It's About Time: Team-Based Editing at the American Journal of Public Health

Public health researchers and practitioners seek to expeditiously publish their findings to share them with the scientific and practice communities, thereby informing the public and advancing public health. In this information age, authors benefit from ever-evolving technology that permits electronic submission of papers at portals around the globe. A corollary is that an ever-increasing multitude of papers now arrive at the American Journal of Public Health (AJPH), many of which are only marginally related to public health or fail to meet minimum criteria for scientific and statistical rigor.^1,2 Here we explicate our team-based approach to the screening and review of papers submitted to the AJPH, along with the time required for the process to proceed step-by-step from electronic submission by authors to formal online publication by production staff.

Red Gate Garden, Brooklyn, NY, 1999. Gardener: James Williams, Jr. Photographer: Steffi Graham. Printed with permission.

SCREENING FOR ETHICAL AND TECHNICAL COMPLIANCE

AJPH policy requires explicit statements by authors upon submission of each paper regarding their affiliations, contributions, acknowledgments and disclosures, and human participant protection.^3–5 In addition, the publisher now asks and tracks responses to three queries regarding publication options, namely:

1. If accepted for publication, would you like this submission to be Open Access upon publication? This service will cost $2500 and will be billed to the corresponding author upon acceptance of the article for publication.

2. If your submission is accepted for publication, would you like to run any color figures or images? If “Yes,” there will a $750 charge per color image.

3. If your submission is accepted for publication, would you like this article to appear as an online-only article? If “Yes,” your article will not appear in the print edition of the Journal, it will only be made available online. There is no charge for this service.⁶

At the technical review stage, the production coordinator checks every new submission for conformance with the AJPH Instructions to Authors⁷ regarding: appropriate text word count, proper citation format, and blinded author identification in the version intended for peer review. Deficient papers are directed back to the authors for attention. In addition, submission flags are assigned for theme issues and supplements as well as open access, color figure, and online-only publication options for proper routing and follow-through by production staff. This step may require up to a week or (rarely) more, depending on the volume of submissions uploaded in the system, the availability of staff to thoroughly screen them, and the responsiveness of the authors in rectifying any identified deficiencies.

ENGENDERING AN EDITORIAL CONVERSATION

Once the technical review is finalized, the deputy editor begins an editorial conversation on each submission with a first impression of the paper's fit for the AJPH. Any specific remarks may be recorded in the manuscript record, and each paper is flagged for rejection absent peer review or potential peer review. The editor-in-chief then weighs this assessment and current AJPH priorities, and often includes additional comments in assigning the paper to a responsible editor for further review–which may be the deputy editor or the editor-in-chief herself–depending on the content and format of the submission. The responsible editor then critically assesses the paper for public health importance, scientific and scholarly rigor, and fit with a department's mission, and may elect to broaden the editorial conversation through tagging additional editorial team members for input. If a paper is not deemed to be a priority for peer review, the responsible editor delivers this recommendation to the editor-in-chief, who reviews the paper history, endorses or modifies the decision, edits any comments to be transmitted, notifies the author that the manuscript “has not been accepted,” and sets the final disposition of “reject.” Figure 1 summarizes the median times required in the process as manuscripts move from one stage to the next.

FIGURE 1.

Flow and median outcome times of all papers (n = 2745) submitted to the American Journal of Public Health in 2009.

In 2009, the last year for which complete data are presently available, a total of 2745 manuscripts were electronically submitted to the AJPH. Of these, 1923 (70%) were rejected absent peer review, and the median time to render this decision was 9 days. Up-front, carefully considered, team-based editorial decisions to reject a paper absent peer review benefit all concerned. Although authors may be disappointed, they are informed fairly quickly that their paper is not a good fit for the AJPH so they can resubmit elsewhere without undue delay. Moreover, team-based editing at the start of the process to jointly decide which smaller subset of papers to send for peer review reserves the bulk of staff, editorial, and peer referee resources for those papers more likely to be published in the AJPH.

PROMOTING DEBATE AND DEFINING VISION

Letters to the Editor and their Responses, Editor's Choice columns, and Editorials move relatively quickly through the formal submission process, with a median time to acceptance or rejection of 3 or 9 days, respectively (Figure 1). These categories of papers undergo editorial review only, and in most cases, the editor-in-chief acts as the responsible editor. Except for Letters to the Editor, these contributions are largely commissioned, either in reply to reader comments (Responses to Letters to the Editor), to set a vision for an AJPH theme issue or supplement (Editor's Choice columns), or to comment on important public health priorities and included papers or collections (Editorials). Although editorial input is sought during the development stage (which may last several months or even years), it is not registered in the formal system. In certain instances, however, editorial and other expert guidance, including from AJPH editorial board members, is sought through the submission process (e.g., on papers outlining AJPH policy). In such cases, the infrastructure provided by the AJPH submission system is a useful platform for gaining wider input.

STRENGTHENING PAPERS THROUGH EDITORIAL AND PEER REVIEW

The AJPH editors adhere to our mission and values in sending for peer review those papers that (1) stand to advance the field on priority topics identified by AJPH editors and editorial board members, and (2) cover the depth and breadth of public health. We view peer review as community-building,⁸ not censorship of ideas. While peer review has long been criticized for failing to identify flaws in research, Bacchetti argued that it is also guilty of the opposite: findings flaws that are not there.⁹ The overall aim is to strengthen and clarify papers through peer review in the service of public health, whether they are eventually published in the AJPH or elsewhere.

In 2009, of the 687 papers sent for peer review, 301 (43%) were rejected after the first round with a median time to decision of 58 days (Figure 1). For the remaining 386 papers, or 57% of those initially sent for peer review, revisions were requested. Responsive and thorough revisions resulted in acceptance of 275 papers after a single round of peer review, with a median time of 124 days since initial submission. The remaining papers (n = 111) were sent back to the peer reviewers for a second look. Of these, 25 (23%) were rejected and 73 (66%) were accepted, typically taking 169 and 161 days from initial submission, respectively. A small number of these revised and resubmitted papers (13 of 111 or 12%) required further revisions, and all but 1 of these multiple-times revised papers were ultimately accepted. Overall, 18% of the papers submitted to the AJPH in 2009 were eventually accepted and published.

REDUCING REVIEW AND PUBLICATION TIMES

In addition to understanding the flow of papers in a given year, we are also interested in monitoring our progress over time, especially with regard to submissions that undergo peer review. Thus, we concentrate next on Research and Practice articles, the category of paper that constitutes the bulk of our submissions, all of which undergo peer review (Table 1). For the years 2007 through 2009, the numbers of total manuscripts and Research and Practice articles both increased, but the percentage of Research and Practice articles to overall submissions held steady at about two thirds (69% in 2007; 69% in 2008; and 68% in 2009). Although larger numbers of Research and Practice articles were sent for peer review and eventually accepted over time, the percentages decreased slightly owing to the larger overall numbers of submissions from 2007 to 2009. The median time from submission to acceptance for Research and Practice articles through all revisions decreased from 168 days in 2007 to 128 days in 2009, even as the time from acceptance to publication held fairly steady over this time period at about 208 days.

TABLE 1.

Key Statistics for American Journal of Public Health Submissions, With a Focus on Research and Practice Articles, 2007–2009.

	2007	2008	2009
Total articles received, no.	2023	2206	2745
Total Research and Practice articles received, no.	1398	1522	1869
Research and Practice articles
Sent for peer review, no. (%)	356 (25.5)	372 (24.4)	425 (22.7)
Accepted overall, no. (%)	205 (14.6)	197 (12.9)	229 (12.2)
Accepted after peer review, %	57.6	52.9	53.9
Median time from submission to rejection without peer review, d	7	6	8
Median time from submission to acceptance (including all revisions), d	168	141	128
Median time from acceptance to publication, d	207	208	208

To further reduce the time from submission to acceptance, the editors are asking authors to return their revisions sooner at every stage of the process, even as extensions are granted where warranted. To meaningfully reduce the time from acceptance to publication, however, the publisher is committed to online publication as the most efficient and sustainable mode. Just how this transition will evolve and what additional features will be made available to members, subscribers, and readers is the subject of continued study. The AJPH has long been mindful of the immensely vital task of the public health workforce in improving the health of the public and achieving equity in health care.¹⁰ Our purpose now is to better ensure our processes are scientifically sound yet broadly accessible, collaborative yet efficient, and fiscally responsible yet environmentally sustainable. It's about time.