Development of a Project to Strengthen Environmental Education in Educational Institutions in Bolivia: “Environmental Care with a One Health Approach”

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Here are my answers to your questions based on the provided manuscript:

What is the main question addressed by the research?

The main question addressed by the research is how to strengthen environmental practices in communities in Bolivia, particularly focusing on solid waste management, through a participatory project using a One Health approach.  

Do you consider the topic original or relevant to the field? Does it address a specific gap in the field? Please also explain why this is/is not the case.

The topic is relevant and addresses a specific gap in the field.

• Relevance: The manuscript highlights the global issue of inadequate solid waste management and its associated health and environmental risks, which is a pressing concern, especially in low- and middle-income countries.
• Originality/Gap: While there are reports of successful environmental education interventions in other countries, the manuscript points out that in Bolivia, environmental education content has not been formally integrated into school curricula. The ECOH project aimed to fill this gap by implementing a community-based intervention focused on solid waste management, using a One Health approach, which emphasizes the interconnectedness of human, animal, and environmental health. This comprehensive approach, involving various stakeholders and addressing the specific needs of the local context, adds originality and relevance to the field.

What does it add to the subject area compared with other published material?

The manuscript adds to the subject area by:

• Providing a case study of a participatory environmental education project in Bolivia: It details the implementation of the ECOH project, offering insights into the process of establishing inter-institutional alliances, conducting situational analyses, implementing educational interventions, and disseminating information.
• Emphasizing the One Health approach in environmental education: The project's focus on the interconnectedness of human, animal, and environmental health provides a holistic perspective to solid waste management.
• Addressing the specific context of Bolivia: The project's adaptation to the local context, including the development of educational materials and the mobile application, makes it relevant to the region's specific challenges and needs.
• Highlighting the importance of community participation and inter-sectoral collaboration: The project's success in engaging various stakeholders, including public and private institutions, local authorities, and the community, underscores the importance of participatory approaches in environmental education.

What specific improvements should the authors consider regarding the methodology?

The authors should consider the following improvements regarding the methodology:

• Enhancing the representativeness of the survey sample: The authors acknowledge that the survey sample was skewed towards young, highly educated participants. To improve the generalizability of the findings, they suggest reinforcing the diagnostic stage with a representative sample of the population.
• Incorporating an objective evaluation of the educational interventions: The authors point out the lack of an objective evaluation of the interventions' effectiveness in improving environmental care practices. They recommend including such an evaluation, as well as assessing the long-term impact of the interventions.
• Providing more detail on the educational interventions: While the authors describe the ARIPE model and the topics covered in the interventions, providing more specific details on the content, activities, and materials used in each educational unit would enhance the replicability and understanding of the interventions.

Are the conclusions consistent with the evidence and arguments presented and do they address the main question posed? Please also explain why this is/is not the case.

Yes, the conclusions are generally consistent with the evidence and arguments presented, and they address the main question posed.

• The study concludes that the ECOH project effectively strengthened environmental care practices in Sucre, Bolivia. This conclusion is supported by the evidence presented in the manuscript, including the positive feedback from teachers and principals regarding students' improved attitudes and behaviors towards environmental issues, and the active use of the provided waste containers.
• The authors emphasize the importance of a participatory approach, the involvement of various stakeholders, and the adaptation of interventions to local contexts, which aligns with the project's methodology and findings.
• The manuscript acknowledges the limitations of the study, such as the non-representative sample and the lack of an objective evaluation of the interventions, which provides a balanced perspective on the conclusions.

Are the references appropriate?

The references appear to be appropriate. They include a mix of academic articles, reports from international organizations, and online resources, which are relevant to the topic and provide support for the arguments and findings presented in the manuscript.  

Any additional comments on the tables and figures.

The tables and figures are generally helpful and contribute to the reader's understanding of the project.

• Figure 1 provides a clear overview of the four phases of the ECOH project.
• Figure 2 effectively presents the beliefs and perceptions of the participants on environmental issues.
• Figure 3 illustrates the level of influence of the environment on various aspects of human life.
• Figure 4 shows screenshots of the mobile application, which helps visualize its features and content.
• Table 1 clearly outlines the planning of educational interventions using the ARIPE model.

However, some minor improvements could be considered:

• In Figure 2, specifying the number of participants who "agree/strongly agree" would provide a clearer understanding of the data.

 

Author Response

Thank you very much for taking the time to review this manuscript and for the constructive feedback. Please find the detailed responses below, along with the corresponding revisions and corrections highlighted in the resubmitted files. We addressed the comments that specifically suggested improvements or observations. We are confident that your comments helped us correct some inaccuracies and information that could have caused confusion. We have made changes that we believe have enhanced the clarity, depth, and overall quality of the paper.

2. Point-by-point response to Comments and Suggestions for Authors

Comments 1: The authors should consider the following improvements regarding the methodology: Enhancing the representativeness of the survey sample: The authors acknowledge that the survey sample was skewed towards young, highly educated participants. To improve the generalizability of the findings, they suggest reinforcing the diagnostic stage with a representative sample of the population. Incorporating an objective evaluation of the educational interventions: The authors point out the lack of an objective evaluation of the interventions' effectiveness in improving environmental care practices. They recommend including such an evaluation, as well as assessing the long-term impact of the interventions. Providing more detail on the educational interventions: While the authors describe the ARIPE model and the topics covered in the interventions, providing more specific details on the content, activities, and materials used in each educational unit would enhance the replicability and understanding of the interventions.

Response 1: Many thanks to the reviewer for their comments and observations. As you mentioned, the methodology has two important limitations related to the representativeness of the sample and the objective evaluation of the interventions. As you can see, these limitations have been previously addressed in the discussion section. We also appreciate your comment on the third point, which suggests providing more details about the interventions in the educational units to facilitate their understanding and replicability. Now, we have included more information on Table 1 and attached a supplementary table (S1) that provides a description of the activities adapted by age group.

Comments 2: In Figure 2, specifying the number of participants who "agree/strongly agree" would provide a clearer understanding of the data. Response 2: Thank you very much for pointing this out. We've incorporated the total sample size into Figures 2 and 3, and we have incorporated in the figures the number of people who are in the “agree/strongly agree" option.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

The paper presents a public education campaign focused on mitigating environmental and health risks associated with solid waste and its disposal. This is an important topic, and it's helpful to share about positive and impactful educational outreach programs across the globe related to solid waste. 

The primary critique of this paper is that it includes very little description of data collection or analysis about the effectiveness of the educational intervention (Phase 3 of the project). In lines 157-160, it is mentioned that site visits were carried out to determine the effectiveness of the dissemination. More details should be included to describe if or how the effectiveness was determined. Did the researchers collect any qualitative interview data from the teachers, or surveys, for example? Similarly, in lines 240-248 of the Results section, what evidence supports the claims that "a better attitude towards environmental issues was observed in the students" and "that primary school children... showed great interest"? Again, this could be qualitative interviews, surveys, pictures or other. Finally, these claims were made again in the Discussion (lines 271-272 and 289-300) without evidence.

Phase 2 of the study was a wonderful way to determine what public outreach education campaign to focus on. The study questions were validated by a previous study, and the process of conducting the survey online makes sense for this time period (which took place during the pandemic) and dissemination. It was unclear how the survey link was distributed and who the target audience was. More details on this process would be helpful - pleas expand on what was described in lines 130-135 in the Project Overview section.

The literature review discussed the lack of formal environmental education in schools (lines 62-70), which implies that the focus of the paper is on students. Additionally, the project team (Phase 1 of the project) were all from educational institutions (lines 82-88). The paper should describe the respondents in a bit more detail and explain why they were so highly educated. Are these respondents representative of the general population, or the target population, for this project? If so, explain why. If not, explain why their responses are OK to guide the rest of the project. Finally, if college and other students are the focus of this project, that should be included in the title, abstract and introduction more clearly. Right now, these imply that this is education for a general audience even though all of the outreach appears to be done in schools.

Lines 279 & 282 refer to the "study" but should really refer to Phase 2 - the survey part of the study. 

In lines 285 - 288, it would be helpful to provide more detail (even just a short list) of the challenges to environmental education in Latin America.

The last paragraph of the Discussion section (lines 310 - 323) have some great points. 

The sentence on line 273 is a bit confusing as written, especially the part "found a challenge the credibility".

The activities described in Table 1 sounds great! Are they available somewhere online? Could a link or appendix with more details be shared? 

On line 225, what is meant by "Alternatives for using solid waste"? Do you really mean for alternatives to generating solid waste? Or the use of alternative products that do NOT generate as much waste? Or alternatives to dispsoing solid waste in landfills, or on the streets?

Some minor issues from earlier in the paper are:

Lines 40-41 discuss environmental impacts of solid waste. An additional impact is the generation of greenhouse gasses from anaerobic decomposition of solid waste, and in transporting solid waste - thereby increasing global warming and climate change in general.

Lines 46-47, please can you define informal recycling practices?

Lines 51-52, what are some successful educational campaigns that increase recycling described in the literature cited?

With more details about Phase 3 and the evidence for positive feedback and implementation of the program, this paper has potential to add to the research literature on the importance of public education campaigns about solid waste. I appreciated very much that the authors surveyed the public about their environmental concerns before planning the focus of their educational campaign!

Author Response

Thank you very much for taking the time to review this manuscript and for the constructive feedback. Please find the detailed responses below, along with the corresponding revisions and corrections highlighted in the resubmitted files. We are confident that your comments helped us correct some inaccuracies and information that could have caused confusion. We have made changes that we believe have enhanced the clarity, depth, and overall quality of the paper.

2. Point-by-point response to Comments and Suggestions for Authors

The paper presents a public education campaign focused on mitigating environmental and health risks associated with solid waste and its disposal. This is an important topic, and it's helpful to share about positive and impactful educational outreach programs across the globe related to solid waste.    Comments 1: The primary critique of this paper is that it includes very little description of data collection or analysis about the effectiveness of the educational intervention (Phase 3 of the project). In lines 157-160, it is mentioned that site visits were carried out to determine the effectiveness of the dissemination. More details should be included to describe if or how the effectiveness was determined. Did the researchers collect any qualitative interview data from the teachers, or surveys, for example? Similarly, in lines 240-248 of the Results section, what evidence supports the claims that "a better attitude towards environmental issues was observed in the students" and "that primary school children... showed great interest"? Again, this could be qualitative interviews, surveys, pictures or other. Finally, these claims were made again in the Discussion (lines 271-272 and 289-300) without evidence.   Response 1: Thank you for this valuable observation. We completely agree with this comment and recognize that it is one of the project's weaknesses. Although the project was not planned methodically from the outset, during one of the project monitoring visits, we conducted semi-structured interviews with school directors and academic authorities at the three educational levels involved (primary, secondary, and university) that had not been incorporated in the first version of the manuscript. These interviews aimed to assess the perceived impact and sustainability of the interventions. From these interviews, several key observations emerged:   - In both urban and rural schools, principals reported increased student motivation, spontaneous classification of recyclables, and the launch of internal recycling competitions.   One school reported that students brought materials from home to fill a container they called “the giant bottle,” turning it into a collective challenge.   - While vermiculture systems faced difficulties during the school holidays, the recycling bins remained in use and were integrated into regular routines.   - At the university level, the bins continue to support campus cleanliness, especially in green areas.   This information has been incorporated in the revised version of the manuscript (Line 264-271) “Teachers reported increased student motivation and spontaneous classification of recyclables. In one school, they started an internal recycling competition to promote waste classification. One school reported that students brought materials from home to fill a container they called “the giant bottle,” turning it into a collective challenge. Although the vermiculture systems faced difficulties during the school holidays, the recycling bins remained in use and were integrated into regular routines; Likewise, at the university, the dean reported that the containers support campus cleanliness, especially in green areas.” Comments 2: Phase 2 of the study was a wonderful way to determine what public outreach education campaign to focus on. The study questions were validated by a previous study, and the process of conducting the survey online makes sense for this time period (which took place during the pandemic) and dissemination. It was unclear how the survey link was distributed and who the target audience was. More details on this process would be helpful - pleas expand on what was described in lines 130-135 in the Project Overview section.   Response 2: ·         Thank you very much for your comments and observation. We've added more details about the survey's target audience and the channels used to distribute it. The paragraph now reads as follows (Line 144-150): “To collect the information, the SurveyMonkey platform [22] was used, disseminating the survey on both personal and institutional levels from the local university (USFX) and other institutions supporting the project. It included social media (e.g., Facebook, WhatsApp groups) and institutional websites. We invite individuals aged 18 years and above to participate. The survey was anonymous and voluntary. The survey results were exported and analyzed using IBM SPSS V.29, with reporting of both absolute and relative frequencies.”   Comments 3: The literature review discussed the lack of formal environmental education in schools (lines 62-70), which implies that the focus of the paper is on students. Additionally, the project team (Phase 1 of the project) were all from educational institutions (lines 82-88). The paper should describe the respondents in a bit more detail and explain why they were so highly educated. Are these respondents representative of the general population, or the target population, for this project? If so, explain why. If not, explain why their responses are OK to guide the rest of the project. Finally, if college and other students are the focus of this project, that should be included in the title, abstract and introduction more clearly. Right now, these imply that this is education for a general audience even though all of the outreach appears to be done in schools.   Response 3. Thank you very much for your feedback. Your comment is very relevant, as the project flow was adapted based on the feasibility of implementing the project and the analysis conducted with the team formed in Phase 1 of the project. The survey targeted the general population aged 18 years and above (due to ethical considerations), since we were interested in understanding the perceptions and practices in a broad sense (daily practices), not just within the academic units. On the other hand, given the online dissemination of the survey, a population with a higher level of education responded, including parents from schools supporting the project, professionals, and university students. For that reason, the participants are not representative of the general population. This issue has been acknowledged in the limitations of our study, and it is a necessary aspect to address in future research and projects, as our results may likely overestimate concern and interest in environmental issues, as well as environmentally friendly practices. On the other hand, due to feasibility aspects, educational interventions focused primarily on academic units. Initially, we also planned to collaborate with a neighborhood association; however, access proved to be very complex due to the sensitivity and political interests of the association's representatives. Taking this into account, one question explored whether respondents considered the implementation of a solid waste management program in schools necessary. That is, if it made sense to the population to focus interventions on groups. These aspects have been reinforced and clarified in the discussion section of the manuscript (Lines 149-372)   “However, this can explain the higher participation of young people (under 30 years old) with higher educational levels than the region's general population. In this way, our results may overestimate the level of environmental concern and environmental care practices. Also, some more prevalent problems in population groups that did not participate in the survey could not have been prioritized. It would be important to reinforce the results of the diagnostic stage with a representative sample of the population or triangulate findings with mixed-methods approaches including complementing the information from the surveys (quantitative approach), with qualitative methods such as focus groups, interviews with key people (e.g. community representatives) in order to reduce potential selection and information biases that may have been introduced into the study. It will allow us to better identify practices and perceptions regarding environmental care and to develop new interventions or educational materials that address problems that have not been considered. Furthermore, although our Phase 2 assessment primarily focused on the general population, accessibility issues limited our educational interventions to academic units, highlighting opportunities to integrate these initiatives into the training of students at various levels. On the other hand, since the academic units included in the interventions were chosen for convenience, it is possible that they were more receptive to the content of the interventions, and their students were more willing to change their behavior in relation to the environment. However, given the COVID-19 restrictions still in place during this period, these units were chosen because they agreed to host the research team to conduct the educational interventions in person. Nevertheless, we sought to ensure some variability in the characteristics of the schools, including those in urban and rural areas, as well as public and private schools.”   On the other hand, we also consider your recommendation to explicitly state the project's focus (students) to be very pertinent, clarifying this in the title, abstract, and introduction.   Comments 4: Lines 279 & 282 refer to the "study" but should really refer to Phase 2 - the survey part of the study.  Response 4: Thank you very much for your comment. We have corrected it. You can see this change in the lines: Line 299: “The survey results in our project were consistent with other studies ..” Line: 311: “Respondents in the diagnosis part of our study (Phase 2) were…” Line 314: “Likewise, most of the participants in Phase 2 of our study…   Comments 5: In lines 285 - 288, it would be helpful to provide more detail (even just a short list) of the challenges to environmental education in Latin America.   Response 5: Thanks for the comment. We've incorporated your suggestion. Lines 318-321: These include limited institutional prioritization, insufficient teacher training, a lack of context-specific teaching materials, fragmented curricular integration, and weak ar-ticulation with local environmental and sustainability policies [35].   Comments 6: The last paragraph of the Discussion section (lines 310 - 323) have some great points.  The sentence on line 273 is a bit confusing as written, especially the part "found a challenge the credibility". Response 6: Thank you for this valuable observation. We improve the writing of the sentence: Lines: 301-302: “On the other hand, some studies found it challenging to assess the credibility of infor-mation sources related to waste management, suggesting ,…”   Comments 7: The activities described in Table 1 sounds great! Are they available somewhere online? Could a link or appendix with more details be shared?  Response 7: Thank you very much for your comment. In this new version, we have included a supplementary table (S1), which provides additional information on the interventions and the adaptations made for each age group, facilitating their reproducibility.   Comments 8: On line 225, what is meant by "Alternatives for using solid waste"? Do you really mean for alternatives to generating solid waste? Or the use of alternative products that do NOT generate as much waste? Or alternatives to dispsoing solid waste in landfills, or on the streets?   Response 8: Thank you for your comment. We realized the wording wasn't very clear. We're referring to alternatives that reduce solid waste generation, promote reuse, and facilitate recycling.   Line 244: Alternatives that reduce solid waste generation, promote reuse, and facilitate recycling.   Comments 9: Some minor issues from earlier in the paper are: Lines 40-41 discuss environmental impacts of solid waste. An additional impact is the generation of greenhouse gasses from anaerobic decomposition of solid waste, and in transporting solid waste - thereby increasing global warming and climate change in general.   Response 9: Thank you very much for your comment. We've incorporated the suggestion to strengthen the impact that improper waste management can have, including its contribution to global climate change. Lines 42-45: Additionally, the improper management of solid waste can contribute to the genera-tion of greenhouse gases from the anaerobic decomposition of solid waste and during the transportation of solid waste, thereby exacerbating global warming and climate change [2,4]   Comments 10: Lines 46-47, please can you define informal recycling practices? Response 10: Thank you very much for highlighting this point. We have revised the wording to clarify this point. We refer to informal work that lacks regulations or worker protection, such as the provision of personal protective equipment. This is a common issue in Bolivia, affecting health. Lines 50-52: “Additionally, informal recycling practices, often conducted without regulations or the use of personal protective equipment, and improper waste disposal lead to water and soil contamination, directly,…”   Comments 11: Lines 51-52, what are some successful educational campaigns that increase recycling described in the literature cited?   Response 11: We appreciate the comment. This has enabled us to better explain the findings on the interventions we cited. In the revised version of the manuscript, we have added that paragraph: Lines: 58-63: Some studies have emphasized that addressing beliefs and values is an effective strat-egy for improving behaviors [8], and similarly, interactive learning interventions have shown that they can trigger greater learning [9]. In this sense, the implementation of interventions that incorporate participatory methodologies, promoting action, reflec-tion, and interaction among students, can enable them to understand the environmen-tal problems in their community, thereby expanding their agency regarding climate change [10].   Comments 12: With more details about Phase 3 and the evidence for positive feedback and implementation of the program, this paper has potential to add to the research literature on the importance of public education campaigns about solid waste. I appreciated very much that the authors surveyed the public about their environmental concerns before planning the focus of their educational campaign!   Response 12: We deeply appreciate your comment, and we are pleased to know that the proposed phase-by-phase methodology (first exploring problems and then planning interventions) makes sense, as it allows us to better address the identified issues. We are confident that your suggestions and recommendations have enabled us to enhance the project's presentation. Although it has some limitations, we believe it has been a positive experience on which we can continue to build.

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

This paper describes a collaborative project focused on environmental education in Sucre, Bolivia, from a One Health perspective. Although the study offers a significant contribution toward addressing a critical gap of evidence for sustainable waste management (SWM) interventions, there are a number of areas in need of refinement that would improve both the scientific rigor and overall clarity of the analysis.

The situational diagnosis (Phase 2) was based on an online survey, which excluded access to the survey for those without internet which likely biased the results towards younger, educated demographics (85% under 30 years old, 51% university/postgraduate education). Although the authors recognize this limitation (Page 10), they should have discussed how this bias may have resulted in finding an overestimated level of environmental concern and practices relative to the general population. For example, rural or less-educated communities may experience unique barriers to SWM not reflected in the survey. ii] A recommendation for triangulating findings with mixed-methods approaches (e.g., in-person surveys or focus groups) would add validity.

Educational interventions did appear to be successful in the short term, with improved student attitudes and container usage (page 8). But without longitudinal data to evaluate sustained behavioral change, claims about the project’s effectiveness are undermined.” The deserves clarification, or should be combined with (pre-post scenerio: waste sepration rates for 6–12 month) to bridge this gap in case of further studies.

The ARIPE model is briefly covered (Page 4), however, there is not enough details around its application. For instance, how were the “Reactivate” and “Process” phases adapted to age groups differently (5–65 years)? It may be more reproducible by mentioning specific activities or learner feedback. Also, reasoning that explains why you only selected five educational units (convenience sampling) must be provided to prevent the attraction of cherry-picking perceptions.

It features the launch of the “ECOH Ambiental” app (Page 8–9), but does not quantify its impact. It was “highly appreciated,” the authors claim, but absent metrics (for example download rates, user engagement, or container utilization associated with geolocation features) the app’s contribution is anecdotal. It would enhance the discussion to compare app-based outreach with other traditional outreach methods (eg, workshops).

Although the project takes a One Health approach, the interconnectedness of human, animal, and environmental health is not well represented in the interventions. OVERVIEW OF STRAY DOG ISSUES IN VET STUDENTSThe stray dog issue (n = 28; 28%) was another point that needed to be mentioned in educational parts but not considered, for example. Make the direct connection with prevention of zoonotic disease/health of the ecosystem—this combination is much more closely aligned with the stated approach.

Grammar and language edits

Abstract (Line 8–9): "solid waste management (SWM) as the main concern (64%)". Then rephrase “problem” as “concern,” and cut parentheses.

Introduction (Page 1): “in the Global South”

Results (Page 5): “70% of participants had an interest in environmental issues, but only 44% were practicing separation of the waste”.

Discussion (Page 9): Paraphrase: "mobile applications could be a good solution for environmental issues”

Changing the subjective "excellent" to the more cautious "may serve as" for an academic tone.

 

Suggestions for Revision

Age group(s) and ARIPE status (flowchart or table) (page 4)

IMPROVE (Page 4) Clarification of criteria to select educational units

How it works to strengthen one health linkages:

Add content about zoonotic risks (such as potential disease vectors like stray dogs and waste-related diseases) to promotional materials (Page 7).

Be Proactive about Addressing Limitations:

Example 3: sampling bias Consider providing a discussion of strategies to reduce sampling bias (e.g., reaching out to community leaders for broader outreach) in the Discussion (Page 10)

Monitoring the Impact of your Dissemination

Add app usage statistics or user testimonials in Results (Page 9).

Author Response

Thank you very much for taking the time to review this manuscript and for the constructive feedback. Please find the detailed responses below, along with the corresponding revisions and corrections highlighted in the resubmitted files. We are confident that your comments helped us correct some inaccuracies and information that could have caused confusion. We have made changes that we believe have enhanced the clarity, depth, and overall quality of the paper.

2. Point-by-point response to Comments and Suggestions for Authors

This paper describes a collaborative project focused on environmental education in Sucre, Bolivia, from a One Health perspective. Although the study offers a significant contribution toward addressing a critical gap of evidence for sustainable waste management (SWM) interventions, there are a number of areas in need of refinement that would improve both the scientific rigor and overall clarity of the analysis.

 

Comments 1: The situational diagnosis (Phase 2) was based on an online survey, which excluded access to the survey for those without internet which likely biased the results towards younger, educated demographics (85% under 30 years old, 51% university/postgraduate education). Although the authors recognize this limitation (Page 10), they should have discussed how this bias may have resulted in finding an overestimated level of environmental concern and practices relative to the general population. For example, rural or less-educated communities may experience unique barriers to SWM not reflected in the survey. ii] A recommendation for triangulating findings with mixed-methods approaches (e.g., in-person surveys or focus groups) would add validity.

 

Response 1: Thank you very much for your valuable comment. Indeed, this is a significant limitation of the study, as the survey results may overestimate certain environmental care practices and concerns about environmental protection. Unfortunately, given the stage of the pandemic at which we conducted phase 2 of the project (diagnosis), we did not consider combining other methods, which would have effectively increased the validity of our results. However, some of the survey results were shared during school visits and other project outreach opportunities, and agreement was found regarding the main identified issues.

 

In the revised version of the manuscript, we have restructured the description of the study's limitations regarding the representativeness of the results and incorporated, as a suggestion for future studies, the combination and triangulation of methods to strengthen the validity of the results.

Line 351-361: “In this way, our results may overestimate the level of environmental concern and environmental care practices. Also, some more prevalent problems in population groups that did not participate in the survey could not have been prioritized. It would be important to reinforce the results of the diagnostic stage with a representative sample of the population or triangulate findings with mixed-methods approaches including complementing the information from the surveys (quantitative approach), with qual-itative methods such as focus groups, interviews with key people (e.g. community representatives) in order to reduce potential selection and information biases that may have been introduced into the study. It will allow us to better identify practices and perceptions regarding environmental care and to develop new interventions or educational materials that address problems that have not been considered..”

 

Comments 2: Educational interventions did appear to be successful in the short term, with improved student attitudes and container usage (page 8). But without longitudinal data to evaluate sustained behavioral change, claims about the project’s effectiveness are undermined.” The deserves clarification, or should be combined with (pre-post scenerio: waste sepration rates for 6–12 month) to bridge this gap in case of further studies.

 

Response 2: We appreciate the observation and recommendation. Indeed, we must be cautious when discussing the effectiveness of interventions and their long-term sustainability.

We have clarified and reinforced this aspect in our study's limitations, providing specific recommendations to incorporate into future studies and generate more solid evidence on the educational interventions implemented.

 

Lineas 372-377: Another significant limitation is the weak monitoring of mobile app usage and the lack of an objective evaluation of the educational interventions, pre-post interventions, and their long-term effectiveness in improving attitudes and environmental care practices (e.g., waste separation at 6-12 months), as other studies have done [9,10,36,40]. This information is necessary to include in future interventions to generate more substantial evidence of their effectiveness, sustainability, and scalability

 

Comments 3: The ARIPE model is briefly covered (Page 4), however, there is not enough details around its application. For instance, how were the “Reactivate” and “Process” phases adapted to age groups differently (5–65 years)? It may be more reproducible by mentioning specific activities or learner feedback. Also, reasoning that explains why you only selected five educational units (convenience sampling) must be provided to prevent the attraction of cherry-picking perceptions.

 

Response 3: We appreciate the comment and understand the importance and concern regarding the need for a clearer description of the intervention to facilitate the reproducibility of this stage of the project. In this regard, we have included more detailed information on the intervention phases and their objectives (table 1). We have also included a new table in the supplementary material (S1) describing the adaptations made according to the age groups addressed.

 

It is very important to note your observation regarding the selection process for educational units to implement the educational interventions. These units were selected because they agreed to receive the research team in person, despite some restrictive measures for the COVID-19 still being in place. They also agreed to "take responsibility" for the containers provided. While some participation bias may exist, given that the selection was not random, the project sought to include schools with diverse characteristics, including urban, rural, public, and private units. We have also reinforced this limitation in the Methods (Phase 3) and Discussion (Limitations) sections.

Lines 157-160

Considering the restrictions imposed during the COVID-19 pandemic, these educa-tional institutions were selected due to their willingness to receive the research team in person. We aimed to include schools from both urban and rural areas, as well as public and private institutions.

 

Lines 368-372

However, given the COVID-19 restrictions still in place during this period, these units were chosen because they agreed to host the research team to conduct the educational interventions in person. Nevertheless, we sought to ensure some variability in the characteristics of the schools, including those in urban and rural areas, as well as public and private schools.

 

Comments 4: It features the launch of the “ECOH Ambiental” app (Page 8–9), but does not quantify its impact. It was “highly appreciated,” the authors claim, but absent metrics (for example download rates, user engagement, or container utilization associated with geolocation features) the app’s contribution is anecdotal. It would enhance the discussion to compare app-based outreach with other traditional outreach methods (eg, workshops).

 

Response 4: We greatly appreciate and value your feedback and the opportunity to better explain this part. Indeed, the weakness in tracking and monitoring the mobile App is an important limitation of project Phase 4 regarding dissemination. Initially, the app's objective was “to socialize educational materials developed by the project and draw attention to environmental issues,” as described in Phase 4 of the project.

For that, we only recorded the number of downloads, which has been included in the results section, but it gives us few elements to compare with other interventions. However, we believe we had a very limited and narrow vision of the mobile app's potential as a learning tool. This experience has been very important for the team, as it has allowed us to develop skills in the design and construction of technological applications, as well as learning in interdisciplinary communication and dissemination of information to the general population (content selection, layout, piloting, cost, etc.). This allowed us to incorporate some elements into subsequent projects, reinforcing the evaluation component of the interventions, including the mobile app. Taking this into account, we have emphasized in the discussion the limitation of not adequately planning a tracking and monitoring system for the mobile app, which would allow us to generate more solid evidence on its effectiveness, sustainability, and scalability.

 

Lineas 305-310: While our project proposed implementing a mobile app primarily to disseminate information, it is important to consider the potential that mobile apps can have in the learning process and in raising awareness on environmental, animal, and health topics. In future interventions, a plan for their evaluation and monitoring that allows visualization of the scope of these tools and implementation of continuous improvements in their operation is necessary.

 

Lines 366-372: Another significant limitation is the weak monitoring of mobile app usage and the lack of an objective evaluation of the educational interventions, pre-post interventions, and their long-term effectiveness in improving attitudes and environmental care practices (e.g., waste separation at 6-12 months), as other studies have done [9,10,36,40]. This information is necessary to include in future interventions to generate more substantial evidence of their effectiveness, sustainability, and scalability.

Comments 5: Although the project takes a One Health approach, the interconnectedness of human, animal, and environmental health is not well represented in the interventions. OVERVIEW OF STRAY DOG ISSUES IN VET STUDENTSThe stray dog issue (n = 28; 28%) was another point that needed to be mentioned in educational parts but not considered, for example. Make the direct connection with prevention of zoonotic disease/health of the ecosystem—this combination is much more closely aligned with the stated approach.

Response 5: This is a valuable suggestion. Your observation allows us to better explain the approach taken by our interventions and describe the efforts made to incorporate the One Health approach. While, for resource reasons, we focused on addressing the main problem identified by survey participants (waste management), we make efforts to address it comprehensively, emphasizing and visualizing the impact it can have on the health of people, animals, and the environment. In our context, it's very common to see dogs scattering trash in landfills or plastic/cardboard collectors for recycling that look for waste directly in the garbage, which can be a potential source of disease transmission. We also see trash-burning sites because there is no public trash collection service. This has a direct impact on the environment and on human and animal health. Our educational interventions sought to promote and encourage analysis by participants, taking this more comprehensive view into account. One way to foster a starting point for this analysis was to show images that reflect these situations, which are common in everyday life in both urban and rural areas of the city. This description is now better described in Table 1 (photovoice and presentation of contents).

 

Grammar and language edits

Comments 6: Abstract (Line 8–9): "solid waste management (SWM) as the main concern (64%)". Then rephrase “problem” as “concern,” and cut parentheses.

Response 6: Thank you very much for the comment. It has been corrected.

Comments 7: Introduction (Page 1): “in the Global South”

Response 7: Thank you very much for the comment. It has been corrected.

 

Comments 8: Results (Page 5): “70% of participants had an interest in environmental issues, but only 44% were practicing separation of the waste”.

 

Response 8: Thank you very much for the suggestion. It was included.

 

Comments 9: Discussion (Page 9): Paraphrase: "mobile applications could be a good solution for environmental issues”

Changing the subjective "excellent" to the more cautious "may serve as" for an academic tone.

Response 9: Thank you very much for the suggestion and observation. It was included.

 

Suggestions for Revision

Comments 10: Age group(s) and ARIPE status (flowchart or table) (page 4)

Response 10: Thank you. It was included in Table 1 and supplementary table S1

Comments 11: IMPROVE (Page 4) Clarification of criteria to select educational units

Response 11: Based on your comments, as explained in comment 3, we have improved the wording in the methodology section to explain the criteria for selecting academic units, and we have also strengthened the discussion section (limitations of the study). Thank you very much; this helps us be more transparent in the project report.

Comments 12: How it works to strengthen one health linkages:

Add content about zoonotic risks (such as potential disease vectors like stray dogs and waste-related diseases) to promotional materials (Page 7).

Response 12: Thanks again for the comment. The incorporation of the One Health approach into educational interventions has been better described, as explained in the comment 5.

Comments 13: Be Proactive about Addressing Limitations:

Example 3: sampling bias Consider providing a discussion of strategies to reduce sampling bias (e.g., reaching out to community leaders for broader outreach) in the Discussion (Page 10).

 

Response 13: We greatly appreciate your valuable input and suggestions. We have strengthened discussion in this regard:

Lineas 354-361: It would be important to reinforce the results of the diagnostic stage with a representa-tive sample of the population or triangulate findings with mixed-methods approaches including complementing the information from the surveys (quantitative approach), with qualitative methods such as focus groups, interviews with key people (e.g. com-munity representatives) in order to reduce potential selection and information biases that may have been introduced into the study. It will allow us to better identify prac-tices and perceptions regarding environmental care and to develop new interventions or educational materials that address problems that have not been considered

 

Comments 14: Monitoring the Impact of your Dissemination

Response 14: Thanks for the comment. We've incorporated the recorded statistics for the app, but as we explained in comment 4, one of the project's limitations is the lack of an adequate monitoring and tracking strategy.

Lineas 372-373: “Another significant limitation is the weak monitoring of mobile app usage and the lack of a….

 

Comments 15: Add app usage statistics or user testimonials in Results (Page 9).

Response 15: Although we have strengthened the wording of this point in the limitations, we have incorporated the only available indicator (number of downloads) in the results section.

 

Line 288: In the first year of implementation, 512 downloads were recorded.

 

Author Response File: Author Response.pdf

Round 2

Reviewer 3 Report

Comments and Suggestions for Authors

Thank you for addressing all the comments of the review report.