Through Internet and Friends: Translation of Air Pollution Research in Malmö Municipality, Sweden

Round 1

Reviewer 1 Report

Maybe there should be a formal learning or actualizing program they must attend regarding  quality improvement programs in their departments and not only depend on the individual drive for keeping actualized.

 

Author Response

Comments from reviewer 1:

- Improve research design
Answer: We have reworked the methods and material section, and we have also provided a model (fig 1) which we hope will make it more clear what part of the bigger, collaborative and transdisciplinary project this article represents.

Maybe there should be a formal learning or actualizing program they must attend regarding quality improvement programs in their departments and not only depend on the individual drive for keeping actualized.

Answer:Reviewer is probably correct in that this might improve the municipal work. We will return this comment to the municipality.  

Reviewer 2 Report

This qualitative research addresses an important issue of translating tax-funded research results into practice by public health officials. The article attempts to explore how research findings are accessed, collected, and applied for public policies/work to reduce air pollution (and noise mitigation) in Southern Sweden based on semi-structured interviews among 8 “public servants.” The longer-term goal is to understand how scientific evidence can help guide the development of denser cities with less reliance on transportation.

While the basis of this study is important, there are major revisions needed prior to publication. I recommend the author’s review the “Consolidated criteria for reporting qualitative research” (COREQ) to help guide their paper and improve the comprehension of the findings. I believe that if the authors make the suggested revisions, the manuscript may be suitable for publication in IJERPH.

Please see attached document with full review comments.

Comments for author File: Comments.pdf

Author Response

First, we would like to thank the reviewer for very thorough and constructive comments!

Comments from reviewer 2:

 Manuscript Review: MS ID: IJERPH-771465

Jensen E.L. et al., 2020

“Through internet and friends: translation of air pollution research in municipal abatement work”

Comments to the Authors

This qualitative research addresses an important issue of translating tax-funded research results into practice by public health officials. The article attempts to explore how research findings are accessed, collected, and applied for public policies/work to reduce air pollution (and noise mitigation) in Southern Sweden based on semi-structured interviews among 8 “public servants.” The longer-term goal is to understand how scientific evidence can help guide the development of denser cities with less reliance on transportation. While the basis of this study is important, there are major revisions needed prior to publication. I recommend the author’s review the “Consolidated criteria for reporting qualitative research” (COREQ)to help guide their paper and improve the comprehension of the findings. I believe that if the authors make the suggested revisions, the manuscript may be suitable for publication in IJERPH.

Abstract

1. Line 18: Unclear what “possibilities” refers to in this sentence.
Answer:We hope this has now been clarified

2. Line 19: Be more specific about what type of research was conducted rather than saying “collaborative.” You later call it “transdisciplinary” and then “qualitative.”
Answer:We have now clarified this in the first part of the introduction, in the methods section and with a figure/model that we hope explains the steps.

-

3. Line 23: Add comma after “Instead” since it is an adverb at beginning of sentence. (i.e., “Instead, data and measurements…”)
Answer:Done

4. Overall, need more specifics about the methods- e.g., 8 practitioners recruited from x, y, z, to participate in semi-structured interviews to address the following research questions…

Answer:We have clarified how interviewees were chosen and recruited in the methods section

Manuscript text

1. Introduction: a. Line 35: Reference 2 is relatively old (2014)- are there more recent data published?
Answer: Newer reference has been found and added

b. Line 39: If referencing the UN Sustainability Goals 2030 by reducing air pollution, shouldn’t “13-Climate Action” be included?
Answer:Added!

c. Line 43: If using a hyphen in “tax-money” (see Abstract) be consistent throughout manuscript.
Answer:Fixed!

d. Line 45: There are formalized “action cycles” for translating research into practice. For example, Graham 2006 or others that outline the actual process of translating scientific evidence to practice. A more formal approach for describing the “steps” in this process is needed, especially as you state in lines 47 and 67, “the last step of the process” without referencing what the full process (e.g., action cycle) actually is.
Answer:
We are very grateful for this suggestion. We read Graham 2006, found it relevant and we mention it as a reference, but the model is not entirely commensurable to our other previous readings and models. 

e. Line 73: Air pollution is receiving enough attention at this point to make this assertion questionable; need to clarify this sentence. The quoted section (lines 78-85) should be shown with quotes or further indented.
Answer:We have removed the section as it was distracting from the aim of the article.

f. Line 93: Space needed before reference [11].
Answer:Reference removed with section.

g. Line 118: Need to define PM2.5, and 2.5 should be subscript: i.e., PM2.5. Does this sentence mean to say PM2.5 guidelines, or current measures? 24-hour or annual means? What are the current levels, and how do they compare to the EU and WHO guidelines? Same with previous sentence regarding NO2.
Answer:The following has been added to address this comment:
“The city of Malmö, southern Sweden, was chosen since it has had problems complying with EU Directive 2008/50/EC and WHO Air Quality Guidelines of 40 µg/m³ NO₂ as an annual mean in the past, and have had action plans since 2006 to reduce emissions.  The city has reduced emissions and complies with these regulations since 2016.  Annual means of NO₂ in Malmö 2018-2019 were 10-12 µg/m³ at the urban background site at roof level and 19-26 µg/m³ at traffic sites. This sometimes exceeds the Swedish Environmental Objective, Clean Air, for NO₂ is 20 µg/m³ as annual mean. Annual means of PM_2.5 in Malmö were 9µg/m³ in urban background site and 10-13 µg/m³ at traffic sites during 2018-2019. This means that Malmö complies with EU Directive 2008/50/EC of annual means of 25 µg/m³, but not always with the more health related WHO air quality guidelines or Swedish Environmental Objective both with an annual mean of 10µg/m³[9,10].”

h. Line 119: Comma after “Further,”
Answer:Fixed

i. Line 123: Define “practitioners.” How are they different than the policy makers you’ve mentioned at the beginning of the paragraph?
Answer:Defined now as i.e. the civil servants in Malmö municipality assigned to put policy into practice

j. The entire Intro is roughly 3 pages- it needs to be made clearer and more concise. Shorten paragraphs by making the main messages easier to understand, and the entire flow of the Intro more manageable. The background information is important, but overly descriptive and does not clearly support the key research questions.
Answer:We have shortened the introduction, restructured and added a second-level subtitle to clarify what is previous research and conceptual framework.

 

2. Materials and Methods
a. Line 195: What do officials mean? Various terms have been used- civil servants, practitioners, public servants, officials- without being clear who that actually refers to.
Answer:We have edited into “civil servants” during the whole article, except for on occasions where other researchers use other labels.

b. Line 206: Explain why noise mitigation is now included when it hadn’t been described previously.
Answer:A few of the civil servants alsoworked with noise mitigation and were relevant to the study, which we now have mentioned in the introduction

c. Line 240: How was the interview created, were questions tested previously or did they come from previously validated instruments?
Answer:After having formulated the questions, according to the initial talks we had with the municipality on the aim of the research, we were (according to normal interview methods) open to refine them during interviews. No previously validated instruments were applied, and shouldn’t be, since the purpose of semi-structured interviews is to catch the interviewees point of view as expressed by him/herself in the moment. Replicability is not the goal in qualitative studies like this, but reflexivity and transferability.

d. Overall, the methods require better descriptions of screening and recruitment process. For example, who might have been excluded? What were the selection criteria to participate? Why were 8 people selected, what support did this sample size have in terms of reaching data saturation with the interviews? Etc.
Answer:With the head of the Malmö municipality Environmental office, we discussed what employees would be of interest to the study depending on their chores and interaction with research results. Eleven persons were listed, and an invitation email was sent out to them by the head of the office, with a letter from the researchers explaining the theme of the study. Follow-up emails and phone-calls set us in contact with eight employees. One moved to another job during the time of the study, two never responded despite several attempts to contact. The eight remaining were interviewed, with data saturation – a clear pattern to direct the abductive research process, was reached after only four interviews. This has now been clarified in the article.

e. Methods require greater explanation of the “qualitative data-handling routine.” It’s stated that data were “manually coded,” but was there any qualitative software program used? How were the categories defined? How was the coding evaluated by other research team members? For example, it is common practice for two members to code text and agree upon coded themes, etc. More explanation is needed for this section.
Answer:“Manually” means without the help of software… In a smaller sample like this, a thorough and reflective reading and marking of interesting and recurrent themes is the most efficient way of getting intimate with your data. We list suggested themes on the side. We discuss and compare notes in a meeting with all four authors, to see if something unexpected (“minor themes/codes”) has come up. The Findings-section is then structured under subtitles according to these themes. We hope this is now better clarified.

 

3. Findings and Discussion, Conclusions a. At the beginning of this section, there should be a description of the study sample- % male/female, specific job positions, time in job, education, etc. The typical “sample characteristics” description.
Answer:The interviewees were informed that the data required in this comment was to be kept anonymous and out of the publication as far as possible, since we were investigating patterns in access to and application of research results, not individual professional achievements. The gender of the interviewees is now presented in the text under “method”.

b. The categories that were coded from the interviews are not clearly defined.
Answer:The categories are the ones presented under each subtitle in the Findings-section, as is standard in qualitative interview-based studies. It has now been clarified in the beginning, as we hope, for better clarity.  

c. Overall, the findings are difficult to follow. What are the categories, and what quotes/info support them? How do they answer the research questions? It’s not clear how the findings presented actually address the study’s original questions. This section requires re-organization and substantial rewriting.
Answer:The categories are the ones presented under each subtitle in the Findings-section. It has now been clarified in the beginning, as we hope, for better clarity. We conclude that the themes presented give a very clear answer to the original questions, in short: The civil servants have a good proficiency in reading research results, but in their everyday work, they more often use municipal data, from their own and other municipalities, official reports or consultancy reports, they don’t have access to latest research publications, and they hardly have time in their work-schedule to read original research results. 

d. I recommend the authors review Allison Tong’s 2007 criteria for reporting qualitative research: Consolidated criteria for reporting qualitative research (COREQ). Int J for Quality in Health Care, Vol 19 (60): pp.349-357. Not all 32 checklist items are essential for this manuscript, but the domains will help guide the paper to a clearer format. This checklist will improve the comprehensive reporting of this work.

Answer:We are grateful for this suggestion and will provide a COREQ form with the submission.

Reviewer 3 Report

The authors aim to present how the staff of the Malmo municipality, in Sweden, incorporate specific scientific/technical information during their daily labours in the Environmental Affairs Office. Overall, the manuscript is well written and the topic is of potential interest for the scientific community and government. Nevertheless, the manuscript has some major flaws. For instance, the introduction section is extremely long and introduces confusion to the reader rather than helping in presenting the problem that will be addressed later. An example of it is the single paragraph of 34 lines comprised between lines 111-145. The number of participants is limited and no information about the total population of employees in the environmental department is given. Although the authors are aware of this limitation, no discussion about this issue was included highlighting if the results and conclusions presented are significant. Thus, the number of participants confers the study a character of case of study rather than a generalisation of the issue, as claimed in the title of the manuscript. The authors failed to include what was the method/methodology followed to design the survey and how the questions included were selected. The results do not present concise information, i.e. describing the answers obtained refers to specific cases, while grouping in categories the global issues found could have helped to better interpret and identify those. A global or specific process diagram may help in having a mental map of where and when the major issues are found. Because of that, I consider that the publication cannot be published in its current form in this journal. However, I recommend the authors to address all the comments received and submit it to a journal more focused on qualitative science and public policies.

Author Response

Comments from reviewer 3:

The authors aim to present how the staff of the Malmo municipality, in Sweden, incorporate specific scientific/technical information during their daily labours in the Environmental Affairs Office. Overall, the manuscript is well written and the topic is of potential interest for the scientific community and government. Nevertheless, the manuscript has some major flaws. For instance, the introduction section is extremely long and introduces confusion to the reader rather than helping in presenting the problem that will be addressed later. An example of it is the single paragraph of 34 lines comprised between lines 111-145.

Answer:The introduction has now been significantly shortened and re-structured, and we hope that this improved coherence will make the context more clear.

 The number of participants is limited and no information about the total population of employees in the environmental department is given. Although the authors are aware of this limitation, no discussion about this issue was included highlighting if the results and conclusions presented are significant. Thus, the number of participants confers the study a character of case of study rather than a generalisation of the issue, as claimed in the title of the manuscript. The authors failed to include what was the method/methodology followed to design the survey and how the questions included were selected.
Answer:The aim of the qualitative part of the study was to understand how civil servants in Malmö municipality Environmental Office was accessing and employing research results (which we hope is now clarified in the title). The interviewees were the eight out of eleven who were working with relevant issues in the office. Three were not accessible for interviews. This is now better clarified in the introduction and the methods section. The aim in a study like this is not statistically significance, “generalisation” or “reproducibility” but “transferability”.
The results do not present concise information, i.e. describing the answers obtained refers to specific cases, while grouping in categories the global issues found could have helped to better interpret and identify those.

Answer:The results are grouped according to the themes found in the interview data and discussed in relation to context, which is the most common and acknowledged form of presenting results in qualitative studies. In the “conclusions” section, more general results, related to the aim of the study and the theoretical aspects, are presented. We have now clarified this better in the methods section and under the Findings headline, hoping this will facilitate reading.
A global or specific process diagram may help in having a mental map of where and when the major issues are found. Because of that, I consider that the publication cannot be published in its current form in this journal. However, I recommend the authors to address all the comments received and submit it to a journal more focused on qualitative science and public policies.
Answer:We have provided a flow-chart of the research project (fig. 1), but we are in doubt whether reviewer 3 is asking for a mental map of the research results? If required, we can produce one.

Round 2

Reviewer 2 Report

The authors did a thorough job of addressing my concerns and revising accordingly. Overall, this is an improved manuscript. The paper reads more clearly and the authors added sufficient details throughout. 

A couple of final suggestions:

• Define "civil servants" more clearly in Intro because this can mean different things across countries. E.g.,"putting policy into practice," does that mean they are politicians?
• The COREQ criteria are helpful, but the current document included as "supplementary" is missing the page numbers to guide readers where the guide questions are reported.
• If possible, make one more sweep of the manuscript to try and make it more concise, especially Intro and Findings. 

Author Response

We would like to express gratitude to the very detailed and constructive comments from reviewer 2. Here are replies to the adressed issues:

- Define "civil servants" more clearly in Intro because this can mean different things across countries. E.g.,"putting policy into practice," does that mean they are politicians?

We have defined as follows and hope this is a clarification:
- Policy then is supposed to be put into best practice by well-informed and rational civil servants, i.e. non-politically appointed employees working in national and municipal administration.Their job is to translate political decisions into practice when, in this case, planning new urban development or improving existent environments.

(This issue was incomprehensible for us to start with– in Sweden, “civil servants” are always unpolitical employees and authorities are directed by formal instructions from the political arena. Politicians are not allowed to interfere in the daily work of (state or municipal) authorities, just to set up political goals. Civil servants can turn to politicians if they need to take actions that are not initially planned for, but they are not allowed to change the directives of the administration substantially on their own. It took a discussion with a foreign colleague to clarify what was unclear, but we are grateful that it has now been clarified…)

- The COREQ criteria are helpful, but the current document included as "supplementary" is missing the page numbers to guide readers where the guide questions are reported.

- We unfortunately uploaded a document where the numbers didn’t show… We apologise – the one with page numbers is now submitted…

If possible, make one more sweep of the manuscript to try and make it more concise, especially Intro and Findings.

- We have done this, focusing on the Introduction, going through the Findings to clarify, and also reformulated parts of the Conclusions. We have marked all the more substantial changes in red. Minor changes, like corrections of typos or shifting a comma, we have not marked.

Reviewer 3 Report

Dear authors,

The revised version of your manuscript presents a more understandable and defined study. Most of my previous concenrns have been addressed succesfully, along with the issues raised by the other reviewers. Therefore, I consider that your manuscript can now be accepted for publication. I just detected some typos that must be revised during the proofreading.

Author Response

The revised version of your manuscript presents a more understandable and defined study. Most of my previous concenrns have been addressed succesfully, along with the issues raised by the other reviewers. Therefore, I consider that your manuscript can now be accepted for publication. I just detected some typos that must be revised during the proofreading.

Reply: We are grateful for the scepticism initially expressed by the reviewer, which challenged us to work on clarification throughout the article. We have clarified the Introduction further, worked through the Findings and restructured the last part of the Conclusions. The more substantial changes are now marked in red. We hope that you find this second version more improved and once again we thank you for your reading.