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

Emerg Infect Dis. 2018 Dec;24(12):2251-2261. doi: 10.3201/eid2412.181056.


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.

Keywords: Puerto Rico; Zika virus; health behavior; interpersonal communication; maternal health; mosquito bed nets; pregnancy; program effectiveness; risk perception; viruses.

Publication types

  • Historical Article

MeSH terms

  • Adult
  • Child
  • Child, Preschool
  • Female
  • Health Behavior
  • History, 21st Century
  • Humans
  • Infant
  • Infant, Newborn
  • Pregnancy
  • Pregnancy Complications, Infectious*
  • Public Health Surveillance
  • Public Health*
  • Puerto Rico / epidemiology
  • Zika Virus Infection / epidemiology*
  • Zika Virus Infection / history
  • Zika Virus Infection / prevention & control*
  • Zika Virus*