Sexual Health Support Interventions for Prepubescents and Young Adolescents (7–14 Years) in the United States and Sub-Saharan Africa: A Scoping Review Protocol

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

This manuscript highlights a protocol for a scoping review mapping sexual-health support interventions for young adolescents (10–14 years) across the United States and Sub-Saharan Africa (SSA). The topic is very intriguing, but please consider my comments or suggestions below:

While the title specifically mentioned the age range from 10 to 14 years old, the eligibility criteria for the intervention arm will include a child as young as 7 years old. The justification for the inclusion is not well elaborated. The framing of the population will be shifted to include seven-year-old children as well.

It appears that the outcomes will provide non-comparable constructs, for the definition of “sexual health support” is too broad. Please explain.

It is observed that the data will be collected from 2010 to 2025, but the information from the MEDLINE strategy shows “2010–2024 [pdat]”. Please explain.

Please review the geographical filters for the US and SSA. It is observed that the PUBMED string uses “NOT”, which may automatically exclude multinational studies involving the US/SSA.

Restriction to an English source only will definitely miss other languages published or produced in SSA. Please address this limitation.

Please elaborate on how you manage the data which will be obtained from text/opinion papers alongside trials and observational studies. Any plan for the appraisal?

The information for the risk-of-bias/credibility assessment is missing.

Please explain why the abbreviation ‘NC’ is used for the 6th reviewer and the stakeholder consultation. Will any declaration of conflict of interest be made?

Comments on the Quality of English Language

minor grammatical errors

Author Response

Dear Editor/ Reviewer 1,

We sincerely thank the reviewer for the careful and thoughtful feedback on our manuscript. We have revised the paper accordingly and provided detailed responses as attached.

 

Regards,

 

Rose

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

1. Do not use future tense in the abstract.
2. Why foucsing on the US and SSA? More justifications should be provided to choose theses two regions, instead of either one. Besides, US is a country and SSA is a region, how could the two places be comparable?
3. The PRISMA checklist should be included in the appendix.
4. The major problem with this paper is the absence of a 'Findings' section. Although the authors state it is a protocol presentation, it would be significantly more meaningful if the search results were shared and analyzed. Without this, the paper's academic merit is highly questionable.

Author Response

Dear Editor and Reviewer 2,

We sincerely thank the reviewer for the careful and thoughtful feedback on our manuscript. We have revised the paper accordingly and provided detailed responses attached.

 

Sincerely,

 

Rose

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

Dear authors,

Thank you for the opportunity to review your manuscript. You are undertaking an important and timely project: mapping sexual health support interventions for young adolescents (ages 10–14) in both the U.S. and Sub-Saharan Africa. As you point out, this population is often overlooked in reviews, with younger adolescents grouped together with older youth. Your work promises to fill a significant gap by offering a comparative, cross-regional perspective that could inform practice, policy, and research in meaningful ways. I was excited to receive the invitation to review this work, and I am impressed with the research plans you outline in your paper.

I would like to begin by pointing out what I see as the primary strengths of your work. As you continue to revise the paper and eventually carry out your review, please consider how you can keep these elements in tact:

1. Clear rationale and significance: The introduction makes a strong case for why a review focused specifically on ages 10–14 is necessary, citing high rates of early pregnancy, STI risk, and the lack of developmentally tailored interventions. I appreciate this context!
2. Methodological rigor: Your alignment with the Arksey and O’Malley framework, JBI Manual, and PRISMA-ScR guidelines demonstrates a strong commitment to transparency and best practices in scoping reviews. As far as I can tell, you carried out the design of this review “by the book,” so to speak.
3. Comparative value: Focusing on both the U.S. and Sub-Saharan Africa allows for a unique cross-contextual analysis. The design anticipates opportunities for mutual learning, transferability, and gap identification.

Although I am a fan of what you have done so far, I have some suggestions that I believe will improve your manuscript and the ultimate review you will carry out. I hope you consider them as you move forward with this project:

• Clarity and concision in writing: While the manuscript is thorough, some sentences are long and could be streamlined for readability. For example, several passages in the introduction contain multiple statistics that might be more digestible if placed in a table or summarized briefly with key highlights.
• Definition of key terms: The concept of “sexual health support” is defined broadly, but at times the boundaries of what counts as an “intervention” are less clear. More precision here (perhaps with illustrative examples) would strengthen consistency when you extract and chart data. Help us to see the nuances of what your careful work allows us to understand!
• Scope of geography: The justification for choosing the U.S. and Sub-Saharan Africa is plausible to me, but it may be helpful to anticipate potential critiques. For example, how might cultural and systemic differences limit comparability, and how will your analysis handle contextual variation? Providing such details in your discussion will help people to use your work in the future and prevent people from dismissing your work out of hand.
• Consultation process: The manuscript mentions consulting an expert. Expanding briefly on this consultation and how it will tie into findings (e.g., validating themes, ensuring cultural relevance, or checking for missing grey literature) would demonstrate the value of this step. Help readers to understand why this strengthens your study and how.
• Formatting and flow: Minor editing will be needed to tighten transitions, fix small typographical errors (e.g., spacing, numbering), and polish readability for your readership.

As you will note, all of my concerns are quite “fixable” things.

Overall, my opinion is that this is a well-prepared and much-needed protocol that lays a strong foundation for the eventual scoping review. With some attention to clarity, definition of concepts, and articulation of methodological choices, the manuscript will be in excellent shape for publication – assuming that Sexes is interested in publishing protocols. I encourage you to move forward with confidence as you complete your scoping review.

Thank you again for the opportunity to review this work. I am excited to see the final published review and the contributions it will make to sexual health scholarship and practice.

Author Response

Dear Editor and Reviewer 3,

Thank you very much for this valuable feedback and for highlighting the strengths of the study. We have addresses all the comments and have provided the detailed responses in the attached document.

 

Regards,

 

Rose

Author Response File: Author Response.pdf