Reviewer’ s report
Title: Effect of health education on knowledge and attitude of menopause among middle age
teachers
Version: 1Date: 29 Jun 2020
Reviewer's report:
The article is improved but several areas still require further clarification/discussion.
Statements are made in the paper that should be qualified as they appear to suggest that all women
experience particular symptoms or problems, e.g line 56-57 'Middle age women are greatlyaffected by physiological, psychological and economic factors.'
Line 59-60...'Even though natural, menopause affects women's health and quality of life to a
greater extent[3-6].' to a great er extent that what...
Lines 92-94 Given the lack of research on Eritrean women's beliefs and knowledge about
menopause, it would be important to describe these in detail at baseline and to describe thedevelopment of the measures so that they capture relevant beliefs/attitudes of these women. Morediscussion would be helpful relating to the decisions about including particular items in themeasures as well as what specific aspects of knowledge and attitudes the intervention is targeting.Is the content of the manuals referred to relevant to the women and is it evidence based?
There may be a problem in translation but it is unclear as to whether some of the of the items of
the knowledge measure should be thought of as correct or incorrect. Items are scored as correct orincorrect which implies that all women either have or do not have a particular symptom/experience. This is a potential limitation that should be discussed. Given the cultural differencesin attribution of symptoms to the menopause it would be important that the items were shown tobe relevant to the women in the study.For example, line 297-298. 'In this study those women who were aware about the appearance ofunwanted hair on face ..... during menopause were below 30% prior to the training.' Perhaps thiswas not a common symptom experienced by the women, rather than a lack of knowledge.
For the attitude scale the changes are statistically significant but relatively small. Could the authors
comment on which individual items changed most.
Lines 349 to 354 Here the baseline data show that for some attitudes/beliefs the majority of
women have positive attitudes. E.g. 'In this study, almost all (94.9%) agreed with the fact thatwomen can care for themselves using the information they have from others.' Does this imply thatthey do not need an intervention to change these attitudes? Do the results highlight negativeattitudes at baseline that are unhelpful and that an intervention could be developed specifically to
change?
The content of ht intervention could be described more fully and the rationale for using the sources
discussed.
Limitations: this sections could be elaborated to include what could have been improved and what
future research could follow this study.
References appear to be incomplete: 20, 28, 32, 42.
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NoAre 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 are required in your comments to the authors.
NoAre the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
YesAre 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 furtherassessment 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:
Needs some language corrections before being publishedDeclaration of competing interests
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