Use of Obstetric Practice Web Sites to Distribute Zika Virus Information to Pregnant Women During a Zika Virus Outbreak

Lehnert, Jonathan D.; Ellingson, Mallory K.; Goryoka, Grace W.; Kasturi, Raghuraj; Maier, Emily; Chamberlain, Allison T.

In addition to documenting the prevalence of Zika virus-related information, we reviewed the information that was available for key content themes. While the total number of Web sites that posted Zika virus information increased over the course of the study, the number of Web sites posting advice on the use of insect repellent and travel advisories to affected areas decreased from January to August. This unexpected decrease could be a cause for concern, as the onset of non-travel-associated transmission drastically increases the at-risk population within the United States. With localized transmission a reality, it is important that individuals, particularly pregnant women, understand the potential risks associated with traveling to areas with ongoing transmission. One hypothesis for the decreases we observed in important prevention-related topics may be an unfortunate side effect of the current paradigm of health information dissemination. As the Zika virus knowledge base expanded over the course of the emergency, posted information began to shift focus to emerging topics. Protective activities such as using insect repellent or avoiding travel to affected areas may have been deemphasized under an assumption of "common knowledge." Public health professionals creating resources for and conducting outreach to providers should consider emphasizing the importance of continually promoting the most effective risk-reduction behaviors, no matter how "common." The low proportion of Web sites posting Zika virus content and the decrease in observed content themes can be a result of a provider's inability to dedicate the necessary time and resources to maintaining an updated practice Web site. Our finding that larger, hospital-affiliated practices were significantly more likely to post content about Zika virus may be particularly indicative of this hypothesis. This could be explained by the fact that large hospitals generally have dedicated information technology (IT) departments focused on maintaining and updating their Web sites. Because it is unreasonable to expect smaller private practices to have significant IT resources, public health organizations that are developing resources for providers to disseminate to their patients should be mindful of this inequity. The most well-designed patient-centered public health communication materials may never be utilized by the majority of providers if posting the content on their Web sites is not easy. If public health practitioners develop downloadable materials or content for provider Web sites, they should specifically focus on low-maintenance tools (eg, widgets, microsites) that include explicit uploading instructions.