Lessons Learned: Why Motivational Interviewing Should Be Adapted to Socio-Cultural Contexts
Round 1
Reviewer 1 Report
Comments and Suggestions for AuthorsPlease see attached.
Comments for author File: 
Comments.pdf
Please see attached for comments and suggestions for revision.
While there are significant issues and considerable re-working is needed, there are important messages in this paper related to working with indigenous peoples and cultural adaptions of MI and other interventions that I think it is worth the effort to revise.
Author Response
Please see attachment.
Author Response File: Author Response.pdf
Reviewer 2 Report
Comments and Suggestions for AuthorsDear Author(s),
The manuscript is coherent and well-structured. However, kindly see below some improvement suggestions:
- I highly suggest a rephrasing of the abstract in making it more appealing
- Sometimes, in the content of the manuscript I have see first person I. It is highly recommended to use third person or passive voice.
- The introduction section needs to be rephrased as it contains a lot of information and does not emphasize the aim of the manuscript. Maybe answering the question why the manuscript is important may help in reorganizing this section
- The discussion section should include some limitations of the study. please refer also to the limitations of a qualitative design
- the conclusion section is very long. please, include only the main ideas and without references. it should not be longer than 2 paragraphs.
Thank you and good luck!
Author Response
Please see attachment.
Author Response File: Author Response.pdf
Reviewer 3 Report
Comments and Suggestions for AuthorsThank you to the authors, their team, and participants, for this fantastic, greatly informative, timeless and of great importance, study. The authors examines and reports, through a qualitative study, the implementation and cultural adaptation of a well-known tool in health education in the Western World, the Motivational Interviewing tool. The study provides relevant and robust data, demonstrate and logic, of how important it is that we confront tools that have been created/developed, and validated, in the Western world, with cultural communities — and particularly, marginalized communities, like Indigenous groups. I have found this study of great interest, well written, well argued, well documented and described. My only issue — minor — pertains to how the quotes/excerpts are reported. The verbatim retains every utterance and loquisms used in verbal speech -- this makes it very difficult to read/comprehend the quotes. I personally would recommend putting these in brackets, somehow; or having a disclaimer, explaining why they are removed, that the 'full, verbal version', could be accessed, elsewhere -- at times, it makes it very difficult to follow/read.
But this is a very minute point!
Otherwise, I consider this manuscript a fine, robust, scientifically sound and strong, study. The study is well described and introduced; the argument and objectives are robust, original, relevant; the study conducted is scientifically sound, appropriate; the data is well presented; the analysis (thematic), relevant and efficacious. I quite enjoyed reading the rich discussion and the important contribution the study will make to not only public health, its mission to communicate and educate in ways that are more cultural humble, attentive, considerate of the 'situatedness' of all tools, including Western approaches, tools, methods.
I recommend the publication of the manuscript.
Author Response
Please see attachment.
Author Response File: Author Response.pdf
Reviewer 4 Report
Comments and Suggestions for AuthorsThis study was novel approach to a problem that I was unaware of to a certain extent and therefore is welcome. In general terms I would have preferred to hear more about the use of MI in oral health education and how it worked rather than using MI as a focus for a more generic report. I have some considerations:
i) The author(s) continually refer to "i". There appear to be 3 authors, so I think the use of "i" is inappropriate. Ideally the manuscript should be written in the third person, past tense, and not as it currently is written.
ii) For consistency you need to either refer to the article or paper or ....
iii) There is a tendency to write too much, particularly in the introduction and the discussion sections. You could be more succinct without losing anything or changing the meaning.
iv) I am not sure travelling 30-40 minutes is a long way. I travel over 60 minutes to my dentist and don't find that unacceptable
v) In Section 4.1, it might be helpful if the authors considered the negative issues surrounding being "insider researchers", which the subjects clearly were.
Results:
v) When including exclamations in the direct quotes (Line384/385) you need to include what the exclamation indicates
vi) When conducting oral health interventions, it seems strange to focus on fluoride use (Line412), rather than less controversial aspects (Line412)?
vii) The explanation of changing the scripts should be part of the Materials & Methods not results
viii) It is unclear what the quote Lines 492-499 is trying to illustrate. please give a clear explanation
ix) Some of the quotes indicate that an in-depth enquiry into what they said would have been useful. This would have emphasised the need to use the semi-structure interview approach. Was this carried out and if so could we see some examples.
x) There are some aspects of discussion within the results.
Discussion:
xi) When considering trust, as an example, the authors needed to write about what the literature says about trust and to use studies in other medical fields to illustrate how trust is so important. Is trust only significant in indigenous populations or in medical treatment/education generally?
Conclusions:
xii) The conclusion was merely an extension of the discussion and needs to be refined to simply present the conclusions of this study based on the results.
Author Response
Please see attachment.
Author Response File: Author Response.pdf
Round 2
Reviewer 1 Report
Comments and Suggestions for AuthorsSee comments on the attached document.
Comments for author File: Comments.pdf
Please see attached for comments and suggestions for revision.
While there are significant issues and considerable re-working is needed, there are important messages in this paper related to working with indigenous peoples and cultural adaptions of MI and other interventions that I think it is worth the effort to revise.
Author Response
Please see attachment.
Author Response File: Author Response.pdf
Reviewer 4 Report
Comments and Suggestions for AuthorsThe appropriate changes/improvements have been made. This is now an interesting study
Author Response
Thank you for reviewing this again and for your comments.
