PONE-D-24-32227“The child of your fellow is your child”: Building on existing protective norms to engage men as caregivers; qualitative findings from an exploratory evaluation of an edutainment intervention to prevent age-disparate transactional sexPLOS ONE

Dear Dr. Pichon,

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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Daniel Romer

Academic Editor

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Additional Editor Comments:

Your paper presents findings from in-depth interviews with a sample of 18 adult men who participated in a radio-drama intervention designed to reduce of the risks of transactional sex with adolescent girls in Tanzania. Before sending this out for review, I have some suggestions for revision that will make the review process go smoother.

My reading suggests that the study gave 331 low-income households the opportunity to listen to the drama on a weekly basis and met with the households to discuss the drama. For this study, 81 members of those households were invited to be interviewed at both the beginning and end of the intervention, including the 18 men who were the focus of this paper.

You provide examples of how the men felt about the role of men as potential change agents in the community to prevent transactional sex among adolescent girls with a focus on the post interviews. However, I have several suggestions for ways to make the results easier to follow and to interpret.

First, it is not clear whether the intervention was merely listening to the drama or of having discussions led by the research team on a weekly basis. Those discussions should be described if they were part of what the 18 men were exposed to. If those discussions focused on the themes of interest, then it is not the drama per se, but the drama as a way to provoke conversations with the researchers that is being studied. It would be preferable if those weekly discussions did not occur for the 18 men, so that one can draw conclusions about the drama as an intervention in itself. Otherwise, those discussions should be described as part of the intervention.

Another aspect of the study is the intervention itself. Can you provide some examples of how the drama featured the themes of interest? What story lines illustrated the need for men to take more responsibility for preventing transactional sex?

It would also be helpful to provide an outline of the interviews. What were the themes that guided the interviews? And what kind of probing was done to clarify the answers to those questions? It would also be helpful to know what the themes were at baseline versus at the end. This would be especially useful for interpreting whether the drama actually changed what the interviewees thought about men’s roles in preventing transactional sex. The results do not make a very clear case that the participants changed their views. It would help a lot to show examples of changes in particular participants views from baseline to the end. For example, did the men not even think about their roles at baseline but then show evidence of change at the end? Such evidence would be the most convincing that the intervention itself and not more extensive probing at the end was the source of change.

Please resubmit the manuscript as we discussed.

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PONE-D-24-32227R1“The child of your fellow is your child”: Building on existing protective norms to engage men as caregivers; qualitative findings from an exploratory evaluation of an edutainment intervention to prevent age-disparate transactional sexPLOS ONE

Dear Dr. Pichon,

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 should note that the delay in follow-up was largely due to reassignment of the manuscript from the original editor; apologies for this.  Two referees provided high-quality reports suggesting a range of generally minor revisions.  I will not add to these beyond noting that in referring to the broader literature around engaging men in the prevention of IPV, you could also draw on the recent systematic review I conducted with a team suggesting that engaging men was as effective in reducing and preventing IPV as other strategies (engaging women directly, community mobilization): Leight et al. in the Journal of Global Health, 2024.  Otherwise, the referees have provided useful suggestions to guide your revision.

Please submit your revised manuscript by Mar 22 2025 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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We look forward to receiving your revised manuscript.

Kind regards,

Jessica Leight, PhD

Academic Editor

PLOS ONE

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Reviewer #1: (No Response)

Reviewer #2: All comments have been addressed

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: N/A

Reviewer #2: N/A

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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6. Review Comments to the Author

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Reviewer #1: This is a very well written paper that makes a strong and unique contribution to the literature. I certainly recommend this paper for publication. The authors clearly justify this paper given the gap in the evidence. I also appreciate the focus on engaging men to prevent adolescent girls' engagement in age disparate transactional relationships. I do have some suggestions to strengthen the paper overall:

The introduction notes that "most research on engaging men in VAWG efforts has focused on men as sexual partners." I would expand this to also reference the wealth of programme and research attention on engaging men as couples in IPV prevention programmes. Indeed, evidence suggests that working with men and women together to prevent IPV can be more effective than working with individual men and women (you could cite for instance Dunkle K, Stern E, Chatterji S, Heise L. Effective prevention of intimate partner violence through couples training: a randomised controlled trial of Indashyikirwa in Rwanda. BMJ Glob Health. 2020 Dec;5(12):e002439. doi: 10.1136/bmjgh-2020-002439. PMID: 33355268; PMCID: PMC7757483)

Another study to consider citing in the introduction around barriers/limitations of engaging men in fatherhood programmes is a study from Bolivia that did not have an impact on IPV, and a significant reason for this from the qualitative study was the poor engagement of men as fathers: Stern E, Alemann C, Delgado GAF, Vásquez AE. Lessons learned from implementing the parenting Program P in Bolivia to prevent family violence. Eval Program Plann. 2023 Apr;97:102207. doi: 10.1016/j.evalprogplan.2022.102207. Epub 2022 Dec 21. PMID: 3658743 2. Part of the reason for this was not doing good formative research or meeting men where they are; for instance men worked long hours and commuted so had limited time available for the time and location of the parenting programme sessions. I think this can come out too more in the recommendations of the importance of engaging men where they are and trying to address barriers to their engagement/meet their particular needs.

In the introduction, it would also be great if you could describe evidence of additional benefits of engaging men as fathers to prevent both violence against children and IPV? See for example the Bandheberho evaluation in Rwanda: .Doyle K, Levtov RG, Barker G, Bastian GG, Bingenheimer JB, Kazimbaya S, Nzabonimpa A, Pulerwitz J, Sayinzoga F, Sharma V, Shattuck D. Gender-transformative Bandebereho couples' intervention to promote male engagement in reproductive and maternal health and violence prevention in Rwanda: Findings from a randomized controlled trial. PLoS One. 2018 Apr 4;13(4):e0192756. doi: 10.1371/journal.pone.0192756. PMID: 29617375; PMCID: PMC5884496.

A recent evidence review published by the Prevention Collaborative (2025) also indicates the value of engaging men as fathers to prevent child maltreatment and IPV, as well as other benefits, including to strengthen men's mental health, and strengthen quality of relationships with their children. I think emphasizing this is important to not only consider men as instrumentalist to the benefits of women and children (absolutely important) but also consider the benefits to men through their engagement in such programming.

In the introduction the authors suggest that joint, or family-wide interventions might be more effective" clarify "than engaging fathers alone"; you could also link this to the benefits of accountability to women and girls through these family wide interventions.

On page 7, I would say 'most programmes have focused on early child outcomes' including to prevent violence against children, as many parenting programmes have violence against children as a primary outcome, and this links it back more broadly to focus on gender transformative programming and age-disparate sexual relationships.

Existing interventions targeting men as fathers of adolescent girls that I am more familiar with are also ones preventing VAC including preventing child marriage. For instance, there is an ongoing adaptation of the Indashyikirwa programme in Syria which has targeted couples who live with adolescent girls to prevent both IPV and child marriage of the parents' adolescent girls.

The method are very rigorous methods and I commend the very rich findings.

In the discussion, I am not sure it's fair to say while men's engagement with parenting programmes is often low, as we have many examples (including the Bandeberho from Rwanda), or this recent scale up of a parenting programme in Tanzania, of successfully engaging men in parenting programmes. I do think it is important to reference the latter study, especially since it is of parenting programmes with adolescent girls: Jamie Lachman, Joyce Wamoyi, Mackenzie Martin, Qing Han, Francisco Antonio Calderón Alfaro, Samwel Mgunga, Esther Nydetabura, Nyasha Manjengenja, Mwita Wambura, Yulia Shenderovich - Reducing family and school-based violence at scale: a large-scale pre–post study of a parenting programme delivered to families with adolescent girls in Tanzania: BMJ Global Health 2024;9:e015472.

I think you can definitely note many barriers to engaging men as fathers but also lots of examples of programmes that have done this. I would definitely cite Equimundo's recent report on what worked with Programming P to engage men as fathers here for examples of what has been learned about what works to engage men as fathers in parenting programmes.

Alemann, Clara, Rachel Mehaffey, and Kate Doyle. 2023. Core Elements of Gender-Transformative Fatherhood Programs to Promote Care Equality and Prevent Violence: A Practitioner Guide. Washington, DC: Equimundo. equimundo.org/resources/core-elements-of-gender-transformative-fatherhood-programs-to-promote-care-equality-and-prevent-violence/.

In limitations: could you add something about positionality of authors/researchers to the participants and how this was navigated? The authors' important point around accountability to women and girls is great; perhaps you can also note something around there can be limitations/risks with notion of men protecting girls including controlling behaviours or limiting agency on behalf of girls around who they are interested/in choose to date. It would be great if this is reflected on a bit more in discussion, including perhaps noting in the limitations that you do not have the perspective from adolescent girls themselves.

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Reviewer #2: I have done the review and the paper is well presented, and a significant contribution to knowledge on the subject. Please see the attached minor comments for review.

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Reviewer #1: Yes:  Erin Stern

Reviewer #2: Yes:  Dr Geofrey Nimrod Sigalla MD, MPH, PhD

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“The child of your fellow is your child”: Building on existing protective norms to engage men as caregivers; qualitative findings from an exploratory evaluation of an edutainment intervention to prevent age-disparate transactional sex

PONE-D-24-32227R2

Dear Dr. Pichon,

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