Impact and Integration of Culturally Centered American Indian/Alaska Native Practices and Training During COVID-19 on Tele-Behavioral Substance Use Treatment: Protocol for a Community-Derived Mixed Methods Study

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The nature of the CBPR and community relationships, including relevant Tribal approvals, or lack thereof needs to be discussed. The exclusion of those living on Tribal lands is grounds for serious ethical concerns. 

Comments for author File: Comments.pdf

Comments on the Quality of English Language

This paper needs significant revisions and refinement. 

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

The authors have put together a good amount of information together for this manuscript but several areas can be improved.

1. The notes section (at the end of the manuscript) must be incorporated into the start of the manuscript in the introduction subsection for better clarity to the readers.

2. Please write the fullform for "SU/SUDs" where it first appears in the manuscript

3. A few of your references embedded in the text don't match the format used for the rest. For instance, (Kirkpatrick & Kirkpatrick, 2016) and (Dutta, 2007)

4. Abstract: The conclusion should be written in the past tense and focused on the interpretation of your results. The current statements sound very arbitrary.

5. The study appears to capture a snapshot in time. Incorporating longitudinal data could help assess the long-term impacts of tele-behavioral health interventions and cultural integration on treatment outcomes. It would be better if both Aim 1 and AIm2 were published together after the completion of this project to give a whole story.

 

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

Thank you very much for your willingness to address the comments provided in the previous review. This version is much clearer and indicates a strong CBPR framework and meaningful collaborations with local communities. I appreciate reading this version which has allowed me to focus more on the science and process rather than the ethical aspects of working with Tribal Nations. I want to recognize that in these settings, it is difficult and a breeding ground for unintentional oversight to focus solely on the science without adequately highlighting the CBPR processes due to things like time, length, etc. I am especially grateful that the authors saw my comments as an attempt to further refine the paper and clarify ethical concerns, which I intended to provide as a good relative. That said, I want to commend the authors for their efforts, refinement, and commitment to doing right through the partnerships they have with Tribal Nations. Looking forward to seeing this work published. 

Author Response

We appreciate you reviewing and providing feedback to greatly improve this manuscript! Thank you for pointing out the inconsistency. We have differentiated the two terms changed "appropriate research design" to "community-based participatory research design" grounded in community-initiated research work . We changed "Research alignment with cultural norms and practices" to Integration of Traditional and Cultural Practices" to highlight integration of traditional and cultural practices in the research design framework as well. We have updated the manuscript to reflect the updated language (with a consistent grammatical structure) in the figures/frameworks.