Provider–Patient Interactions as Predictors of Lifestyle Behaviors Related to the Prevention and Management of Diabetes
Round 1
Reviewer 1 Report
The topic of the research is very fashionable and much needed to improve the health in population level: over the last 2 years, more than 25 publications dedicated to provider-to-patient communication/counseling have been found.
Higher perceived quality of provider-patient communication in patients with prediabetes/Type 2 DM was associated with improved self-management, adherence to diabetes care and greater well-being, perceived personal control, self-efficacy, and less diabetes distress.
The article is very well written using adequate statistical methods. The questions that arose while reading the article are largely answered in the limitations section.
Minor comments:
The analysis of the data obtained clearly shows that simple, easily identifiable targets (reduction of salt, frequency of using food label or nutrition facts label) are easier to achieve with this intervention/counseling. This is in line with “Small Steps for Big Changes” or similar prevention programs often used in practice. This would help to focus on the authors' suggested idea of ​​the necessary innovations in interaction/ counseling techniques. This aspect should be added to the discussion.
Author Response
We thank the reviewer for the thoughtful comments. Attached is a response detailing the comments.
Author Response File: 
Author Response.docx
Reviewer 2 Report
Dear Authors,
The results presented are important and should be published. However, my concerns are the following:
Line 14: To make the sentence clearer add the examples of a provider.
Line 18: The number of the participants in the study should be added in the text.
Lines 62-64: The impact of brief lifestyle interventions for diabetes preventions is not only less well understood, but also more complex and less straightforward than brief interventions on tobacco cassation and problem drinking. This can be also added in the text.
Lines 66-74: In this paragraph the uniqueness and the novelty of the study should be better emphasized. Is this the only study that address the association between the adopting life style behaviors and provider-patient interactions in US?
Lines 83-84: Describe in more detail how the participants were chosen.
Lines 171-183 (Nutritional knowledge): In my opinion the assessment of the participants’ nutritional knowledge was not entirely adequate, because it included just knowledge about the appropriate values, but not the knowledge about the appropriate food that has less sodium, more fiber, less calories, etc. Maybe this should be address in the discussion (Limitations).
Lines 229-237: The assessment of the normal distribution of the variables should be added.
Tables: In all the tables the p values below 0.05 should be bold in order to emphasize the statistically significant results.
Line 286: The “mean level” should be replaced with “median level”.
Lines 408-423: The conclusions is mostly related to the improvement of US health care system. But what about in general, in the world? From this study results, is it possible to make conclusions in general?
I would recommend to combine results with the discussion. In this way the results would be more clear and easier to read. I would also involve more literature in the discussion.
Overall, mine suggestion is that the manuscript would be acceptable with major revision. Substantial changes should be carried out before acceptance.
Author Response
We appreciate the reviewer's time in providing us with feedback that has helped us significantly improve our manuscript. Attached is a detailed response to each of the reviewer's comments.
Author Response File: Author Response.docx
Round 2
Reviewer 2 Report
Dear Authors,
substantial changes were made. In my opinion the manuscript is now acceptable for the publication.
Kind regards.
