Reviewer's report
Title:Treatments and hazards: A qualitative study of perspectives from women
aged 35 and over on contraceptive methods and use
Version: 1Date:10 August 2010
Reviewer: Deborah Oakley
Reviewer's report:
1. Is the question posed by the authors well defined?
The question being investigated is clear, and important.
2. Are the methods appropriate and well described?
Specific suggestions are made for clarifying ambiguities or logical lacunae.
3. Are the data sound?
The qualitative data are appropriately presented.
4. Does the manuscript adhere to the relevant standards for reporting and data
deposition?
Yes. According to style preferences, the qualitative quotations may be italicized
or quotation marks used, as the editor requires.
5. Are the discussion and conclusions well balanced and adequately supported
by the data?
The authors have not over-stretched their data. They could bring in a bit more of
recent literature, particularly referring more to Frost, Singh, & Finer’s 2007 article.
6. Are limitations of the work clearly stated?
Yes, although the reservations about “national” implications might be modified to
something like “other geographic areas.”
7. Do the authors clearly acknowledge any work upon which they are building,
both published and unpublished?
Yes.
8. Do the title and abstract accurately convey what has been found?
Yes, except The title’s words of “treatments and hazards” have no apparent
relationship to the paper’s contents. Why not just omit those 3 words?
9. Is the writing acceptable?
Yes, although a few specific suggestions are made to improve usage and clarity.
Minor essential/suggested changes:
1st para.
Change sentence ending to: with those who did not regarding perceptions about
contraceptive methods and use.
2nd para.
What is an “edited style approach?” “Analysis focused…” is ambiguous. Does it
mean that you pre-selected these themes (if so, why?) or that analysis produced
these themes (if so, this part of the sentence belongs in results, doesn’t it?) Now,
having read the Methods section, it is evident that Grounded Theory was used,
with concept mapping. Those would be more familiar words to use in the
abstract.
3rd para.
The first sentence is awkward, particularly with the extra “that” in “…or that they
perceived pregnancy as…” How about something like: Women who avoided
unintended pregnancy used contraception consistently and mentioned 3 reasons:
a medical contraindication, perception of pregnancy … etc.
Also, do you actually know the motives and their connections to use? How about
just stating that the Women who experienced an unintended pregnancy were
less consistent, stating that….
Background:
Think about use of “contraception” vs. “contraceptive.” Better to be consistent.
There is also an awkwardness about placement of the age group when
discussing here (and earlier) the comparison groups. For instance, in the last
para., it would be more comfortable reading to say…”We compare perceptions
about contraceptive methods and use among women aged 35 and over who had
vs. did not have an unintended pregnancy. Also, here and earlier, it would be
very helpful to explain: is this their most recent pregnancy or were these women
followed over x months of use?
Methods:
It would be helpful to move
We recruited participants through several mechanisms, including flyers posted in
workplaces, family planning clinics, hospitals and women’s shelters and
word-of-mouth referrals from neighborhood contacts and other study participants.
Women who telephoned seeking further information were screened to determine
if they met the study criteria.
i.e., these two sentences would begin the 2nd para. The remainder of the “We
recruited..” para would then begin the next para and continue on telling about the
interview. It would be more precise, and clearer, to say that informed consent
was obtained in person, BEFORE any interview proceeded.
Would you consider changing “disadvantaged” to “less advantaged”?
Results:
In the first para (an perhaps also in Methods and in the Abstract) it is important to
state whether your variable of interest, i.e., contraceptive use, refers to
CURRENT use, the entire period of time since turning 35, or ? I take it that you
have measured current use (can it be 1 day, 1 month or ??), but every time the
unintended pregnancy comes up, I wonder if their inconsistent use was during a
use-segment when they were using inconsistently. Of course, it all seems evident
to you but confounds the reader.
My quandries always seem to be settled by subsequent materials, but it is always
better to avoid readers’ quandries in the first place. Example: the word “tended”
makes me wonder how many of such small groups can really justify
generalizations at all. It might be better to admit there are counter-examples, or
to re-think your definitions of consistent and inconsistent…or at least to recognize
that some inconsistent users became consistent over time. Thus, experience and
learning (from medical providers) is another influencing factor. Perhaps this is a
point for the discussion.
Tables 1:
Not absolutely sure what “Complete w/childbearing” is. Want no more children?
Plan no more children?
Table 2:
Not sure this table is worth the space. If used, “irritative” is an unusual word to
use for “irritating.”
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
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.