Table 4.

Intended outcomes for Zika virus–related communication efforts in the United States during the 2016-2017 Zika virus outbreak, illustrative quotes from informants, and examples of activities^a

Intended Outcome	Description	Selected Quotes and Examples
Prevent mosquito bites	Many jurisdictions focused on general mosquito bite prevention and not specifically on the mosquito species that transmits Zika as part of a wider campaign to prevent all mosquito-borne diseases (eg, West Nile virus). Actions encouraged included wearing mosquito repellent, wearing long pants and sleeves, and using window/door screens.	“Our main message isn’t just preventing Zika. . . . Our message is always fighting Zika and every mosquito-borne disease.” One health department used the slogan “fight the bite day and night” to encourage persons to wear repellent during the day and night to prevent both Zika virus (which is transmitted by a day-biting mosquito) and West Nile virus (which is transmitted by a dusk-biting mosquito).
Reduce mosquito breeding sites	Mosquito-source reduction messages included how to identify areas where mosquitoes may lay eggs and tips on how to eliminate standing water, and often appealed to the civic duty of all to prevent disease transmission.	“Zika prevention takes a community. . . . We wanted to educate [them] about the type of mosquito, educate about why they need to pay attention, and then get them to do the behavior once a week. They’re going to go out and tip, toss, and cover—not just to keep your own family safe, but also in your neighborhood.” “We can’t spray our way out of this problem.”
Prevent sexual transmission	Some participants highlighted the importance of potential importation of a travel case and subsequent spread via sexual contact and therefore emphasized safe-sex practices such as condom use.	“Our focus right now has been on travel and pregnant women and sexual transmission.”
Prevent travel-associated cases	Travel-related messages were targeted to incoming and outgoing travelers (often specifically pregnant women and women of childbearing age and their partners) and frequently focused on personal prevention methods.	“We provide key information about travel-related exposure. So, our goal at this point is to make sure that people that are traveling know what’s the risk if they travel and bring those viruses back to [redacted] county, then we could begin local transmission here, and that’s what we’re trying to prevent.”
Educate health care practitioners	Efforts included communication with members of the health system, specifically OB-GYNs [obstetricians/gynecologists] to provide education about Zika virus itself and Zika testing recommendations.	“We have a sizeable component that focuses on the medical community—making sure they are apprised of guidance on clinical management of Zika cases, diagnostics, assessment of cases, etc.”
Educate pregnant women, their partners, and women of childbearing age	Many messages warned pregnant women or those who thought they might be or become pregnant not to travel to places with ongoing Zika transmission, and also encouraged them to practice safe sex if their partner had recently traveled to an outbreak area.	“The other [emphasis] was not to travel to places where there was ongoing infection if pregnant or they thought they might be pregnant. . . . And some kind of secondary messaging for partners to take precautions during sex if you’ve traveled to that area.”

^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.