Development of a digital tool to assist in monitoring compliance for a public health initiative: “A Better Choice Food and Drink Supply Strategy for Queensland Healthcare Facilities”

Hai Pham; Sherridan Cluff; Mathew Dick; Erica Clifford; Nicole McDonald; Jason D. Pole

doi:10.1371/journal.pone.0341747

Peer Review History

Original SubmissionApril 14, 2025
1 Sep 2025 Decision Letter - Ali B. Mahmoud, Editor Dear Dr. Pole, 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 Oct 16 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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When you resubmit, please ensure that you provide the correct grant numbers for the awards you received for your study in the ‘Funding Information’ section. 3. Thank you for stating in your Funding Statement: “The project was funded by the Queensland Government through Health and Wellbeing Queensland, as part of The University of Queensland Health Research Accelerator initiative program for the Queensland Digital Health Centre.” Please provide an amended statement that declares all the funding or sources of support (whether external or internal to your organization) received during this study, as detailed online in our guide for authors at http://journals.plos.org/plosone/s/submit-now. Please also include the statement “There was no additional external funding received for this study.” in your updated Funding Statement. Please include your amended Funding Statement within your cover letter. We will change the online submission form on your behalf. 4. Thank you for stating the following financial disclosure: “The project was funded by the Queensland Government through Health and Wellbeing Queensland, as part of The University of Queensland Health Research Accelerator initiative program for the Queensland Digital Health Centre.” Please state what role the funders took in the study. If the funders had no role, please state: "The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript." If this statement is not correct you must amend it as needed. Please include this amended Role of Funder statement in your cover letter; we will change the online submission form on your behalf. 5. Thank you for stating the following in the Acknowledgments Section of your manuscript: “The project was funded by the Queensland Government through Health and Wellbeing Queensland, as part of The University of Queensland Health Research Accelerator initiative program for the Queensland Digital Health Centre. We also acknowledge Dr Brooke Maund at Queensland Statewide Food Services for supporting in updating data collection survey and communication of changes to HHSs regarding the new method of data collection. “ We note that you have provided funding information that is currently declared in your Funding Statement. However, funding information should not appear in the Acknowledgments section or other areas of your manuscript. We will only publish funding information present in the Funding Statement section of the online submission form. Please remove any funding-related text from the manuscript and let us know how you would like to update your Funding Statement. 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Has the statistical analysis been performed appropriately and rigorously? -->?> Reviewer #1: N/A Reviewer #2: N/A ****** 3. Have the authors made all data underlying the findings in their manuscript fully available??> The PLOS Data policy Reviewer #1: No 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: The work require a mix of professionals and a high level of IT involvement. A considerable work has been done User interface and accessibility: (I) how user-friendly it is? Any advantage in relation to other systems used earlier? Interactivity???? (ii) The idea compliance is weighted by service volume for each facility is not clear, because I could not see relationship between food and drink provided and compliance. The principle, I thought, is compliance regardless of the size of the institution served. In the Discussion section, authors could not compare the system with any other system which may have similar function. If this is completely new, it is good to say it loudly. Even no comparison was made with the previous system to show the relative advantage of the current one. It would have been good to also use the data for some statistical analysis to show it on the dashboard Reviewer #2: Development of a digital tool to assist in monitoring compliance for a public health initiative: "A Better Choice Food and Drink Supply Strategy for Queensland Healthcare Facilities" Thank you for the opportunity to review this manuscript. It is a timely and engaging contribution to the field, particularly in its innovative approach to visualising policy-related data on food and drink availability in Queensland. The development of a dashboard tool to support both the interpretation of results and the monitoring of compliance with the ABC Policy is a valuable initiative that uses existing platforms and software. The manuscript is generally well-structured and clearly written. Below is a series of comments that aim to support further refinement of the manuscript. Scope and Policy Context The manuscript appropriately focuses on Queensland, which is appropriate given the jurisdictional differences in policy targets across Australian states. A brief note acknowledging that different states have varying policies and policy targets could enhance the clarity for readers outside Australia, and indicate whether the tool could be adapted for use in other jurisdictions. This would help readers understand the broader relevance of the approach. Introduction The introduction outlines several monitoring systems, but it would be strengthened by the inclusion of more examples directly related to nutrition and food environments. Relevant dashboards include the World Obesity Observatory (https://data.worldobesity.org/), the GBD Compare tool (https://vizhub.healthdata.org/gbd-compare/), and the Australian Food Environment Dashboard (https://foodenvironmentdashboard.com.au/) - but others can also be included. Briefly summarising the focus of such platforms would situate the study within ongoing public health nutrition initiatives and underline the rationale for the proposed dashboard (even if only available internally). These examples also reflect a broader trend away from static, report-heavy outputs towards interactive, user-driven platforms that allow tailored exploration of data (especially for time-poor policy makers). The first paragraph on page 4 briefly outlines findings from the scoping review. However, this section would benefit from examples clarifying what "user requirements, robust infrastructure and intuitive interfaces" entail in practice. For instance, how such requirements shape dashboard design and usability. NB Page 5 paragraph 1: There appears to be "(ref)" included after (8), possibly a typo. Clarifications The manuscript refers to traffic light food and drink categories. On page 5, paragraph 2, 'red' items should it say (limited or no nutritional value)? It would be helpful to include a brief explanation of what specific targets or thresholds apply under the policy to the green, amber and red categories, and why "artificially sweetened beverages" are treated differently as a separate category (and what is the target for these)? This would improve accessibility for readers unfamiliar with the policy framework. The term "Mater Health" is used without explanation. A brief clarification in brackets or a footnote would be helpful for readers unfamiliar with Queensland's health system structure. Please include the ref number for the ethics approval. Purpose of the Dashboard and Aim of the Study The manuscript states that the purpose of the dashboard is to monitor compliance/trends. However, it is more of a visualising tool for results and trends since the monitoring includes more broadly all actions taken to obtain the results (which does not diminish its value). The authors should use the terminology more consistently across the different parts of the manuscript. Additionally, the objective includes "to explore its usability for decision-makers"; it appears the study did not fully realise this aim - it would be expected that some interaction with policy makers took place to explore that (if this was the case, there might not be enough details included to explain this aspect). It would be helpful to outline how reporting for this policy has been undertaken to date. Page 6 refers to PDF-based reports, but a clearer description of the existing process would add context; for example, who is responsible for analysing the data after collection, preparing the reports, and disseminating them. If available, information on how the proposed dashboard approach compares in terms of streamlining or feasibility would also strengthen the case for its added value. Data Preparation and Analysis The manuscript would benefit from a more detailed description of the data flow between Qualtrics and the dashboard. Key points needing clarification include what data are collected in hospitals (e.g. product photos, nutrition information), how items are classified as green/amber/red (and at what point), who undertakes data cleaning and quality assurance, how discrepancies across services are resolved, and how was data that previously was reported as percentages integrated with the updated reporting on numbers. Greater detail would help readers understand the workflow and effort required to generate dashboard outputs for those wanting to develop their own dashboard. Dashboard The functionality of the dashboard is well outlined, and the weighted outputs by population are a particularly strong feature, demonstrating the potential of a digital approach that integrates data from multiple sources. This aspect is well done. A few points could be clarified further: -Figures: In Figure 2, there are no amber results, whereas amber appears in Figure 4; an explanation would be helpful. -Flags: More detail is needed on how the dashboard flags specific items, why certain flags were chosen, and how these flags support validity checks, given that most users would not independently verify data quality. -Communication: It would also be useful to describe how results are (or will be) communicated back to individual retailers (if at all), as this will be important for practical application. Figures The mock-up figures illustrating dashboard results are generally self-explanatory, but some features would benefit from additional clarification, for example, through a legend. It is not clear what the 53% value shown for the overall performance metric represents (and for the other, more detailed results), compared to the green/amber/red categories. A greater explanation of how users or policymakers should interpret such metrics would improve clarity, and where the flagging function would be shown. ****** 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: Girma Taye 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.] 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.0341747.r001
Revision 1
3 Nov 2025 Author Response Reviewer 1: The work require a mix of professionals and a high level of IT involvement. A considerable work has been done. Thank you for acknowledging the interdisciplinary nature and technical complexity of this project. 1. User interface and accessibility: (I) how user-friendly it is? Any advantage in relation to other systems used earlier? Interactivity???? Thank you for raising these important points regarding the dashboard’s usability and interactivity. As stated in the manuscript, we used Power BI to develop the dashboard which is widely accessible via desktop, web, and mobile apps and widely used across HWQld and HHSs. We designed the user interface with a strong emphasis on simplicity, clarity, and interactivity. The layout ensures that users – regardless of technical background – can intuitively navigate the dashboard. Key features such as dropdown filters, hover-over tooltips, and responsive charts allow users to explore data dynamically without requiring prior training. Comparing to other systems such as the Australian food environment dashboard (foodenvironmentdashboard.com.au) which reports food availability across hospital and heath services in Western Australia and New South Wales along with compliance with government policy and recommendations, our dashboard provides detailed audit information in a user-friendly and highly interactive way. Our dashboards inclusion of comprehensive data visualisation and interactivity are key design features that set it apart. To highlight this, the advantages of user interface and interactivity have been added to the manuscript in the method and discussion sections (paragraph 3, page 8 and paragraph 4 page 11). “The dashboard was designed to be user-friendly and in a form that could potentially be deployed to HHSs to stay informed about their compliance data. Its comprehensive nature and layout prioritise intuitive navigation, enabling users, regardless of technical expertise, to engage with the dashboard effectively. Key interactive features, including dropdown filters, hover-over tooltips, and responsive charts, facilitate dynamic data exploration without the need for prior training.” “We have successfully developed an interactive dashboard that is accessible to HWQld and shareable with HHSs to monitor compliance with the Directive. To date, there are no directly comparable systems that provide an accessible, policy-aligned, and visually structured overview of food environments within Australian hospitals and health services. While nutrition audit reports from jurisdictions such as Western Australia and New South Wales have offered valuable insights into compliance with healthy food policies, these reports are typically static and lack the interactive, user-oriented design featured in this dashboard (6). Compared to the traditional paper-based report, this new approach achieved faster turnaround times in providing feedback to HHSs due to streamlined survey structures and improved processes for data exporting, cleaning and analysis.” 2. The idea compliance is weighted by service volume for each facility is not clear, because I could not see relationship between food and drink provided and compliance. The principle, I thought, is compliance regardless of the size of the institution served. The decision to apply service volume weighting was based on the principle of equity and proportional impact. Facilities that serve a greater volume of the public and hence a larger number of meals or beverages have a greater influence on the overall food environment within the health system. Weighting compliance scores by service volume ensures that the evaluation reflects not just whether healthy options are available, but how widely they are accessed. This approach captures the real-world exposure of consumers to healthier (or less healthy) choices, giving greater analytical weight to facilities that shape dietary patterns at scale. In doing so, it supports a more equitable and representative assessment of system-wide food service performance. For example, a small facility with high compliance may have limited reach, whereas a large hospital with low compliance could affect thousands of consumers daily. Weighting ensures that the dashboard captures this difference in scale and better represents the population-level implications of food environment policies. That said, we acknowledge that this approach may not be immediately intuitive and recognize the value of presenting both unweighted compliance alongside weighted to allow users to interpret both perspectives. No changes were made to the manuscript. 3. In the Discussion section, authors could not compare the system with any other system which may have similar function. If this is completely new, it is good to say it loudly. Even no comparison was made with the previous system to show the relative advantage of the current one. To our knowledge, there are no directly comparable systems that offer an accessible, policy-aligned, and visually structured overview of food environments within Australian hospitals and health services. While nutrition audit reports such as those conducted by the Western Australia Department of Health and New South Wales Health provide valuable data on compliance with healthy food policies, these are typically presented in static formats and lack the interactive, user-friendly interface offered by the Food Environment Dashboard (foodenvironmentdashboard.com.au). We have now emphasised this advantage in the manuscript as described in response 1 (paragraph 4, page 11). 4. It would have been good to also use the data for some statistical analysis to show it on the dashboard Statistical analysis is only useful if there is a specific question of difference that is trying to be assessed. For this project, there were no questions of difference proposed that required a statistical analysis. That said, we thank you for this suggestion and agree that incorporating statistical analysis using real audit data could strengthen the demonstration of the dashboard’s analytical capabilities when appropriate. We have added in paragraph 3, page 12 a statement to integrate statistical tools to analyse trend and identify differences in compliance rates across HHSs as one of the upcoming focus areas. Paragraph 4, page 12 now reads: “The dashboard is currently accessible to policy makers but not available to HHSs. The current design of the dashboard allows for a number of options for sharing; however, maintaining a robust digital dashboard requires significant technical expertise and infrastructure [5]. Ensuring the privacy and security of the data is critical. Effective use of dashboards requires training for users to interpret and use the data correctly [5]. All these aspects need to be considered before sharing the dashboards to broader users. Upcoming efforts will also focus on exploring effective methods for communicating results to individual retailers and determining which entities fall within the scope of the Directive. Future enhancements to the dashboard may include integrated statistical tools to analyse trend and identify differences in compliance rates.” Reviewer 2: Development of a digital tool to assist in monitoring compliance for a public health initiative: "A Better Choice Food and Drink Supply Strategy for Queensland Healthcare Facilities" Thank you for the opportunity to review this manuscript. It is a timely and engaging contribution to the field, particularly in its innovative approach to visualising policy-related data on food and drink availability in Queensland. The development of a dashboard tool to support both the interpretation of results and the monitoring of compliance with the ABC Policy is a valuable initiative that uses existing platforms and software. The manuscript is generally well-structured and clearly written. Below is a series of comments that aim to support further refinement of the manuscript. 1. Scope and Policy Context The manuscript appropriately focuses on Queensland, which is appropriate given the jurisdictional differences in policy targets across Australian states. A brief note acknowledging that different states have varying policies and policy targets could enhance the clarity for readers outside Australia and indicate whether the tool could be adapted for use in other jurisdictions. This would help readers understand the broader relevance of the approach. Thank you for this thoughtful suggestion. We agree that acknowledging the variation in food and nutrition policies across Australian states would enhance clarity, particularly for international readers. In response, we have revised the Discussion section to include a brief note highlighting these jurisdictional differences and the implications for dashboard adaptability. While the current dashboard is tailored to Queensland’s Directive, its modular structure, policy-aligned metrics, and scalable design allow for adaptation to other jurisdictions with similar institutional food environment policies. This addition helps contextualize the broader relevance of the tool and its potential application beyond Queensland. Paragraph 2, page 13 now reads: “While this dashboard has been developed specifically for Queensland, its design principles and monitoring framework have broader applicability. It is important to note that food and nutrition policies vary significantly across Australian states and territories, with each jurisdiction adopting distinct policy targets, implementation strategies, and compliance mechanisms. By aligning the dashboard with the Queensland Directive, we ensured contextual relevance; however, the underlying structure—particularly its modular design, service-volume weighting, and visual reporting tools—could be adapted to suit other jurisdictions across Australia and internationally. Acknowledging these policy differences not only clarifies the scope of the current tool but also highlights its potential as a scalable model for national or cross-jurisdictional monitoring of institutional food environments.” 2. Introduction The introduction outlines several monitoring systems, but it would be strengthened by the inclusion of more examples directly related to nutrition and food environments. Relevant dashboards include the World Obesity Observatory (https://data.worldobesity.org/), the GBD Compare tool (https://vizhub.healthdata.org/gbd-compare/), and the Australian Food Environment Dashboard (https://foodenvironmentdashboard.com.au/) - but others can also be included. Briefly summarising the focus of such platforms would situate the study within ongoing public health nutrition initiatives and underline the rationale for the proposed dashboard (even if only available internally). These examples also reflect a broader trend away from static, report-heavy outputs towards interactive, user-driven platforms that allow tailored exploration of data (especially for time-poor policy makers). Thank you for this valuable suggestion. We agree that situating our dashboard within the broader landscape of public health nutrition monitoring tools will enhance the relevance and clarity of the Introduction. In response, we have revised the section to include examples of established platforms such as the Australian Food Environment Dashboard, Global Food Environment Dashboard, and Food System Dashboard. These examples illustrate the growing shift toward interactive, user-driven systems that support tailored data exploration—particularly beneficial for policy makers and practitioners. This addition helps contextualize our dashboard within ongoing global and national efforts to improve food environments and public health outcomes. Paragraph 3, page 4 now reads: “Still, there is sparse evidence on the use of digital dashboards to monitor preventive health policies, particularly in the domain of nutrition and institutional food environments. While platforms such as the Australian Food Environment Dashboard (6), Global Food Environment Dashboard (7), Food System Dashboard (8) demonstrate the growing use of interactive tools in public health nutrition, they primarily focus on population-level indicators and broader environmental metrics. These examples reflect a broader trend away from static, report-heavy outputs toward dynamic, user-driven platforms that support tailored data exploration—especially valuable for time-poor policymakers. Building on this momentum, we aim to present a case study for developing a visual digital dashboard to monitor a preventive health policy related to nutrition within Queensland hospitals and health services”. 3. The first paragraph on page 4 briefly outlines findings from the scoping review. However, this section would benefit from examples clarifying what "user requirements, robust infrastructure and intuitive interfaces" entail in practice. For instance, how such requirements shape dashboard design and usability. NB Page 5 paragraph 1: There appears to be "(ref)" included after (8), possibly a typo. Thank you for citing the typo and also providing this helpful suggestion. We agree that providing concrete examples of how user requirements, infrastructure, and interface design influence dashboard development would enhance clarity and relevance. In response, we have revised the paragraph to include practical illustrations drawn from the scoping review and our own dashboard experience. These additions help demonstrate how such considerations translate into design decisions that improve usability, accessibility, and functionality for end users. Paragraph 1 page 4 now reads: “Current literature highlights the significant role of digital health dashboards in the context of public health risks and diseases. A systematic review examining the state of research on dashboards in the context of public health risks and diseases found 65 studies reported the development of digital dashboards to monitor infectious diseases (e.g., Dengue, Corona, Ebola; N=21), crises (e.g., disaster, emergencies; N=10), health related services (e.g., aging population, health promotion programs; N=17), and other health hazards (e.g., substance abuse, pollution; N=17) [4]. The systematic review noted that while many studies focused on the functional aspects of dashboards, there was a need for more user-centric evaluations [4]. A scoping review published in 2024 identified key design principles for developing effective public health surveillance dashboards, emphasizing the importance of user requirements, robust infrastructure, and intuitive interfaces [5]. Examples of these elements include user requirements such as fast data access, customizable views, and minimal training shape dashboard design through filterable visuals, simple navigation, and role-specific access. Robust infrastructure ensures secure handling of large datasets and timely updates via scalable systems and reliable data pipelines. Intuitive interfaces reduce cognitive load with clean layouts, consistent icons, and interactive features like tooltips and drilldowns.” 4. Clarifications The manuscript refers to traffic light food and drink categories. On page 5, paragraph 2, 'red' items should it say (limited or no nutritional value)? It would be helpful to include a brief explanation of what specific targets or thresholds apply under the policy to the green, amber and red categories, and why "artificially sweetened beverages" are treated differently as a separate category (and what is the target for these)? This would improve accessibility for readers unfamiliar with the policy framework. Thank you for this helpful suggestion. We agree that clarifying the traffic light classification system and associated targets will improve accessibility for readers unfamiliar with the policy. In response, we have revised the manuscript to define the green, amber, and red categories more explicitly, including the nutritional rationale behind each classification. We have also added a brief explanation of the specific thresholds applied to each category under the policy and clarified why artificially sweetened beverages are treated as a separate category, including the volume restriction that applies (Table S1). These additions aim to enhance clarity and contextual understanding for a broader audience Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0341747.r002
19 Dec 2025 Decision Letter - Ali B. Mahmoud, Editor Dear Dr. Pole, Please submit your revised manuscript by Feb 02 2026 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 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, Ali B. Mahmoud, Ph.D. Academic Editor PLOS One Journal Requirements: 1. 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. 2. 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: 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: N/A ****** 4. Have the authors made all data underlying the findings in their manuscript fully available??> The PLOS Data policy Reviewer #1: No 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: Although I am satisfied by the responses to my question, I still feel that you need to correct the editorial and language issues in order to make the manuscript readable. marking of graph axis, their relative size, and the need for each of them need to be evaluated. Reviewer #2: Thank you very much for addressing all of my previous comments and providing clarifications. I just have a few minor suggestions for further improvement: Abstract - Results section: The third sentence and the last sentence feel slightly repetitive, and could be reworded for clarity. It might also help to combine the entire visualisation description into one cohesive statement at the end of this section. Abstract - Conclusion: There is a conflict between singular and plural grammar. Suggest changing to a plural form as it is a conclusion so it refers to more generalisable findings. Introduction - Second paragraph: Briefly explain what 'drilldowns' are as features of the digital tools (e.g., in brackets) for reader clarity. Materials and Methods - First paragraph: In the last sentence, where it says 'AS drinks is no more than 20%', please clarify whether this refers to available drink options only or all options (including food and drink). Consistency in terminology: Throughout the text, there is now some inconsistency in describing the purpose of the digital dashboard (e.g., 'to monitor compliance' vs. 'to visualise compliance'). ****** 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: Girma Taye Aweke Reviewer #2: Yes: Magda Rosin ******** [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". 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Revision 2
6 Jan 2026 Author Response STATEMENT ADDRESSING REVIEWERS’ COMMENTS Note: Responses to reviewers’ comments are in blue. Changes made to the manuscript are in underlined red. Page and paragraph numbers cited herein pertain to the marked-up version provided. Reviewer #1: Although I am satisfied by the responses to my question, I still feel that you need to correct the editorial and language issues in order to make the manuscript readable. marking of graph axis, their relative size, and the need for each of them need to be evaluated. Thank you for your comments. We have revised the manuscript, corrected grammar issues, and reviewed the overall readability. We hope this has improved reliability but are happy to address any further specific feedback. We have also reviewed the figures and appreciate the suggestions regarding axis labelling and relative sizing. However, the visualisations presented in this study were designed for use within an interactive dashboard intended for policy makers and stakeholders. As such, the standards applied to static figures in published materials may not be directly applicable. The dashboard visualisations allow users to interact with the data and access additional detail, which cannot be fully represented in static screenshots included in the manuscript. Reviewer #2: Thank you very much for addressing all of my previous comments and providing clarifications. I just have a few minor suggestions for further improvement: 1. Abstract - Results section: The third sentence and the last sentence feel slightly repetitive, and could be reworded for clarity. It might also help to combine the entire visualisation description into one cohesive statement at the end of this section. The results section of the abstract (on page 3) has been reworded for clarity and now reads: “The development process resulted in a replicable digital dashboard for reporting and decision-making. The ABC dashboard provides previous and current compliance data for all HHSs, featuring visualisations that illustrate changes in compliance over time to help identify emerging trends. Users can interact with the dashboard to filter data by HHS, year and by outlet and food or drink type. This digital innovation has facilitated faster delivery of food and drink supply trend analysis and compliance reporting for HHSs and statewide policy makers.” 2. Abstract - Conclusion: There is a conflict between singular and plural grammar. Suggest changing to a plural form as it is a conclusion so it refers to more generalisable findings. Grammar has been checked and changed to plural form. The abstract conclusions section now reads (page 3): “Digital dashboards for public health policy compliance enable greater interrogation of data and provide visualisation tools to track trends in compliance over time. This allows more responsive and effective action to increase the impact of public health policies.” 3. Introduction - Second paragraph: Briefly explain what 'drilldowns' are as features of the digital tools (e.g., in brackets) for reader clarity. “Drilldowns” function is now explained in more detailed in paragraph 2 of the Introduction: “…Robust infrastructure ensures secure handling of large datasets and timely updates via scalable systems and reliable data pipelines. Intuitive interfaces reduce cognitive load with clean layouts, consistent icons, and interactive features like tooltips and drilldowns (an interactive technique allowing users to see more detailed information when selecting a category).” 4. Materials and Methods - First paragraph: In the last sentence, where it says 'AS drinks is no more than 20%', please clarify whether this refers to available drink options only or all options (including food and drink). Thank you for the suggestion, we have now clarified that the specific target for AS drinks is only for drink options: “…The specific target for AS drinks is not more than 20% of all drink options.” 5. Consistency in terminology: Throughout the text, there is now some inconsistency in describing the purpose of the digital dashboard (e.g., 'to monitor compliance' vs. 'to visualise compliance'). We acknowledge the inconsistency in how the purpose of the digital dashboard was described. We have revised the manuscript accordingly and now consistently state that the dashboard is designed to visualise, rather than monitor, compliance. Attachments Attachment Submitted filename: Responses to reviewers.docx https://doi.org/10.1371/journal.pone.0341747.r004
12 Jan 2026 Decision Letter - Ali B. Mahmoud, Editor Development of a digital tool to assist in monitoring compliance for a public health initiative: “A Better Choice Food and Drink Supply Strategy for Queensland Healthcare Facilities” PONE-D-25-19154R2 Dear Dr. Pole, 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, Ali B. Mahmoud, Ph.D. Academic Editor PLOS One Additional Editor Comments (optional): Reviewers' comments: Reviewer's Responses to Questions Comments to the Author Reviewer #2: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions??> Reviewer #2: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? -->?> Reviewer #2: N/A ****** 4. Have the authors made all data underlying the findings in their manuscript fully available??> The PLOS Data policy Reviewer #2: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English??> Reviewer #2: Yes ****** 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 #2: No ******** https://doi.org/10.1371/journal.pone.0341747.r005
Formally Accepted
Acceptance Letter - Ali B. Mahmoud, Editor PONE-D-25-19154R2 PLOS One Dear Dr. Pole, 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. Ali B. Mahmoud Academic Editor PLOS One https://doi.org/10.1371/journal.pone.0341747.r006

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