Reviewer ’s report  
 
Title: "A Secret Club": Focus groups about women's toileting behaviors  
 
Version: 0 Date: 17 Dec 2018  
 
Reviewer: Dongjuan Xu  
 
Reviewer's report:  
 
1). Page 5, Line 17, "OAB bladder", OAB already has the word bladder.  
 
2). Regarding TB -WEB (Page 7 Lines 47 -48) , the five factors' na me is not exactly the same as 
mentioned in the development paper ( Wang & Palmer 2011). Later, in Page 8, Lines 76 -77, 
different concepts were mentioned. It might be better to have consistent names.  
 
3). Page 7 Lines 56 -59, the study sample was "from olde r adult women". However, one of the 
inclusion criteria was "aged 21 years and over" (Page 8, Line 67).  
 
4). Page 8. Lines 81 -82, I would like to know the seven interview questions (supplement 
material).  
 
5). Page 9, Line 90. It might be better to spell o ut the full names of ICIQ -UI SF and ICIQ -OAB.  
These two questionnaires were used in this study. In the method section, full descriptions of 
them would be necessary.  
 
6). In Table 1, it seems the women in Pennsylvania were older, had higher BMI, higher 
prevalence of UI and OAB compared to those in North Carolina. I would like to know whether 
the themes vary by study sites. I am not sure the meaning of the last row N(%) of Table 1.  
 
7). Almost all participants in Pennsylvania (93.8%) had OAB. It is possibl e that they engaged in 
behaviors to adapt to OAB.  
 
8). It is better to use title and subtitle to organize the result section. For example,  
     1. Bladder health  
    1.1 how the bladder functions  
    1.2 the presence or absence of infection or disease  
    1.3 control over the bladder   
     2. Toileting behaviors  
   2.1 Cures/triggers/alerts  
   2.2        Cleanliness matters  
   2.3 Toileting as a nuisance  
   2.4 Situational awareness  
 
9). It may be useful to distinguish healthy toileting behaviors from  unhealthy toileting behaviors 
under each theme.  
 
10). I am not sure it would be better to organize the results using three categories: antecedents, 
urination itself, and consequences (Page 5, Lines 21 -23) , or the concepts: preferred place for 
voiding, p remature voiding, delay voiding, straining to void, and position preference for voiding 
(Page 8, Lines 76 -77).  
 
11). page 17. Line 283, I am not sure the meaning of "USA2".  
 
 
 
 
 
 
 
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 c omments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additio nal statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.   
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
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3. Do you hold or are you currently applying for any patents relating to the content of the  
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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 t his paper?  
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