Reviewer ’s report  
 
Title: Using Theory -Based Messages to Motiv ate U.S. Pregnant Women to Prevent  
Cytomegalovirus Infection: Results from Formative Research  
 
Version: 0 Date: 24 Nov 2016  
 
Reviewer: Cheryl Jones  
 
Reviewer's report:  
 
The authors undertook qualitative research using fear appeals theory -based messages about 
CMV and prevention with U.S.women. The investigators evaluated views in two groups - women 
with CMV infect ed children who were enrolled in a longitudinal study about CMV, and pregnant 
and non pregnant women with young children in two US cites. Key findings were that women 
welcomed combined messages that CMV is common, can reduce in severe harm to their babies,  
and that there are prevention strategies, and communication strategies surrounding these 
messages. It also provided insight into a perceived lack of feasibility of some behavioural 
strategies to limit pregnant women's exposure to CMV.  
 
Congenital CMV is a n important cause of childhood disability. There is limited understanding in 
the communication about this infection. This study is an important piece of research that will 
provide a much needed evidence base for antenatal education strategies to reduce har ms from 
congenital CMV. The methodology is sound. The manuscript is well written although could be 
more concise.  
 
Minor comments:  
page 3, lines 4 - In the abstract - provide some explanation for informed non content readers 
about the premised underlying fear appeals theory -based messages .  
Some   of the methodology tables could be provided as supplemental material  
Some specific discussion about how the findings would inform change of the current CDC 
cCMV prevention strategy would be helpful.  
 
 
 
 
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.  
 
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 manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects req uire further  
assessment in your comments to the editors.  
 
Not re levant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
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No competing interests.  
 
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