Reviewer's report
Title:Awareness and correlates of the role of physical activity in breast cancer
prevention among Japanese women: a cross-sectional study
Version:1Date:29 March 2014
Reviewer: Kei Hirai
Reviewer's report:
The article seems to be very interesting and important using an unique concept,
awareness of relationship between breast cancer and physical activities.
However the main rationale of the article should be modified as indicating
bellows:
1) The article concludes that prevalence (31%) of awareness of the relationship
is low among middle aged women. However, as the authors indicated the
limitation of this study, the representativeness of the sampling in this survey is
limited because of limited sampling only in the Japanese women and using
internet-based sampling. Thus, authors should modified the tittle and conclusion
as clearly indicating the limitation of the sampling, by adding such as "among the
Japanese sample through internet based study” Also, the confidence interval of
the average proportion of prevalence, 31% should be indicated to compare the
results with other studies.
2) The correlations between awareness of breast cancer prevention and physical
activities and other demographic and knowledge of breast cancer were observed
in this study. However the item about the awareness is in the part of knowledge
of breast cancer and the intercorrelations seems to be higher among the items
within them. Thus, the correlations that the article presented as between other
variables and awareness seems not to be specific observation for awareness but
more general trend in knowledge of breast cancer. The authors should present
the specificity of the awareness from other knowledge items by additional
analyses.
3) Awareness in this study seems to be one of hypothetical constructs. However
awareness was only measured by a single item. Authors should present
rationales for reliability and validity or limitations using single item measurement.
4) The article suggests that the development of specific communication
strategies for subgroups with low awareness is needed in conclusions. However,
it may be not enough for planning strategic communication only to enhance the
awareness of relationship between breast cancer and physical activities in
certain subgroups. If the article succeeded to identify the certain psychological
and behavioral characteristics of the segment with low awareness, it will be
helpful to plan the strategic communication such as mass media campaign.
Present data does not cover this scope. Also, the authors' argument seems that
the only enhancing awareness of relationship between breast cancer prevention
and physical activity is necessary and sufficient for breast cancer prevention. If
the people aware about the relationships, there would be several types of
segments for the people who differently respond the information. I think there are
a lot of people without the awareness but with daily exercise habits, or exercise
habits are good not only for prevention of breast cancer but for prevention of
other disease. If it is difficult to present the other compelling data conceded with
awareness, the authors should write a more humble conclusion and implications
consistent with the conclusion.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
I declare no competing interests.