PONE-D-21-05419

Comparing the effect of childbirth preparation courses by two methods of in-person training and social media-based training on pregnancy experience, fear of childbirth, and type of delivery in pregnant women: A quasi-experimental study

PLOS ONE

Dear Dr. Amiri-Farahani,

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The reviewers raised a number of issues, including their concern about the appropriateness and clarity in your choice of study design. They raised concerns about the methodological/statistical approach, as well as with the English grammar and language usage in the manuscript. Their concerns can be viewed in full, below and in the attached file.

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Reviewers' comments:

Reviewer's Responses to Questions

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: No

Reviewer #2: Yes

Reviewer #3: Yes

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

Reviewer #1: No

Reviewer #2: I Don't Know

Reviewer #3: 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: No

Reviewer #2: No

Reviewer #3: 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: No

Reviewer #2: No

Reviewer #3: 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: The abstract is entirely unclear: Example:

Pregnant women are more interested to obtain information from internet sources, so this study aimed to compare the effect of childbirth preparation courses by two methods of in-person and social media-based education on pregnancy experience, fear of childbirth, birth preference, and type of delivery.

Unclear content!

Another example:

Sampling was done by convenience method and the samples were divided into three groups.

Unclear, grammar errors.

The entire abstract needs to be rewritten because it is unclear and contains many grammar errors.

The paper needs to be carefully checked by a native speaker because aside from content related problems also the presentation in English is very difficult to read.

parallel quasi-experimental study: How is this defined? Add a citation if this is a standard term, otherwiese make it clear that you created this term and explain it.

Table 2: Individualcharacteristicsofstudyparticipantssandcomparisons

What is 's'?

The authors apply multiple tests, however, no multiple testing correction is applied. I suggest Bonferroni (cite the ref)

https://www.mdpi.com/2504-4990/1/2/39

Reviewer #2: Abstract: Drop " PES and WDEQ-A" and replace with " Pregnancy Experience Scale" and Wijma Delivery Expectancy / Experience Questionnaire since the acronym isn't used later in the abstract.

Abstract: -The authors should indicate to which of the interventions A and B were attributed.

-page 6: A sentence or two should be included to provide possible justifications for the mixed results of the previous studies. Will different approaches work better in different settings?

-Page 7: It would be helpful to explain why nulliparous women are more likely to obtain information from virtual networks.

-Page 8: Provide a detailed description of how the women were allocated into 3 groups.

- The authors mentioned that the objective of this research was to compare the effect of childbirth preparation courses by two methods of in-person and social media-based education, however, it seems that participants of group A received a mixed intervention; they were provided social media-based training and a two 2-hour sessions in-person training in the hospital. Please clarify.

- It is important that the authors check each reference carefully against the original publication to ensure the information is accurate and relevant. there are several cases that the references that have not been used carefully for example on page 5, in reference 10 it is no data regarding the prevalence of FOC, and reference 5 did not provide adverse outcomes of poor care of pregnant women.

- More information is needed on how the PES and WDEQ-A questionnaires were used in this study; how the authors assessed the reliability of these tools?

- The methodological limitations of the study need to be clearly stated.

- I would suggest that the manuscript undergo a careful review for English grammar and sentence structure. Also a more appropriate use of terminology is needed.

Reviewer #3: PlosONE REVIEW Carmen Power 22.2.22

Short title: Social media-based training and pregnancy and childbirth outcome

ABSTRACT – note the whole text here is repeated twice

Results section: Give percentages of vaginal birth and elective CS for different study groups otherwise the conclusion doesn’t make sense as it’s not a summary of the results section.

*Ethical permission and written consent – yes

SUMMARY

Expand limitations section – Was the drop-out rate different between groups? If so, this in itself could be a suggestion that women prefer to attend in-person/online pregnancy/birth prep classes.

INTRODUCTION

Check meaning in sentence 2 – repeat of childbirth preparation courses after ‘provide’.

METHOD

Good use of validated questionnaires. Description of statistical methods is good.

A few things to think about and possibly discuss:

1. I’m not sure I understand why the women were ‘non-randomly’ allocated to the 3 groups? How did this prevent their awareness of the other groups if they were choosing their group? And think about how might this have affected the results as it could mean that women who wanted a vaginal birth were more likely to choose a certain group and vice versa. Having studied the flow chart, perhaps you meant to say they were randomly allocated to groups? (i.e. neither the participant nor researcher could show any bias)

2. Could the content involved in online prep (5-15 mins) sessions be linked to it being available on a daily basis so women could watch videos repeatedly, remembering and reinforcing the information?

3. Did Group A having a 2 x 2 hour face to face component blur the findings at all?

4. Did Group B also receiving videos and music blur the difference between the 2 groups?

RESULTS

1. Think about showing your full statistical workings and outcomes in the tables.

2. Clarify in Table 2 (and other tables where needed) whether bracketed numbers are the standard deviation or a percentage of the non-bracketed number directly before.

3. P19 – text underneath table 4 is confusing – please clarify your meaning here – what did the statistical outcomes signify?

DISCUSSION

1. The findings are important in that FOC is a crippling psychological condition that can results in unnecessary interventions. Could a larger sample size be used in a future study?

2. It might also be mentioned that a mixture of online and face to face classes is more manageable for pregnant women who have other children or who have to travel.

GENERAL

Ideally this paper needs to be proofread and edited by a fluent English speaker as there are differences in grammar and turns of phrase that interfere with a smooth reading process. More importantly, the semantics are sometimes lost and your results could be misinterpreted during reading although ultimately they become clear.

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Reviewer #1: No

Reviewer #2: No

Reviewer #3: Yes: Dr Carmen Power

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Attachments

Attachment

Submitted filename: PlosONE REVIEW FOC 22.2.22.docx

Comparing the effect of childbirth preparation courses delivered both in-person and via social media on pregnancy experience, fear of childbirth, birth preference and mode of birth in pregnant Iranian women: A quasi-experimental study

PONE-D-21-05419R1

Dear Dr. Amiri-Farahani,

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,

James Mockridge

Staff Editor

PLOS ONE

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 #2: (No Response)

Reviewer #3: 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 #2: (No Response)

Reviewer #3: Yes

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

Reviewer #2: (No Response)

Reviewer #3: Yes

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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 #2: (No Response)

Reviewer #3: Yes

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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 #2: (No Response)

Reviewer #3: Yes

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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 #2: (No Response)

Reviewer #3: (No Response)

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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 #2: No

Reviewer #3: No

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