Couples data from north-western Tanzania: Insights from a survey of male partners of women enrolled in the MAISHA cluster randomized trial of an intimate partner violence prevention intervention

Tanya Abramsky; Imma Kapinga; Gerry Mshana; Shelley Lees; Christian Holm Hansen; Ramadhan Hashim; Heidi Stöckl; Saidi Kapiga; Sheila Harvey

doi:10.1371/journal.pone.0240112

Peer Review History

Original SubmissionFebruary 25, 2020
9 Apr 2020 Decision Letter - Kristin Dunkle, Editor PONE-D-20-05439 Factors associated with intimate partner violence in north-western Tanzania: Results from a survey of male partners of women enrolled in the MAISHA cluster randomised trial PLOS ONE Dear Miss Abramsky, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not yet fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please address or carefully rebut reviewer comments as per your best judgement, and ensure that you will be fully aligned with PLOS' data availability policy should the revised manuscript be accepted for publication. We would appreciate receiving your revised manuscript by May 24 2020 11:59PM. 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The views expressed in the paper do not necessarily reflect the Department’s official policies. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. " PLOS ONE requires you to include in your manuscript further information about the funder so that any relevant competing interests can be assessed. 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For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: No Reviewer #2: No ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Congratulations on a well written paper. My comments reflect suggestions for minor revisions. Abstract: The abstract does not accurately reflect your most important findings. The first paragraph of the discussion nicely describes your three most important findings but you only present results from the third among these. Suggest revising the abstract to present the data most reflective of these three points. In the abstract you discuss man- woman- relationship- and household level factors. While Figure 1 aptly explains this combining relationship and household factors, in the full paper the relationship and household factors are never clearly delineated nor are the defined elsewhere in the paper. Are they the same or not. If not need to more clearly define in the full paper. General: Data are plural. Do a control f and check grammar, "Data are/were" as opposed to "Data is" (ie page 10, line 66) Background: Add delineation of social ecology (man, woman, relationship and household) here or otherwise define more clearly in the methods measures Methods: methods are well done and clear. Add info on social ecology as relates to your specific measures in this section with the sub section on IPV outcomes Results: Add percents to the phrase "938 (%) were interviewed of whom 790 (%) reported..." Table 1: extend spacing of column 1 so it reads more clearly. There is space in columns 2-4 to do this Table 2a: define income quartiles and BRAC for readers unfamiliar with these terms Table 3: add the word quartiles under income quartile so consistently labeled across tables 2a and 3 Do not begin sentences with a number (ie 30%... page 21, row 260) Discussion: This is the most strongly written part of this paper and this strength should be reflected in the abstract as mentioned previously Page 32, line 399-411 speak to measures of severity of violence experienced by men and whether this might have played a role in your finding of no association Page 33, line 429-439 need to address how increased financial independence and/or women's increased autonomy may also trigger violence Reviewer #2: Thank you for the opportunity to review this paper that is a valuable contribution to literature that focuses on the dynamics of conducting violence related research among couples. I have several comments to make which may be helpful to the authors Title: Although the paper does look at factors associated with women’s victimisation and corroborates data from male partners, the current title misses the main objective and novelty of the paper which is the process and selection associated with women’s willingness to have male partners participating in research with them. It may be good to reflect this somehow in the title if possible. Introduction: This is well written and has logical flow including a strong rationale for the study. Methods: It is clear that male partners were not asked about violence perpetration to minimise risks to female participants. However, in line 138 there’s reference that men were asked about relationship characteristics and dynamics. Male participants were also questioned about attitudes towards IPV. It will be important for authors to also discuss the potential for risk associated with administering such questions with male partners in context of them being abusive. It may be without asking about violence perpetration there is chance of suspicion by male partners who may well be guarded about their partners discussing their relationships with outsiders. Results: The authors report on insignificant associations i.e 95%CI overlapping with 1 as “weak associations”. This is problematic and must be rectified including discussions that allude to these as follows: Line 320 Physical IPV is associated with financial hardship Line 324 men’s attitudes are said to be weakly associated with physical and sexual IPV Line 327 -typo- 95% CI from table is 1.03-3.08 Line 328- Men’s alcohol is associated with physical IPV Line 331- There is “suggestion “that women’s alcohol is weakly associated with physical IPV Overall authors must use the standard that every OR with 95%CI overlapping with 1 should not be considered as a significant weak association. Discussion: The discussion must be revised in accordance to changes in interpretation of results as alluded above. The finding that men’s violence perpetration was not associated with their attitudes towards IPV warrants further discussion. Could that have been a result of social desirability biases or how else can this be explained. The discussion does not provide explanation about what could be happening with women who did not disclose IPV but still were unwilling for their male partners to participate. These may be an important group to understand Limitations A missed opportunity is that researchers did not explore women’s motivations for their un/willingness to let their male partners participate in the study. It is important to cite this as a limitation. However, the speculated explanations based on data distribution of women who consented is well argued. ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. 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Attachments Attachment Submitted filename: Plos bReview 24032020.docx https://doi.org/10.1371/journal.pone.0240112.r001
Revision 1
21 May 2020 Author Response Reviewer #1: Congratulations on a well written paper. My comments reflect suggestions for minor revisions. TA: THANK YOU FOR THIS POSITIVE FEEDBACK. Abstract: The abstract does not accurately reflect your most important findings. The first paragraph of the discussion nicely describes your three most important findings but you only present results from the third among these. Suggest revising the abstract to present the data most reflective of these three points. TA: THANK YOU FOR THIS COMMENT. IT IS ALWAYS A CHALLENGE TO SUMMARISE ALL OF THE KEY POINTS WITHIN THE STRICT WORD LIMIT OF AN ABSTRACT. WE CITE THE CONSENT RATES IN THE ABSTRACT’S RESULTS SECTION AND HAVE ADDED A SENTENCE TO THE ABSTRACT’S CONCLUSION STATING THAT WE SUCCESSFULLY CONDUCTED A SURVEY OF MALE PARTNERS WITH THE FULL CONSENT OF WOMEN. WE HAVE ALSO ADDED A SENTENCE TO THE RESULTS SECTION OF THE ABSTRACT REGARDING THE DIFFERENT PATTERNS OF ASSOCIATION OBSERVED IN THE TWO TRIAL ARMS WITH RESPECT TO WOMEN’S IPV EXPERIENCE AND CONSENT. In the abstract you discuss man- woman- relationship- and household level factors. While Figure 1 aptly explains this combining relationship and household factors, in the full paper the relationship and household factors are never clearly delineated nor are the defined elsewhere in the paper. Are they the same or not. If not need to more clearly define in the full paper. TA: WE HAVE NOW ADDED A SUBSECTION TO THE METHODS SECTION OF THE FULL PAPER ENTITLED “EXPOSURE VARIABLES FOR THE IPV ANALYSIS”. THIS OUTLINES THE DIFFERENT LEVELS OF THE SOCIAL ECOLOGY CONSIDERED, AND REFERS TO THE CONCEPTUAL FRAMEWORK (FIGURE 1) WHERE VARIABLES ARE LAID OUT IN MORE DETAIL. IN THIS PARAGRAPH, WE CLARIFY THAT RELATIONSHIP/HOUSEHOLD FACTORS ARE “FACTORS PERTAINING TO THE RELATIONSHIP ITSELF AS WELL AS TO THE BROADER HOUSEHOLD IN WHICH THE COUPLE LIVES”. HERE, AS WELL AS IN THE ABSTRACT AND THROUGHOUT THE PAPER, RELATIONSHIP- AND HOUSEHOLD-LEVEL FACTORS ARE REFERRED TO AS “RELATIONSHIP-/HOUSEHOLD-LEVEL FACTORS” TO MAKE IT CLEAR THAT THEY ARE BEING CONSIDERED TOGETHER. General: Data are plural. Do a control f and check grammar, "Data are/were" as opposed to "Data is" (ie page 10, line 66) TA: THANKS FOR POINTING THIS OUT. I HAVE MADE THE NECESSARY CHANGES THROUGHOUT THE MANUSCRIPT. Background: Add delineation of social ecology (man, woman, relationship and household) here or otherwise define more clearly in the methods measures TA: SEE ABOVE COMMENT ON SOCIAL ECOLOGY Methods: methods are well done and clear. Add info on social ecology as relates to your specific measures in this section with the sub section on IPV outcomes TA: SEE ABOVE COMMENT ON SOCIAL ECOLOGY Results: Add percents to the phrase "938 (%) were interviewed of whom 790 (%) reported..." TA: WE HAVE ADDED THESE PERCENTAGES AS REQUESTED. Table 1: extend spacing of column 1 so it reads more clearly. There is space in columns 2-4 to do this TA: WE HAVE MADE THIS CHANGE TO TABLE 1 Table 2a: define income quartiles and BRAC for readers unfamiliar with these terms TA: WE HAVE CHANGED THE LABELS FOR THESE VARIABLES, AND ADDED FOOTNOTES TO TABLE 2 TO EXPLAIN BRAC AND INCOME QUARTILES. Table 3: add the word quartiles under income quartile so consistently labeled across tables 2a and 3 TA: WE HAVE MADE THIS CHANGE TO TABLES 3, 4B AND 5. Do not begin sentences with a number (ie 30%... page 21, row 260) TA: WE HAVE FIXED THE THREE INSTANCES WHERE THIS OCCURRED ON PAGE 16. Discussion: This is the most strongly written part of this paper and this strength should be reflected in the abstract as mentioned previously TA: THE ABSTRACT WAS AMENDED TO MORE ACCURATELY SUMMARISE KEY POINTS FROM THE DISCUSSION, AS DESCRIBED IN RESPONSE TO YOUR FIRST COMMENT. Page 32, line 399-411 speak to measures of severity of violence experienced by men and whether this might have played a role in your finding of no association TA: WE HAVE ADDED THE FOLLOWING SENTENCE TO THIS PARAGRAPH: “WHILE WE FOCUSED ON CHILDHOOD EXPERIENCE OF SEVERE PHYSICAL ABUSE (THAT LEFT MARKS OR INJURIES), WE OBSERVED SIMILAR NULL FINDINGS IN RELATION TO A MORE GENERAL MEASURE OF PHYSICAL ABUSE IN CHILDHOOD (INCLUDING LESS SEVERE INCIDENTS).” Page 33, line 429-439 need to address how increased financial independence and/or women's increased autonomy may also trigger violence TA: WE HAVE AMENDED THE SENTENCE AT THE END OF THIS PARAGRAPH TO READ: “THIS FINDING, ALONGSIDE THE CONVERSE POTENTIAL FOR WOMEN’S GREATER FINANCIAL AUTONOMY TO INCREASE RISK OF RELATIONSHIP CONFLICT IF IT IS PERCEIVED AS UNDERMINING THE MALE PARTNER’S AUTHORITY OR TRANSGRESSING WOMEN’S TRADITIONAL GENDER NORMS, IS DISCUSSED IN MORE DETAIL ELSEWHERE.” Reviewer 2 Thank you for the opportunity to review this paper that is a valuable contribution to literature that focuses on the dynamics of conducting violence related research among couples. I have several comments to make which may be helpful to the authors Title: Although the paper does look at factors associated with women’s victimisation and corroborates data from male partners, the current title misses the main objective and novelty of the paper which is the process and selection associated with women’s willingness to have male partners participating in research with them. It may be good to reflect this somehow in the title if possible. TA: WE HAVE CHANGED THE TITLE TO: COUPLES DATA FROM NORTH-WESTERN TANZANIA: INSIGHTS FROM A SURVEY OF MALE PARTNERS OF WOMEN ENROLLED IN THE MAISHA CLUSTER RANDOMIZED TRIAL OF AN INTIMATE PARTNER VIOLENCE PREVENTION INTERVENTION Introduction: This is well written and has logical flow including a strong rationale for the study. TA: Thank you for this positive feedback. Methods: It is clear that male partners were not asked about violence perpetration to minimise risks to female participants. However, in line 138 there’s reference that men were asked about relationship characteristics and dynamics. Male participants were also questioned about attitudes towards IPV. It will be important for authors to also discuss the potential for risk associated with administering such questions with male partners in context of them being abusive. It may be without asking about violence perpetration there is chance of suspicion by male partners who may well be guarded about their partners discussing their relationships with outsiders. TA: THIS IS AN IMPORTANT POINT. WE HAVE ADDED A COUPLE OF SENTENCES TO THE BOTTOM OF THIS PARAGRAPH ON HOW QUESTIONS ON ATTITUDES AND RELATIONSHIP DYNAMICS WERE FRAMED TO MINIMISE RISK TO FEMALE PARTICIPANTS: “QUESTIONS ON ATTITUDES TOWARDS IPV WERE EMBEDDED IN A SECTION ON BROADER NORMS AND ATTITUDES (INCLUDING EQUITABLE AS WELL AS CONSERVATIVE NORMS), AND INTRODUCED IN NEUTRAL TERMS, SO AS NOT TO CAST MEN AS THE AGGRESSORS WITHIN RELATIONSHIPS. IN THE SAME VEIN, QUESTIONS ON RELATIONSHIP DYNAMICS COVERED POSITIVE AS WELL AS NEGATIVE INTERACTIONS WITHIN THE COUPLE.” IT IS ALSO IMPORTANT TO EMPHASISE THAT, AS DESCRIBED IN THE METHODS SECTION, WOMEN WERE MADE AWARE OF THE NATURE OF QUESTIONS IN THE MALE SURVEY BEFORE GIVING CONSENT FOR THE TEAM TO APPROACH THEIR PARTNER. CONCERNS ABOUT RISK POSED BY SUCH QUESTIONS IN THE CONTEXT OF SPECIFIC RELATIONSHIPS WERE NO DOUBT BEHIND SOME WOMEN’S DECISIONS TO WITHHOLD CONSENT, AS HAS BEEN DISCUSSED IN THE PAPER. Results: The authors report on insignificant associations i.e 95%CI overlapping with 1 as “weak associations”. This is problematic and must be rectified including discussions that allude to these as follows: Line 320 Physical IPV is associated with financial hardship Line 324 men’s attitudes are said to be weakly associated with physical and sexual IPV Line 328- Men’s alcohol is associated with physical IPV Line 331- There is “suggestion “that women’s alcohol is weakly associated with physical IPV Overall authors must use the standard that every OR with 95%CI overlapping with 1 should not be considered as a significant weak association. TA: THERE IS INCREASING RECOGNITION THAT THE IMPORTANCE OR RELEVANCE OF AN OBSERVED ASSOCIATION SHOULD NOT BE ACCEPTED OR DISMISSED SOLELY ON THE BASIS OF WHETHER IT IS STATISTICALLY SIGNIFICANT AT THE 5% LEVEL. NOT ONLY IS THIS A SOMEWHAT ARBITRARY CUT-OFF POINT (WITH GRADED INFERENCE FROM THE ACTUAL P-VALUE POTENTIALLY MORE USEFUL), BUT IT IS ALSO LARGELY INFLUENCED BY SAMPLE SIZE AND THE CONSEQUENT POWER OF THE STUDY TO DETECT ASSOCIATIONS OF ANY GIVEN SIZE. WHILE P-VALUES AND CONFIDENCE INTERVALS ARE OBVIOUSLY CRUCIAL TO EVALUATE THE STRENGTH OF EVIDENCE, IT IS ALSO IMPORTANT TO CONSIDER THE DIRECTION AND MAGNITUDE OF AN OBSERVED ASSOCIATION. IN RELATION TO THE FINDINGS YOU MENTION ABOVE, WE HAVE CHANGED THE WORDING TO MAKE IT CLEAR WHERE CONFIDENCE INTERVALS INCLUDE UNITY – HOWEVER, WE STILL DRAW ATTENTION TO OBSERVED PATTERNS IN THE DATA WHERE RELATIVELY LARGE ODDS RATIOS SUGGEST THAT ODDS OF IPV ARE INCREASED IN ONE EXPOSURE CATEGORY COMPARED TO ANOTHER. FOR EXAMPLE: “PHYSICAL IPV WAS ALSO LOWER WHERE NEITHER THE MAN NOR WOMAN HAD REPORTED HOUSEHOLD-LEVEL FINANCIAL HARDSHIP, THOUGH THE CONFIDENCE INTERVAL WAS WIDE AND INCLUDED UNITY IN THE ADJUSTED ANALYSIS (AOR 0.39, 95%CI 0.13-1.14).” WE HAVE REMOVED MENTION OF MEN’S ALCOHOL AS A RISK FACTOR FOR PHYSICAL IPV FROM THE ABSTRACT WHERE MORE DETAILED DISCUSSION OF DIRECTION VERSUS STATISTICAL SIGNIFICANCE IS NOT POSSIBLE. Line 327 -typo- 95% CI from table is 1.03-3.08 TA: THANKS FOR POINTING OUT THE TYPO. THIS HAS NOW BEEN CORRECTED. Discussion: The discussion must be revised in accordance to changes in interpretation of results as alluded above. TA: SEE RESPONSE TO ABOVE COMMENT. The finding that men’s violence perpetration was not associated with their attitudes towards IPV warrants further discussion. Could that have been a result of social desirability biases or how else can this be explained. TA: THIS IS AN IMPORTANT COMMENT. WE HAD ALREADY INCLUDED SOME DISCUSSION OF HOW THE INCLUSION OF ALCOHOL IN THE MODEL FURTHER ATTENUATED OBSERVED ASSOCIATIONS BETWEEN ATTITUDES AND IPV. WE HAVE ALSO ADDED THE FOLLOWING SENTENCE TO THE PARAGRAPH DISCUSSING MEN’S ATTITUDES: “IT IS POSSIBLE THAT THE LACK OF A STRONG ASSOCIATION IN OUR SAMPLE IS DUE TO SOCIAL DESIRABILITY BIAS IN MEN’S REPORTING OF ATTITUDES WHICH MIGHT BE EXACERBATED BY THEIR KNOWLEDGE OF THEIR PARTNER’S INVOLVEMENT IN AN INTERVENTION ON HEALTHY RELATIONSHIPS.” The discussion does not provide explanation about what could be happening with women who did not disclose IPV but still were unwilling for their male partners to participate. These may be an important group to understand. TA: THANKS FOR THIS USEFUL COMMENT. WE HAD ALREADY INCLUDED DISCUSSION OF NON-IPV RELATED FACTORS ASSOCIATED WITH CONSENT/LACK OF CONSENT – FOR EXAMPLE LOWER CONSENT AMONG WOMEN IN SHORTER TERM RELATIONSHIPS. IN THE SECOND PARAGRAPH OF THE DISCUSSION, WE HAVE NOW INCLUDED MORE EXPLICIT DISCUSSION OF WHY THIS MIGHT BE: “IT IS POSSIBLE THAT THOSE IN NEWER RELATIONSHIPS FEEL LESS COMFORTABLE BEING ASSOCIATED WITH DEMANDS ON THEIR PARTNER’S TIME. WOMEN IN RELATIONSHIPS WITH POORER COMMUNICATION MIGHT ALSO BE LESS LIKELY TO HAVE TOLD THEIR PARTNER ABOUT THEIR OWN PARTICIPATION IN MAISHA OR BE CONCERNED THAT HE WOULD REACT NEGATIVELY TO HER SHARING HIS DETAILS WITH THE STUDY TEAM.” Limitations A missed opportunity is that researchers did not explore women’s motivations for their un/willingness to let their male partners participate in the study. It is important to cite this as a limitation. However, the speculated explanations based on data distribution of women who consented is well argued. TA: SEE ABOVE RESPONSE. IN ADDITION TO THE POINTS RAISED ABOVE, WE HAD ALSO ALREADY INCLUDED DISCUSSION OF HOW: • WOMEN’S IPV EXPERIENCE AND CONCERNS FOR THEIR OWN SAFETY MAY MOTIVATE THEM TO WITHHOLD CONSENT IN THE CONTROL GROUP • WOMEN’S POSITIVE EXPERIENCES OF PARTICIPATING IN THE INTERVENTION MAY PREDISPOSE THEM TO CONSENT TO THEIR PARTNER BEING APPROACHED, PERHAPS EVEN MORE SO IN CASES WHERE THE PARTNER IS VIOLENT AND THEY FEEL CONTACT WITH THE TRIAL TEAM MIGHT BE BENEFICIAL. Editor’s comments When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at http://www.journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf andhttp://www.journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf TA: WE HAVE RENAMED THE SUPPLEMENTARY FILES TO COMPLY WITH PLOS ONE REQUIREMENTS. THEY NOW INCLUDE THE PREFIX S1, S2, ETC. 2. Please include additional information regarding the survey or questionnaire used in the study and ensure that you have provided sufficient details that others could replicate the analyses. For instance, if you developed a questionnaire as part of this study and it is not under a copyright more restrictive than CC-BY, please include a copy, in both the original language and English, as Supporting Information. TA: WE HAVE INCLUDED THE QUESTIONNAIRES IN ENGLISH AND SWAHILI AS SUPPLEMENTARY FILES 1-4. 3. Thank you for stating in your financial disclosure: "The MAISHA study was funded by an anonymous donor and supported by the STRIVE Research Consortium, which is funded by UK Aid (Grant number PO5244 held by SL) from the UK government Department for International Development (https://www.ukaiddirect.org/) . The views expressed in the paper do not necessarily reflect the Department’s official policies. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. " PLOS ONE requires you to include in your manuscript further information about the funder so that any relevant competing interests can be assessed. Please respond to the following questions:cc a) Please state whether any of the research costs or authors' salaries were funded, in whole or in part, by a tobacco company (our policy on tobacco funding is athttp://journals.plos.org/plosone/s/disclosure-of-funding-sources) TA: NONE OF THE RESEARCH COSTS OR AUTHORS’ SALARIES WERE FUNDED, IN WHOLE OR IN PART, BY A TOBACCO COMPANY. b) Please state whether the donor has any competing interests in relation to this work (see http://journals.plos.org/plosone/s/competing-interests) . TA: THE DONORS HAVE NO COMPETING INTERESTS IN RELATION TO THIS WORK. c) Please state whether the identity of the donor might be considered relevant to editors or reviewers’ assessment of the validity of the work. TA: THE DONORS’ IDENTITIES WOULD NOT BE CONSIDERED RELEVANT TO EDITORS OR REVIEWERS’ ASSESSMENT OF THE VALIDITY OF THE WORK. d) If the donors have no perceived or actual competing interests, please state: “The authors are not aware of any competing interests”. TA: THE AUTHORS ARE NOT AWARE OF ANY COMPETING INTERESTS. This information should be included in your cover letter. We will amend your financial disclosure and competing interests on your behalf. 4. We note that you have stated that you will provide repository information for your data at acceptance. Should your manuscript be accepted for publication, we will hold it until you provide the relevant accession numbers or DOIs necessary to access your data. If you wish to make changes to your Data Availability statement, please describe these changes in your cover letter and we will update your Data Availability statement to reflect the information you provide. TA: WE DO NOT WISH TO CHANGE OUR DATA AVAILABILITY STATEMENT. WE ARE IN THE PROCESS OF PREPARING THE DATASETS FOR THE LSHTM DATA REPOSITORY. DUE TO THE CURRENT LOCKDOWN SITUATION AND WORKING FROM HOME ARRANGEMENTS, THIS PROCESS MAY TAKE SLIGHTLY LONGER THAN ANTICIPATED. UNTIL THE URL IS AVAILABLE, WE WOULD BE HAPPY TO HANDLE DATA REQUESTS SUBMITTED DIRECTLY TO THE CORRESPONDING AUTHOR. https://doi.org/10.1371/journal.pone.0240112.r002
3 Aug 2020 Decision Letter - Thach Duc Tran, Editor PONE-D-20-05439R1 Couples data from north-western Tanzania: Insights from a survey of male partners of women enrolled in the MAISHA cluster randomized trial of an intimate partner violence prevention intervention PLOS ONE Dear Dr. Abramsky, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please submit your revised manuscript by Sep 17 2020 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. 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(Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #2: Thank you for the opportunity to review the paper: Couples data from north-western Tanzania: Insights from a survey of male partners of women enrolled in the MAISHA cluster randomized trial of an intimate partner violence prevention intervention. Please see my comments below Title: The title now reflects better on the contents of the paper Interpretation of results: The reflection of the authors on the usefulness of the p-value in determining significance is reasonable. The changes they made based on directions of the associations are acceptable. However, it will be desirable to have some of this explanation – i.e consideration of direction of associations over significance levels provide in the statistical analysis section of the paper. Discussion: • Authors have appropriately addressed the comment around potential of social desirability bias influencing men's responses. • I am satisfied with the explicit discussion of why women in newer relationships may have given less consent- i.e they may have been less comfortable, have poorer communication such that their partner was not aware of their participation, or unsure of the demands on their partner's and reactions. • The authors have added satisfactory explanation about how they ensured minimal risk to participants whose partners were abusive. ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. 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Revision 2
11 Sep 2020 Author Response Dear Editor, Thank you for considering our manuscript: "Couples data from north-western Tanzania: Insights from a survey of male partners of women enrolled in the MAISHA cluster randomized trial of an intimate partner violence prevention intervention." We are pleased that the reviewers are satisfied with the changes we made to the original manuscript. The two outstanding comments are addressed below: 1) We recently submitted an Email via editorial manager to advise of a change to our data availability statement. The data have now been submitted to the London School of Hygiene and Tropical Medicine (LSHTM) data archive, Data Compass( DOI: https://doi.org/10.17037/DATA.00001773 ). However, the LSHTM Research Data Management team have raised ethical/data protection concerns regarding open access to this data. This research was performed prior to data sharing requirements being established and participant consent for sharing was not obtained. For this reason, and due to the sensitivity of the research topic, we have been advised that it will not be possible to make the datasets openly available. Instead, access to an anonymised subset will be provided for use in ethically approved research, on condition those requesting access comply with ethical conditions associated with the study. Researchers are invited to apply for data access, outlining the analysis they wish to perform and the data variables requested. If the proposed use is approved, they will be asked to sign a Data Transfer Agreement that requires them to keep data confidential. 2) In relation to reviewer 2’s comment that the statistical analysis section should include explanation of our consideration of the direction as well as p-values of associations, we have added the following paragraph to the statistical analysis section of the manuscript: “In recognition of low study power in relation to some of the associations under study (the CRT sample size having been determined around power to detect intervention impacts on primary outcomes), interpretation of results will involve consideration of the magnitude and direction of observed associations in addition to p-values and 95% confidence intervals.” Thank you again for considering our paper. Please let us know if you require any more information regarding data availability. We have submitted a revised manuscript with tracked changes, as well as an unmarked copy. We look forward to hearing from you. Yours Sincerely, Tanya Abramsky https://doi.org/10.1371/journal.pone.0240112.r004
21 Sep 2020 Decision Letter - Thach Duc Tran, Editor Couples data from north-western Tanzania: Insights from a survey of male partners of women enrolled in the MAISHA cluster randomized trial of an intimate partner violence prevention intervention PONE-D-20-05439R2 Dear Dr. Abramsky, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Thach Duc Tran, M.Sc., Ph.D. Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0240112.r005
Formally Accepted
24 Sep 2020 Acceptance Letter - Thach Duc Tran, Editor PONE-D-20-05439R2 Couples data from north-western Tanzania: Insights from a survey of male partners of women enrolled in the MAISHA cluster randomized trial of an intimate partner violence prevention intervention Dear Dr. Abramsky: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Thach Duc Tran Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0240112.r006

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