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Volume 24, Number 12—December 2018

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

Giulia Earle-RichardsonComments to Author , Christine Prue, Khadija Turay, and Dana Thomas
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA

Main Article

Table 6

Logistic regression models for Zika prevention behaviors performed by pregnant women that were significantly associated with >1 Zika prevention interventions, Puerto Rico, July 2016–June 2017*†

Behavior Odds ratio (95% CI)
Received ZPK Recalled Detén el Zika campaign Received WIC 
Zika orientation Offered free residential spraying
Personal protection behaviors
  Bed net use 3.1 (1.9–5.1) 1.2 (0.8–1.7) 2.2 (1.0–4.8) NA
  Condom use‡ 1.4 (0.9–2.1) 1.4 (1.0–2.0) 2.4 (1.2–4.7) NA
  Mosquito repellent use 1.5 (1.1–2.0) 1.6 (1.2–2.1) 1.2 (0.8–1.9) NA
  Sexual abstinence 0.9 (0.6–1.4) 0.9 (0.6–1.3) 1.2 (0.5–2.5) NA
  Wearing long sleeves 1.9 (0.6–6.2) 2.9 (0.9–8.8) 1.9 (0.2–14.9) NA
  Wearing long pants
1.1 (0.7–1.7)
1.0 (0.7–1.5)
1.4 (0.6–3.0)
Home protection behaviors
Larvicide application 8.0 (4.8–13.3) 0.8 (0.6–1.1) 2.7 (1.4–5.5) 0.4 (0.3–0.5)
Spraying home or yard for mosquitoes 1.5 (1.1–2.3) 1.0 (0.7–1.4) 1.6 (0.9–2.9) 13.1 (8.5–20.3)
Removing or covering standing water 2.2 (0.8–5.7) 2.7 (1.1–6.5) 0.5 (0.1–4.4) 1.1 (0.4–2.9)
Installing window or door screens 0.8 (0.6–1.2) 0.8 (0.6,1.2) 0.7 (0.4–1.5) 0.9 (0.6–1.5)

*Bold indicates significant result. WIC, Women, Infants, and Children Program (US Department of Agriculture Food and Nutrition Service); ZPK, Zika prevention kit.
†Models for WIC orientation and offer of free residential spraying were modeled separately, whereas ZPK distribution and Detén el Zika recall were modeled together to measure independent effects. Thus, each Zika prevention behavior had 3 models. To reduce possible bias associated with sparse data, calendar month of interview was consolidated into a 3-level, 3-month variable. All 5 demographic variables and consolidated calendar month of interview were controlled for in each model, except for the following cases: 1) WIC orientation did not include any calendar month of interview variable; or 2) very few respondents did not receive WIC orientation, thus the naturally occurring control group was very small. To not bias the models, no time of interview variable was included in models of WIC orientation. Education was excluded from bed net, larvicide, and repellent use models. Because of the substantial amount of missing data for education, additional testing was performed to determine whether women with missing education data performed the 10 behaviors with significantly higher or lower frequency. Three behaviors (repellent, bed net, and larvicide use) were significantly associated with whether education data were missing, so education was not included in these models. No calendar month or consolidated month variable was used for any of the larvicide use models because of small cell sizes.
‡Among those reporting having had sex during pregnancy.

Main Article

1Preliminary results from this study were presented as a poster presentation at the International Conference on Emerging Infectious Diseases, August 29, 2018, Atlanta, Georgia, USA.

Page created: November 20, 2018
Page updated: November 20, 2018
Page reviewed: November 20, 2018
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