Table 2.

US public health engagement strategies for selected populations during the 2016-2017 Zika virus outbreak response, illustrative quotes from informants, and examples of activities^a

Population and Strategy	Selected Quotes and Examples
Pregnant women, their partners, and women of childbearing age
Engaging women’s health care providers	“We put together Zika prevention kits, and distributed over 10 000 of those to OB-GYN [obstetrician-gynecologist] professionals across the state. And in this prevention kit, not only is there bug spray and condoms, but there’s all of our print information about preventing Zika and the Tip and Toss campaign.”
Addressing travel-related risks for pregnant women	“We definitely try to push, ‘You are a person of childbearing age. We want you to realize [that Zika] is something that can affect [your child if you] become pregnant within the next couple of months. Also, if your sexual partner is on this trip with you . . . that’s an additional risk.’”
Highly mobile populations
Targeting recreational travelers	“We have [messages] that are targeted toward business travelers and then some that are specifically for the destination-wedding, honeymoon population, because that age group tends to be more in the childbearing ages.”
Communicating risk to families visiting high-risk locations	“Demographically, we know that the highest risk for Zika introduction will be [among those] visiting family in Mexico or South and Central America. . . . So our goal at this point is to make sure that [they] know that if they bring those viruses back to [this county], [it] could begin local transmission here, and that’s what we’re trying to prevent.”
Addressing risks unique to occupational travelers (eg, business travelers, migrant workers, volunteers) traveling to endemic regions	“[Migrant workers] stay in family camps, depending upon what type of immigrant worker they are, and then others stay in big barracks or big barns, and they cohabitate, and some bring their families with them.” “We had vector surveillance coordinators going to the migrant worker camps and giving them information.” “You have all these NGOs [nongovernmental organizations] that are sending people to help . . . in Haiti and different Caribbean countries. We have outreach for these NGOs that are willing to send people like that. And we provide them with a lot of information.”
Non-English speakers
Finding translators	“For our Spanish populations, we worked with that promotoras group—we sent them all the materials and asked for feedback on it . . . and we did the same thing with our materials that we translated in Vietnamese.”
Seeking diversity in visual messaging	“Some of [our] posters were in Spanish and English and featured Latinos in two of them, and then one was focusing on Caribbean people who potentially might travel or be from the Caribbean.”
Adapting existing communication materials	“I have found a lot of really good resources [from] other countries’ ministries of health to be very helpful because they have things in Spanish that I can repurpose, or they say things in Spanish that I can run by our Spanish-speaking staff and they will agree that that’s a better way to say it than how we’ve been saying it.”
Achieving multiplatform message dissemination	One health department partnered with Univision to organize telephone banks and disseminate Zika messages to Spanish speakers and health care providers via Spanish-language news programming.
Additional target populations
Outreach to off-the-grid populations	“Colonias are notorious and rather plentiful, unfortunately. . . . Essentially, they’re not part of a city. They don’t have a lot of city services. They don’t necessarily always have paved roads. . . . They tend to be places where you can have a lot of standing water. You’ve got poor people. You’ve got plenty of mosquitoes. And those folks we found don’t really even listen to the news. So, they’re not even getting their news through the radio, let alone television.”
Engagement with lawmakers	“We actually went to the state house here and provided a presentation and overview to lawmakers so that they could respond to their constituent concerns, and they could let them know that . . . they had information and [the health department] was in touch with them.”

^aFrom interviews conducted with public health policy makers, public health practitioners, public information officers, and vector-control officials (n = 28) in 17 states (Alabama, Arizona, California, Florida, Georgia, Hawaii, Illinois, Louisiana, Maryland, Mississippi, New Mexico, New York, Oklahoma, Pennsylvania, South Carolina, Texas, and Virginia) during May–August 2017.