Reviewer's report 
 Women's attitudes towards mechanisms of action of family planning methods: survey in primary Title: 
health centres. 
 2  5 March 2007 Version: Date: 
 Margareta Larsson Reviewer: 
Reviewer's report: 
General 
This paper presents the results of a cross sectional study investigating Spanish women’s attitudes towards mechanism of action of family planning methods. It is well written and methods and results are presented in a clear and concise way. However, the fact that women were asked to comment only on the mechanism of 
action and not on any other factors related to choice of a FP method is a drawback in my opinion, and not 
mentioned in the discussion. No definition of FP is included, but when hypothetical methods are presented to women they were also asked to consider methods which may potentially act after implantation which could then be considered to be an abortion method rather than a family planning method. No “real” method 
was discussed, only hypothetical methods, which is a limiting factor. This is briefly discussed, but should be 
expanded before publication. 
------------------------------------------------------------------------------- Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) 
1. No definition of FP is included, but when hypothetical methods are presented to women, they were asked 
to consider methods that may potentially act after implantation, which could then be considered an abortion method rather than a family planning method. The authors should define in the introduction section what 
they mean with family planning. 
2. Secondly, the fact that women were asked to comment only on the mechanism of action and not on any other factors related to choice of a FP method is a drawback in my opinion, and must be discussed in the discussion section. Many other factors, except mechanism of action influence choice of a FP method; cost, 
availability, user friendliness, side effects and partner preference. These put together may be much more 
important when it comes to “real life” choices. This must be discussed. 
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Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) Conclusion: Use passed tense “women were concerned” Key words: I question why “pill” is used as a key word. The study did not specifically deal with any FP 
method. 
Pilot test carried out in a Primary Health Centre. Was this centre also included among the study sites? Results: The response rate is not clear. The response rate should be calculated according to the population of all eligible women attending the clinics and invited to participate in relation to the number of 
questionnaires analyzed. Those who declined and the dropouts are not discussed. Do the authors know 
anything about them or have a reason to believe that they differed from the respondents? Technical school is unclear and must be explained somewhere. Are not separated and divorced women 
single? Were none of the participants a muslim, hindu or buddist? Or are they included in the group “none”? 
Table 2 uses “opinion or attitude”. In the text it is also referred to as a “belief”. Try to be consistent. 
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Discretionary Revisions (which the author can choose to ignore) 
Abstract: Some percentages are presented with decimals, others without. I suggest omitting the decimals. 
Methods: Logistic regression analyzes associations, whereas the term predictor implies a causal 
relationship. Suggest rephrasing. Appears also in the result section. 
Discussion: Physicians are not the only care providers of FP methods, in fact in some countries 
nurse-midwives are the main providers. Tables: The CI for the proportions could be omitted. 
 Unable to decide on acceptance or rejection until the authors have responded to the major What next?: 
compulsory revisions 
 An article whose findings are important to those with closely related research interests Level of interest: 
 Acceptable Quality of written English: 
 No, the manuscript does not need to be seen by a statistician. Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests