PONE-D-20-22730

Does Family Life Education Influence Attitudes Towards Sexual and Reproductive Health Matters among Unmarried Young Women in India?

PLOS ONE

Dear Dr. Niharika Tripathi,

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.

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We look forward to receiving your revised manuscript.

Kind regards,

Eugene Kofuor Maafo Darteh, Ph.D.

Academic Editor

PLOS ONE

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Reviewers' comments:

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Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: No

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. 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: Yes

Reviewer #2: Yes

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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: No

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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: This paper uses nationally representative data to assess exposure to family life education, and the association between exposure to family life education and knowledge about reproductive health issues (e.g., contraception, STIs, and HIV).

I have a few overall concerns about the analysis:

1. Knowledge of reproductive health outcomes was measured with several items. Why were the items treated as separate outcomes, instead of added for singles scores (i.e., one score on knowledge/awareness of contraception; one score on knowledge/awareness of HIV; one score on knowledge/awareness of STIs)? There is likely correlation among items in each set of questions.

2. It is unclear why family life education would be associated with menstrual problems (it is, but a justification for thinking that such education is related to such problems needs to be provided).

3. It is unclear if weights were used for the analysis. If not, why not?

Other comments

1. The abstract mentions two data sets, but the results are based on only one data set.

2. The introduction/background section can be streamlined, so as to focus on the importance of family life education to knowledge and reproductive health behaviors. I understand that improved reproductive health outcomes for young women may lead to other development outcomes, but that is beyond the scope of the analysis/paper.

3. The reproductive health knowledge variables need to be described in the text (it wasn't until I read the tables that I understood the analysis was looking at knowledge/awareness and not reproductive behaviors).

4. It is not clear, in table 1, whether any of the variables are significantly associated with exposure to family life education.

Reviewer #2: Thank you for the invitation to review this insightful paper. Though its of interest, there are essential issues that need to be addressed for it to be publishable.

General comments:

Authors should format the paper to the journal’s requirements. For instance, “Context” as used in the abstract section should be changed to “Introduction”. A thorough proofreading is required to rectify the typo and grammatical issues. There are several occasions where “adolescent” is used instead of “adolescents”, first sentence of third paragraph of introduction should bear “depict” not “depicts”, “unpleasantstate” “These includes” and several others.

Abstract

1. Under Context: revise to “…adolescents and young people…” not “…adolescent and young people…”

2. The author should remove “etc”

Introduction

3. Second paragraph: The author wrote “At many international negotiable platforms, including Programme of Action of the International Conference on Population and Development (ICPD, 1994), the World Plan of Action for Youth of the United Nations General Assembly (1995) and ICPD+15 2009, the global agenda was streamlined for empowering the situation of adolescents and youth [13–15]”. The conferences aimed at empowering the youth but not “empowering the situation of the youth” as indicated. This should be rectified.

4. This sentence should be referenced: “Majority of these youth reside in the poorest and least developed countries of Asia, Africa and Latin America which together constitute over 85 percent of world’s youth population.”

5. The author has done well by acknowledging some initiatives/policies in the country. Is there any data/evidence on how these have helped improved the attitude towards sexual and reproductive health?

6. The author wrote “India is one of the youngest nations…” what is the basis for this or is the author implying that it has a high proportion of young women/men globally?

7. The background needs to be summarised, it is too bulky. The historical accounts can be truncated and rather project the Indian context.

Methods

8. One of the outcome variables is “menstruation related problems”. Most of the problems are biological and conceptually does not make sense to investigate with Family Life Education.

9. How was “family life education” as an outcome variable measured and what does it constitutes? Explanation is required here.

10. Change “Methods” to “data analysis”

Results

11. The author can present about three regression results per table to make it more presentable.

Discussion and conclusion

The author spends more time describing other studies in some instances instead of situating the present study within the existing literature. For instance, this occupies a full paragraph but not informative enough for a discussion “Another household level representative survey entitled ‘Youth in India: Situation and Needs’ was conducted in 2006-07 across six Indian states [26]. The main objective of this survey was to gather evidence on key life transitions experienced by youth as well as their awareness, attitudes and life choices. The study was conducted in the following selected Indian states: Andhra Pradesh, Bihar, Jharkhand, Maharashtra, Rajasthan and Tamil Nadu. Overall, about 50,773married and unmarried young women and men were successfully interviewed, from 1,74,037 sample households. Unmarried men and women as well as married women (15-24 years) were interviewed, whereas the age group for married men was extended to 15-29 years, in the first ever 22 landmark survey on youth in India. The results from this survey lend support to the findings of our study”

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Reviewer #1: No

Reviewer #2: No

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

PONE-D-20-22730R1

Does Family Life Education Influence Attitudes Towards Sexual and Reproductive Health Matters among Unmarried Young Women in India?

PLOS ONE

Dear Dr.Niharika Tripathi,

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.

I would not treat the measures of knowledge as individual items in bi-variate analysis.  It isn't clear that the level of detail is warranted.  Also, kindly address the comments of the review below. The paper needs copy editing.

Please submit your revised manuscript by 25th December 2020. 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.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols

We look forward to receiving your revised manuscript.

Kind regards,

Eugene Kofuor Maafo Darteh, Ph.D.

Academic Editor

PLOS ONE

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: (No Response)

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. 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: Yes

Reviewer #2: No

**********

5. 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

**********

6. 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: I appreciate the revisions to the manuscript. I have a few remaining comments.

1. In the methods section, you indicate that you created scales to measure knowledge and awareness of RH matters. In fact, you treat the variables as individual items in the bi-variate analysis and as scales in the multi-variate analysis. I would treat them as scales in both the bi-variate and multi-variate analysis. If not, you need to clarify that you treat the variables in two different ways.

Reviewer #2: Thanks to the authros for addressing all my initial comments. I have no further comment on this manuscript.

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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.

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.

Reviewer #1: No

Reviewer #2: No

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

Does Family Life Education Influence Attitudes Towards Sexual and Reproductive Health Matters among Unmarried Young Women in India?

PONE-D-20-22730R2

Dear Dr. Niharika Tripathi,

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.

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Kind regards,

Eugene Kofuor Maafo Darteh, Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

**********

2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. 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: Yes

Reviewer #2: No

**********

5. 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

**********

6. 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: I have no further comments for the author at this point, and have made my recommendation in other parts of this form.

Reviewer #2: I have no additional comment for the authors. Thanks to the authors for attending to the comments I raised.

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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.

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.

Reviewer #1: No

Reviewer #2: No