Fast, Formative Research for the “Detén El Zika” Campaign

Background:  Responding to an emerging health threat often requires rapid deployment of behavior change communication. Health communication best practices include developing and testing draft messages and materials to ensure that they resonate with and inspire priority groups to act. Formative research for comprehensive campaigns typically takes several months to plan, conduct, and summarize.  When faced with an emergency health threat, this timeline is often compressed from months to weeks, and many skip the step of testing campaign concepts, messages, and materials. 

Program background:  In response to the emerging Zika epidemic in Puerto Rico, the CDC Foundation, CDC, and RTI International collaborated on the rapid development and implementation of a Zika prevention campaign for pregnant women in Puerto Rico, which was launched in spring 2016. The goal of the campaign was to increase knowledge among and motivate pregnant women, their partners and family members, and the community to follow Zika prevention recommendations. 

Evaluation Methods and Results:  To develop a campaign that was relevant to and resonated with the target groups, it was essential to quickly get their input. In Puerto Rico, more than 90% of pregnant women receive assistance from the Women, Infants, and Children (WIC) program. CDC had previously established a relationship with WIC to conduct initial formative research; this relationship was leveraged for further concept testing. WIC staff agreed to recruit pregnant women and their partners and family members to participate in in-depth interviews to rapidly test campaign concepts. In 4 days and with three teams, including a bilingual interviewer and notetaker, the RTI/CDC team conducted 82 concept testing interviews at seven WIC clinics throughout northeastern Puerto Rico. We will discuss the procedures for and challenges in conducting interviews within a busy clinic. Participants’ feedback on four concepts was used to develop the final campaign concept (This is How We Stop Zika /Detén el Zika), which merged multiple initial concepts. Once the final campaign concept and overarching messages were finalized, we developed draft campaign materials including logos, print ads, and a script for a public service announcement. We conducted one focus group with each of the following groups to test material prototypes: pregnant women (n=11), male partners of pregnant women (n=9), and community members (n=11).  Focus group findings will be shared as well as how they were used to revise materials.

Conclusions: This campaign was the first large-scale, comprehensive Zika prevention campaign in Puerto Rico and continues to be promoted (http://detenelzika.org/ and http://helpstopzika.org/). Despite the short timeframe, we followed best practices for conducting formative research with priority audiences, which was integral to developing a campaign and materials that resonated with and were well-received by both primary and secondary audience groups. 

Implications for research and/or practice: 

• Even in a limited timeframe, formative research can be conducted if planned efficiently. 
• Intercept interviews, when coordinated with service providers, can provide an effective means of rapidly recruiting and testing concepts and materials.