PONE-D-24-01385YouTube and the implementation and discontinuation the oral contraceptive pill: A mixed-method content analysisPLOS ONE

Dear Dr. Niemann

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.

Interesting and innovative research but technically it needs attention. Typographical and syntax errors. Please ask a professional to edit or proofread the document.Please see the comments below and comments in the attached document. Please submit your revised manuscript by  Mar 24 2024 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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Deidre Pretorius, PhD

Academic Editor

PLOS ONE

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Additional Editor Comments (if provided):

Interesting and innovative research however, it needs serious technical attention.

Reviewer 1:

This was a very interesting study exploring OCP discontinuation using social media (Youtube) and I enjoyed reading it. This study demonstrates the utility of using Youtube as an acceptable way to explore the lived experiences of women and their choices on OCP, particularly discontinuation. I have a few comments which I hope will strengthen the paper:

Introduction

p.4 line 37 remove the brackets from mainstream. It is an important concept that described the locality of Youtube in social media and should not be in brackets.

p.4 line 40 Pill-scare - perhaps consider adding the word phenomenon to bring across that it was an observed situation that was in question. Also, add where this took place - was it a global phenomenon? Or mostly in US or Europe = HICs?

p.4 line 43 which countries did those studies on unintended pregnancies and abortion take place?

p.4 line 44 instead of beginning the sentence with 'however', consider using 'while'

p.4 line 45 In Germany, this stance was also taken up... (add the word stance). Also, expand a little more on the pill report for context.

p.4 line 47 ...the media focused on the findings of increased risk of depression...(add the word findings for better coherence of this sentence)

p.4 line 48 consider change the word context to community

p.4 line 49 are the weaknesses that the findings could not be generalised?

p.5 line 55 rephrase this sentence for better clarity

p.5 line 59 remove the brackets from hormonal

p.5 line 69 and 'on these sites' to bring across that the shortcoming were related to these sites

p.5 line 76 Add an in-text citation for the S&R Justice Framework; also expand more on this justice lens and it's relevance to your study

p.6 line 80 comma after reason. In text citation for that sentence as it is a definition (or it is the way the researchers have defined it in the study of drawn from a definition in the literature?). Please indicate what the German study was a bout, In a German study on...

Throughout the document please ensure that your in-text citations are in line with the journal requirements - usually at the end of the sentence, rather than for example next to the authors surname at the beginning of the sentence. This may just be a difference in our styles so ensure it meets the journal requirements.

p.6 line 84 relationships...with? Is it intimate/family/friends?

p.6 line 94 mostly positive = in what kind of ways? Agreement? or shared experiences of discontinuation

p.6 line 103 live video and recordings?

p.7 lines 109 - 116 perhaps consider an overall research question or aim, with these RQs reframed as objectives? It will make it easier to begin that opening paragraph in the discussion a lot more succinct and coherent. See my comment on that later.

METHODS

P.7 line 119 pre-registered - what does pre-reg involve? Was that of the study of the video?

p.7 line 121 were findings interpreted together? Where di the mixing take place? In the abstract the researchers state that this was a concurrent explanatory study - this must come through clearly in the design section of this paper.

p.7 126-127 keep the date format consistent. Also explain why the browser and cookies history were cleared & how this links to algorithms and what shows up in your search results/feed?

p.8 line 135 = what was the relevance filter?

p.8 line 140 If repeated

p.9 the flow chart should have arrows illustrating how the decisions took place

p.10 line 188 registration of?

p.11 line 199 Who did the transcribing?

How could you assess that they are adults? Could this be a limitation?

p.11 line 200 where did you obtain ethical clearance to conduct this study? I understand that informed consent wasn't a requirement (as per lines 202 - 203). Also, please expand on the ethical appropriateness of conducting the study without informed consent from the Youtubers.

p.11 line 208 what do you mean by different media?

RESULTS

p.12 line 226 facial skin = facial skin impurities? please ensure this is consistent throughout to illustrate that it is the impurities that became a problem rather than just facial skin.

p.12 line 229 is it about easing menstrual impurities?

p.12 lines 235 - 236 Is it about irregular periods or a decrease in relation to heavy bleeding?

p.1 line 246 add an example so it is consistent with the previous results

p.13 247 mention % in the table = frequency?

p.14 line 248 double nomination = overlap?p.15 line 268 what is the meaning of extreme in this context of libido?

p.15 line 271 restructure sentence for better coherence = 32 women experienced psychological changes..

p.15 line 272 An increase in facial skin blemishes were..

p.15 line 275 remove exclamation point (!)

p.16 line 293 mention = frequency

p.20 line 315 very interesting please expand a bit more here on "not an issue between a man and woman"

DISCUSSION

p.21 lines 339 - 354 My suggestion is that you start with the overall RQ (I suggested earlier) or aim and then highlight the key findings from the study. Be more coherent in this opening paragraph of the discussion. At the moment, it is written so that it overlaps with the results section.

p.22 lines 372 The main reported reasons...

p.23 line 391 caution in interpretation = why?

p.23 line 408 in-text citation is missing here and you're citing a German study.

p.24 line 424 ...method choice, particularly discontinuation. Remove brackets.

p.24 line 425 add how these choices change over the life course.

p.24 line 431 ...information publicly, especially in the context (merge the sentences)

p.24 line 434 please emphasise where the mixing of methods took place?

Reviewer 2

This study was an innovative method for data collection as it avoided ethical considerations as well as labour-intensive participant recruitment.

It does, however, have some limitations in terms of the validation methods for the qualitative aspect of this study. Because the data is retrospective, iteration was not possible. It was also not possible for triangulation as another method to validate your results. Perhaps self-reflection (reflexivity) should also be considered. These are just aspects to acknowledge. I do not think it disqualifies this study from being published.

There are some typing errors and many grammatical problems. Many sentences are difficult to understand. I would suggest proofreading and language editing to be done by a certified professional before resubmission. I have highlighted a few typing errors and confusion re meaning of terms or sentences, but my role was not to proofread, or language edit this manuscript as other professionals should assist you with it.

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

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: Yes

Reviewer #2: Yes

**********

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

Reviewer #1: Yes

Reviewer #2: Yes

**********

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

**********

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

**********

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 was a very interesting study exploring OCP discontinuation using social media (Youtube) and I enjoyed reading it. This study demonstrates the utility of using Youtube as an acceptable way to explore the lived experiences of women and their choices on OCP, particularly discontinuation. I have a few comments which I hope will strengthen the paper:

Introduction

p.4 line 37 remove the brackets from mainstream. It is an important concept that described the locality of Youtube in social media and should not be in brackets.

p.4 line 40 Pill-scare - perhaps consider adding the word phenomenon to bring across that it was an observed situation that was in question. Also, add where this took place - was it a global phenomenon? Or mostly in US or Europe = HICs?

p.4 line 43 which countries did those studies on unintended pregnancies and abortion take place?

p.4 line 44 instead of beginning the sentence with 'however', consider using 'while'

p.4 line 45 In Germany, this stance was also taken up... (add the word stance). Also, expand a little more on the pill report for context.

p.4 line 47 ...the media focused on the findings of increased risk of depression...(add the word findings for better coherence of this sentence)

p.4 line 48 consider change the word context to community

p.4 line 49 are the weaknesses that the findings could not be generalised?

p.5 line 55 rephrase this sentence for better clarity

p.5 line 59 remove the brackets from hormonal

p.5 line 69 and 'on these sites' to bring across that the shortcoming were related to these sites

p.5 line 76 Add an in-text citation for the S&R Justice Framework; also expand more on this justice lens and it's relevance to your study

p.6 line 80 comma after reason. In text citation for that sentence as it is a definition (or it is the way the researchers have defined it in the study of drawn from a definition in the literature?). Please indicate what the German study was a bout, In a German study on...

Throughout the document please ensure that your in-text citations are in line with the journal requirements - usually at the end of the sentence, rather than for example next to the authors surname at the beginning of the sentence. This may just be a difference in our styles so ensure it meets the journal requirements.

p.6 line 84 relationships...with? Is it intimate/family/friends?

p.6 line 94 mostly positive = in what kind of ways? Agreement? or shared experiences of discontinuation

p.6 line 103 live video and recordings?

p.7 lines 109 - 116 perhaps consider an overall research question or aim, with these RQs reframed as objectives? It will make it easier to begin that opening paragraph in the discussion a lot more succinct and coherent. See my comment on that later.

METHODS

P.7 line 119 pre-registered - what does pre-reg involve? Was that of the study of the video?

p.7 line 121 were findings interpreted together? Where di the mixing take place? In the abstract the researchers state that this was a concurrent explanatory study - this must come through clearly in the design section of this paper.

p.7 126-127 keep the date format consistent. Also explain why the browser and cookies history were cleared & how this links to algorithms and what shows up in your search results/feed?

p.8 line 135 = what was the relevance filter?

p.8 line 140 If repeated

p.9 the flow chart should have arrows illustrating how the decisions took place

p.10 line 188 registration of?

p.11 line 199 Who did the transcribing?

How could you assess that they are adults? Could this be a limitation?

p.11 line 200 where did you obtain ethical clearance to conduct this study? I understand that informed consent wasn't a requirement (as per lines 202 - 203). Also, please expand on the ethical appropriateness of conducting the study without informed consent from the Youtubers.

p.11 line 208 what do you mean by different media?

RESULTS

p.12 line 226 facial skin = facial skin impurities? please ensure this is consistent throughout to illustrate that it is the impurities that became a problem rather than just facial skin.

p.12 line 229 is it about easing menstrual impurities?

p.12 lines 235 - 236 Is it about irregular periods or a decrease in relation to heavy bleeding?

p.1 line 246 add an example so it is consistent with the previous results

p.13 247 mention % in the table = frequency?

p.14 lin 248 double nomination = overlap?p.15 line 268 what is th emeaning of extreme in this context of libido?

p.15 line 271 restructure sentence for better coherence = 32 women experienced psychological changes..

p.15 line 272 An increase in facial skin blemishes were..

p.15 line 275 remove exclamation point (!)

p.16 line 293 mention = frequency

p.20 line 315 very interesting please expand a bit more here on "not an issue between a man and woman"

DISCUSSION

p.21 lines 339 - 354 My suggestion is that you start with the overall RQ (I suggested earlier) or aim and then highlight the key findings from the study. Be more coherent in this opening paragraph of the discussion. At the moment, it is written so that it overlaps with the results section.

p.22 lines 372 The main reported reasons...

p.23 line 391 caution in interpretation = why?

p.23 line 408 in-text citation is missing here and you're citing a German study.

p.24 line 424 ...method choice, particularly discontinuation. Remove brackets.

p.24 line 425 add how these choices change over the life course.

p.24 line 431 ...information publicly, especially in the context (merge the sentences)

p.24 line 434 please emphasise where the mixing of methods took place?

Reviewer #2: This study was an innovative method for data collection as it avoided ethical considerations as well as labour-intensive participant recruitment.

It does, however, have some limitations in terms of the validation methods for the qualitative aspect of this study. Because the data is retrospective, iteration was not possible. It was also not possible for triangulation as another method to validate your results. Perhaps self reflection (reflexivity) should also be considered. These are just aspects to acknowledge. I do not think it disqualifies this study from being published.

There are some typing errors and many grammatical problems. Many sentences are difficult to understand. I would suggest proofreading and language editing to be done by a certified professional before resubmission. I have highlighted a few typing errors and confusion re meaning of terms or sentences, but my role was not to proofread or language edit this manuscript as other professionals should assist you with it.

**********

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.

Reviewer #1: Yes: Janine White

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.]

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Attachments

Attachment

Submitted filename: PONE-D-24-01385_reviewer.pdf

PONE-D-24-01385R1YouTube and the implementation and discontinuation of the oral contraceptive pill: A mixed-method content analysisPLOS ONE

Dear Dr. Niemann,

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 see the feedback from the reviewers. Please do all the corrections and submit a document indicating the corrections in track changes or motivate why it could not be done.

Please submit your revised manuscript by Apr 29 2024 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.

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: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Deidre Pretorius, PhD

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

Additional Editor Comments:

Reviewer 1

This was a very interesting study exploring OCP discontinuation using social media (Youtube) and I enjoyed reading it. This study demonstrates the utility of using Youtube as an acceptable way to explore the lived experiences of women and their choices on OCP, particularly discontinuation. I have a few comments which I hope will strengthen the paper:

Introduction

p.4 line 37 remove the brackets from mainstream. It is an important concept that described the locality of Youtube in social media and should not be in brackets.

p.4 line 40 Pill-scare - perhaps consider adding the word phenomenon to bring across that it was an observed situation that was in question. Also, add where this took place - was it a global phenomenon? Or mostly in US or Europe = HICs?

p.4 line 43 which countries did those studies on unintended pregnancies and abortion take place?

p.4 line 44 instead of beginning the sentence with 'however', consider using 'while'

p.4 line 45 In Germany, this stance was also taken up... (add the word stance). Also, expand a little more on the pill report for context.

p.4 line 47 ...the media focused on the findings of increased risk of depression...(add the word findings for better coherence of this sentence)

p.4 line 48 consider change the word context to community

p.4 line 49 are the weaknesses that the findings could not be generalised?

p.5 line 55 rephrase this sentence for better clarity

p.5 line 59 remove the brackets from hormonal

p.5 line 69 and 'on these sites' to bring across that the shortcoming were related to these sites

p.5 line 76 Add an in-text citation for the S&R Justice Framework; also expand more on this justice lens and it's relevance to your study

p.6 line 80 comma after reason. In text citation for that sentence as it is a definition (or it is the way the researchers have defined it in the study of drawn from a definition in the literature?). Please indicate what the German study was a bout, In a German study on...

Throughout the document please ensure that your in-text citations are in line with the journal requirements - usually at the end of the sentence, rather than for example next to the authors surname at the beginning of the sentence. This may just be a difference in our styles so ensure it meets the journal requirements.

p.6 line 84 relationships...with? Is it intimate/family/friends?

p.6 line 94 mostly positive = in what kind of ways? Agreement? or shared experiences of discontinuation

p.6 line 103 live video and recordings?

p.7 lines 109 - 116 perhaps consider an overall research question or aim, with these RQs reframed as objectives? It will make it easier to begin that opening paragraph in the discussion a lot more succinct and coherent. See my comment on that later.

METHODS

P.7 line 119 pre-registered - what does pre-reg involve? Was that of the study of the video?

p.7 line 121 were findings interpreted together? Where di the mixing take place? In the abstract the researchers state that this was a concurrent explanatory study - this must come through clearly in the design section of this paper.

p.7 126-127 keep the date format consistent. Also explain why the browser and cookies history were cleared & how this links to algorithms and what shows up in your search results/feed?

p.8 line 135 = what was the relevance filter?

p.8 line 140 If repeated

p.9 the flow chart should have arrows illustrating how the decisions took place

p.10 line 188 registration of?

p.11 line 199 Who did the transcribing?

How could you assess that they are adults? Could this be a limitation?

p.11 line 200 where did you obtain ethical clearance to conduct this study? I understand that informed consent wasn't a requirement (as per lines 202 - 203). Also, please expand on the ethical appropriateness of conducting the study without informed consent from the Youtubers.

p.11 line 208 what do you mean by different media?

RESULTS

p.12 line 226 facial skin = facial skin impurities? please ensure this is consistent throughout to illustrate that it is the impurities that became a problem rather than just facial skin.

p.12 line 229 is it about easing menstrual impurities?

p.12 lines 235 - 236 Is it about irregular periods or a decrease in relation to heavy bleeding?

p.1 line 246 add an example so it is consistent with the previous results

p.13 247 mention % in the table = frequency?

p.14 lin 248 double nomination = overlap?p.15 line 268 what is th emeaning of extreme in this context of libido?

p.15 line 271 restructure sentence for better coherence = 32 women experienced psychological changes..

p.15 line 272 An increase in facial skin blemishes were..

p.15 line 275 remove exclamation point (!)

p.16 line 293 mention = frequency

p.20 line 315 very interesting please expand a bit more here on "not an issue between a man and woman"

DISCUSSION

p.21 lines 339 - 354 My suggestion is that you start with the overall RQ (I suggested earlier) or aim and then highlight the key findings from the study. Be more coherent in this opening paragraph of the discussion. At the moment, it is written so that it overlaps with the results section.

p.22 lines 372 The main reported reasons...

p.23 line 391 caution in interpretation = why?

p.23 line 408 in-text citation is missing here and you're citing a German study.

p.24 line 424 ...method choice, particularly discontinuation. Remove brackets.

p.24 line 425 add how these choices change over the life course.

p.24 line 431 ...information publicly, especially in the context (merge the sentences)

p.24 line 434 please emphasise where the mixing of methods took place?

REVIEWER 2

This study was an innovative method for data collection as it avoided ethical considerations as well as labour-intensive participant recruitment.

It does, however, have some limitations in terms of the validation methods for the qualitative aspect of this study. Because the data is retrospective, iteration was not possible. It was also not possible for triangulation as another method to validate your results. Perhaps self reflection (reflexivity) should also be considered. These are just aspects to acknowledge. I do not think it disqualifies this study from being published.

There are some typing errors and many grammatical problems. Many sentences are difficult to understand. I would suggest proofreading and language editing to be done by a certified professional before resubmission. I have highlighted a few typing errors and confusion re meaning of terms or sentences, but my role was not to proofread or language edit this manuscript as other professionals should assist you with it.

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

[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.

YouTube and the implementation and discontinuation of the oral contraceptive pill: A mixed-method content analysis

PONE-D-24-01385R2

Dear Dr. Nieman

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,

Deidre Pretorius, PhD

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Interesting research!

Reviewers' comments: