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<article article-type="letter" dtd-version="2.0" xmlns:xlink="http://www.w3.org/1999/xlink">
  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">JMIR</journal-id>
      <journal-id journal-id-type="nlm-ta">J Med Internet Res</journal-id>
      <journal-title>Journal of Medical Internet Research</journal-title>
      <issn pub-type="epub">1438-8871</issn>
      <publisher>
        <publisher-name>JMIR Publications</publisher-name>
        <publisher-loc>Toronto, Canada</publisher-loc>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="publisher-id">v24i3e37440</article-id>
      <article-id pub-id-type="pmid">35275072</article-id>
      <article-id pub-id-type="doi">10.2196/37440</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Letter to the Editor</subject>
        </subj-group>
        <subj-group subj-group-type="article-type">
          <subject>Letter to the Editor</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Authors’ Reply to: Toward a Better Understanding of Quality Social Connections. Comment on “Quality Social Connection as an Active Ingredient in Digital Interventions for Young People With Depression and Anxiety: Systematic Scoping Review and Meta-analysis”</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="editor">
          <name>
            <surname>Leung</surname>
            <given-names>Tiffany</given-names>
          </name>
        </contrib>
      </contrib-group>
      <contrib-group>
        <contrib id="contrib1" contrib-type="author" corresp="yes">
          <name name-style="western">
            <surname>Dewa</surname>
            <given-names>Lindsay H</given-names>
          </name>
          <degrees>BA, MSc, PhD</degrees>
          <xref rid="aff1" ref-type="aff">1</xref>
          <address>
            <institution>Institute of Global Health Innovation</institution>
            <institution>Imperial College London</institution>
            <addr-line>Reynolds Building, 3rd Floor</addr-line>
            <addr-line>London, W6 8RP</addr-line>
            <country>United Kingdom</country>
            <phone>44 02075940815</phone>
            <email>l.dewa@imperial.ac.uk</email>
          </address>
          <xref rid="aff2" ref-type="aff">2</xref>
          <ext-link ext-link-type="orcid">https://orcid.org/0000-0001-8359-8834</ext-link>
        </contrib>
        <contrib id="contrib2" contrib-type="author">
          <name name-style="western">
            <surname>Roberts</surname>
            <given-names>Lily</given-names>
          </name>
          <degrees>BSc, PGCert</degrees>
          <xref rid="aff1" ref-type="aff">1</xref>
          <ext-link ext-link-type="orcid">https://orcid.org/0000-0003-0785-4634</ext-link>
        </contrib>
        <contrib id="contrib3" contrib-type="author">
          <name name-style="western">
            <surname>Lawrance</surname>
            <given-names>Emma</given-names>
          </name>
          <degrees>BSc, Grad Dip, MSc, DPhil</degrees>
          <xref rid="aff1" ref-type="aff">1</xref>
          <xref rid="aff3" ref-type="aff">3</xref>
          <ext-link ext-link-type="orcid">https://orcid.org/0000-0003-1343-3916</ext-link>
        </contrib>
        <contrib id="contrib4" contrib-type="author">
          <name name-style="western">
            <surname>Ashrafian</surname>
            <given-names>Hutan</given-names>
          </name>
          <degrees>BSc, MBBS, MRCS, PhD</degrees>
          <xref rid="aff1" ref-type="aff">1</xref>
          <ext-link ext-link-type="orcid">https://orcid.org/0000-0003-1668-0672</ext-link>
        </contrib>
      </contrib-group>
      <aff id="aff1">
        <label>1</label>
        <institution>Institute of Global Health Innovation</institution>
        <institution>Imperial College London</institution>
        <addr-line>London</addr-line>
        <country>United Kingdom</country>
      </aff>
      <aff id="aff2">
        <label>2</label>
        <institution>School of Public Health</institution>
        <institution>Imperial College London</institution>
        <addr-line>London</addr-line>
        <country>United Kingdom</country>
      </aff>
      <aff id="aff3">
        <label>3</label>
        <institution>Mental Health Innovations</institution>
        <addr-line>London</addr-line>
        <country>United Kingdom</country>
      </aff>
      <author-notes>
        <corresp>Corresponding Author: Lindsay H Dewa <email>l.dewa@imperial.ac.uk</email></corresp>
      </author-notes>
      <pub-date pub-type="collection">
        <month>3</month>
        <year>2022</year>
      </pub-date>
      <pub-date pub-type="epub">
        <day>11</day>
        <month>3</month>
        <year>2022</year>
      </pub-date>
      <volume>24</volume>
      <issue>3</issue>
      <elocation-id>e37440</elocation-id>
      <history>
        <date date-type="received">
          <day>21</day>
          <month>2</month>
          <year>2022</year>
        </date>
        <date date-type="accepted">
          <day>21</day>
          <month>2</month>
          <year>2022</year>
        </date>
      </history>
      <copyright-statement>©Lindsay H Dewa, Lily Roberts, Emma Lawrance, Hutan Ashrafian. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 11.03.2022.</copyright-statement>
      <copyright-year>2022</copyright-year>
      <license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by/4.0/">
        <p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.</p>
      </license>
      <self-uri xlink:href="https://www.jmir.org/2022/3/e37440" xlink:type="simple"/>
      <related-article related-article-type="commentary-article" id="v23i12e26584" ext-link-type="doi" xlink:href="10.2196/26584" vol="23" page="e26584" xlink:type="simple">https://www.jmir.org/2021/12/e26584</related-article>
      <related-article related-article-type="commentary-article" id="v24i2e36739" ext-link-type="doi" xlink:href="10.2196/36739" vol="24" page="e36739" xlink:type="simple">https://www.jmir.org/2022/2/e36739</related-article>
      <kwd-group>
        <kwd>mental health</kwd>
        <kwd>digital interventions</kwd>
        <kwd>young people</kwd>
        <kwd>quality social connection</kwd>
        <kwd>depression</kwd>
        <kwd>anxiety</kwd>
        <kwd>systematic review</kwd>
        <kwd>meta-analysis</kwd>
        <kwd>patient and public involvement</kwd>
        <kwd>mobile phone</kwd>
      </kwd-group>
      <abstract>
        <p> </p>
      </abstract>
    </article-meta>
  </front>
  <body>
    <p>We welcome feedback from the authors Deng and Qin through their comment [<xref ref-type="bibr" rid="ref1">1</xref>] on our paper “Quality Social Connection as an Active Ingredient in Digital Interventions for Young People With Depression and Anxiety: Systematic Scoping Review and Meta-analysis” [<xref ref-type="bibr" rid="ref2">2</xref>]. They suggest that two included studies [<xref ref-type="bibr" rid="ref3">3</xref>,<xref ref-type="bibr" rid="ref4">4</xref>] should not be included in our review as individual studies as data extraction and quality assessment of both studies is the same, and that this impacts the quality of the meta-analysis. We have the following response. First, our review is scoping in nature, therefore we included and extracted any study that matched our inclusion criteria and appropriately extracted each study separately. Second, both studies have different designs and methodologies, and obtain different outcomes. For example, one study is a co-designed study, and the other is a qualitative study; therefore, neither study should be included in the meta-analysis itself. Third, these studies are included and discussed in the review in relation to indicators of quality social connection within digital interventions and each study finding is different. In this case, different data are presented and referenced in relation to distinct digital intervention mechanisms that facilitate quality social connection and they are appropriately presented separately. For example, the importance of anonymity is mentioned in one but not the other. Finally, we have already discussed the statistical and methodological variation within our scoping review as a potential limitation.</p>
    <p>Thank you for considering our response to the comment.</p>
  </body>
  <back>
    <app-group/>
    <ack>
      <p>We are supported by Institute of Global Health Innovation, Imperial College London. This work was funded by a Wellcome Trust Mental Health Priority Area Active Ingredients commission awarded to LD at Imperial College London.</p>
    </ack>
    <fn-group>
      <fn fn-type="conflict">
        <p>HA is the Chief Scientific Officer, Preemptive Medicine and Health Security at <italic>Flagship Pioneering</italic>.</p>
      </fn>
    </fn-group>
    <ref-list>
      <ref id="ref1">
        <label>1</label>
        <nlm-citation citation-type="journal">
          <person-group person-group-type="author">
            <name name-style="western">
              <surname>Deng</surname>
              <given-names>H</given-names>
            </name>
            <name name-style="western">
              <surname>Qin</surname>
              <given-names>X</given-names>
            </name>
          </person-group>
          <article-title>Comment on 'Quality Social Connection as an Active Ingredient in Digital Interventions for Young People With Depression and Anxiety: Systematic Scoping Review and Meta-analysis'</article-title>
          <source>J Med Internet Res</source>
          <year>2022</year>
          <fpage>e36739</fpage>
          <comment>
            <ext-link ext-link-type="uri" xlink:type="simple" xlink:href="https://www.jmir.org/2022/2/e36739/"/>
          </comment>
          <pub-id pub-id-type="doi">10.2196/36739</pub-id>
        </nlm-citation>
      </ref>
      <ref id="ref2">
        <label>2</label>
        <nlm-citation citation-type="journal">
          <person-group person-group-type="author">
            <name name-style="western">
              <surname>Dewa</surname>
              <given-names>LH</given-names>
            </name>
            <name name-style="western">
              <surname>Lawrance</surname>
              <given-names>E</given-names>
            </name>
            <name name-style="western">
              <surname>Roberts</surname>
              <given-names>L</given-names>
            </name>
            <name name-style="western">
              <surname>Brooks-Hall</surname>
              <given-names>E</given-names>
            </name>
            <name name-style="western">
              <surname>Ashrafian</surname>
              <given-names>H</given-names>
            </name>
            <name name-style="western">
              <surname>Fontana</surname>
              <given-names>G</given-names>
            </name>
            <name name-style="western">
              <surname>Aylin</surname>
              <given-names>P</given-names>
            </name>
          </person-group>
          <article-title>Quality Social Connection as an Active Ingredient in Digital Interventions for Young People With Depression and Anxiety: Systematic Scoping Review and Meta-analysis</article-title>
          <source>J Med Internet Res</source>
          <year>2021</year>
          <month>12</month>
          <day>17</day>
          <volume>23</volume>
          <issue>12</issue>
          <fpage>e26584</fpage>
          <comment>
            <ext-link ext-link-type="uri" xlink:type="simple" xlink:href="https://www.jmir.org/2021/12/e26584/"/>
          </comment>
          <pub-id pub-id-type="doi">10.2196/26584</pub-id>
          <pub-id pub-id-type="medline">34927592</pub-id>
          <pub-id pub-id-type="pii">v23i12e26584</pub-id>
          <pub-id pub-id-type="pmcid">PMC8726025</pub-id>
        </nlm-citation>
      </ref>
      <ref id="ref3">
        <label>3</label>
        <nlm-citation citation-type="journal">
          <person-group person-group-type="author">
            <name name-style="western">
              <surname>Radovic</surname>
              <given-names>A</given-names>
            </name>
            <name name-style="western">
              <surname>DeMand</surname>
              <given-names>AL</given-names>
            </name>
            <name name-style="western">
              <surname>Gmelin</surname>
              <given-names>T</given-names>
            </name>
            <name name-style="western">
              <surname>Stein</surname>
              <given-names>BD</given-names>
            </name>
            <name name-style="western">
              <surname>Miller</surname>
              <given-names>E</given-names>
            </name>
          </person-group>
          <article-title>SOVA: Design of a stakeholder informed social media website for depressed adolescents and their parents</article-title>
          <source>J Technol Hum Serv</source>
          <year>2018</year>
          <volume>35</volume>
          <issue>3</issue>
          <fpage>169</fpage>
          <lpage>182</lpage>
          <comment>
            <ext-link ext-link-type="uri" xlink:type="simple" xlink:href="http://europepmc.org/abstract/MED/29743822"/>
          </comment>
          <pub-id pub-id-type="doi">10.1080/15228835.2017.1347552</pub-id>
          <pub-id pub-id-type="medline">29743822</pub-id>
          <pub-id pub-id-type="pmcid">PMC5937703</pub-id>
        </nlm-citation>
      </ref>
      <ref id="ref4">
        <label>4</label>
        <nlm-citation citation-type="journal">
          <person-group person-group-type="author">
            <name name-style="western">
              <surname>Radovic</surname>
              <given-names>A</given-names>
            </name>
            <name name-style="western">
              <surname>Gmelin</surname>
              <given-names>T</given-names>
            </name>
            <name name-style="western">
              <surname>Stein</surname>
              <given-names>BD</given-names>
            </name>
            <name name-style="western">
              <surname>Miller</surname>
              <given-names>E</given-names>
            </name>
          </person-group>
          <article-title>Depressed adolescents' positive and negative use of social media</article-title>
          <source>J Adolesc</source>
          <year>2017</year>
          <month>02</month>
          <volume>55</volume>
          <fpage>5</fpage>
          <lpage>15</lpage>
          <comment>
            <ext-link ext-link-type="uri" xlink:type="simple" xlink:href="http://europepmc.org/abstract/MED/27997851"/>
          </comment>
          <pub-id pub-id-type="doi">10.1016/j.adolescence.2016.12.002</pub-id>
          <pub-id pub-id-type="medline">27997851</pub-id>
          <pub-id pub-id-type="pii">S0140-1971(16)30171-3</pub-id>
          <pub-id pub-id-type="pmcid">PMC5485251</pub-id>
        </nlm-citation>
      </ref>
    </ref-list>
  </back>
</article>
