Reviewer ’s report  
 
Title:  Women’s Circles as a culturally safe psychosocial intervention in Guatemalan indigenous 
communities: a community -led pilot randomised trial  
 
Version: 0 Date: 28 Jan 2019 
 
Reviewer:  Lin Zhu 
 
Reviewer’s report:  
 
This study evaluates the effects of an psychosocial intervention in a underserved and vulnerable 
population in Guatemala. The mix -method research design was well presented in the paper, and 
the conclusions were supported by the findings. Particularly inter esting was the discussion on the 
community engagement. However, several issues could be addressed to strengthen the quality of 
the study, most of which regarding the quantitative methodology part.  
 
1. The authors used linear regression for the secondary an alysis, which makes sense given that 
the outcome variables are continuous. However, it is possible that these outcome variables did 
not have a linear relationship with # of sessions attended (Table 5), which means there is the 
possibility for a violation o f the linearity assumption of linear regression. It'd be great if the 
authors could provide some rest results for the assumptions of OLS regression for the models, or 
just briefly mention how they were met. This is a concern, because we rarely see a linear  dose 
response. If the linearity assumption was not met, the standard errors might have been distorted.  
 
2. Have the authors considered z -standardizing the psychosocial scores? It might help better 
interpret the results in Table 4 and 5. These scores are o n different scales, and using standardized 
score in regression models could help readers better make sense of the effect size of the 
intervention.  
 
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 commen ts 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 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 l anguage 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, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
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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?  
 
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below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests.  
 
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