Title: The impact of training based on the Transtheoretical Model on increasing physical activity
in overweight and obese housewives
Version: 2 Date: 28 Feb 2025
Reviewer:  Majid Mohammadi
Reviewer's report:
________________________________________
Review of the Article: " The impact of training based on the Transtheoretical Model on
increasing physical activity in overweight and obese housewives: a quasi-experimental study"
Dear Authors,
To enhance the quality of this article, I kindly suggest the following revisions:
Title:
The title can be shortened.
Suggested Revision:
" The impact of training based on the Transtheoretical Model on increasing physical activity in
overweight and obese housewives."
Abstract:
# The introduction is lengthy and can be reduced as follows:
" Due to the nature of their activities, housewives are often at higher risk of weight gain.
Considering the importance of interventions and the role of housewives in the family, the present
study was designed and conducted to examine the effect of training based on the Transtheoretical
Model on increasing physical activity in overweight and obese housewives residing in Yazd,
Iran."
# The objective needs to align with the title.
# The sampling method is available and is not cluster sampling.
# Considering that your variables were multi-level and assessed before and after the intervention,
it would have been better to use a multivariate analysis of variance.
# It is advisable to provide information regarding the age, activity level, and body mass index
of the participants in the methodology section.
# It should be noted how many participants were obese and how many were overweight.
# In the results section, a summary of the statistical tests used should be reported.
# The introductory part of the results can be omitted.
# Overall, the abstract can be shortened.
Introduction:
# The introduction should be written cohesively, with the content connected to one another.
# It would be better to provide a summary of several studies regarding the prevalence of obesity
and overweight after the first paragraph, and then discuss the complications and issues that
obesity can cause for individuals and communities. Following that, reference should be made
to treatment methods and interventions.
# These two paragraphs can be summarized and combined:
" including 11 million obese individuals and 18 million overweight individuals (12). The
prevalence of overweight in individuals over 18 years of age in 2021 was 38%, with rates of
36.8% in women and 39.6% in men (13). The prevalence of obesity in 2021 increased by 9.9%
compared to 2016 (14). Abiri et al. (2023) reported overweight and obesity prevalence rates
of 20.1% and 13.44%, respectively, in Iran (15). In a study by Abdollahi et al. (2023), the
prevalence of obesity among Iranian middle-aged women was 23.3%, and the prevalence of
overweight was 48.5% (16). Similarly, Dastgheib et al. (2021) reported a 62.7% prevalence of
overweight among women in southern Fars Province (17).
Middle-aged women are not immune to the alarming trend of obesity (18). Overweight and
obese middle-aged women face numerous challenges. Moushumi et al. (2025) linked infertility
in women to obesity and overweight (19), while Gan et al. (2025) associated psychiatric
disorders such as depression with obesity in middle-aged women (20). Chen et al. (2023)
identified a relationship between overweight/obesity in women and conditions such as fatty
liver disease, prediabetes, and hypertension (21). Other complications related to obesity include
cardiovascular diseases (22), certain cancers (23), fertility disorders (24), and diabetes (25)."
# Overall, the introduction needs to be revised: it is recommended that it be shortened and
organized according to the research variables. Initially, define obesity and its complications,
discuss the challenges faced by women with obesity, outline intervention methods, address the
role of physical activity and its connection to obesity, and finally, state the objective of the study.
Method:
# Considering that intervention programs may have different effects on overweight and obesity,
it is necessary to accurately state how many participants in the sample were obese and how many
were overweight. It is also necessary to explain how individuals were selected into the groups.
# The Data collection tools section needs to be written in an essay format. The physical activity
questionnaire was mentioned in the abstract.
# In the statistical analysis section, the Kolmogorov-Smirnov test is mentioned, but there is no
reference to it in the findings.
# In general, it is suggested that for the methodology section, you first state the research method,
then the participants and how they were selected into the groups. Then, the procedure should
be presented with better details. It is also necessary to present the research tools and mention
their validity and reliability in the present study or in studies conducted in Iran. The type of
intervention and how it was implemented should be mentioned in detail and with a source. In
addition, considering the multi-level nature of the variables and their examination in pre- and
post-tests, it is better to use multivariate analysis of variance or covariance.
Results:
# According to the BMI levels reported in Table 2, your samples were classified as overweight,
not obese.
# If there were obese individuals in the samples, the results should be presented separately for
overweight and obese individuals in different tables.
# The Effect Size in Table 3 should be checked and revised.
# This section can be rewritten based on a better statistical test.
Discussion:
# It would be better to delete this paragraph:
" Comparing the demographic characteristics of the intervention and control groups, the results
indicated that most participants in both groups were middle-aged, highlighting the relatively
young age of housewives. The majority had primary education, no specific diseases, and no
history of smoking. Chi-square analysis showed no significant differences in most demographic
variables between the two groups, confirming demographic homogeneity. This homogeneity
strengthens the study’s validity, as any observed differences in outcomes can be attributed to
the intervention rather than pre-existing differences between the groups."
# In this section, it is necessary to first present the results of the study and then compare them
with existing studies in this area. Finally, potential reasons for the results should be discussed,
leading to a conclusion. Additionally, this section should address the limitations of the research
and provide suggestions for future studies.
Ethical Approval and consent to participate:
# Some sentences are repeated twice; please revise.
References:
# The citation format for all references should be consistent.
# References 1, 2, 3, and 12 are outdated. Given the numerous studies that have been conducted
in this area, please replace them with more recent sources.
# The research year for reference 33 has not been mentioned.
# In Persian references, the year should be stated in Gregorian format. References 13, 14, and
31 need to be corrected.
# Reference 28 should be revised.