Influences of Community Interventions on Zika Prevention Behaviors of Pregnant Women, Puerto Rico, July 2016–June 20171

Abstract

We assessed how community education efforts influenced pregnant women’s Zika prevention behaviors during the 2016 Centers for Disease Control and Prevention–Puerto Rico Department of Health Zika virus response. Efforts included Zika virus training, distribution of Zika prevention kits, a mass media campaign, and free home mosquito spraying. We used telephone interview data from pregnant women participating in Puerto Rico’s Women, Infants, and Children Program to test associations between program participation and Zika prevention behaviors. Behavior percentages ranged from 4% (wearing long-sleeved shirt) to 90% (removing standing water). Appropriate mosquito repellent use (28%) and condom use (44%) were common. Receiving a Zika prevention kit was significantly associated with larvicide application (odds ratio [OR] 8.0) and bed net use (OR 3.1), suggesting the kit's importance for lesser-known behaviors. Offer of free residential spraying was associated with spraying home for mosquitoes (OR 13.1), indicating that women supported home spraying when barriers were removed.

Analysis of Risk Perceptions and Related Factors Concerning COVID-19 Epidemic in Chongqing, China

“…For one thing, high risk perceptions may enhance the public's active response to the epidemic. In Zika prevention, pregnant women's personal risk perception was increased after exposure to intervention provided by CDC [15]. Their degree of concerning about Zika, self-rated chance of being infected and confidence in ability to protect self and baby was significantly elevated, and self-protection behaviors like mosquito repellent use, long-pant wearing became more frequent.…”

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“…Countries such as the United States that value individual rights and freedom are more reliant on the willingness of the general public to adhere to protective action recommendations than on containment or migration measures [ 22 ]. Given the link between risk perception and preventive behaviors documented in previous research [ 5 , 26 , 27 ], it is imperative to monitor public risk perceptions during public health emergencies, as part of emergence management to effectively control the transmission of infectious diseases.…”

“…Previous research has demonstrated a positive relationship between high-risk perceptions and the public’s active response to an epidemic. In the case of Zika prevention in Puerto Rico, pregnant women’s risk perception increased after they participated in a community intervention program, which also motivated them to engage in self-protective behaviors, such as mosquito repellent use and long-pant wearing [ 26 ]. In a study focusing on the first wave of the 2009 H1N1 pandemic in Hong Kong, despite the lack of consistency in their findings, researchers detected that the lower perceived severity was, the fewer hygiene measures were adopted [ 27 ].…”

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“…The cost of insect repellent may be one of the obstacles to its use [ 33 , 35 ]. Programs that include free distribution of preventative items is an effective method in the control of infections, especially in populations with few resources, as has already been observed in a study from Puerto Rico [ 41 ]. However, in our study, repellents were freely available at no cost.…”