Reviewer ’s report  
 
Title:  Prevalence of emergency co ntraceptive pill use among Spanish adolescent girls and their 
family and psychological profiles  
 
Version: 0 Date: 19 Jul 2017 
 
Reviewer:  Safeera  Hussainy  
 
Reviewer’s report:  
 
Thank you for the opportunity to review this exciting and interesting work. Please find my 
comments below.  
 
 
Background  
 
Lines 46-50 - It's not true that EC is only effective in the first few days after intercourse (few 
indicates 3 days). Levonorgestrel (LNG) is effective up to 4 days and ulipristal acetate (UPA) up 
to 5 days. Please correct. Consider rewording sentence on EC bein g a 'second opportunity' - 
either delete second or replace with another word.  
 
Line 52 - From where is LNG freely distributed? Pharmacies or other places? Is it the only EC 
available in Spain or is UPA also available? Some context here would be good.  
 
Line 5 5 - What does 'petitioners' mean in this context? Should it be patients?  
 
Line 57 - Reword sentence about ECP preventing abortions to saying it can prevent unwanted 
pregnancies  
 
Line 59 - Reword to '...pregnancy at this stage of life...'  
 
Line 62 and elsewher e in manuscript - Please try to use a different word to 'suppose' to improve 
readability  
 
Lines 63 -67 - Please provide more information about the HBSC study for readers e.g. study of 45 
countries across EU and North America, since what year, areas of invest igation of study and 
italicize 'only' where it states that 'Spain is the only country in the study in which % of condom 
use was higher for girls than boys'  
 
Line 68 - Delete 'an' and please add which countries France is being compared to in terms of 
ECP acc ess 
 
Line 75 - Add 'the' before male condom  
 
Line 79 - Add 'a' before 'source'  
Line 84 - Replace 'tell them their' with 'talk to them about their'  
 
Lines 116 -121 - There are two aims not one, and please list them in number format as it will be 
easier to read and cross -reference back to when reading other sections of the manuscript  
 
 
Methods  
 
Participants, Lines 129 -138 - Please clarify that the study sample was 398 and was drawn from 
the HBSC representative sample of the Spanish population (i.e. 1,735 Spanish girls)? Please 
make this more clear.  
 
 
Measures  
 
Line 140 - Add reference for questionna ire from HBSC study  
 
Line 149 - Reword to 'life outside of home' as I assume this doesn't necessarily mean being 
physically away from home  
 
Line 164 - Define 'salutogenesis' as it would be unknown to many readers or reword  
 
Line 167 - Delete 'scale' after ref erence 30  
 
 
Data analyses  
 
Lines 178 -185 - Too long, please reword  
 
Line 178 - Add owner and location of SPSS in brackets  
 
Line 179 - Replace objective with aim here and elsewhere in manuscript to align with aims 
mentioned in background  
 
Line 187 - Replace 'in' with 'on'  
 
 
Results  
 
Lines 191 -192 - Provide total prevalence of 30.65% along with breakdown that is already 
included for frequency of use  
 
Lines 194 -198 - Too long and difficult to follow, please reword and highlight significant 
relationships in Table 1 (and  in Table 2) and in text more clearly along with trends  
 
 
Discussion  
 
Line 220 - What does 'lack of effectiveness in some crosses' mean???  
 
Lines 222 -224 - How does prevalence compare to other EU countries and around the world 
(where data are available in th e adolescent population)?  
 
Line 264 - What does 'agentivity' mean? I could not find this word in the dictionary.  
 
 
Conclusions  
 
Lines 282 -287 - The work presented in this paper does not support the WHO's finding to provide 
adolescents with S&RH services etc. It would be better to say that the work points towards 
education of parents and supports their enhanced role in this area etc.  
 
 
References  
 
A number of references are in Spanish and not accessible to readers. Are they available in 
English translated version s? 
 
Are the methods appropriate and well described?  
If not, please specify what is required in  your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
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 requi re further 
assessment 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 published  
 
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 salary from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, eithe r 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 publication 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 interest s? 
 
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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on my report to the authors and, if the manuscript is accepted for publication, my named report 
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which I do not wish to be included in my named report can be included as confidential comments 
to the editors, which will not be published.  
 
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