Measuring the readiness to screen and manage intimate partner violence: Cross-cultural adaptation and psychometric evaluation of the PREMIS tool for perinatal care providers.

INTRODUCTION: Pregnancy and perinatal periods are significant risk factors of intimate partner violence (IPV), a major public health problem that could begin or intensify during these periods. Perinatal care providers have a major role in the identification and the management of IPV. This study aimed to cross-culturally adapt into French the Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) tool, a reliable instrument to assess the knowledge, attitudes and preparedness to address IPV, and to evaluate its psychometric properties.
METHODS: The PREMIS was cross-culturally adapted by conducting forward and backward translations, following international guidelines. An online cross-sectional study was conducted to assess the psychometric properties of the PREMIS-French in perinatal care providers: data completeness, factor analysis, score distribution, floor and ceiling effects, internal consistency, item-total correlations, inter-subscale correlations and test-retest reliability.
RESULTS: The PREMIS was successfully translated and cross-culturally adapted to the context of metropolitan France. The results obtained from 360 perinatal care providers showed good acceptability. Exploratory factor analysis of the "Opinions" items resulted in a six-factor solution with six of the eight subscales of the original structure identified. Good internal consistency (Cronbach's alpha ranging from 0.54 to 0.97) and good test-retest reliability (intraclass correlation coefficients ranging from 0.46 to 0.92) for the "Background" and "Opinions" subscales were found. DISCUSSION: This study provides evidence of the good psychometric properties of the PREMIS-French. This valid instrument will help to understand perinatal care providers' barriers to IPV screening and management and will help to focus on specific lacks of knowledge for developing IPV education programs.

Introduction

Intimate partner violence (IPV) is well recognized as a major public health problem [1]. IPV prevalence in Europe is estimated to exceed 20% in women aged 15 years and older and is higher in women of reproductive age [2]. Pregnancy and perinatal periods are significant risk factors of IPV that could begin or intensify during these periods. In 2013, a meta-analysis reported a mean IPV prevalence rate among pregnant women of 19.8% for 23 countries; the mean reported prevalence of abuse was 28.4% for emotional abuse, 13.8% for physical abuse and 8.0% for sexual abuse [3]. Acts of violence during pregnancy affects directly and indirectly the mortality and the morbidity of the child and the mother. IPV is associated to unwanted pregnancies, termination of pregnancy [4] and adverse maternal and neonatal outcomes [5-7]. Moreover, the prevalence of maternal death by homicide was estimated between 13 and 24%, considering all causes of deaths during pregnancy [8].

Given these serious health consequences, healthcare professionals specializing in the perinatal period (perinatal care providers), have a major role in the identification and the management of abused women. The French National Health Authority recommended in 2019 that perinatal care providers screen all women for IPV during the first prenatal visit and continue at least once per trimester and during postpartum visits [9], in accordance with international guidelines [10]. Pregnancy is recognized as a privileged moment to detect past or current violence suffered by a woman. Indeed, the frequency of prenatal consultations and the bond of trust that is established between the care provider and the women offer the opportunity to disclose IPV.

However, several studies shown that IPV screening was not always done by healthcare professionals, often in reason of insufficient preparedness [11-13]. In 2014, the French inter-ministerial mission for the protection of women victims of violence and the fight against human trafficking conducted a national study to evaluate the midwives’ IPV knowledge and their ability to screen IPV with a non-validated questionnaire [14]. They reported insufficient education on IPV and limited knowledge. Almost one third had never assessed their patients’ exposure to IPV and in case of IPV, 81% felt insufficiently prepared. Nonetheless, 90% considered that midwives had a role to play in the disclosure and management of IPV. The reasons given for not screening were the lack of training, the absence of clear referral procedures and the ignorance of appropriate response or local specialist IPV services. Similar results were found among Italian midwives [15]. An American study identified in 2015 that 31.2% of obstetricians-gynecologists screen all pregnant patients at specific times of their pregnancy and 36.8% report insufficient training to assist their patients in addressing IPV [16].

Thus, the creation of specific IPV education and training programs for perinatal care providers, teaching how to recognize and respond to IPV is primordial [17,18], as well as assessing the effectiveness of these educational interventions with reliable outcomes. Among them, the PREMIS (Physician Readiness to Manage Intimate Partner Violence Survey), developed by Short et al. in 2006, is a valid and reliable self-reported instrument designed to measure the knowledge, attitudes and preparedness of physician to manage IPV [19]. They demonstrated evidence for its construct validity, internal consistency (with Cronbach’s alpha higher than 0.65 for reliable subscales), predictive validity, external validity (correlations between self-reported practices and observed clinical behaviors) and temporal stability over 12 months in the absence of IPV education or intervention. The developers shown that the PREMIS could discriminate between trained and untrained physicians [20].

This instrument has been adapted and widely used in multiple populations, cultures and languages [16,21-33]. It was also used to measure the effectiveness of IPV training programs proposed to physicians [20], practicing general practitioners and residents of general practice [34], nurses [35], and healthcare providers working in fracture clinics [36].

To our knowledge, no study in France assessed with a valid and reliable tool neither IPV knowledge of perinatal care providers nor their ability to identify and address IPV victims. Thus, we performed a study to cross-culturally adapt and evaluate the psychometric properties of a French version of the PREMIS tool.

Methods

Study design and participants

This cross-sectional online study was conducted from May 2017 to December 2019 in two phases: first, the original PREMIS was cross-culturally adapted from English to French; then psychometric properties of the French version of PREMIS were assessed.

The study was approved by the French regional ethics committee “Comité d’Ethique des Centres d’Investigation Clinique de l’inter-région Rhône-Alpes-Auvergne, CE-CIC Grenoble” (n° IRB 0005921, 03 October 2016). The aims and procedures were explained to participants, who gave their written informed consents.

An online link was created and data were collected using REDCap electronic data capture tools hosted at Clermont-Ferrand University Hospital. The French Federation of Perinatal Heath Network (‘Fédération Française des Réseaux de Santé en Périnatalité’) invited by email its care providers’ memberships (except healthcare students) to take part in the study and spread the internet link to complete the questionnaire. A reminder was done one time during the period of the study.

To assess test-retest reliability of the PREMIS, the internet link to complete the questionnaire a first time was sent by email to a subsample of memberships of two regional perinatal networks who were identified by their email address. They completed a second time the same questionnaire online between fifteen days and one month after the first assessment. Respondents who reported having a training course about IPV between test and retest were excluded for this reliability analysis.

The sample size of the study was determined according to quality criteria established by COSMIN [37] and Terwee et al. [38] that recommend a minimum number of 100 subjects to ensure satisfactory factor analysis and internal consistency evaluation and a sample size of at least 50 subjects in order to guarantee an acceptable assessment for reliability.

The PREMIS tool

The PREMIS self-administrated questionnaire contains 67 items comprising five sections: “Respondent profile”, “Background”, “Actual IPV Knowledge”, “Opinions” and “Practice issues”.

From the “Background” section, two subscales scores are obtained by calculating the mean of the individual scores of the items listed in the subscale. The ‘Perceived preparation’ subscale includes 12 items asking respondents how prepared they feel to assist IPV victims and rated on a 7-point Likert scale from 1 (not prepared) to 7 (quite well prepared). The ‘Perceived knowledge’ subscale includes 16 items asking respondents how much respondents feel they know about IPV and rated on a 7-point Likert scale from 1 (nothing) to 7 (very much).

In the “Actual IPV Knowledge” section, a combination of 7 multiple choice items and 11 true/false items (on IPV risk, manifestations, victim’s behavior and physician’s professional practice) form the ‘Actual knowledge’ subscale, scored by the number of correct items.

The “Opinions” section includes 36 items, rated on a 7-point Likert scale from 1 (strongly disagree) to 7 (strongly agree) and evaluating attitudes, beliefs and physician’s role in IPV management, on which 31 items forms six reliable subscales in the original version of PREMIS: ‘Preparation’, ‘Legal requirements’, ‘Workplace issues’, ‘Self-efficacy’, ‘Alcohol/drugs’ and ‘Victim understanding’. Two other subscales, ‘Constraints’ and ‘Victim autonomy’, needed future testing for validity and reliability.

Scores are obtained by calculating the mean of the individual scores of the items listed in the subscale (provided that answers are given to at least half of the items), with reversed scores for negatively worded opinion items.

The 13 items of the “Practice issues” section evaluated self-reported behaviors and personal IPV experience of the respondent, with various responding options.

Translation and cross-cultural adaptation of the French version of PREMIS

The PREMIS questionnaire was translated from English into French and cross-culturally adapted to be relevant to the French context, following international guidelines for the adaptation of self-administered instruments [39].

Forward translations were independently made by two bilingual translators fluent in English, with French as mother tongue, and naïves to the outcome measure. A multidisciplinary expert committee (composed of an obstetrician-gynecologist practicing forensic assessments, an obstetrician-gynecologist supervising a perinatal network, a referent midwife for IPV, and methodologists) reviewed the two translations and edited a first consensus French version. Cultural adaptations and linguistic equivalence with the original English version of PREMIS were discussed.

Then a native English translator fluent in French, blinded to the original English version then made a backward translation. The expert committee compared source and target versions, and resolved discrepancies. Item translation, semantic, idiomatic, cultural, experiential, and conceptual equivalents were discussed. The consensus French version was pre-tested on a sample of ten health care providers (general practitioners, obstetrician-gynecologists, and midwives) in order to evaluate the comprehensibility of instructions and items. Their responses and comments were reviewed.

The evaluation of psychometric properties (given in details below) was then conducted.

Statistical analysis

Statistical analysis were performed with SAS software (version 9.4, SAS Institute, Cary, NC, 2002–2012) and conducted at a two-sided alpha = 0.05 significance level.

Sociodemographic and professional characteristics of participants were described.

The psychometric properties evaluation of the PREMIS-French consisted in data completeness, factor analysis, descriptive statistics and score distributions, internal consistency, item-total correlations, inter-subscale correlations and reliability.

Data completeness

The respondent acceptability was assessed by looking at the frequency of missing values. Data quality was considered satisfactory if less than 15% of the item data were missing.

Factor analysis

Factor analysis with an oblique promax rotation, allowing the factors to correlate, were performed to study the multidimensionality and distribution of the items of the “Opinions” section in subscales [40]. As attitudes and clinical practice in IPV management could vary from culture to culture, there was no guarantee that the French version reproduced the subscales of the original PREMIS questionnaire. Hence, we chose an exploratory analysis of the structure of the items [39,41-43]. The Kaiser-Meyer-Olkin (KMO) statistic and Bartlett’s test of sphericity were used to check the appropriateness of running the factor analysis. KMO values higher than 0.50 are acceptable [44]. Bartlett’s test requires to yield significant result (p<0.05). Eigenvalues higher than 1 (Kaiser criterion) and Cattell’s scree plot [45] were used for factor retention. The solution giving the most adequate factor structure (item loadings greater than 0.32, no or few item cross loadings, i.e. no or few items with loadings at 0.32 or higher on two or more factors) was retained [40].

Descriptive statistics and score distributions

The PREMIS-French subscales scores’ distribution were described by mean, standard deviation, median and range. The variability of the PREMIS-French scores was investigated for each subscale with the floor and ceiling effects. These effects were considered to be present if more than 15% of the subjects obtained the lowest or highest possible score [46].

Internal consistency

Cronbach’s α coefficient was used to evaluate the internal consistency of each subscale of the “Background” and “Opinions” sections [47]. The minimum required for the coefficient was 0.70, according to the standard used for group comparisons [48]. Internal consistency was not evaluated for the ‘Actual knowledge’ subscale as it is a criterion-referenced subscale [19,49].

Item-total correlations

Item-total consistency was used to evaluate the extent of the linear relationship between an item and its subscale for the “Background” and “Opinions” sections, corrected for overlap (the item which is to be correlated with the scale was omitted from the subscale total) [43]. A minimum correlation coefficient of 0.40 was considered indicative of good item-total consistency [50].

Inter-subscale correlations

Spearman’s coefficients were used to evaluate inter-subscale correlations of the “Opinions” section subscales. Correlations were considered very small for coefficients lower than 0.30, small for coefficients between 0.30 and 0.50, moderate from 0.50 to 0.70 and strong if higher than 0.70 [51].

Convergent validity

Spearman’s coefficients were used to evaluate correlations between (1) the number of hours of previous IPV training, ‘Perceived knowledge’, ‘Perceived preparation’, and ‘Actual knowledge’ subscales, (2) the subscales from the “Opinions” section and the number of hours of previous IPV training, ‘Perceived knowledge’, ‘Perceived preparation’, ‘Actual knowledge’ subscales. Positive correlations were expected.

Reliability

Stability over time was assessed by the test-retest method. Reliability of the subscales from the “Background”, “Actual IPV knowledge” and “Opinions” sections was estimated by intraclass correlation coefficient (ICC), based on the two-way mixed effect model. The following categories were selected to interpret the agreement levels: 0–0.2 small, 0.21–0.40 fair, 0.41–0.60 moderate, 0.61–0.80 substantial and 0.81–1 almost perfect [52].

Results

Translation and cross-cultural adaptation

Cultural adaptations were made during the forward translations. In “Respondent profile” section, an item was added: ‘Including you, how many midwives practice at your work site?’. In “Actual IPV Knowledge” section, ‘Child Protective Services’ was adapted to the French context using ‘Cellule de Recueil des Informations Préoccupantes (CRIP)’. In “Opinions” section, item 17 (‘I comply with the Joint Commission standards that require assessment for IPV’) was adapted to the French context, as the Joint Commission did not exist in France. In “Practice issues” section, one item was not culturally relevant in the French context and was removed (item 8: ‘Do you practice in a state where it is legally mandated to report IPV cases involving competent (non-vulnerable) adults?’). Moreover, local DV/IPV hotline and Child Protective Services were omitted from the list of referral resources in item 4, as these support services are not available in France.

In pre-testing the French version, none of the ten health care providers reported any understanding difficulty or completion’s problem. Consequently, the expert committee adopted this version as the pre-final cross-cultural adaptation (S1 File). We named this version the PREMIS-French.

Psychometric evaluation of the PREMIS-French

Participants

The online survey was answered by 360 perinatal care providers. The characteristics of these respondents are described in Table 1 and S1 Table. They were predominantly women with a mean age of 43.3 years (SD 10.7) and practicing for 17.9 years (SD 10.8) mainly in gynecology and obstetrics. Less than 4% had no actual clinical activity. About one quarter of the care providers never had training about IPV issues. The mean amount of previous IPV training was 15.0 hours (SD 19.3) and the more frequent type of training was to attend a lecture or talk. In the last 6 months, 63.7% made at least one new diagnose of IPV (picked up an acute case, uncovered ongoing abuse, or had a patient disclose a past history).

Table 1

Sociodemographic and professional characteristics of participants.

Participants’ characteristics	N = 360
Age (years), n (%)
20–29	32 (8.9)
30–39	112 (31.1)
40–49	97 (26.9)
50–59	93 (25.8)
60–69	26 (7.2)
Women, n (%)	337 (93.9)
Field of practice, n (%)
Internal medicine	1 (0.3)
General practitioner	25 (6.9)
Pediatrics	44 (12.2)
Psychiatry	4 (1.1)
Surgery	1 (0.3)
Gynecology and obstetrics	244 (67.8)
Mother and child protection services	29 (8.1)
Other	32 (8.9)
Number of years practicing, mean ± SD	17.9 ± 10.8
Total number of hours of previous IPV training, n (%)
None	85 (26.6)
< 10h	117 (36.7)
10h-19h	56 (17.6)
≥ 20h	61 (19.1)
IPV experience in the last 6 months *, n (%)
Yes	205 (63.7)
No	117 (36.3)

* At least one new diagnose of IPV (picked up an acute case, uncovered ongoing abuse, or had a patient disclose a past history) made in the last 6 months.

In the “Respondent profile” section, the percentage of missing values per item varied between 0 and 16.1% (for the item on the number of practitioners that have participated in an IPV training course in the past 6 months at the work site). In the “Background” section, the percentage of missing values was 11.4% for the item on the amount of previous IPV training and ranged from 0 to 1.7% for items of the ‘Perceived preparation’ subscale and from 0.6 to 2.2% for items of the ‘Perceived knowledge’ subscale. The percentage of missing values ranged from 0.3 to 2.8% for items of the “Actual IPV knowledge” section and from 1.9 to 7.8% for items of the “Opinion” section. In the “Practice issues” section, with items on the screening and management of IPV victims in the last 6 months, the percentage of missing values per item were higher and ranged between 4.2 and 16.4%.

Factor analysis with an oblique promax rotation were performed to study the distribution of the 36 items of the “Opinions” section in subscales. The significance value of Bartlett’s test of sphericity was <0.0001 (χ = 3606.5, df = 630) and KMO measures of sampling adequacy was 0.846, indicating that the data were suitable for factor analysis. An initial Maximum Likelihood Factor (MLF) analysis identified a 11-factor solution that was statistically sound (χ = 323.7, df = 289, p = 0.0783). However, four factors contained only two items, ten items cross-loaded on two or more factors, indicating a complex solution that lacked a good theoretical basis. Thus, new factor analysis were performed after discarding items with loadings lower than 0.32, with loadings greater than 0.32 on two or more factors or items that significantly lowered internal consistency. The final factor analysis identified six factors with eigenvalues greater than one and accounting for 59.1% of the total variance (Table 2). All items loaded higher than 0.40 on its subscale. The first factor comprised five items and was named ‘Preparation’. It had four items in common with the original ‘Preparation’ subscale (items 6, 10a, 10b and 10c) and one item from the original ‘Self-efficacy’ subscale (item 9). The second factor named ‘Workplace issues’ comprised six items, four items were in common with the original subscale (items 3, 4, 19, 25), item 2 was from the original ‘Self-efficacy’ subscale and item 18 was from the original ‘Victim understanding’ subscale. The third factor comprised the four items of the original ‘Legal requirements’ subscale (items 12a, 12b, 12c, 17) and was labeled identically. Item 17 loaded higher than 0.32 on two factors: 0.55 on its factor and 0.38 on factor 2. The fourth factor comprised four items (items 5, 14, 26, 32) and was labeled ‘Self-efficacy’. It had three items in common with the original subscale (items 5, 14, 32) and one item from the original ‘Workplace issues’ subscale (item 26). The fifth factor comprised the three items of the original ‘Alcohol/drugs’ subscale (items 7, 21, 31) and was named identically. The sixth factor comprised three items of the original ‘Victim understanding’ subscales (items 11, 15, 16) and was labeled identically. Item 15 loaded higher than 0.32 on two factors: 0.71 on its factor and 0.33 on factor 4.

Table 2

Factor loadings from the factor analysis of the PREMIS-French “Opinions” items.

	Factor 1	Factor 2	Factor 3	Factor 4	Factor 5	Factor 6
Variance explained (%)	27.5	8.1	6.7	6.4	5.5	4.9
‘Preparation’ subscale
6. Do not have sufficient training to assist individuals in addressing IPV situations	0.54	0.09	0.07	0.07	-0.14	0.00
9. Feel comfortable discussing IPV with patients	0.50	0.29	0.06	0.21	-0.02	0.04
10a. Do not have the necessary skills to discuss abuse with a female IPV victim	0.94	0.03	-0.05	-0.02	0.02	0.00
10b. Do not have the necessary skills to discuss abuse with a male IPV victim	0.90	-0.15	-0.01	-0.01	0.04	-0.01
10c. Do not have the necessary skills to discuss abuse with an IPV victim from a different cultural/ethnic background	0.98	-0.01	-0.09	-0.06	0.01	0.01
‘Workplace issues’ subscale
2. Ask all new patients about abuse in their relationships	0.01	0.84	-0.14	0.00	0.03	0.10
3. Workplace encourages to respond to IPV	0.09	0.60	0.22	-0.12	-0.09	-0.01
4. Can make appropriate referrals to services within the community for IPV victims	0.25	0.41	0.21	-0.12	0.01	0.00
18. Health care providers have a responsibility to ask all patients about IPV	-0.06	0.87	-0.18	-0.10	0.11	0.06
19. Practice setting allows adequate time to respond to victims of IPV	0.02	0.43	0.17	0.22	-0.05	-0.12
25.Adequate private space to provide care for victims of IPV	-0.05	0.45	0.16	0.18	-0.04	-0.13
‘Legal requirements’ subscale
12a. Aware of legal requirements regarding reporting of IPV suspected cases	0.09	0.14	0.68	0.07	-0.07	0.11
12b. Aware of legal requirements regarding reporting of child abuse suspected cases	0.05	0.07	0.81	-0.11	0.04	0.01
12c. Aware of legal requirements regarding reporting of elder abuse suspected cases	-0.04	-0.26	0.85	0.07	0.06	0.00
17. Comply with the law standards that require reporting for IPV	-0.19	0.38	0.55	-0.03	0.02	0.02
‘Self-efficacy’ subscale
5. Capable of identifying IPV without asking patient about it	0.03	-0.14	0.06	0.77	0.08	-0.01
14. Able to gather the necessary information to identify IPV as the underlying cause of patient illnesses	0.25	0.18	0.08	0.48	0.02	-0.03
26. Able to gather the necessary information to identify IPV as the underlying cause of patient injuries	0.18	0.31	0.09	0.44	0.03	-0.08
32. Can recognize victims of IPV by the way they behave	-0.08	-0.02	-0.11	0.83	0.09	0.06
‘Alcohol/drugs’ subscale
7. Patients who abuse alcohol or other drugs are likely to have a history of IPV	0.01	0.15	0.02	0.09	0.69	0.04
21. Alcohol abuse is a leading cause of IPV	0.08	-0.16	0.12	0.00	0.76	0.03
31. Use of alcohol or other drugs is related to IPV victimization	-0.15	0.08	-0.08	0.14	0.69	-0.04
‘Victim understanding’ subscale
11. If victims of abuse remain in the relationship after repeated episodes of violence, they must accept responsibility for that violence	-0.02	0.07	0.03	-0.08	0.03	0.69
15. If a patient refuses to discuss the abuse, health care providers can only treat the patient’s injuries	-0.06	-0.07	-0.04	0.33	-0.25	0.71
16. Victims of abuse could leave the relationship if they wanted to	0.07	0.01	0.08	-0.13	0.18	0.73

Loadings equal or higher than 0.32 are presented in bold.

Two original “Opinions” subscales were not found in the current model. The items of ‘Victim autonomy’ (items 8, 22, 30) and ‘Constraints’ (items 13 and 23) subscales were discarded during the selection process of the most adequate factor structure.

Descriptive statistics, score distribution, floor and ceiling effects

The descriptive statistics and score distributions of the PREMIS-French subscales are presented in Table 3. The percentage of missing values were less than 7%, except for the ‘Actual knowledge’ subscale with 25% of missing values. Neither floor nor ceiling effects were found for the “Background”, “Actual IPV knowledge” and “Opinions” subscales.

Table 3

Descriptive statistics and score distributions of the PREMIS-French subscales.

PREMIS-French subscales	Missing values (%)	Mean ± SD	Range	Median	Floor effect (%)	Ceiling effect (%)
Background
Perceived preparation	0	3.47 ± 1.28	1.00–7.00	3.42	1.39	0.56
Perceived knowledge	0.56	3.59 ± 1.27	1.25–7.00	3.56	0	0.56
Actual IPV knowledge
Actual knowledge	25	25.44 ± 4.77	0–38.00	26.00	0	0
Opinions
Preparation	3.33	4.39 ± 1.46	1.00–7.00	4.55	1.72	2.01
Workplace issues	1.67	4.58 ±1.19	1.40–7.00	4.50	0	1.13
Legal requirements	3.89	3.87 ±1.30	1.00–7.00	3.75	1.16	0.87
Self-efficacy	3.89	3.66 ±1.10	1.00–7.00	3.75	0.29	0.29
Alcohol/drugs	6.11	4.30 ±1.00	1.00–7.00	4.33	0.30	0.89
Victim understanding	4.72	5.37 ±1.04	2.67–7.00	5.33	0	9.62

Internal consistency and item-total correlations

The “Background” subscales showed good internal consistency, with Cronbach’s α equal to 0.95 and 0.97 for ‘Perceived preparation’ and ‘Perceived knowledge’ subscales respectively. All corrected item-total correlations were higher than the required 0.40, ranging from 0.54 to 0.87 for ‘Perceived preparation’ subscale and from 0.50 to 0.90 for ‘Perceived knowledge’ subscale.

For “Opinions” subscales, Cronbach’s α ranged from 0.54 to 0.88 (Table 4), showing good internal consistency for four subscales, and moderate internal consistency for the ‘Alcohol/drugs’ and ‘Victim understanding’ subscales, which did not obtain the minimum required coefficient of 0.70. All corrected item-total correlations were higher than the required 0.40, ranging from 0.40 to 0.85, except for item 21 from ‘Alcohol/drugs’ subscale with a value of 0.38, and for items 11 and 15 from ‘Victim understanding’ subscale with values of 0.32 and 0.34 (S2 Table).

Table 4

Internal consistency (Cronbach’s α) and inter-subscale correlations for the PREMIS-French “Opinions” subscales.

PREMIS-French “Opinions” subscales	Preparation	Workplace issues	Legal requirements	Self-efficacy	Alcohol/drugs	Victim understanding
Preparation	0.88
Workplace issues	0.54 ***	0.77
Legal requirements	0.44 ***	0.45 ***	0.76
Self-efficacy	0.53 ***	0.50 ***	0.45 ***	0.72
Alcohol/drugs	-0.003	0.14 *	0.10	0.17 **	0.59
Victim understanding	0.21 ***	0.13 *	0.09	0.09	0.02	0.54

Adapted from Short et al. [19].

Cronbach’s α are reported on the diagonal and in bold text.

Spearman’s correlation coefficients significantly different from zero:

* p<0.05,

** p<0.01 and

*** p<0.001.

In addition, each item of the “Opinions” section correlated better with its parent subscale (corrected for overlap) than with the other subscales, except for two items of the ‘Self-efficacy’ subscale (S2 Table). For item 14 (Able to gather the necessary information to identify IPV as the underlying cause of patient illnesses), the item-total correlation with its subscale was 0.57 and the correlation with the ‘Preparation’ subscale was also 0.57. For item 26 (Able to gather the necessary information to identify IPV as the underlying cause of patient injuries), the item-total correlation with its subscale was 0.54 and the correlation with the ‘Workplace issues’ subscale was 0.57.

Correlations between PREMIS-French “Opinions” subscales ranged from -0.003 to 0.54 (Table 4). The ‘Preparation’ subscale had a significant moderate correlation with the ‘Workplace issues’ subscale (r = 0.54). The ‘Legal requirements’ subscale had significant small correlations with ‘Preparation’ (r = 0.44), ‘Workplace issues’ (r = 0.45) and ‘Self-efficacy’ (r = 0.45) subscales. The ‘Self-efficacy’ subscale had significant moderate correlations with ‘Preparation’ (r = 0.53) and ‘Workplace issues’ (r = 0.50) subscales. The ‘Alcohol/drugs’ subscales had significant very small correlations with ‘Workplace issues’ (r = 0.14) and ‘Self-efficacy’ (r = 0.17) subscales, and no significant correlation with the others. The ‘Victim understanding’ subscale had only significant very small correlations with ‘Preparation’ (r = 0.21) and ‘Workplace issues’ (r = 0.13) subscales.

Correlations between the amount of previous IPV training, the “Background” subscales, the ‘Actual knowledge’ subscale and the “Opinions” subscales are shown in Table 5.

Table 5

Spearman’s correlation coefficients between the amount of previous IPV training and the PREMIS-French “Background”, “Actual IPV knowledge”, “Opinions” subscales.

		Background		Actual IPV knowledge
	Hours of previous IPV training	Perceived preparation	Perceived knowledge	Actual knowledge
Background
Perceived preparation	0.66 ***	1
Perceived knowledge	0.67 ***	0.91 ***	1
Actual IPV knowledge
Actual knowledge	0.28 ***	0.22 ***	0.27***	1
Opinions
Preparation	0.52 ***	0.70 ***	0.74 ***	0.18 **
Workplace issues	0.52 ***	0.52 ***	0.54 ***	0.18 **
Legal requirements	0.45 ***	0.61 ***	0.64 ***	0.17 **
Self-efficacy	0.46 ***	0.62 ***	0.61 ***	0.23 ***
Alcohol/drugs	0.05	-0.004	0.01	0.14 *
Victim understanding	0.11	0.15 **	0.18 ***	0.33 ***

Adapted from Short et al. [19].

Correlations significantly different from zero:

* p<0.05,

** p<0.01 and

*** p<0.001.

The amount of previous IPV training was moderately correlated to ‘Perceived preparation’ and ‘Perceived knowledge’ subscales (r = 0.66 and r = 0.67, respectively) and very weakly to ‘Actual knowledge’ subscale (r = 0.28). The ‘Perceived knowledge’ and ‘Perceived preparation’ subscales were strongly correlated (r = 0.91). Correlations between the ‘Actual knowledge’ subscale and the “Background” subscales were significant but very small: r = 0.22 with ‘Perceived preparation’ and r = 0.27 with ‘Perceived knowledge’.

Hours of IPV training showed moderate correlations with ‘Preparation’ (r = 0.52) and ‘Workplace issues’ (r = 0.52) subscales, almost moderate correlations with ‘Legal requirements’ (r = 0.45) and ‘Self-efficacy’ (r = 0.46) subscales, and no significant correlation with the two other “Opinions” subscales. All “Opinions” subscales except for the ‘Alcohol/drugs’ one were significantly correlated to the ‘Perceived preparation’ and ‘Perceived knowledge’ subscales. Correlations were strong with the ‘Preparation’ subscale (r = 0.70 and 0.74, respectively), moderate with ‘Workplace issues’, ‘Legal requirements’ and ‘Self-efficacy’ subscales (ranging from 0.52 to 0.62 and from 0.54 to 0.64, respectively) and very small for the ‘Victim understanding’ subscale (r = 0.15 and 0.18, respectively). Correlations between “Opinions” subscales and the ‘Actual knowledge’ subscale were significant but very small, ranging from 0.14 to 0.23, except for the ‘Victim understanding’ subscale with a higher correlation of 0.33.

Of the fifty perinatal care providers randomly selected for the test-retest, 40 (80.0%) completed the test questionnaire. Among them, 24 (60.0%) completed the retest questionnaire. No one reported having a training course about IPV between test and retest. The characteristics of the test-retest participants are described in S1 Table. They were predominantly women (83.3%), with a mean age of 44.2 years (SD 11.6). Twenty of them practiced in gynecology and obstetrics, two in mother and child protection services, one in pediatrics and one in psychology.

Test-retest reliability was almost perfect for the “Background” subscales, with ICCs equal to 0.92 for ‘Perceived preparation’ and 0.88 for ‘Perceived knowledge’ (Table 6). Agreement was substantial for ‘Actual knowledge’ subscale with an ICC of 0.69. Reliability was also substantial for “Opinions” subscales, with ICCs ranging from 0.65 to 0.83, except for ‘Alcohol/drugs’ subscale with a moderate ICC of 0.46.

Table 6

Test-retest reliability for the PREMIS-French “Background”, “Actual IPV knowledge” and “Opinions” subscales.

PREMIS-French subscales	ICC (95% CI)
Background
Perceived preparation	0.92 (0.83–0.97)
Perceived knowledge	0.88 (0.74–0.95)
Actual IPV knowledge
Actual knowledge	0.69 (0.27–0.89)
Opinions
Preparation	0.65 (0.35–0.83)
Workplace issues	0.78 (0.54–0.90)
Legal requirements	0.77 (0.55–0.89)
Self-efficacy	0.83 (0.62–0.93)
Alcohol/drugs	0.46 (0.07–0.73)
Victim understanding	0.74 (0.48–0.88)

ICC (95% CI): Intraclass correlation coefficient (95% confidence interval).

Discussion

The present study describes the cross-cultural adaptation and the evaluation of the psychometric properties of the French version of the PREMIS, named the PREMIS-French, in a national sample of perinatal care providers.

The PREMIS was successfully translated and cross-culturally adapted from English to French. The PREMIS-French had good acceptability with low percentages of missing values per item, except for some items from the “Practice issues” section, evaluating practices or workplace specificities that could be not relevant for some participants. It also had good response distribution, neither floor nor ceiling effect were found for the subscales, indicating that the instrument was adapted to the studied population.

The six-factor structure of the PREMIS-French “Opinions” section differs slightly from the eight-factor structure of the original version of the PREMIS [19]. Only the two original ‘Victim autonomy’ and ‘Constraints’ subscales were not found in our validation. However, in the original PREMIS, this subscales were not sufficiently reliable and only kept for future testing.

The ‘Preparation’ subscale groups together four items from the original ‘Preparation’ subscale and one item from the original ‘Self-efficacy’ subscale. This item (Feel comfortable discussing IPV with patients) was more related to the feeling of being prepared in the French context. The PREMIS-French ‘Workplace issues’ subscale comprised items from the original subscale, and two items related to the systematic abuse screening of patients from the original ‘Self-efficacy’ and ‘Victim understanding’ subscales. IPV screening in France depends on the institutions’ policies where health care providers work and not all encourage IPV identification unfortunately. The ‘Self-efficacy’ subscale comprised one item from the original ‘Workplace issues’ subscale. Being able to gather the necessary information to identify IPV as the underlying cause of patient injuries is more related to self-efficacy than to work site. The ‘Victim understanding’ subscale comprised three items on the seven items of the original subscale. Lastly, ‘Legal requirements’ and ‘Alcohol/drugs’ subscales were identical in the French and the original versions [19].

The other PREMIS versions also presented factor structures that were somewhat different from the original version. Two subscales were identified in all other studies, ‘Preparation’ and ‘Alcohol/drugs’ subscales. The Greek physicians’ version [23] identified a 2-item ‘IPV screening’ subscale. The ‘Legal requirements’ subscale was not found in this version where the items were excluded during the adaptation of the PREMIS [23], as the ‘Victim autonomy’ subscale. The Spanish version for physicians and nurses identified a ‘Barriers’ subscale [24]. The American pharmacists’ version identified one single subscale for self-efficacy and workplace-efficacy [22]. The American health care students’ version identified a 2-item ‘IPV screening’ subscale [21]. The ‘Workplace issues’ and the ‘Constraints’ subscales were not identified, as it was not appropriate for students [21]. The Australian paramedic and nursing students’ version did not find the ‘Workplace issues’ and ‘Constraints’ subscales [25]. The ‘Legal requirements’ subscale was not found in this version as the items were excluded during the adaptation of the PREMIS [25].

Internal consistency of the “Background” subscales was high and comparable to those of the original subscales with Cronbach’s α superior to 0.90 [19]. Same results were found for the physicians’ Greek and Spanish versions [23,24], the American and Australian healthcare students’ versions [21,25] and the American pharmacists’ version [22]. For “Opinions” section, ‘Preparation’, ‘Workplace issues’, ‘Legal requirements’ and ‘Self-efficacy’ subscales demonstrated good internal consistency (α = 0.88, α = 0.77, α = 0.76, and α = 0.72), comparable to those reported in the original version (α = 0.85, α = 0.82, α = 0.79, and α = 0.69 respectively) [19]. ‘Alcohol/drugs’ and ‘Victim understanding’ subscales displayed moderate internal consistency (α = 0.59 and α = 0.54), lower than those reported in the original version (α = 0.70 and α = 0.69 respectively) [19]. This moderate internal consistency was also found in the Greek physicians’ version (α<0.50 and α = 0.63 respectively) [23], in the American healthcare students’ version (α = 0.48 and α = 0.46 respectively) [21], and in the Australian paramedic and nursing students’ version (α = 0.57 for the ‘Alcohol/drugs’ subscale) [25]. The Spanish physicians and the American pharmacists’ versions reported higher internal consistency for the ‘Alcohol/drugs’ subscale (α = 0.66 and α = 0.80 respectively) [22,24].

The very small to moderate correlations between the “Opinions” subscales imply that they measures related but relatively different constructs. ‘Alcohol/drugs’ subscale displayed the lowest correlations with the other subscales, results found in the original development of the PREMIS [19] and in the other studies [21-25].

Convergent validity was explored by assessing the inter-subscales correlations. The majority of the correlations replicated findings of previous studies. Only the Spanish validation did not explore these correlations [24]. ‘Perceived preparation’ and ‘Perceived knowledge’ subscales were strongly correlated (r = 0.91). In the previous studies, correlations ranged from 0.74 to 0.89 [19,21-25]. These subscales were not significantly correlated to ‘Alcohol/drugs’ subscale, as found in the original version [19], the Greek physicians’ version [23] and the Australian healthcare students’ version [25]. Correlations between the amount of previous IPV training and the “Background” subscales were moderate and higher than those found in all previous studies [19,21-25]. ‘Actual knowledge’ subscale had small correlations with the amount of previous training, the “Background” and “Opinions” subscales. The higher correlation was found with the ‘Victim understanding’ subscale, which was the only significant correlation in the Greek physicians [23] and American healthcare students’ versions [21]. Short et al in the original version found significant but small correlations between ‘Actual knowledge’ and ‘Perceived knowledge’, and between ‘Actual knowledge’ and “Opinions” subscales, except ‘Preparation’ and ‘Legal requirements’ subscales [19]. In the American pharmacists’ version, ‘Actual knowledge’ was only significantly correlated to ‘Legal requirements’ subscale [22].

Test-retest reliability, which is an essential property [53], showed substantial to almost perfect ICCs, except for the ‘Alcohol/drugs’ opinions subscale, with moderate reliability. Only the Greek physicians validation reported ICCs for test-retest reliability over a 3- to 4-week period [23]. In our study, ICCs for the ‘Perceived preparation’, ‘Perceived knowledge’, ‘Actual knowledge’ and ‘Self-efficacy’ subscales were higher (0.92, 0.88, 0.69, and 0.83 versus 0.84, 0.78, 0.68, and.078 respectively). For the other similar “Opinions” subscales, our ICCs were lower: 0.65 versus 0.83 for ‘Preparation’ subscale, 0.78 versus 0.93 for ‘Workplace issues’, 0.74 versus 0.81 for ‘Victim understanding’, 0.46 versus 0.79 for ‘Alcohol/drugs’.

Our study has some limitations. First, participants were mainly women. This could be explained by the fact that midwives are widely represented in perinatal care occupations. In France in 2017, only 2.6% of midwives were men. As women, these participants certainly felt more concerned about this topic and this could have affected their responses. Almost one quarter of the participants reported no previous IPV training. In the other cross-cultural validations, this proportion varied from 45.7% [21] to 95% [23]. Nevertheless, Short et al reported that 13.5% of their first sample and 31.3% of their second sample used to validate the original PREMIS reported no previous training, which was closer to our results [19]. Besides, it was not possible to distinguish between town and clinic caregivers and those who are regular employees of the hospitals or health care institutions. Practice variations could be explained by the work site, in particular by the presence of protocol for dealing with abused women, IPV referral resources or institutional policies. For the reliability test, 24 respondents completed the retest, a number lower than the 50 subjects recommended by Terwee et al. [38], but higher than in the other validation studies:10 subjects for the Spanish version [24], 18 subjects for the Australian version [25] and 20 subjects for the Greek version [23].

Further studies are needed on sample with more men to confirm the psychometric properties of the questionnaire, and in other settings, like in primary health care physicians. The responsiveness to change, that is the ability of the PREMIS-French to detect changes after IPV training, had to be evaluated, as well as convergent validity, as no validated instruments was validated in French to serve for comparison.

Conclusion

This study provides evidence of the good psychometric properties of the PREMIS-French when delivered to perinatal care providers to assess their readiness to manage IPV. As the original and the other versions of the PREMIS, the PREMIS-French could be used in several ways: to assess knowledge, attitudes, beliefs, behaviors and skills in order to assess needs that could be addressed during IPV education program; as a pre and post-test to measure the changes over time (spontaneous evolution of practices) or after IPV trainings or interventions; to compare perinatal care providers who had received training and those who did not have it. This is a valid and easy instrument to use which will help to understand perinatal care providers’ barriers to IPV screening and management and will help to focus on specific lacks of knowledge for developing IPV education programs. This measure of educational outcome would also allow the evaluation of IPV training courses that will be developed in the near future, in accordance with the recent recommendations of the French National Health Authority.

(DOCX)

Click here for additional data file.

Corrected item-total correlations for the PREMIS-French “Opinions” subscales.

(DOCX)

Click here for additional data file.

PREMIS-French questionnaire.

(DOCX)

Click here for additional data file.

27 Aug 2021

PONE-D-21-19470

Measuring the readiness to screen and manage intimate partner violence: cross-cultural adaptation and psychometric properties of the PREMIS tool for perinatal healthcare professionals

PLOS ONE

Dear Dr. Guiguet-Auclair,

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.

A thorough and rich review was conducted on the manuscript, which will surely guide the authors to carefully revise the work to make it suitable for publication.

Please submit your revised manuscript by Oct 10 2021 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: http://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,

Stefano Federici, Ph.D.

Academic Editor

PLOS ONE

Journal Requirements:

When submitting your revision, we need you to address these additional requirements.

1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at

https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and

https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf

2. We note the tables in your submission have been adapted from the scales in https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1451776/ and https://www.ajpmonline.org/article/S0749-3797(05)00401-0/fulltext#tables.

Before we can proceed, please clarify if you received explicit written permission from the copyright holder of the scales to publish your tables in PLOS ONE under a CC BY 4.0 license.

To seek permission from the American Journal of Preventative Medicine to publish the scales used in your tables under the Creative Commons Attribution License (CCAL), CC BY 4.0, please contact them please contact them with the following text and the PLOS ONE Request for Permission form (http://journals.plos.org/plosone/s/file?id=7c09/content-permission-form.pdf):

“I request permission for the open-access journal PLOS ONE to publish XXX under the Creative Commons Attribution License (CCAL) CC BY 4.0 (http://creativecommons.org/licenses/by/4.0/). Please be aware that this license allows unrestricted use and distribution, even commercially, by third parties. Please reply and provide explicit written permission to publish XXX under a CC BY license.”

Please upload the granted permission to the manuscript as a supporting information file. In the table captions where the scales are used, please include the following text: “Republished from [ref] under a CC BY license, with permission from [name of publisher], original copyright [original copyright year].”

Please note that RightsLink permission forms often impose use restrictions that are incompatible with our CC BY 4.0 license, and we are therefore unable to accept these permissions. For this reason, we strongly recommend contacting copyright holders with the PLOS ONE Request for Permission form.

If you are unable to obtain permission from the journal, please either A) remove the tables or B) link to or refer to the previously published scales in your manuscript.

3.  Thank you for stating the following financial disclosure:

"The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."

At this time, please address the following queries:

a) Please clarify the sources of funding (financial or material support) for your study. List the grants or organizations that supported your study, including funding received from your institution.

b) State what role the funders took in the study. If the funders had no role in your study, please state: “The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.”

c) If any authors received a salary from any of your funders, please state which authors and which funders.

d) If you did not receive any funding for this study, please state: “The authors received no specific funding for this work.”

Please include your amended statements within your cover letter; we will change the online submission form on your behalf

4. We note that you have stated that you will provide repository information for your data at acceptance. Should your manuscript be accepted for publication, we will hold it until you provide the relevant accession numbers or DOIs necessary to access your data. If you wish to make changes to your Data Availability statement, please describe these changes in your cover letter and we will update your Data Availability statement to reflect the information you provide.

Additional Editor Comments (if provided):

A thorough and rich review was conducted on the manuscript, which will surely guide the authors to carefully revise the work to make it suitable for publication.

[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

**********

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

Reviewer #1: 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

**********

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

**********

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: Thank you very much for giving me the opportunity to review this original article based on the analysis of 360 responses to a questionnaire translated by the authors.

The authors' objectives were to translate an existing questionnaire and then describe its psychometric properties.

After some revisions, this article deserves to be published in my opinion as it makes an important contribution to the current literature. Indeed, to my knowledge, there is no validated questionnaire in French to measure the readiness/capacity of health care workers to manage intimate partner violence.

Regarding the title, the authors have chosen to use the term "cross-cultural adaptation" whereas I would describe it more as a translation. The authors have chosen to present the method and the result of this translation in the method part of their article. Consequently, it seems to me that the main objective of this article is not to present the translation of the questionnaire but rather to describe its psychometric properties. Please justify the choice of using the term "cross-cultural adaptation" in the title by specifying how you did not only translate but also culturally adapt the original questionnaire or please edit the title.

Regarding the abstract, the introduction part could be reduced to two sentences. There is a gap between the two announced aims (of translating the questionnaire and then describing its psychometric properties) and the first sentence of the results which talks about "acceptability". In the scenario where the authors choose to keep translation as the main aim of this study, I recommend that the authors start the results directly by talking about the translation (and the addition of one item and the deletion of another) and then the psychometric results (data completeness, factor analysis, score distribution, floor and ceiling effects, internal consistency, item-total correlations, inter-subscale correlations and test-retest reliability). The questionnaire consists of 5 parts including 9 (?) subscales but the subscale "Actual IPV Knowledge" is not presented in the abstract. Please explain why or revise it.

Regarding the introduction part:

- page 3, line 53, delete the 'r' between "factors" and "of IPV".

- page 3, line 63, I am confused by the wording "perinatal healthcare professionals" which I would be inclined to translate as "healthcare professional specialising in the perinatal period". Please check with an experienced linguist.

- page 4, line 76, specify whether or not the questionnaire ref 14 has been validated.

Regarding the methods part:

It is not clear to me how the authors were able to identify participants, avoid multiple responses from the same person and, conversely, make the link between test and retest.

- page 6, line 138, replace "IPV Knowledge" by "Actual IPV Knowledge"

- page 9, line 196, replace "date" by "data"

As I am not a specialist in factor analysis according to KMO, I am not able to comment on this part. The other sections of the method are clear and do not call for any further comment.

Regarding the results part:

Do the authors have data on the response rate, or on the rate of completed questionnaires in relation to those started?

The tables are numerous (7) but clear and useful. Perhaps a simplified version of table 1 could be presented in the article and the full table put in an appendix. In any case, it would be interesting to have the characteristics of the 24 re-test participants in this table. Similarly, the authors should consider putting other tables in the appendix, such as Table 4. Please explain why you have separated the inter-subscale correlations analysis into two tables 5 and 6 and included the number of hours of previous IPV training?

- page 14, line 294, add a bracket after "Table 2".

- page 397, you mention the mean age and its standard deviation but with 24 responses, does this follow a normal distribution? If not, the median and the 25th and 75th percentiles would be more appropriate.

Do not put spaces before and after the slash (/).

Regarding the discusion part:

- page 9, line 418, The authors report "good acceptability" due to a "high response rates" although the response rates are unknown. A total of 360 responses were obtained but the deonominator is not reported in this article. To how many healthcare professionals was the questionnaire sent? What are the response rates? These considerations also need to be clarified for the re-test where 24 persons responded but where the denominator is unknown. Do the authors know the proportion of men in these two populations (to be able to compare them to the proportions of their two samples)?

Although a little long, the discussion part is relevant and the limitations of the study are fairly presented.

Regarding the Annex (S1 File.docx):

- page 1, question 2, please consider replacing "Sexe" with "Genre";

- page 1, question 4, I recommend that you add "Maïeutique" after "Gynécologie / Obstétrique";

- page 1, question 5, I recommend that you reword the sentence as follows: "En quelle année avec-vous obtenu votre diplôme d'exercice professionnel ?";

- page 2, question 1, there is an extra space after "résidanat/";

- On page 2, question 3b, I understand that the questionnaire has been tested as it is and that a modification after the fact is questionable however please consider replacing "divulgations de maltraitance" by "révélations de maltraitance/abusbecause in French the word "révéler" means "to inform someone of something that was ignored, unknown, hidden or secret", while "divulguer" means "to bring to the attention of a large audience information that was initially considered to be or should remain confidential";

- page 5, question 8, you have translated "Child Protective Services" by "CRIP" without specifying the meaning of this acronym. I suggest that you either use a generic term or specify the acronym;

- page 6, question 4, delete the full stop at the end of the sentence;

- page 7, question 17, there is an extra space between "signalement" and "de". The full stop at the end of the sentence should be removed;

- page 10, question 4, replace "1 avocat" by "un avocat".

Regarding the accessibility of the data, the authors state that the data are fully available without restriction at Mendeley data repository. A digital object identifier (DOI) to easily access this data would be useful.

All my comments may seem too numerous, but for the most part they are minor details that can easily be corrected by the authors. Once again, I would like to highlight the importance of this work which fills a gap in the training of health professionals regarding intimate partner violence. The number of responses is significant for a 25-minute questionnaire administered to professionals. These data are presented with rigour by the authors and deserve to be published in my opinion.

**********

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: Laurent Gaucher

[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.

16 Sep 2021

Journal Requirements

1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming.

Response: We ensure that our manuscript meets PLOS ONE’s style requirements, using the PLOS ONE style templates.

2. We note the tables in your submission have been adapted from the scales in https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1451776/

and https://www.ajpmonline.org/article/S0749-3797(05)00401-0/fulltext#tables. If you are unable to obtain permission from the journal, please either A) remove the tables or B) link to or refer to the previously published scales in your manuscript.

Response: Tables 5 and 6 in our first manuscript are adapted from Tables 3 and 2 respectively in the validation of the original PREMIS by Short et al. (Short LM, Alpert E, Harris JM, Surprenant ZJ. A tool for measuring physician readiness to manage intimate partner violence. Am J Prev Med. 2006; 30: 173–180. doi:10.1016/j.amepre.2005.10.009).

We were unable to obtain permission from the American Journal of Preventive Medicine. So, we added “Adapted from Short et al. [19]” in the footnotes of Tables 5 and 6 (Tables 4 and 5 in the revised manuscript).

3. Thank you for stating the following financial disclosure:

"The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."

At this time, please address the following queries:

a) Please clarify the sources of funding (financial or material support) for your study. List the grants or organizations that supported your study, including funding received from your institution.

b) State what role the funders took in the study. If the funders had no role in your study, please state: “The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.”c) If any authors received a salary from any of your funders, please state which authors and which funders.d) If you did not receive any funding for this study, please state: “The authors received no specific funding for this work.”

Please include your amended statements within your cover letter; we will change the online submission form on your behalf

Response: We did not receive any funding for this study. We precise this in the cover letter.

4. We note that you have stated that you will provide repository information for your data at acceptance. Should your manuscript be accepted for publication, we will hold it until you provide the relevant accession numbers or DOIs necessary to access your data. If you wish to make changes to your Data Availability statement, please describe these changes in your cover letter and we will update your Data Availability statement to reflect the information you provide.

Response: We have described the changes made to our Data Availability statement in the cover letter.

Reviewers' comments

Thank you very much for giving me the opportunity to review this original article based on the analysis of 360 responses to a questionnaire translated by the authors. The authors' objectives were to translate an existing questionnaire and then describe its psychometric properties.

After some revisions, this article deserves to be published in my opinion as it makes an important contribution to the current literature. Indeed, to my knowledge, there is no validated questionnaire in French to measure the readiness/capacity of health care workers to manage intimate partner violence.

Regarding the title, the authors have chosen to use the term "cross-cultural adaptation" whereas I would describe it more as a translation. The authors have chosen to present the method and the result of this translation in the method part of their article. Consequently, it seems to me that the main objective of this article is not to present the translation of the questionnaire but rather to describe its psychometric properties. Please justify the choice of using the term "cross-cultural adaptation" in the title by specifying how you did not only translate but also culturally adapt the original questionnaire or please edit the title.

Response: In order to be more precise, we have changed the presentation of the translation and cross-cultural adaptation of the PREMIS in the method and results sections. In the method section, we only described the methodology used for the translation and cross-cultural adaptation. Then, in the results section, we added a sub-section “Translation and cross-cultural adaptation” where we detailed the cultural adaptations made to the original PREMIS tool. We also detailed here the results of the pre-testing of the French version (obtained after the forward-backward translations) on a sample of 10 health care providers. In the abstract, we added a sentence at the beginning of the results section: “The PREMIS was successfully translated and cross-culturally adapted into French”.

We chose to use the term “cross-cultural adaptation” as we did not only translate into French, but also culturally adapt the PREMIS, as recommended in international guidelines. It is important that the translation produces a questionnaire comparable in terms of language but also a questionnaire culturally relevant to the French context. For example, ‘Child Protective Services’ was not simply translated into ‘Services de protection des Enfants’ but was cross-culturally adapted into ‘Cellule de Recueil des Informations Préoccupantes (CRIP)’.

Beaton et al. (Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine. 2000;25: 3186–3191) suggested that “the items must not only be translated well linguistically, but also must be adapted culturally to maintain the content validity of the instrument at a conceptual level across different cultures (…) The term “cross-cultural adaptation” is used to encompass a process that looks at both language (translation) and cultural adaptation issues in the process of preparing a questionnaire for use in another setting.”

Guillemin et al. (Guillemin F, Bombardier C, Beaton D. Cross-cultural adaptation of Health-Related Quality of Life measures: literature review and proposed guidelines. J Clin Epidemiol 1993;46: 1417–32) stated that “cross-cultural adaptation has two components: the translation of HRQL measure and its adaptation, i.e., a combination of the literal translation of individual words and sentences from one language to another and an adaptation with regards to idiom, and to cultural context and lifestyle. “

Regarding the abstract, the introduction part could be reduced to two sentences.

Response: We reduced the introduction of the abstract as recommended:

“Pregnancy and perinatal periods are significant risk factors of intimate partner violence (IPV), a major public health problem that could begin or intensify during these periods. Perinatal care providers have a major role in the identifications and the management of IPV. This study aimed to cross-culturally adapt into French the Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) tool, a reliable instrument to assess the knowledge, attitudes and preparedness to address IPV, and to evaluate its psychometric properties”.

There is a gap between the two announced aims (of translating the questionnaire and then describing its psychometric properties) and the first sentence of the results which talks about "acceptability". In the scenario where the authors choose to keep translation as the main aim of this study, I recommend that the authors start the results directly by talking about the translation (and the addition of one item and the deletion of another) and then the psychometric results (data completeness, factor analysis, score distribution, floor and ceiling effects, internal consistency, item-total correlations, inter-subscale correlations and test-retest reliability).

Response: In the abstract, as recommended, we added a sentence at the beginning of the results section: “The PREMIS was successfully translated and cross-culturally adapted into French”.

The questionnaire consists of 5 parts including 9 (?) subscales but the subscale "Actual IPV Knowledge" is not presented in the abstract. Please explain why or revise it.

Response: Short et al. explained in the validation study of the PREMIS that for the ‘Actual Knowledge’ subscale “measurement of internal consistency for this criterion-referenced section of the instrument was not appropriate” and cited Brown et al (Brown JD. The Cronbach alpha reliability estimate. Shiken: JALT Testing & Evaluation SIG Newsletter, February 2002, vol. 6, no. 1, pp.16 –18. Available at: www.jalt.org/test/bro_13.htm).

Brown et al. explained that “Cronbach alpha is appropriately applied to norm-referenced tests and norm-referenced decisions (e.g., admissions and placement decisions), but not to criterion-referenced tests and criterion-referenced decisions (e.g., diagnostic and achievement decisions)”.

We added a sentence in the methods section (page 11, lines 223-224 of the revised manuscript): “Internal consistency was not evaluated for the ‘Actual knowledge’ subscale as it is a criterion-referenced subscale [19,49]”.

Regarding the introduction part:

- page 3, line 53, delete the 'r' between "factors" and "of IPV".

Response: This was done.

- page 3, line 63, I am confused by the wording "perinatal healthcare professionals" which I would be inclined to translate as "healthcare professional specialising in the perinatal period". Please check with an experienced linguist.

Response: We replaced “perinatal healthcare professionals” by “perinatal care providers” in all the manuscript. In the second paragraph of the introduction (page 4, lines 64-65 of the revised manuscript), we first defined perinatal care providers by healthcare professionals specializing in the perinatal period.

- page 4, line 76, specify whether or not the questionnaire ref 14 has been validated.

Response: We specified that the questionnaire ref 14 has not been validated (page 5, lines 78-79 of the revised manuscript):

“In 2014, the French inter-ministerial mission for the protection of women victims of violence and the fight against human trafficking conducted a national study to evaluate the midwives’ IPV knowledge and their ability to screen IPV with a non-validated questionnaire [14]”.

Regarding the methods part:

It is not clear to me how the authors were able to identify participants, avoid multiple responses from the same person and, conversely, make the link between test and retest.

Response: We were not able to identify precisely participants. The French Federation of Perinatal Heath Network (‘Fédération Française des Réseaux de Santé en Périnatalité’, FFRSP) contacted its care providers’ memberships to participate. We revised this part describing how the participants received the link to complete the questionnaire in the ‘Study design and participants’ sub-section (pages 6-7, lines 121-125 of the revised manuscript):

“The French Federation of Perinatal Heath Network (‘Fédération Française des Réseaux de Santé en Périnatalité’) invited by email its care providers’ memberships (except healthcare students) to take part in the study and spread the internet link to complete the questionnaire.”

We checked for multiple responses from the same person by crossing variables: age, gender, department of France, field of practice, number of years practicing and number of patients seen per week.

We revised the part describing how participants to test-retest were recruited (page 7, lines 126-130 of the revised manuscript):

“To assess test-retest reliability of the PREMIS, the internet link to complete the questionnaire a first time was sent by email to a subsample of memberships of two regional perinatal networks who were identified by their email address. They completed a second time the same questionnaire online between fifteen days and one month after the first assessment.”

- page 6, line 138, replace "IPV Knowledge" by "Actual IPV Knowledge"

Response: This was replaced.

- page 9, line 196, replace "date" by "data"

Response: This was replaced.

As I am not a specialist in factor analysis according to KMO, I am not able to comment on this part. The other sections of the method are clear and do not call for any further comment.

Regarding the results part:

Do the authors have data on the response rate, or on the rate of completed questionnaires in relation to those started?

Response: Unfortunately we did know the response rate, as the number of perinatal care providers invited to participate by the French Federation of Perinatal Health Network was not known.

However, this is not a major problem in our study, as our purpose was not to assess the knowledge, attitudes and preparedness to address intimate partner violence, with a representative sample, but was to study the psychometric properties of the French version of the PREMIS.

A sample size of 100 subjects at least is recommended for a psychometric evaluation by COSMIN (COSMIN. COSMIN - Improving the selection of outcome measurement instruments. 2020. Available: https://www.cosmin.nl/) and Terwee et al. (Terwee CB, Bot SDM, de Boer MR, van der Windt DAWM, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60: 34–42. doi:10.1016/j.jclinepi.2006.03.012).

A subject-item ratio from 4 to 10 subjects is also often recommended for factor analysis. In our study, 360 subjects provided a subject-item ratio of 10:1 regarding the factor analysis of the 36 items of the “Opinions” section.

The tables are numerous (7) but clear and useful. Perhaps a simplified version of table 1 could be presented in the article and the full table put in an appendix. In any case, it would be interesting to have the characteristics of the 24 re-test participants in this table.

Response: As proposed, a simplified version of Table 1 was presented in the article and the full table 1 was put in a supplementary file (S1 Table).The characteristics of the 24 test-retest participants was added in the S1 Table.

Similarly, the authors should consider putting other tables in the appendix, such as Table 4.

Response: Table 4 was presented in a supplementary file as suggested (S2 Table).

Please explain why you have separated the inter-subscale correlations analysis into two tables 5 and 6 and included the number of hours of previous IPV training?

Response: We thanks the reviewer for this important remark. We have not been sufficiently clear in our methodology. The inter-subscale correlations analysis was for the “Opinions” section subscales. That is why the results are reported in one table (Table 4 in the revised manuscript).

The correlations presented in Table 6 (Table 5 in the revised manuscript) assessed the convergent validity of the PREMIS. Correlations between the different subscales themselves and with the amount of previous training were hypothetically attempted. Good convergent validity is demonstrated when expected correlations are found.

We have modified in the methods section the sub-section “Inter-subscale correlations” and have added a sub-section for the convergent validity analysis. In the results part, we added a sub-section title for the convergent validity.

- page 14, line 294, add a bracket after "Table 2".

Response: This was done.

- page 397, you mention the mean age and its standard deviation but with 24 responses, does this follow a normal distribution? If not, the median and the 25th and 75th percentiles would be more appropriate.

Response: We checked that the distribution of age among the 24 responses follow a normal distribution (Shapiro-Wilk test: p=0.3408). For this reason, mean age and its standard deviation was reported.

Do not put spaces before and after the slash (/).

Response: This was done.

Regarding the discusion part:

- page 9, line 418, The authors report "good acceptability" due to a "high response rates" although the response rates are unknown.

Response: In the second paragraph of discussion part, we replaced “high response rates” by “low percentages of missing values per item”, as response rate could lead to confusion (page 29, line 437 of the revised manuscript).

A total of 360 responses were obtained but the deonominator is not reported in this article. To how many healthcare professionals was the questionnaire sent? What are the response rates?

Response: Unfortunately we did know the response rate. As mentioned above, the number of perinatal care providers invited to participate by email by the French Federation of Perinatal Health Network was not known. However, as previously specified, recommendations for psychometric evaluation of 100 subjects at least and of subject-item ratio from 4 to 10 were achieved.

These considerations also need to be clarified for the re-test where 24 persons responded but where the denominator is unknown.

Response: A sentence concerning the response rate for test-retest was added in the Reliability subsection (page 27, lines 413-414 of the revised manuscript).

“Of the fifty perinatal care providers randomly selected for the test-retest, 40 (80.0%) completed the test questionnaire. Among them, 24 (60.0%) completed the retest questionnaire”.

Do the authors know the proportion of men in these two populations (to be able to compare them to the proportions of their two samples)?

Response: We did not know the proportion of men among the memberships of the French Federation of Perinatal Health Network and among the memberships of the two regional perinatal networks (sample for test-retest reliability). Unfortunately, the FFRSP (‘Fédération Française des Réseaux de Santé en Périnatalité’) did not produce statistics on sociodemographics and clinical characteristics of their memberships.

We only found that in 2017, the proportion of men among midwives was 2.6% (https://www.ordre-sages-femmes.fr/etre-sage-femme/donnees-demographiques-de-la-profession/). We added this information in the discussion (page 32, lines 517-518 of the revised manuscript):

“In France in 2017, only 2.6% of midwives were men”.

Although a little long, the discussion part is relevant and the limitations of the study are fairly presented.

Regarding the Annex (S1 File.docx):

- page 1, question 2, please consider replacing "Sexe" with "Genre";

Response: This was replaced.

- page 1, question 4, I recommend that you add "Maïeutique" after "Gynécologie / Obstétrique";

Response: “Maïeutique” was added.

- page 1, question 5, I recommend that you reword the sentence as follows: "En quelle année avec-vous obtenu votre diplôme d'exercice professionnel ?";

Response: The sentence was reworded as recommended.

- page 2, question 1, there is an extra space after "résidanat/";

Response: This was corrected.

- On page 2, question 3b, I understand that the questionnaire has been tested as it is and that a modification after the fact is questionable however please consider replacing "divulgations de maltraitance" by "révélations de maltraitance/abusbecause in French the word "révéler" means "to inform someone of something that was ignored, unknown, hidden or secret", while "divulguer" means "to bring to the attention of a large audience information that was initially considered to be or should remain confidential";

Response: The term “disclosures” was first translated by “révélations” in the forward translations. The multidisciplinary committee decided to modify “révélations” by “divulgations”. This term “divulgations” was correctly backward translated in “disclosures”. During the pre-test study, no difficulties concerning this item was reported and no comments as well.

- page 5, question 8, you have translated "Child Protective Services" by "CRIP" without specifying the meaning of this acronym. I suggest that you either use a generic term or specify the acronym;

Response: We have specified the acronym:

« Si l'enfant ne court pas un danger immédiat, les professionnels de santé ne doivent pas effectuer un signalement de cas d’enfants témoin de violence conjugale auprès de la Cellule de Recueil des Informations Préoccupantes (CRIP) »

- page 6, question 4, delete the full stop at the end of the sentence;

Response: This was deleted.

- page 7, question 17, there is an extra space between "signalement" and "de". The full stop at the end of the sentence should be removed;

Response: This was corrected.

- page 10, question 4, replace "1 avocat" by "un avocat".

Response: This was replaced.

Regarding the accessibility of the data, the authors state that the data are fully available without restriction at Mendeley data repository. A digital object identifier (DOI) to easily access this data would be useful.

Response: We made changes to our Data Availability statement:

All data are available at Mendely: Guiguet-Auclair, Candy; Debost-Legrand, Anne; Lémery, Didier; Barasinski, Chloé; Mulin, Blandine; Vendittelli, Françoise (2021), “Measuring the readiness to screen and manage intimate partner violence : cross-cultural adaptation and psychometric evaluation of the PREMIS tool for perinatal care providers”, Mendeley Data, V1, doi: 10.17632/7x989dtpk7.1.

Submitted filename: Response to reviewers.docx

Click here for additional data file.

5 Oct 2021

PONE-D-21-19470R1Measuring the readiness to screen and manage intimate partner violence: cross-cultural adaptation and psychometric evaluation of the PREMIS tool for perinatal care providersPLOS ONE

Dear Dr. Guiguet-Auclair,

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.

Just one more minor revision and then the manuscript will go to the Acdemic Editor's decision without further review by the Reviewer.

Please submit your revised manuscript by Nov 19 2021 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: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.

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 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,

Stefano Federici, Ph.D.

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 (if provided):

Just one more minor revision and then the manuscript will go to the Acdemic Editor's decision without further review by the Reviewer.

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

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 #1: All comments have been addressed

**********

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 #1: Yes

**********

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

Reviewer #1: Yes

**********

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 #1: Yes

**********

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 #1: Yes

**********

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 #1: Many thanks to the authors for taking my comments into account.

Regarding the abstract, I would substitute the following sentence "Results: The PREMIS was successfully translated and cross-culturally adapted into French." by "Results: The PREMIS was successfully translated and cross-culturally adapted to the context of metropolitan France.". Indeed, French is spoken in many countries but in different contexts.

I have no further comments and again I thank the authors for their conscientious work.

**********

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 #1: Yes: Laurent GAUCHER

[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.

8 Oct 2021

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.

Response: We have reviewed all the references in the manuscript and we have modified the formatting of some of them, in order to be conform with the “Vancouver” style.

Reviewer' comments

Regarding the abstract, I would substitute the following sentence "Results: The PREMIS was successfully translated and cross-culturally adapted into French." by "Results: The PREMIS was successfully translated and cross-culturally adapted to the context of metropolitan France.". Indeed, French is spoken in many countries but in different contexts.

Response: We modified the first sentence of the Results section in the abstract as recommended.

Submitted filename: Response to Reviewers.docx

Click here for additional data file.

11 Oct 2021

Measuring the readiness to screen and manage intimate partner violence: cross-cultural adaptation and psychometric evaluation of the PREMIS tool for perinatal care providers

PONE-D-21-19470R2

Dear Dr. Guiguet-Auclair,

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.

An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org.

If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org.

Kind regards,

Stefano Federici, Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

27 Oct 2021

PONE-D-21-19470R2

Measuring the readiness to screen and manage intimate partner violence: cross-cultural adaptation and psychometric evaluation of the PREMIS tool for perinatal care providers

Dear Dr. Guiguet-Auclair:

I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department.

If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org.

If we can help with anything else, please email us at plosone@plos.org.

Thank you for submitting your work to PLOS ONE and supporting open access.

Kind regards,

PLOS ONE Editorial Office Staff

on behalf of

Prof. Stefano Federici

Academic Editor

PLOS ONE