Title: Social influences on Moroccan and Pakistani immigrant women’s access and use of
cervical cancer screening in Catalonia, Spain: a social network analysis
Version: 3 Date: 24 Jun 2024
Reviewer's report:
First of all, congratulations for the study and the concern to gain knowledge about the social
inequalities in healthcare by migration origin, specifically in CC screening. The research topic
of the manuscript is interesting and suitable according to the scope of the journal.
Then, in general, the manuscript is of high quality and I only give you some small comments to
improve the comprehension and contents of the manuscript.
Background
I would recommend to the authors to revise and reflect on including the social representations’
theory by Moscovici. Although authors define clearly the concept of “social norms”,
I think it would be better complemented mentioning the role of social representations
related to health, prevention practices and health-related behaviours. The following link can
be useful to check the concept and most relevant bibliography: https://link.springer.com/
referenceworkentry/10.1007/978-1-4614-5583-7_292
Methods
In the first subsection, the study participants should be deeply described. In a qualitative study
or qualitative-based sample study, the information about the characteristics of the sample used
to be explained in Methods. Therefore, the subsection Participants characteristics of the Results
section, could be moved above, and adapted to qualitative ways of describing sample. Instead
of numbers and percentages as it should be in Table 1 of a quantitative study, please detail for
each participant the main information, above all, the variable by which they have been selected.
Besides, include the code of participant (for example: PC01), as it should be linked the verbatims
with the characteristics of the participant.
The recruitment process is explained in another published article, in which the final sample size
was 74 participants, but only 22 in the case of this manuscript. Why? You should explained
the reasons under the inclusion of a final sample of 22 participants, if the data saturation was
reached or there were other explanations.
In terms of justification of the selected communities (Morocco and Pakistan), it is not
clear the variable took into consideration. Although you say “19% of the foreign-born
population” (country of birth), the references of INE and Idescat seem to refer to foreign
population in terms of nationality. Clarify this and used when possible the country of birth as
variable for migratory status.
Results
Despite the main ideas are clear, I would like to have found a more integrative way of presenting
the results of the sociogram and the narratives of participants. It would be interesting to provide a
more comprehensive way of showing how the size and type of the networks “influence the self-
care and prevention practises relating to SRH and CC” as mention in “Data Analysis” subsection.
Discussion
In general, the discussion is well argued. However, it is not clear alongside the results section
the conclusion “our findings point to how immigrant women’s experience social influences and
sources of information and advice change over time”, specifically about the effect of the length
of residence in the narratives about CC screening and finally in practices.