Reviewer ’s report  
 
Title: Structural Equation Modeling of Psychosocial  Determinants of Health for the 
Empowerment of Iranian Women in Reproductive Decision Making  
 
Version: 2 Date: 08 Sep 2018  
 
Reviewer: Reviewer 2  
 
Reviewer's report:  
 
PEER REVIEWER COMMENTS: To view the full report from the academic peer reviewer, 
please see the attached file.  
 
 
REVIEWER COMMENTS FROM REPORT: The manuscript entitled "A Structural Equation 
Model of Psychosocial Determinants of Health for Empowerment of Women in Reproductive 
Decision -Making in Iran" addresses an interesting and important topic. However, I feel that a 
good enough case was made out for this paper. Moreover, I do not agree with the following 
sentence: "Due to the physiological changes in women's lives, they are more vulnerable than 
men." Physiological factor is only one aspect that differentiates women from men.  
 
 
REQUESTED REVISIONS:  
 
The aim of the article is not clear to me. The primary and/or secondary hypotheses of the study 
are missing. I suggest the author to clearly state the hypotheses. Moreover, I would like to see a 
close linkage between the l iterature review and the hypotheses proposed and between these 
hypotheses and the analyses.  
 
The sample was not described. Detail the sample's major demographic characteristics.  
 
The psychometrics properties (e.g., reliability and validity) of the Women's e mpowerment in 
reproductive decision -making (WERD) questionnaire are not investigated in a previous study. 
There is one citation for the measure and this is about a qualitative study. Is there a validation 
study for this measure? What are the criteria for dividing the scores into five classes? Are there 
well-grounded cut -off points? I believe that, first, a validation study for this measure should be 
published, then this article could be submitted.  
 
In general, path models are read from left to right, with t he variables on the left (predictors) 
predicting the outcome variable on the right. In the path model, it is not clear to me what are the 
predictor and the outcomes. Relative fit indices such as the normed fit index and comparative fit 
index should be repo rted.  
 
the limitations of the research are not acknowledged, and alternative explanations of the results 
are not addressed.  
It is not clear to me what the theoretical and practical implications of the study are. At present I 
feel that the discussion focuse s mainly upon description of the findings and not enough on the 
broader theoretical and practical implications of this data.  
 
 
ADDITIONAL REQUESTS/SUGGESTIONS:  
 
see comments above  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the aut hors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an add itional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs s ome 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, f ees, funding, or salary 
from an organisation that may in any way gain or lose financial ly from the 
publication of this manuscript, either now or in the future?  
 
2.  Do you hold any stocks or shares  in an organisation t hat 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 recei ved 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 interests?  
 
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.  
 
This reviewer has been recruited by a partner organization, Research Sq uare. Reviewers with 
declared or apparent competing interests are not utilized for t hese reviews. This reviewer  has 
agreed to publication of their comments online under a Creat ive Commons Attribution License 
attributed to Research Square and was paid a sma ll honorarium for  completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer 
recommendation.  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Acce ss Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded  as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal