines 660-688). Comment 4: Reduce repetition Thank you for this comment. Without more specific details regarding what repetition the reviewer is referring to it was hard to know what to change. However, we have made the following revisions with the intention of reducing repetition: 1) We deleted the last two paragraphs of the introduction which included information that was repeated in the Methods section (e.g., sampling and participant recruitment). 2) We deleted the “Study Site Selection,” as this presents information that is included in other parts of the Methods and Discussion section. 3) Removed any reference to the ethics process (Page 8) as this is included in the “Ethics Statement” (Page 12). 4) Finally, we edited the discussion to remove any references to results. Comment 5: Clarify FCM figures We added a concise overview of FCM at the beginning of the Methods section and ensured that figure legends clearly explain interpretation of node size, edge color, and arrow thickness. Adjacency matrices are included as supplementary material. Reviewer #2 The comments provided under Reviewer #2 refer to a study involving the Smartphone Addiction Scale (SAS-SV) and logistic regression analysis, which is unrelated to our manuscript. We respectfully believe this review was inadvertently assigned from another submission. Data Availability Adjacency matrices for each stakeholder group are provided in the supplementary material. Qualitative transcripts are not publicly available due to participant confidentiality and IRB restrictions; however, coding structures and analytical procedures are described in detail in the Methods. Conclusion We greatly appreciate the constructive feedback provided by the Academic Editor and Reviewer #1. The revisions have strengthened the manuscript’s clarity, transparency, and theoretical contribution. We believe the revised version more clearly articulates its empirical and methodological contributions to participatory One Health research. Sincerely, Evan Griffith, DVM, MPH, MS On behalf of all co-authors Attachments Attachment Submitted filename: Response_to_Reviewers.docx https://doi.org/10.1371/journal.pone.0338167.r002
16 Feb 2026 Decision Letter - Eric Ogola, Editor Stakeholder priorities and conceptualization of One Health: Insights from fuzzy cognitive mapping and grounded theory PONE-D-25-61857R1 Dear Dr. Griffith, We are 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, Eric Ogola, MPH Academic Editor PLOS One Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0338167.r003
Formally Accepted
Acceptance Letter - Eric Ogola, Editor PONE-D-25-61857R1 PLOS One Dear Dr. Griffith, I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS One. Congratulations! Your manuscript is now being handed over to our production team. At this stage, our production department will prepare your paper for publication. This includes ensuring the following: * All references, tables, and figures are properly cited * All relevant supporting information is included in the manuscript submission, * There are no issues that prevent the paper from being properly typeset You will receive further instructions from the production team, including instructions on how to review your proof when it is ready. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few days to review your paper and let you know the next and final steps. Lastly, if your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. 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. You will receive an invoice from PLOS for your publication fee after your manuscript has reached the completed accept phase. If you receive an email requesting payment before acceptance or for any other service, this may be a phishing scheme. Learn how to identify phishing emails and protect your accounts at https://explore.plos.org/phishing. If we can help with anything else, please email us at customercare@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Eric Ogola Academic Editor PLOS One https://doi.org/10.1371/journal.pone.0338167.r004

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