Reviewer ’s report  
 
Title: When User -Centered Design meets Implementatio n Science: Integrating Provider 
Perspectives in the Development of an Intimate Partner Violence  Intervention for Women 
Treated in the United States ’ Largest Integrated Healthcare System  
 
Version: 0 Date: 19 Jan 2 019 
 
Reviewer: Colleen Varcoe  
 
Reviewer's report:  
 
BMC Women's Health RISE  
 
For the most part, this paper is clearly written. The methods, use of frameworks and limitations 
are particularly clear. The paper may make a useful contribution if it is more carefully framed 
within the larger intervention development project. The greates t gap is the absence of attention to 
what outcomes are imagined for women.  
 
 
I have identified several ways in which the paper can be strengthened.  
 
1. Clarify earlier and more cautiously the contribution of this sub -study to the overall 
intervention developm ent and testing process. It eventually becomes clear that the work 
reported in this paper is part of the development of RISE, but earlier the paper can be 
read as though it is focused on the implementation of an Evidence Based Treatment. I 
don't think this  is the author's intent, but think that it would be clearer if they:  
 
a. Clarify when first describing RISE 'where' they are at in the development 
process (earlier than page 6 where it says "The current study is a part of a 
larger project designed to refine  and formally evaluate RISE in preparation 
for a large -scale effectiveness trial within VHA."  
 
b. Be a bit more cautious with a statement that the study is aimed "to increase 
the likelihood of the usefulness, acceptability, and feasibility of the RISE 
intervention to VHA providers…" perhaps with something such as "should it 
prove effective".  
 
c. Insure they are not implying that they have already produced evidence of 
effectiveness. The only apparent evidence of impact is related to the inclusion 
of Motivation al Interviewing. A clearer description of any evidence of 
effectiveness is needed, including what outcomes are being pursued.  
 
2. More fully describe RISE. It is clear that RISE is a brief counseling intervention 
consisting of 1 -6 sessions and the focus of the modules is clear. However, it eventually 
reads as though it is not an 'intervention' but rather an 'intervention manual' FOR 
PROVIDERS. If this is the case, then that should be made clear; it is not clear WHO is 
intended to deliver the intervention, in  WHAT settings, and WHAT training the 
interventionists ought to have. There is also no description of intended outcomes. How 
long is the manual? What are its characteristics? It seems as though (related to point #1 
above) the authors are seeking through th is sub -study to define how this manual might 
best be used in practice - that is, to develop the missing aspects of the intervention. The 
rationale for this approach should be provided, as opposed to, for example, drawing on 
the literature regarding brief c ounselling interventions to determine these elements. The 
findings are not surprising, given that the literature and studies of other interventions 
have already shown such element of interventions to be useful (e.g. training for 
interventionists).  
 
3. Clari fy why service providers, rather than women are positioned as the end users. I think 
this is related to point #2 above; this is not so much an 'intervention' as a manual to 
support service providers intervening with women.  
 
4. Be careful not to overstep th e data. This paper reports on the opinions of service 
providers (presumably with expertise) about a manual describing an untested 
intervention, with which they are familiarized in advance "if time permitted" or during 
the interview with "up to 20 minutes" to review it. There is thus no basis for a statement 
such as "A consistent finding was that the RISE intervention helps to facilitate provider 
comfort and self -efficacy in addressing IPV, especially for those who have less 
familiarity with addressing IPV".  First, comfort and self -efficacy were not measured; 
second there was no study of how the providers addressed IPV, and third, there was no 
indication of the participants' familiarity with addressing IPV.  
 
5. Related to the above, more detail is required reg arding the participants (specifically, what 
experience and knowledge did they have about IPV?) and interviews (how long where 
they?).  
 
6. For the most part the paper is adequately supported with literature. However, the 
paragraph on page 15, beginning line  9, "in addition…."needs support.  
 
7. Finally there are a few places were clarity could be increased.  
 
* Throughout the paper, eliminate passive voice. For example, findings do not 
"emerge" (a term the authors use frequently); findings are identified by 
researchers.  
 
* A sentence in the abstract reads "Implementation science and user -centered -
design (UCD) play an important role in accelerating the research pipeline." 
First, is this a general statement? If so, it might be better stated as 
"Implementation scien ce and user -centered -design (UCD) CAN play an 
important role in accelerating the research pipeline". Second, later the authors 
identify the 'pipeline' as the research to practice pipeline, which is much 
clearer.  
* A key word is "Women Veterans" and the con text of the VHA is likely 
important (as the author's note, the practitioners are familiar with dealing with 
historical trauma), but a) nothing in the abstract or title specifies this context 
(it appears late in the background), and b) the authors do not ex plicitly 
explore the impact of this context (and should do so)  
 
* In the discussion the authors explain that "VA Medical Centers are required to 
have an identified IPV Assistance Program Coordinator to assist with 
developing local policies and procedures fo r addressing IPV, but this should 
be explained on first mention of IPV coordinators.  
 
* The statement in the results "(with nearly equivalent representation across the 
two study sites)" is the first and only mention of two sites. Describe earlier 
and provi de detail.  
 
* For an international audience, a number of US specific elements need to be 
explained - OEF/OIF  
 
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 auth ors. 
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an add itional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language 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, f ees, funding, or salary 
from an organisation that may in a ny way gain or lose financial ly from the 
publication of this manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or 
lose financially from the publication of this manuscript, either now or  in the 
future?  
 
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?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interest s' 
below. If your reply is yes to any, please give details below.  
 
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