Reviewer ’s report  
 
Title: Structural Equation Modeling of Psychosocial  Determinants of Health for the 
Empowerment of Iranian Women in Reproductive Decision Making  
 
Version: 4 Date: 14 Nov 2019  
 
Reviewer: Reviewer 2  
 
Reviewer's report:  
 
PEER REVIEWER ASSESSMENTS:  
 
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several 
testable research questions? (Brief or other article types: is there a clear objective?)  
 
No - there are minor issues  
 
 
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for the 
objective?  
 
Yes - the approach is appropriate  
 
 
EXECUTION - Are the experiments and analyses performed with sufficient technical rigor to 
allow confidence in the result s? 
 
Yes - experiments and analyses were performed appropriately  
 
 
STATISTICS - Is the use of statistics in the manuscript appropriate?  
 
No - there are issues with the statistics in the study  
 
 
INTERPRETATION - Is the current interpretation/discussion of the re sults reasonable and not 
overstated?  
 
Yes - the author's interpretation is reasonable  
 
 
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently 
for you to now recommend the work as a technically sound contribution? If not, can furt her 
revisions be made to make the work technically sound?  
 
Probably - with minor revisions  
 
 
PEER REVIEWER COMMENTS:  
 
GENERAL COMMENTS: I appreciate the revisions. The theoretical novelty and contribution of 
your research is much clearer now. Internal consistency for the measures has been reported and 
is good. The author(s) used the Monte Carlo simulation method to estima te appropriate sample 
size. The limitation section was fleshed out. I have a couple of suggestions for (minor) revisions 
to improve the quality of the manuscript.  
 
 
REQUESTED REVISIONS:  
 
I appreciate the fact that the hypotheses section was added. However, a hypothesis should be 
constructed as a statement of expectations. Please clarify the meaning of "significantly related." 
Do you mean positively or negatively? Moreover, you should clearly define the exact meaning of 
"psychosocial parameters of health." Fi nally, there is a discrepancy between the hypothesis and 
the relationships reported in both the Conceptual framework (Fig 2) and Structural Equation 
Model (Fig 3).  
 
I appreciate the fact that the Monte Carlo simulation method to estimate appropriate sample  size 
was used. However, details of the procedure were not reported (e.g., the software used, the 
hypothesized relationships between factors, the number of samples/replications, the estimated 
statistical power). In addition, did the parameter and standard error biases exceed 10% for any 
parameter in the model? Were the parameter and standard error biases for the focused parameter 
larger than 5 %? Did the coverage range from 0.91 to 0.98?  
 
Are the methods app ropriate 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.  
 
Yes 
 
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 manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require 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:  
 
Acceptable  
 
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 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 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 Square. Reviewers with 
declared or apparent competing interests are not utilized for t hese reviews. This reviewer has 
agreed to pub lication of their comments online under a Creat ive Commons Attribution License 
attributed to Research Square and was paid a small honorarium for  completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of t he 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 Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wi sh to be included in my named report can be in cluded as confident ial comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal