Title: The Effect of Video-Based Multimedia Training on Knowledge, Attitude, and
Performance in Breast Self-Examination
Version: 2 Date: 14 Mar 2022
Reviewer's report:
Dear authors,
Thank you for your great research and important study in comparing the two platforms of
educating the public with regard to BSE.
There are few comments for improvement of the manuscript
Abstract:
1)There are mixture of small and big letter at the beginning of the paragraph. Kindly double
check on this and make it homogenous either you would like to start with small or big letter on
each section or headings.
2) Kindly include what factors based on your analysis would associated with the KAP score in
both groups.
Introduction:
1) Other than mentioning factors associated with low breast cancer screening "  such as lack of
education and training, fear, cultural and social taboos", how is about the other factors that you
included in your sociodemographic factors such as marital status, age, family history and etc..
Kindly cite any references.
Methodology:
1) In the intervention group, authors mentioned " In face to face group, participants received
lectures in workshops (PowerPoints and practical modules) ". Kindly elaborate on the inclusion
of the topics, rationale to include the topics and who are the person delivering the topics?
2) Authors mentioned "In video-based multimedia group, the content was categorized into theory
and practical and was delivered via a diverse range of multimedia activities". Kindly list what
kind of multimedia / medium and what sort of activities.
3) For the face validation (Knowledge research instruments), kindly state background of the
experts and how many of them involved.
4) For the performance, authors mentioned that " a research-made checklist including 15
questions, was used, covering 5 categories, such as Performing for the BSE (2); hands position
(2); patterns of BSE (3); BSE position (2); BSE practical steps (6). The scores included
completely right (3), relatively right (2), and wrong (0)". Please state any validation done on
this checklist.
5) Any cut off value for good performance or not?
6) For data analysis, I am strongly suggest the authors to include multivariate analysis in order
to find the significant factors contributing to the KAP score as well.
Results:
1) For sociodemographic characteristics, can authors kindly include the job of the respondents,
are they housewife or working? This is important as well in determining their KAP.
2) Please include multivariate analysis as well.
Discussion:
1) Authors mentioned "very low score in terms of attitude pre-test, even for those women with
high knowledge/awareness ". How authors determine the cut off values for low or high score?
kindly state.
2) Authors mentioned "Those with a higher level of education, particularly those with university
qualifications had a much better performance in regards to BSE, using multimodal video-based
training". This is actually not finalized, please do multivariate analysis.
3) For paragraphs 7 - 10, kindly include any citations or references for the points or reasons
mentioned.
References:
1) There are several references beyond 10 years (No 22, 34,35, 39). Kindly revised.
Thank you.