Prevention and Control: Community Engagement

Without an effective vaccine for people, the best way to prevent mosquito-borne disease is by preventing mosquito bites. This can be accomplished through community-based IVM programs and by personal protection behaviors, such as

• Mosquito-avoidance. Health officials may recommend residents avoid outdoor activities when high virus activity levels have been detected or when mosquitoes are most active.
• Use of personal insect repellents. CDC recommends using EPA-registered insect repellents or covering up with long-sleeved shirts and long pants when outside.
• Removal of residential mosquito sources. Once a week, residents should empty, cover, or throw out items that hold water, such as tires, buckets, planters, toys, pools, birdbaths, flowerpots, or trash containers.

Jurisdictions can promote individual and community-based prevention measures through public education and risk communication activities. Messages should acknowledge the seriousness of the disease without promoting undue fear or panic in the target population. Fear-driven messages may heighten the powerlessness people express in dealing with vector-borne diseases. Messages should be clear and consistent with the recommendations of coordinating agencies and include a call to action. Use plain language and adapt materials for lower literacy and non-English speaking audiences.

People can further reduce their risk of mosquito bites by not going outdoors when mosquitoes are biting and following recommendations to avoid outdoor activity when and where high virus activity levels have been detected are a component of prevention programs. Recommendations to avoid being outdoors during peak mosquito biting times may conflict with neighborhood social patterns, community events, people’s jobs or the practices of persons without air-conditioning. It is important to communicate when the important mosquito vectors are most active. Emphasize that insect repellent use is protective and should be used when outdoors, particularly during the prime mosquito-biting hours.

Additional information about personal insect repellents, including permethrin, can be found at https://www.cdc.gov/mosquitoes/mosquito-bites/prevent-mosquito-bites.html.

Information for individuals on control mosquitoes around their home can be found at https://www.cdc.gov/mosquitoes/mosquito-control/athome/outside-your-home/index.html.

Audience members have different disease-related concerns and motivations for action. Proper message targeting (including use of plain language) permits better use of limited communication and prevention resources. The following are some population segments that require specific targeting. See Human Disease Section for additional information about risk groups that should be targeted.

Persons with Outdoor Exposure. People who engage in extensive outdoor work or recreational activities are at greater risk of being bitten by mosquitoes. Messages for these individuals should encourage use of insect repellent and long-sleeved shirts and pants. Local spokespersons (e.g., union officials, job-site supervisors, golf pros, sports organizations, lawn care professionals, public works officials, gardening experts) may be useful collaborators. Place messages in locations where people engage in outdoor activities (e.g., parks, golf courses, hiking trails).

People Experiencing Homelessness. Extensive outdoor exposure and limited financial resources in this group present special challenges. Application of insect repellents to exposed skin and clothing may be most appropriate prevention measures for this population. Work with social service groups in your area to educate and provide insect repellents to this population segment.

Residences Lacking Window and Door Screens. The absence of intact window/door screens might increase exposure to mosquito bites. Encourage residents to consistently use screened windows and doors to keep mosquitoes outside. Focus attention on the need to repair screens and provide access to resources to do so. Partner with community organizations that can assist with installing or repairing screens for older persons or others with financial or physical barriers.

Older Adults. For many mosquito-borne diseases, older adults are at greater risk for serious disease. Messages on mosquito avoidance, insect repellent use, and weekly removal of standing water where mosquitoes lay eggs around the home should be shared with this audience.

At the community level, advocating for organized mosquito abatement and participating in community mobilization projects to address sources of mosquitoes such as trash, standing water, or untreated swimming pools are activities that can help protect individuals and at-risk groups.

Providing clear messages and understandable concepts promotes community understanding and acceptance. The following provides a description of selected best practices for reaching high-risk groups, offers suggestions for cultivating partnerships with media and communities, and provides select outreach measures for mobilizing communities.

Communicating about Vector Control. Public understanding and acceptance of emergency adult mosquito control operations using insecticides is critical to its success, especially where these measures are unfamiliar. Questions about the products being used, their safety, and their effects on the environment are common. Improved communication about surveillance and how decisions to use mosquito adulticides are made may help residents weigh the risks and benefits of control. When possible, provide detailed information regarding the schedule for adulticiding through newspapers, radio, government-access television, the internet, recorded phone messages, social media, or other means your agency uses to successfully communicate with its constituencies.

Community Mobilization and Outreach. Community mobilization can improve education and help achieve behavior change goals. Promote the concept that health departments and mosquito control programs require community assistance to reduce mosquito-borne disease risk. Leverage online platforms to further disseminate your messages.

A community task force that addresses civic, business, public health, and environmental concerns can be valuable in achieving buy-in from various segments of the community, and in developing common messages. Community mobilization activities can include clean-up days to get rid of mosquito habitats (e.g., tires, trash). Effective community outreach also involves presenting messages in person, involving citizens in prevention and control activities, and using traditional and social media outreach. Hearing the message of personal prevention from community leaders can validate the importance of the disease and serve as a community call to action. Health promotion events and activities reinforce the importance of prevention and control in a community setting.

Partnership with Media and the Community. It can be beneficial to cultivate relationships with the media (e.g., radio, TV, newspaper, web-based news outlets) prior to an outbreak. Obtain media training for at least one member of your staff and designate that individual as the organization’s spokesperson. Develop key messages and a communication plan, including press releases, prior to developing products. Many communities have heard mosquito prevention and control messages repeated for several years. Getting the public’s attention when risk levels increase can be a challenge. Therefore, evaluate and update mosquito bite prevention messages annually and test new messages with different population segments to evaluate effectiveness. Develop partnerships with agencies and organizations that have relationships with populations at higher risk (such as persons over 50 years of age) or are recognized as community leaders (e.g., churches, service groups). Working through sources trusted by the priority audience can heighten the credibility of and attention to messages. Partnerships with businesses that sell materials to fix or install window screens or that sell insect repellent may be useful in some settings (e.g., local hardware stores, grocery stores).

Social Media. A majority of Americans use social media which can be an inexpensive and rapid method for disseminating information to the community. Outreach can be conducted using Twitter, Facebook, YouTube, blogs, and other websites that may reach constituents less connected to more traditional media sources. Using images or videos in your posts make them more attention grabbing. It is also best practice to include a call-to-action people can take. Provide links that direct users to webpages or other resources with more complete information.

Online Resources. The Internet has become a primary source of health information for most Americans. Encourage constituents to seek advice from credible sources. Make sure local public health agency websites are clear, accurate, and up to date. Useful information is available from a number of resources:

• The CDC web pages are updated frequently to reflect new findings and recommendations. Materials on the CDC web site are in the public domain and serve as a resource for state and local health departments and other organizations.
• CDC staff can provide technical assistance in the development of audience research and strategies for public education and community outreach. Contact CDC, Division of Vector-Borne Diseases’ health communications staff in Fort Collins, CO at 970-221-6400.
• The U.S. Environmental Protection Agency (EPA) is the government’s regulatory agency for insecticide and insect repellent use, safety, and effectiveness. Information about mosquito control insecticides and repellents is available at https://www.epa.gov/mosquitocontrol. These include guidance for using insect repellents safely and a search tool to assist in finding a repellent that is right for you (https://www.epa.gov/insect-repellents/find-repellent-right-you#searchform), which allows the user to examine the protection time afforded by registered insect repellents containing various concentrations of the active ingredients.

There are several non-governmental organizations that have developed useful tools and information that can be adapted for local needs. Examples include: the American Mosquito Control Association (https://www.mosquito.org/default.aspx) and the National Pesticide Information Center (NPIC) (www.npic.orst.edu).