Reviewer's report
Title:Educating women about congenital cytomegalovirus: Assessment of health
education materials through a web-based survey
Version:4Date:23 September 2014
Reviewer: Daniel E Noyola
Reviewer's report:
-Major Compulsory Revisions:
1. Abstract, Conclusion section. The last sentence indicates that findings suggest
that "appropriate CMV materials could increase knowledge of CMV which could
lead to adoption of prevention behaviors, which could reduce the risk of CMV
infection among women." The first part of the statement "CMV materials could
increase knowledge of CMV" is supported by the data in this study; although it is
expected that this may have an impact on prevention behaviors and, as a
consequence, have an impact on CMV infection rates, these results were not
assessed in the study. I suggest that the phrase should be rephrased or divided
in two separate sentences to clarify this.
2. Methods section, Sampling and screening. Because the survey was done
though the internet from a pre-existing "web panel" it is somewhat difficult to
understand how the final survey group was assembled. It would be useful to
have additional information regarding how this was achieved. Please provide
information regarding how large the "original" pre-existing web panel is; how
were the potential participants contacted (Through e-mail? Were invitations sent
sequentially/randomly until a certain number of responses were obtained?); what
process was followed to identify women that did not qualify for the survey?
3. Results section, under "Baseline behaviors associated with CMV risk". The
first statement appears to be contradictory to the second statement and the
overall results: the authors state that "most women did not frequently engage in
activities that increase their risk of CMV transmission"; however, 433/809
(53.5%) women reported "kissing child on lips" every day. Other behaviors that
may be associated to CMV transmission were also reported "every day" by 7.2 to
30.2% of women. This sentence should be modified to reflect the results.
Regarding this point, I imagine that women that report behaviors associated to
CMV transmission "every day" (share food, share cup, share eating utensils, kiss
child on lips, put child’s pacifier in their mouth) may report more than one of
these behaviors; however, there may not be a complete correlation between
them. Could the authors provide the percentage of women that reported any (one
or more) of these behaviors every day?
4. Discussion section, last paragraph. I think that the authors should include in
the limitations of the study the fact that the results obtained assessed the
"support for CMV preventive behaviors" if women were pregnant (the material
encourage me to avoid….); although these questions address the intent of
women, the study does not provide information regarding actual behavior
change. Although mention of this is included in the Conclusion section I suggest
that this also be included in the Discussion section.
- Minor Essential Revisions
5. Abstract, Conclusion section. The last phrase indicates that "…these findings
suggest that with appropriate CMV materials could increase knowledge…". I
think that the word "with" should be deleted.
6. Discussion section, 5th paragraph, last sentence ("Overall these findings
suggest…."). I find this sentence difficult to follow. I suggest rewording the
sentence or dividing the information in two separate sentences.
7. Table 1.
Under "Education" spell HS (High school)
Under "Income categories" add comma for “$25000-$49,999”
8. References.
Reference no. 22: the Journal is not abbreviated ("The New England journal of
medicine"). Please review references for uniformity.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
I declare that I have no competing interests.