Reviewer's report
Title:Health Belief Mode constructs as factors associated with Breast
Self-Examination behavior in a sample of women in Bandar Abass, Iran
Version: 3Date:8 May 2009
Reviewer: Paul Norman
Reviewer's report:
Overall Comments:
The manuscript reports an interesting study applying the Health Belief Model
(HBM) to the prediction of breast self-examination among Iranian women. The
manuscript is likely to make a positive contribution to the literature given that are
no other HBM studies on BSE in Iran. In addition, the relatively large sample and
the use of Champion’s HBM scale are positive features of the study.
The authors have made a number of changes to their manuscript in response to
my comments on the original submission. These have addressed most of my
concerns. However, there are still a few points that still require attention as
detailed below.
Major revisions:
The manuscript would benefit from further copy-editing. There were too many
minor grammatical errors for me to list.
The description of the BSE measures still lacks detail – this needs to be reported
more precisely given that BSE performance is the dependent variable.
Were there any differences in BSE performance according to age, education and
history of breast problems? These results need to be reported in the text.
It’s not clear why age and education are included in the logistic regression
analysis but history of breast problems isn’t. One option would be to only include
those that are significantly associated with BSE performance or, alternatively, to
include all three variables.
Minor revisions:
The title doesn’t appear to have been changed. It would be better as “An
application of health belief model to the prediction of breast self-examination in
Iranian women” or “Breast self-examination in Iranian women: An application of
health belief model”
There’s no need to provide such detailed information on the demographic profile
of the women in the abstract.
The information on the incidence of breast cancer in Iran in the introduction could
be reported more succinctly. In addition, further information on applications of the
HBM to the prediction of BSE could be provided. For example, which HBM
constructs are most strongly or most consistently associated with BSE
performance?
The method would benefit from the use of more sub-headings to structure the
material.
It is not immediately clear from the text on page 5 that the comparison reported in
Table 2 is between BSE performers (regular and irregular) and non-performers
(never). This needs to be stated more clearly.
The reporting/interpretation of the odds ratios in the text could be clearer.
Table 1. The meaning of the second table note is very unclear.
Table 2, 3 and 4. p = .000 should be reported as p < .001.
Discussion.
Page 9, paragraph 3. The first sentence is technically incorrect as the BSE group
consisted of regular and irregular BSE performers.
Page 10, final paragraph before the conclusion. There doesn’t appear to be a
strong case for suggesting the use of factor analysis given that the scales were
found to be reliable in the present study.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Not suitable for publication unless extensively edited
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests