Reviewer's report 
 Correlates of Women's Preventive Health Screening and Contraceptive Knowledge Title: 
 1  28 December 2006 Version: Date: 
 Ann Carroll Klassen Reviewer: 
Reviewer's report: 
General 
This is a straight-forward report of a survey with women seen in an urban ED, regarding knowledge and 
practices in several areas of womens health. There are a few modifications that should be done in order to make the report more accurate, as well as some limitations and refocussing that could also improve its 
impact. 
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Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) 
The authors describe their research as focusing on womens preventive health, but they actually focus on 
only a few specific areas - screening for breast and cervical cancers, and contraception. They therefore 
should modify their description of the survey goals etc accordingly. There are many recommended 
preventive actions and screening tests for this wide age range that are not touched on at all in their work. 
They also are not clear enough on the main objectives of their work. There seem to be two - one is to test 
whether an ED is a viable mechanism for monitoring knowledge and practices among women, and this 
seems to be successfully demonstrated. The other, which is somehow implied in their literature review, is 
that this setting is also an appropriate place to intervene with underscreened or undereducated women - however, their research does not actually test this in any way. Some clarification in their conclusions would 
be helpful, ie, the next steps might be to develop and test and intervention, etc. 
Their analysis of breast screening for some reason uses women 45 and older. They should re-run their 
analysis using women 40 and older - the age group for whom mammograms are currently recommended. It 
makes no sense to use only women 45 and older. 
They also need to add more connection to the huge literature on womne's health care utlization and receipt 
of preventive screening - there are many strong models within the health services literature showing that 
having a primary care provider, for instance, as well as having a recent ob/gyn visit, is very important for 
predicting both knowledge and recency of screening. There are many studies using nationally representative samples such as the national health interview survey, for example, which show women in this age group are strong users of primary care. These studies would contradict the authors statement that 
most women receive the majority of their care from emergency rooms - this is simply not accurate. 
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Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
The reference groups need to be clearly specified in the multivariate models. 
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Discretionary Revisions (which the author can choose to ignore) 
 Unable to decide on acceptance or rejection until the authors have responded to the major What next?: 
compulsory revisions 
 An article of importance in its field Level of interest: 
 Needs some language corrections before being published Quality of written English: 
 No, the manuscript does not need to be seen by a statistician. Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests