Reviewer ’s report  
 
Title: Correlates of Alcoholics Anonymous affiliation among justice -involved women  
 
Version: 0 Date : 20 Jan 2018  
 
Reviewer: Vivia V. McCutcheon  
 
Reviewer's report:  
 
This study examines correlates of past -year AA affiliation in a sample of women with alcohol 
use disorders (AUDs) in pretrial jail detention. The measures used are thoughtfully selected to 
represent factors t hat might influence a woman's willingness to participate in groups like 
Alcoholics Anonymous (AA), such as trust/mistrust of others, previous violent victimization, 
lack of autonomy. Some measures are based on previous qualitative work by the authors.  
Results showed that older age, greater AUD severity, more trust in others, and more housing 
instability after release from jail were associated with greater AA affiliation. The study would 
benefit from a better description of the sample and evaluation of resu lts in relation to previous 
studies.  
 
Specific comments are below.  
Background: 2nd page, lines 6 -15: Some expansion on the ideas contained in this paragraph 
would provide a stronger rationale for the measures selected for the study. For example, the 
phrase "people who are risky to their sobriety due to lack of basic needs" requires more 
explanation to link it to the measure of limited choice. An example, e.g., needing to trade sex for 
food or shelter, or staying with an abusive or drug -using partner for l ack of options, and/or a 
reference, would be helpful. Likewise, references for or descriptions of victimization, low levels 
of self -care, stress, and homelessness, and how they might be "plausibly related to women's 
ability to participate in AA" would prov ide a stronger foundation for the methods and measures 
that follow.  
References: Statements related to references do not always correctly reflect the studies cited. For 
example, on page 1 the authors state "Among women leaving jail or prison, attendance o f AA 
meetings after release is associated with a significant decrease in drinking," followed by a 
reference to work by Gossop which does show a decrease in drinking but has nothing to do with 
women leaving jail. Page 1, lines 24 -25 state that lower educati on, income and employment 
"generally" predict disaffiliation with AA but cite studies dealing with specific populations 
(adults with HIV/AIDS and injection drug users). Need references for the Violent Victimization 
score, Perceived Stress Scale and the Gen eral Trust Scale.  
Participants: A description of the circumstances surrounding pretrial jail detention would be 
helpful, e.g., how long are participants in pretrial detention, are they in jail because they cannot 
afford bail? How were women recruited into  the study? What proportion who were invited to 
participate did?  Have they been incarcerated before? Have they had professional or mandated 
treatment for alcohol or drug problems before? How do they compare to other female jail 
populations?  
Data analysis : Describe censored regression and why it is appropriate for this analysis. Describe 
why robust variance estimators were used.  
Results: Before collapsing Hispanic, Black, and "other" racial/ethnic categories, were differences 
in their levels of AA affili ation, stigma, choice, self -care, victimization, housing, stress, trust 
tested? What was the rationale for combining the categories for the regression models?   
Table 2: Why were robust variance estimators used for confidence intervals?  
Discussion: Do the authors have any ideas about why some of their expected correlates of AA 
affiliation were not significant? It would be helpful to place these findings in the context of 
previous literature and/or to highlight the novel nature of this pop ulation and these measures.   
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls ar e 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 the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify 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 qua lity 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 salar y 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 publicati on 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.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests.  
 
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