The Role of Risk Communication in Shaping Health-Protective Behavior Amid the COVID-19 Pandemic in Thailand

Round 1

Reviewer 1 Report

 

I want to thank the author for the opportunity to read his work. I believe that the paper “The Role of Risk Communication in Shaping Health-Protective Behaviour amid COVID-19 Pandemic in Thailand” represents a valuable contribution to various disciplines, from social sciences, communication studies (in particular, with health and risk communication), sociology, and international relations, among other related disciplines. However, I understand its main fields are social sciences and health communication (risk communication). Therefore, the following comments are driven to increase the overall quality, clarify some points and offer a constructive review.

 

1. The design of hypostasis can be better explained. It is lots in the middle of your paper. My recommendation is to present it in your introduction, justifying it.  

 

2. Discussion should be improved, and all the theories presented earlier should be recovered. Getting back the theoretical lens (such as risk communication) to drive your analysis is important. You did a fairly good job dealing with theories, and it is not reflected in your discussions.   

 

3. Conclusions must be sharper. Therefore, by organizing your paper according to previous comments, you could get it.  

 

Although my analysis encompasses major reviews, they can make the article more accurate, and I believe can collaborate with it in general. Despite it, your paper addresses an important issue and has an interesting approach.

Author Response

Dear reviewer and editor, 

Please see the attachment

best regards

Author Response File: Author Response.pdf

Reviewer 2 Report

This paper attempts to understand the factors for risk perception and protective behaviors during COVID-19.

While the main idea sounds quite good, the performance was, how to say, at least unsatisfying. The article is currently of such a low quality that I have doubts it can be published anywhere. There are so many issues to resolve that even a major revision will not be enough. I definitely recommend a rejection.

I will address each part separately. In each one of them, you will be able to see both major and minor concerns of mine.

ABSTRACT:

- The following information is missing. Please add it:

a. When were the data collected?

b. How many observations were analyzed? 

c. What was the method for the data analysis?

d. What was the nature of the relationships found (positive, negative, who demonstrated larger scores than whom, and for which parameters)?

- Please avoid claiming unclear and ambiguous statements like "social media factor" or "played a significant role". Please replace them with more precise expressions or terms.

- Please arrange the keywords in alphabetical order.

INTRODUCTION

- Generally said, it currently looks too long, and some things are provided twice in different manners. Please significantly shorten this chapter, inter alia, by providing a more clear separation between the paragraphs describing risk communication and its importance in general and during COVID-19 in particular, risk communication planning by the Thai government, and its success/failure. 

- Please review the previous research better and outline what are its shortcomings and in which ways your study is going to address them. Put simply, what are the advantages of your research?

- Throughout the chapter (and in other parts of the manuscript) I paid attention to a quite odd way of citing articles. When you cite more than one source, you do not have to put it in separate brackets but separate between them using a semicolon or a comma. 

- Throughout the chapter, there are oddly sounding or unclear expressions appear. I provide some examples: "this kind of feeling" (unclear to what kind of feeling you refer), "were heavily influenced by fear and uncertainty" (unclear how the antipandemic measures can be influenced by them - maybe you meant "accompanied"?), "that risk communication and risk perception of individuals have a favourable relationship" (unclear what is meant by the word "favorable"). I would like the authors to review their article before sending it to a journal in order to avoid such statements and subsequent embarrassment. 

- Page 2, statement "Thai citizens demonstrated excellent understanding of protective behaviour during the COVID-19 pandemic in Thailand..." In which ways this understanding was excellent? What are the figures that support this claim? Please add to the text.

- Page 2, statement "However, it was revealed that Thai citizens faced problems and concerns about unclear communication". What were these problems and/or concerns? Please add to the text.

- Page 2, statement "For Thailand, risk communication during the COVID-19 pandemic was a huge challenge for the Thai government to implement effectively." Two paragraphs beforehand, there was a statement that claimed "Online media and mass media were effective tools to enhance the risk communication process when both media were crucial during the pandemic (Anwar, Malik, Raees, Anwar, 2020)" How do these two statements correlate? Please elaborate.

- Please avoid situations when the citation appears in the text but not in the reference list (like that by Belostecinic et al., 2020). Please address this issue.

- Page 3, statement "Therefore, the role of risk communication in developing individuals’ health-protective behaviours needs further investigation." It is unclear why, because largely the previously coming sentence does not provide any ground for that. To claim arguments like this, the research should improperly address the problem, and not what you claimed in the sentence beforehand. Please elaborate.

- Page 3 - what do you mean by "risk understanding"? Please express yourself in a more clear way.

- Page 3, statements "The objectives of this study were to analyze the factors that significantly influenced risk perception and risk communication, which in turn affected protective behavior, and to provide recommendations for improving pandemic management. Risk communication during the pandemic was crucial for providing information for public decision making (Gamhewage, 2014)." First, it can hardly be understood what you aim to investigate. Second, it is unclear whether direct and indirect effects will be investigated, and if yes - how (I mean using which method). Please elaborate much better here.

THEORETICAL FRAMEWORK

- This chapter can largely be addressed to as "theoretical background" because no theory was provided for understanding of what you are going to study. This is one of your study's weaknesses and this is why the theoretical contribution of the study is questionable. Please elaborate better in this chapter.

- Page 3, the statement "...social media plays a significant role in shaping risk perception..." It is unclear what is the role of social media. Is this about the media effect or the effect of a use? Please be more clear here.

- Page 3 - how can the factor be both social and cultural? Please elaborate.

- Generally said, your empirical approach is quite mechanic, and it can be very clearly seen in Figure 1. You just outline many possible factors but neither show the directions found by previous research nor explain the mechanisms underlying the proposed relationships (there are actually not many really proposed relationships in this chapter). For these reasons, it is quite difficult for me to accept your empirical model. Please elaborate way better on the previous research and show everything I referred to in the text. Please also provide hypotheses and research questions.

MATERIALS AND METHODS

- A significant bulk of the information is missing from the text. Please add all of it:

a. How did you reach the final number of observations? I mean 625 of how many people did approach the survey? Please describe the flow of participants in a much more detailed way. You may consider adding the figure which describes this process.

- How the questionnaire was constructed? Who was responsible for that? Where the items were adapted from? Please add all this information.

- What are the study measures? What are the values of each variable employed? Please add all this information.

- Was there any pilot study conducted before running the survey? If yes, please add information about it.

- What are the dates between which the data were collected? Please add. 

- How were the missing data treated? Please add.

- Please provide more information about the analysis. In general, I would suggest redoing the analysis as I can hardly agree that the current method properly addresses all the effects you wanted to discover.

RESULTS

- Please provide two tables for the descriptive statistics. One will contain sample data and another one will refer to the distributions of the study measures. 

- Please avoid providing incomplete information. The statement on Page 5 ("...18–30 years old represented the highest percentage.") does not provide detailed information. The same is about the statement "Other factors like marriage status, religion, and salary were also considered in this questionnaire." Please be more detailed while providing sample statistics. 

- Pay attention that the information about the distribution of the occupational status variable appears twice. Please remove it in one of the places.

- Figure 2 is very difficult to interpret. Please elaborate better on it.

- It is unclear where the hypotheses in the tables come from. As previously mentioned, please outline them before the Materials and Methods chapter.

DISCUSSION

- Please outline the study limitations. They seem to be numerous.

- Please discuss the implications of the study - for theory, empirical research, and practice. However, please do this after you significantly revise the manuscript in accordance with all the abovementioned comments.

Extensive proofreading is necessary as many sentences or sentence parts sound awkwardly, incompletely, or illogically.

Author Response

Dear reviewer and editor,

Please see the attachment

best regards

Author Response File: Author Response.pdf

Reviewer 3 Report

The topic is important and timely as the authors examine voluntary actions about individuals’ health behavior predicated on five classes of independent variables in Figures 1 and 2.  There are some issues and concerns and if properly addressed might merit publication. In this instance I will address concerns in a linear manner in the manuscript.

First, let me observe that greater attention be devoted to subject-predicate and verb tense.  Along with this serious attention should be given to paragraph structure – paragraphs focus on a single idea with a clear opening sentence.

The Introduction – this section is unwieldy in its present form, and it is not a concise summary of the aims of the study and relevant literature.  It is at least one page too long, making it difficult to understand why the study is important. The authors should include reference to and/or incorporation of the Health Beliefs Model (Rosenstock) the initial focus of which was preventive health behavior.

Under “Materials and Methods,” the first paragraph can be eliminated as it does not include anything of substance. In sampling did the authors use for the second stage random or systematic methods? How were respondents contacted? Were there assurances of confidentiality? Was the study approved by some type of institutional review board? How many individuals were contacted overall before the sample size of 625 was reached?  Is there any reason indicating that the non-respondents were demographically the same or different from the final sample? How many surveys were received and how many were eliminated for several reasons? Was the questionnaire pretested?

Results – quite a number of variables are used. It is not clear what are the response categories for each variable. A table for the variables expressing category percentages or means/standard deviations is necessary along with a separate commentary.

Methods – Table 1 and Figure 2 – It is not clear how Figure 2 relates to Table 1 because there is no explanation of the statistical tests used in Figure 1.  I am further confused in Table 1 as to the statistical method – t-test or contingency table or something else? Note: lower case “t” is normally used; not a capital T.  Significance value is usually referred as “p value.” Degrees of freedom art not reported. Is “0.05” used as the critical level and is a one-tail or two-tail test used?

A problem with the results – sections 4.2.1 – 4.2.4 – is referencing the statistically significant p- values of variables. What do the authors conclude regarding the non-significant results?

In general, the Discussion and Conclusions are consistent with the data as presented.  It is not altogether clear if attempts were made for more extensive multi-variable analysis. Furthermore, the limitations of the study must be addressed.

The authors have the beginnings of an interesting paper. What I have suggested is basic research writing 101.  Substantial editing of the type I mentioned is necessary along with English writing and style.

Author Response

Dear reviewer and editor,

Please see the attachment.

best regards

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

The new version of the paper has had the requested improvements.

Author Response

The authors wanted to express the sincere gratitude for taking the time to review the manuscript and provide feedback.

Thank you for your time and consideration.

Reviewer 2 Report

I would like to thank the editors for sending me this article for another round of review. 

True to say, the improvement of the article, although took place indeed, was quite minor. My opinion is that the authors still have to undergo some seminars or lectures on how to properly write an academic article in general and which pieces of information to include in the particular sections. Currently, I cannot recommend anything better than rejection.

Please see my comments below.

ABSTRACT

- The opening sentence is unnecessarily long and can easily be split into two sentences. Not all the study objects are similar in their meaning. For example, the latter should perhaps be seen as a consequence of reaching the purpose rather than the purpose in itself. 

- Lines 11-12 - What were the gender and occupation categories that were negatively associated with the outcome? Please be more precise.

- Line 14 - The "positive impact" on what? Please add.

- Line 15 and other lines where similar conceptualization appears - I do not understand the purpose of using the words "the factor of". It unnecessarily extends the abstract. Please remove.

- Line 16 - What kind of influences do you mean? Please avoid using ambiguous expressions.

- Line 17 - This is an academic, not a newspaper, article. Therefore, it is inappropriate to use expressions like "...did not always lead to all types...". Please rewrite.

INTRODUCTION

- Lines 31-33 - You remind here of the government's effectiveness in risk communication without providing even a word on the general role of governments in risk communication during major world crises. Please add one to two sentences beforehand. 

- Lines 33-35 - Even after your explanation, I do not understand why further research in the domain is necessary. No sentence in this paragraph has led me to this conclusion. Please either substitute or better justify the introduction of this sentence.

- Lines 43-44 - How were those "different health-protective behaviors" influenced? Please elaborate better in the text.

- Line 49 - Which "escalating situation" do you mean? Please elaborate better in the text.

- Lines 73-78 - Please add related statistics that back your statements in these lines. This is what I indirectly asked you in the previous round of the review.

- Lines 81-82 - You just state the difficulty experienced by the Thai government and leave it unexplained. What were the difficulties? How did the government try to overcome them? What were the solutions provided? Please add all this information. 

- Lines 87-88 - This was quite a strange statement. If the government conducts risk communication, does this sound logical that it has to ensure that there is no misinformation in its messages? Or at least does it make attempts not to misinform people? I do not understand the meaning of the sentence provided here. Please elaborate better.

Again, after reading this section, I do not understand what is special about this study. How and in which ways does it differ from the previous studies in the field? Which pieces of new information it brings to the field? Please elaborate here much more extensively. In addition, who is going to benefit from the findings of the study? Please discuss this. 

THEORETICAL BACKGROUND

My comment here corresponds to a similar one provided above. In case the researchers do not know, the purpose of this section is not only to present the theoretical framework of the study but also connect it to the studied phenomena and establish the hypotheses. Please perform all this work. 

MATERIALS AND METHODS

- Line 127 - Did the questionnaire include open questions or all items were closed? Please mention in the text.

- Line 143 - Seems quite unusual to me that the sample of 625 people were approached and all of them provided valid responses. Again, how many people were contacted for the purposes of this study? Please add this information and revise Figure 2 accordingly.

- The information that is still missing from the text, although partially provided in the response letter: where were the constructs adapted from? Please provide this information. Please also insert what you wrote me regarding the pilot study.

RESULTS

- I write this again - it is impossible to test the hypotheses and report the results of the tests without their clear presentation in the Theoretical Background section. Please do this. 

- No information on the distribution of the study measures is included. Please provide the table where you include this information and describe it afterwards.

- Descriptive statistics should be more detailed. Please elaborate better in the text.

- Associations between the variables should include the report on coefficients/odds ratios and p-values. Please add them to the text.

DISCUSSION

- There are many more limitations that you listed: a relatively small sample with questionable representativeness; the fact that the data from one country only was analyzed; the fact that the data is cross-sectional. Please add these limitations to the text and elaborate on each one of them.

More proofreading is necessary.

Author Response

Please see the attachment

Author Response File: Author Response.pdf

Reviewer 3 Report

I am pleased to review the revised paper.  It is a substantial compared to the original version of the paper.

I have one concern, although it can be easily resolved.  This is in reference to Table 1.  If the authors use Pearson's chi-square, I do not see the degrees of freedom. It may be given the number of variable categories that a number of cells have five or fewer observations.  If so, the chi-square interpretation could be compromised.  I am not exactly sure what the categories are for many of the variables.

 English language use is good.  Some minor editing for conciseness should be explored.

Author Response

Please see the attachment

Author Response File: Author Response.pdf