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PLOS ONE

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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

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

Reviewer #1: Yes

Reviewer #2: N/A

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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

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4. Is the manuscript presented in an intelligible fashion and written in standard English??>

Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: The paper fills in a gap in our understanding of homelessness among women and the experiences they go through. It is a valuable resource in that sense.

A few points merit noting :

- There are different metrics of homelessness in the nine HICs [ lines 11,189-192]. As pointed out at lines 369-370, only 14 of 32 studies had had agreed sample reference for homelessness. This could skew our understanding somewhat, but as given in the London/Dublin example at the end, this is driven by the laws unique to each country. This has been circumvented to some extent in the paper and a standardized definition has been used[ line 70 and others], however, this point does remain as an issue to be addressed

- The studies had a total of 227 women in 9 HICs. Of these, one third are in USA [line 174]. It is possible that the interpretation may be skewed by what happens in US, which needs to be addressed upfront. It is possible that a woman in Dublin may have a different experience relating to shelters- for example, which may not get captured, being the experience of a small minority of the sample. Besides, it is also possible that 227 data points may not be a large enough sample to derive a common conclusion for all the nine HICs.

- The paper mentions the power dynamics between researchers and women. In all the studies, the expectations from the persons asking the questions may be different. In fact the designation of the researcher, whether NGO, shelter staff, volunteer etc. may elicit responses unconsciously tailored to their expectations, since the women are already in a vulnerable position. These unsaid expectations could thus very well colour the responses, as is well documented in case of qualitative studies. It is not clear if indeed in some studies the power dynamics could have played out in the conclusions derived. This factor, indicating the kind of persons/researchers who did the studies, may be useful as a note for the readers.

Reviewer #2: Reviewer Comments

Thank you for this important research that aims to shed light on the invisibility of women’s homelessness in high-income countries. Because the majority of women deal with issues of abuse, shame, and stigma regarding their household dynamics, they are unlikely to be seen at public shelters or drop-ins, resulting in a lot of undocumented cases of women’s homelessness issues. The few that end up in shelters or seek support face structural challenges and may be excluded from research about homelessness. This meta-ethnography analysis is timely and critical in adding to the literature about women and homelessness in high-income countries. While the study has merit and contributes to knowledge, authors must address the following comments to get the manuscript to publication.

**Introduction**

The authors need to expand the introduction by providing a justification for their chosen context—high-income countries—and addressing why we need to understand the gendered homelessness situation in these countries. What is currently known about this issue in the study contexts, and why is it important?

Line 45 – please expand ‘multiple exclusion homelessness (MEH) and provide examples.

Lines 64-68 – why high-income countries; explain. While it is essential that the authors mention using the World Bank classification of high-income countries, they need to state the countries under review.

**Methods**

The authors claim to have used Noblit and Hare's (1998) meta-ethnography framework but fail to explain how they followed the seven steps Noblit and Hare provided. The authors need to expand the methods section to include what they did at every stage. If the authors did otherwise, they must justify and explain any modification.

Lines 108-111: The authors said they completed searches for 10 years (2012-2022) and then decided to expand the search to include literature from 2022 through January 2024 but did not explain why this was done. First, why did you decide on 10 years? Second, what led to the inclusion of additional data? These things need to be clearly explained.

Lines 119-120 – were there specific things the author excluded and/or included, and did any decision about the inclusion/exclusion criteria affect the data analysis?

**Results**

The authors decided to capture some information about the methods under the results section, which affected the flow of the paper. I suggest moving information from lines 122-158 to the methods section and making a link to Noblit and Hare’s framework.

Line 126 – please explain this statement: ‘34 papers reporting on 32 studies in the review.’ Does this statement suggest two papers written in the same context? If so, clearly state that. The reverse is captured in Figure 1.

Line 159 – is where the result section should begin.

Lines 124-126—Please review the numbers and compare them to the ones in the figure. There are discrepancies. For example, the authors said they screened 3332, but in the diagram, 3594 is captured. Also, they said the final list under review is 159, but in the figure, 158 is captured. Please make the necessary corrections. But if this is not an error, the authors should explain this discrepancy.

Line 171 – ‘five were mixed methods’ – but Figure 1 records 2. Which one is correct?

Line 169 – list the 9 high-income countries.

Lines 202-203 – the title of the figure/image should come under the image.

Lines 205-207 – there should be a signal to the theoretical framework in the Introduction section. This should tie in with the lit review on the motivation for the study; please revise accordingly.

Line 223 – there is something missing in the sentence…’they survive…’

Lines 247-249 – there should be a note about the use of quotes either in the methods section or the first paragraph in the results section.

**Discussion**

How has the social ecological model helped explain the results; that is missing in the discussion section.

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what does this mean? ). If published, this will include your full peer review and any attached files.

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Reviewer #1: No

Reviewer #2: No

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Attachments

Attachment

Submitted filename: Reviewer Comment_Plos One.docx

Dear Dr. Radcliffe,

Please address also these issues:

All included studies come from urban or predominantly urban contexts; rural homelessness experiences are absent. Please, explicitly acknowledge this limitation in the Discussion, outlining implications for transferability of findings.

Almost half the included studies do not define “homelessness,” potentially undermining synthesis consistency.

Hence, provide a critical reflection on how definitional variability may affect comparability, perhaps including a sensitivity analysis excluding studies without definitions.

There is a large variation in data collection methods (single interview, ethnography, photovoice) and absence of reflexivity in most included studies. Please, discuss explicitly how methodological heterogeneity was handled in the synthesis to mitigate bias.

The time restriction (10 years) is described as “pragmatic” but lacks a strong methodological justification beyond contemporaneity. Please, provide stronger rationale or explore inclusion of older, high-quality studies in a sensitivity check.

You state there were no significantly refutational studies, but this is unexpected in qualitative synthesis.

So, revisit dataset to ensure potentially divergent findings are not being subsumed into dominant narratives; even subtle contradictions can enrich the synthesis.

Intersectionality is acknowledged but underdeveloped; ethnicity, migration status, and disability receive little explicit attention despite likely importance. Please, incorporate more targeted analysis of how overlapping identities shape the homelessness experience.

Please submit your revised manuscript by Sep 28 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 atplosone@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,

Andrea Cioffi

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

Reviewer #1: All comments have been addressed

Reviewer #3: All comments have been addressed

Reviewer #4: All comments have been addressed

**********

2. Is the manuscript technically sound, and do the data support the conclusions??>

Reviewer #1: Yes

Reviewer #3: Yes

Reviewer #4: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously? -->?>

Reviewer #1: N/A

Reviewer #3: Yes

Reviewer #4: I Don't Know

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4. Have the authors made all data underlying the findings in their manuscript fully available??>

The PLOS Data policy

Reviewer #1: Yes

Reviewer #3: Yes

Reviewer #4: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English??>

Reviewer #1: Yes

Reviewer #3: Yes

Reviewer #4: Yes

**********

Reviewer #1: The revised paper is more comprehensive and addresses the concerns raised earlier. it can be published in it's present form as it addresses a key area of concern

Reviewer #3: The authors succeeded in selecting study tiopic and up to my observtions, they followed PLOS ONE protocols. In revieing the revised manuscript, the authors responded well to comments and revised accordingly.

Reviewer #4: The author has incorporated all suggestions and comments. The paper could be accepted for publications.

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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 #3: No

Reviewer #4: Yes: Dr. JAYANTA KUMAR BASU

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[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

A Meta-ethnographic systematic review of women's experiences of homelessness in high income environments.

PONE-D-24-50809R2

Dear Dr. Radcliffe,

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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Kind regards,

Andrea Cioffi

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 #4: All comments have been addressed

**********

2. Is the manuscript technically sound, and do the data support the conclusions??>

Reviewer #1: Yes

Reviewer #4: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously? -->?>

Reviewer #1: Yes

Reviewer #4: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available??>

The PLOS Data policy

Reviewer #1: Yes

Reviewer #4: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English??>

Reviewer #1: Yes

Reviewer #4: Yes

**********

Reviewer #1: i find that the changes suggested earlier have been accepted and addressed. the current article is more comprehensive and presents the case better than the earlier version. the qualitataive data and womens experience add richness and context.

Reviewer #4: Most of the comments and recommendations are incorporated in the revised manuscript. The paper could be considered for publications.

**********

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 #4: Yes: Dr. JAYANTA KUMAR BASU

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