Can creative activities and mind-body practices help enhance well-being and mental health awareness? An exploratory qualitative study in UK higher education

Marianna Cortesi; Federico Pendenza; Elizabeth Haddon; Andrea Schiavio

doi:10.1371/journal.pone.0338938

Peer Review History

Original SubmissionMay 30, 2025
7 Aug 2025 Decision Letter - Jenna Scaramanga, Editor PONE-D-25-29029-->-->Can creative activities and mind-body practices help enhance well-being and mental health awareness? An exploratory qualitative study in UK higher education-->-->PLOS ONE?> Dear Dr. Cortesi, 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. 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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In your statement, please include the full name of the IRB or ethics committee who approved or waived your study, as well as whether or not you obtained informed written or verbal consent. If consent was waived for your study, please include this information in your statement as well. 6. If the reviewer comments include a recommendation to cite specific previously published works, please review and evaluate these publications to determine whether they are relevant and should be cited. There is no requirement to cite these works unless the editor has indicated otherwise. Additional Editor Comments: The reviewer has raised a number of concerns that need attention. --> -->-->Please note that we have only been able to secure a single reviewer to assess your manuscript. We are issuing a decision on your manuscript at this point to prevent further delays in the evaluation of your manuscript. Please be aware that the editor who handles your revised manuscript might find it necessary to invite additional reviewers to assess this work once the revised manuscript is submitted. However, we will aim to proceed on the basis of this single review if possible. -->?> [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 ******** 2. Has the statistical analysis been performed appropriately and rigorously? -->?> Reviewer #1: N/A ****** 3. Have the authors made all data underlying the findings in their manuscript fully available??> The PLOS Data policy Reviewer #1: No ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English??> Reviewer #1: Yes ****** Reviewer #1: This is an engaging and timely manuscript that addresses an important gap in the literature on creative and mind-body practices within the UK higher education context. The study offers valuable exploratory insights into how such activities may foster well-being awareness, social connection, and community building among students and staff. The use of an open-ended questionnaire and thematic analysis is appropriate, and the findings are presented with clarity, supported by rich participant quotes. The manuscript is sound, well-written, and meets PLOS ONE’s publication criteria. With minor revisions—mainly clarifying data availability, expanding the discussion of limitations, and tightening the narrative—it will be a strong contribution to the literature. Strengths: Clear rationale for the study situated within relevant literature. Appropriate qualitative design with transparent analytic procedures: The study is methodologically appropriate for an exploratory qualitative design. The use of an open-ended questionnaire analyzed via thematic analysis is consistent with the study’s aims. The conclusions drawn—mainly that creative and mind-body activities may enhance well-being awareness and community building—are supported by the data presented. However, the authors should better clarify the limitations of self-reported data, the relatively small sample size, and the absence of triangulation beyond researcher review. Inclusion of both students and staff offers a broader institutional perspective. Practical implications for higher education are well articulated. Suggestions for improvement: Clarify limitations. Explicitly acknowledge the limited sample size and self-selection bias, and explain how these may affect the transferability of findings. Refine data availability statement. Provide a more detailed description of how interested researchers can access de-identified data or analytic materials while maintaining participant anonymity. The data availability statement indicates that data cannot be shared publicly due to confidentiality concerns but may be available on request from the corresponding author. While this is permissible under PLOS ONE policy in specific cases (e.g., to protect participant anonymity), the authors should provide greater detail on what data will be shared and the process for access (e.g., de-identified excerpts, coding framework). This would improve transparency. Streamline sections of the manuscript. Consider condensing the literature review and parts of the discussion where points are repeated, focusing on the most salient findings and implications. Broaden the implications. Consider including a brief reflection on how these findings might inform institutional policy beyond the immediate context (e.g., implications for other universities or community-based programs). Address researcher positionality. While insider status is acknowledged, more discussion of how this was managed during data collection and analysis (e.g., reflexive journaling or audit trails) would strengthen trustworthiness. ****** 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: Tonje M. Molyneux, PhD ******** [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. https://doi.org/10.1371/journal.pone.0338938.r001
Revision 1
17 Sep 2025 Author Response Please find below my responses to the Reviewer, as also outlined in the 'Response to reviewers' letter. 1) Comment: Clarify limitations. Explicitly acknowledge the limited sample size and self-selection bias, and explain how these may affect the transferability of findings. Response: A dedicated section on limitations has been added following the ‘Discussion’. This section explicitly acknowledges self-selection bias, potential inaccuracies inherent in self-reported data, the small sample size, and its implications for the generalizability of the findings. 2) Comment: Refine data availability statement. Response: The ‘Data availability statement’ has been updated in alignment with the reviewer (and the journal)’s comment. 3) Comment: Streamline sections of the manuscript. Consider condensing the literature review and parts of the discussion where points are repeated, focusing on the most salient findings and implications. Response: Sections of the ‘Discussion’ have been streamlined, reducing the word count from approximately 1300 to 900 words, and the discussion of findings has been presented in a more integrated manner to enhance readability and impact. The Literature review (Introduction) has not been further shortened (remaining around 500 words), as it was already heavily streamlined during manuscript drafting. The authors believe that additional cuts could compromise the clarity of the research rationale and weaken the demonstration of a thorough review of relevant literature. 4) Comment: Broaden the implications. Consider including a brief reflection on how these findings might inform institutional policy beyond the immediate context (e.g., implications for other universities or community-based programs). Response: The Conclusions section has been revised to broaden the implications of our findings, highlighting their relevance for other higher education institutions and community-based programs. 5) Comment: Address researcher positionality. While insider status is acknowledged, more discussion of how this was managed during data collection and analysis (e.g., reflexive journaling or audit trails) would strengthen trustworthiness. Additional details have been added to both the ‘The Insider Researcher’ and ‘Data Analysis’ sections to clarify how we managed our positions as insider researchers and ensured the trustworthiness of the findings. Attachments Attachment Submitted filename: Response to reviewers.docx https://doi.org/10.1371/journal.pone.0338938.r002
16 Oct 2025 Decision Letter - Hariom Solanki, Editor PONE-D-25-29029R1-->-->Can creative activities and mind-body practices help enhance well-being and mental health awareness? An exploratory qualitative study in UK higher education-->-->PLOS ONE?> Dear Dr. Cortesi, 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 30 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'. 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 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, Hariom Kumar Solanki, M.D. Academic Editor PLOS ONE Journal Requirements: If the reviewer comments include a recommendation to cite specific previously published works, please review and evaluate these publications to determine whether they are relevant and should be cited. There is no requirement to cite these works unless the editor has indicated otherwise. 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. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author Reviewer #1: All comments have been addressed Reviewer #2: (No Response) Reviewer #3: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions??> Reviewer #1: Yes Reviewer #2: Partly Reviewer #3: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? -->?> Reviewer #1: N/A Reviewer #2: N/A Reviewer #3: Yes ****** 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 Reviewer #3: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English??> Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ****** Reviewer #1: Thank you for your thorough revisions. I have reviewed the revised manuscript and am satisfied that you have adequately addressed all of my concerns. The new limitations section appropriately acknowledges sample size, self-selection bias, and self-reported data constraints. The data availability statement now includes proper institutional contact information. The Discussion section is more concise and focused with improved flow, and I accept your rationale for maintaining the Introduction's current length. The Conclusions section effectively situates your findings for broader application beyond the immediate study context. The enhanced descriptions of reflexive practices and collaborative analysis procedures substantially strengthen the methodological rigor and trustworthiness of the study. These revisions have improved the manuscript's overall clarity and scholarly contribution. Reviewer #2: - Expand the limitations section to discuss how questionnaire format may limit depth and suggest future mixed-methods follow-ups. - Add a brief subsection in discussion on how findings align with or diverge from US studies cited, to strengthen the UK gap argument. - Consider including a supplementary file with the full questionnaire for transparency. Reviewer #3: The Author is able to respond to the initial comments made. However, there are gaps that need to be covered including: 1. Under methodology, the study design is not made clear, this needes to be stated clearly. 2. Under results section, last column of Table 2 is not clear; it needs to be made clear. If these can be addressed, the article can be published, it is good based on the subject matter and the limitations highlighted regarding the study. ****** 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: Yes: Dr Syed Irfan Ali Reviewer #3: Yes: Abdulrahman Ahmad ******** [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 https://doi.org/10.1371/journal.pone.0338938.r003
Revision 2
5 Nov 2025 Author Response The following summarizes the revisions made in response to the reviewers’ comments. Reviewer 2 comments 1) Comment: Expand the limitations section to discuss how questionnaire format may limit depth and suggest future mixed-methods follow-ups. Response: The limitations of the questionnaire format have been addressed in the ‘Limitations’ section, explicitly noting the potential constraints on response depth and recommending that future research adopt a mixed-methods approach. 2) Comment: Add a brief subsection in discussion on how findings align with or diverge from US studies cited, to strengthen the UK gap argument. Response: At the beginning of the Discussion section, a brief summary has been added to highlight how the findings of this study both align with and differ from US-based research. In particular, the shared positive effects of creative activities and mind-body practices are acknowledged, while the distinction between the controlled interventions typical of some US studies and the investigation of pre-existing activities in this UK-based study is clearly noted. 3) Comment: Consider including a supplementary file with the full questionnaire for transparency. Response: Unfortunately it is not possible to include the full questionnaire as a supplementary file, as it contains identifying references that could, directly or indirectly, compromise the privacy of individuals involved in the activities. However, as added in the Data Availability statement, a copy of the questionnaire can be provided upon reasonable request. Reviewer 3 comments. 1) Comment: Under methodology, the study design is not made clear, this needs to be stated clearly. Response: In the ‘Study Design’ section we added a statement that clarifies why the questionnaire was chosen as the data collection tool as opposed to others such as interviews. The ‘Materials and Methods’ section, along with its subsequent subsections, addresses all key components of the design, including the research aim and rationale, the methodological approach (qualitative phenomenological design), data collection, participant selection, and data analysis. The authors, supported by feedback from the first reviewer, consider the study design to be clear and consistent with reporting practices in recent qualitative publications in PLOS ONE (e.g. Khan et al., 2025). 2) Comment: Under results section, last column of Table 2 is not clear; it needs to be made clear. Response: The last column of Table 2 has been revised for clarity to indicate that participants did not respond to the question addressed in the Table. In the staff responses, ‘0’ has been used instead of ‘N/A’ to avoid confusion. Attachments Attachment Submitted filename: Response_to_reviewers_auresp_2.docx https://doi.org/10.1371/journal.pone.0338938.r004
30 Nov 2025 Decision Letter - Hariom Solanki, Editor Can creative activities and mind-body practices help enhance well-being and mental health awareness? An exploratory qualitative study in UK higher education PONE-D-25-29029R2 Dear Dr. Cortesi, 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, Hariom Kumar Solanki, M.D. Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0338938.r005
Formally Accepted
Acceptance Letter - Hariom Solanki, Editor PONE-D-25-29029R2 PLOS One Dear Dr. Cortesi, 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. Hariom Kumar Solanki Academic Editor PLOS One https://doi.org/10.1371/journal.pone.0338938.r006

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