PONE-D-21-02054

The role of risk communication in public health interventions. An analysis of risk communication for a community quarantine in Germany to curb the SARS-CoV-2 pandemic.

PLOS ONE

Dear Dr. Scholz,

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Please provide further details as requested from reviewer 1. Please address the issue of bias as raised by reviewer 2.;

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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?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Partly

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

Reviewer #1: Yes

Reviewer #2: Yes

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

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The authors present an interesting case study of risk communication examining a community quarantine in a German town. The paper presents only the quantitative aspects of the survey they fielded, qualitative results will follow in another planned manuscript. The article is well-written but perhaps too concise. The findings reflect important aspects of communication that will be useful to public health authorities in planning and implementing future interventions.

I think the paper would benefit from some additional background and clarity of terms, as listed below:

Pg 4, Background

I would like more explanation of the quarantine implementation and the related communication effort. Who was responsible, was it the local health authority? What protocol did they follow, something designed locally or other system (EU or WHO)? Similarly, was the communication effort designed locally or a pre-existing plan?

Pg 5, Methods

I would like more detail on the concept/definition of 'level of information'. This seems to be key to the whole project of good communication since 'level of information' was statistically significantly correlated with 'acceptance of quarantine'. Getting an affected community the right "level of information" would be a goal for future communication efforts.

Because terms like 'source' of communication are used in different ways I suggest the authors include in the Methods section a simple model of communication (Berlo's Source-Message-Channel-Receiver might work) to add clarity. For example, on page 11 (line 334), loud speaker announcements are called a 'source' and then later on there is discussion of whether public health authorities are a trusted 'source' (line 345). Using the Berlo model, public health authorities are a source and loud speaker announcements are considered a channel.

Pg 6 line 153: Please include description of how was the survey returned.

Reviewer #2: The social health importance and timeliness of this research are obvious and commendable.

The likely biases in the sample (selection bias, age bias, social desirability bias) matter a great deal to the viability of this study however, and this should be more thoroughly acknowledged at relevant points throughout the paper. Those biases make it difficult to draw very accurate conclusions about the wider population with respect to the descriptive statistics cited, and even moreso with the inferential conclusions drawn from the correlations between variables, and associated p values. How for example do you know the reported 'high acceptance of quarantine', 'information levels', and 'media exposure patterns' actually reflect the Neustadt am Rennsteig population as a whole--if certain types of respondents have been underrepresented? Given the strong views of those who oppose Covid community interventions, it seems unlikely that survey nonresponse was just randomly distributed, with no appreciable affect on the results.

To the authors' credit, the 'implications' section does briefly acknowledge the likelihood that those not supporting the intervention might have also declined participation in this study, and also the unevenness in study participation across the age spectrum. However this weakness needs to be more thoroughly discussed, and the limitations in what can, and cannot, be concluded--given the sample limitations--more clearly spelled out for the reader. As it presently stands, the paper appears to be drawing more extensive conclusions about the subject than are warranted given the likely skewed sample. The fact that the "questionnaire was handed out together with the epidemiological questionnaire" also suggests there may have been some 'social desirability bias' affecting the question responses. This, too, should be considered in the limitations section.

Minor issue: Grammatically in English, 'data' are plural, not singular, so make sure you say 'data are' rather than 'data is'. (in line 156 for example)

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Reviewer #1: No

Reviewer #2: No

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The role of risk communication in public health interventions. An analysis of risk communication for a community quarantine in Germany to curb the SARS-CoV-2 pandemic.

PONE-D-21-02054R1

Dear Dr. Scholz,

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,

Rosemary Frey

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Partly

**********

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

Reviewer #1: Yes

Reviewer #2: Yes

**********

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

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: (No Response)

Reviewer #2: The authors' thorough discussion in the 'limitations' section of the likely selection, age and social desirability biases, which limit the generalizability of the study results, now makes the presentation more balanced. Although some of these factors should have been foreseen at the stage of initial study design, not after completion, this study nevertheless makes a useful contribution and should be published.

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7. PLOS authors have the option to publish the peer review history of their article (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