Reviewer ’s report  
 
Title: Effectiveness of a Culturally Tailored SMS Alcohol Inte rvention for Same -Sex Attracted 
Women: Protocol for an RCT  
 
Version: 0 Date: 31 Oct 2018  
 
Reviewer: Joseph Lee  
 
Reviewer's report:  
 
Dear Authors:  
 
 
 
Thank you for this important work to design and test an intervention addressing an substantial 
inequity for lesbian and bisexual women (or same -sex attracted women as you more technically 
note). There are substantial gaps in the knowledge base regarding interven tions to address health 
inequities for sexual and gender minority populations. As such, your work fills an important gap. 
I have one larger comment and several smaller ones.  
 
 
LARGER COMMENT  
 
1. You are comparing a tailored intervention to a generic message . I wonder about the 
importance of testing if the tailoring is needed. I say this because there is an increasingly large 
literature in tobacco control that culturally targeted interventions are desired and appreciated but 
do not improve outcomes over stand ard interventions for sexual and gender minority 
populations. For example: https://www.ncbi.nlm.nih.gov/pubmed/30169797 We covered the 
older literature in this systematic review: https://www.ncbi.nlm.nih.gov/pubmed/25455123 Thus, 
I think it's a bit of a mi ssed opportunity to test if the tailoring of the intervention to SSAW is 
important or not. (This is not a fatal flaw, just a comment.)  
 
SMALLER COMMENTS  
 
 
2. Page 21, recruitment challenges. Ther e may be ideas from this literature: 
https://www.ncbi.nlm.nih. gov/pubmed/29914861  
 
 
3. You use "tailored" and "culturally tailored" terminology. I find the field is not uniform in its 
use of tailored versus targeted. It may be worth directly clarifying that. See: 
https://www.ncbi.nlm.nih.gov/pubmed/18389854  and 
https: //www.ncbi.nlm.nih.gov/pubmed/10788196  and this conflicting one: Pasick, R. J., 
D'Onofrio, C. N. and Otero -Sabogal, R. (1996) Similarities and differences across cultures: 
questions to inform a third generation for health promotion research. Health Educati on Quarterly 
, 23 (Suppl.), S142 -S161.  
 
 
4. I don't love the language "hard to reach" -- this is a personal preference not a required change -
- I always wondered if it put the blame on the clients rather than on our systems. See: Crozier G, 
Davies J. Hard t o reach parents or hard to reach schools? A discussion of home -school relations, 
with particular reference to Bangladeshi and Pakistani parents. Br Educ Res J. 2007;33(3):295 -
313. and: Riggs E, Gussy M, Gibbs L, Gemert C, Waters E, Kilpatrick N. Hard to re ach 
communities or hard to access services? Migrant mothers' experiences of dental services. Aust 
Dent J. 2014;59(2):201 -207. 
 
 
5. Page 5, "Research also indicates that SSAW are reluctant to seek help for alcohol -related 
problems" and similar statements. I would just make sure that this is less of a blanket statement. 
As a population, yes, but individuals may not match the population average.  
 
 
Thank you for your important work in this area.  
 
 
 
Sincerely,  
 
Joseph G. L. Lee, PhD, MPH  
 
Department of Health Education and Promotion  
 
East Carolina University, Greenville, NC USA  
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls ? 
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
Are you able to assess any statistics in t he manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any  way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content  of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. I f your reply is yes to any, please give details below.  
 
I declare that I have no competing interests.  
 
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