Reviewer’s report
Title: 
IMPROVING KNOWLEDGE ABOUT BREAST CANCER AND
BREAST SELF EXAMINATION IN FEMALE NIGERIAN ADOLESCENTS
USING PEER EDUCATION: a pre- post interventional study.
Version: 
0 
Date: 
21 Apr 2021
Reviewer: 
Marjan 
Ahmad Shirvani
Reviewer's report:
This study reported the result of peer education on improving adolescences'
knowledge about breast cancer. This is an important issue, but the standards for
reporting the results of an interventional study have not been met. There is a lot
of ambiguity about the methodology. English language also needs revision.
Title: The type of intervention must be specified. What type of interventional
studies? 
Abstract is too long, especially in the background section. Kindly adjust the
number of words according to this journal. The method was not well explained.
How many students were trained (sample size)? What was the design of the
study/intervention, time (year) of the study, sampling method, time of follow-up?
Kindly mention the statistical methods; explanation is not necessary. Report the
proportion of students who knew about BSE (page 3, line10). The statistical
change of knowledge about BSE should be reported. 
Kindly replace peer education with Nigeria in the key words.
Introduction is too long. Moreover, the paragraphs should be logically integrated,
for example paragraphs 1-3. 
Effect of peer education on increasing of knowledge in different subjects has
been confirmed in previous studies. The need for this study is not clear based on
the lack of knowledge or inconsistency of the reports. 
The aim in the end of this section is not similar to the title. Assessment of
practice was not considered in the title. 
Methodology
Kindly report the design of the study/intervention and time (year) of the study.
The explanation about education in Nigeria (the second and third paragraphs) is
not necessary (page 7).
The adequacy of the sample size is not known. How did you calculate it? How
many students were totally recruited prior to training seminar? Why were the
same proportion (30%) of students recruited in each school? Was the number of
papulations the same in all schools? The results show you considered the school
group as a control, so how did you calculate the necessary sample size for two
groups of the study?
What was the type of randomization? It seems you used the systematic
randomization, is it true? 
The explanations about participants and sampling method are confusing. At first
30% of students were recruited and took part in the seminar. They are expected
to be taken pre and post- test, while you reported post-test were taken from 30%
of them after one week!! 
"The pre training questionnaires were not linked to post training questionnaires"
(page 9, line 7) and " The same questionnaire was used for the collection of data
at … pre and post-test"; which one is correct?!
What was the reliability of questionnaires? In addition, explain scoring and its
interpretation. 
You mean by school cohort and seminar cohort is vague. What do you mean by
cohort? Was it group? If it was, you should explain them in the participants
section, not in analysis. How did you deal with these groups? 
Was school group
as a control group?
"The proportions of students ….. simple percentages", This sentence is not clear.
Write used descriptive statistics completely.
Scoring should be explained in the instrument section, not in the data analysis.
Results
It seems a major revision is necessary. If you considered a control group as
school group, the results should be reported and compared for those who
completed the study. It means data for 1201 should be compared with 124 both
pre and post training.
Table 1. sociodemographic characteristics should be compared between two
groups pre intervention (1201 with 124 students)
Table 2. Kindly report p values with maximum 3 decimals.
Discussion is more appropriate for a descriptive study. Comparison the effect of
intervention with the results of other studies was less considered. Limitation of
this study should be reported in the end of discussion.
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
No
Are the methods sufficiently described to allow the study to be repeated?
No
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
No
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes