Firefighters are vital for public health safety, representing over a million individuals nationally, of which the majority are volunteer firefighter (VFFs). Because they are required to respond at a moment's notice to almost every domestic emergency, there is wide agreement that their health and readiness is critical to our public safety net. However, current evidence suggests VFFs struggle with poor health and low levels of fitness, including very high (> 80%) rates of overweight and obesity. This has resulted in cardiovascular events being the leading cause of line of duty deaths annually in the fire service. In addition to risk factors endemic to firefighting (e.g. exposure to particulate matter in fires), VFFs face a number of unique obstacles to maintaining health and fitness, such the stress of being on call 24 hours a day, 7 days a week and maintaining training while also managing the pressures of family life and their full time primary jobs. Unfortunately, there are no tailored health promotion interventions for the volunteer fire service and few volunteer departments offer any services to their personnel. Furthermore, for many VFFs, their only interaction with the healthcare system is their annual medical fitness for duty exam. The First Twenty(R) (TF20) was recently developed as a not-for- profit, web-mobile program for firefighters (FF) specifically focused on improving fitness and nutrition knowledge and practices. The program was designed by FFs with backgrounds in tactical fitness, marketing and program development professionals, and nutrition and exercise scientists. Preliminary data suggests the program is well-received by FFs and results in significant improvement in body composition and physical fitness. One innovative approach for the eventual dissemination of TF20 to VFFs is through their fitness-for duty medical examinations. The synergy created by linking the TF20 intervention components, feedback to the VFFs from their medical examination, and health messages from their physician is predicted to maximize the impact of this much needed intervention. The goal of the proposed project is to tailor TF20 for use in a clinic based setting (CB-TF20) for those providing medical exams to VFFs and pilot test it in comparison to the American Heart Association's Life's Simple 7 (LS7), a web-based diet and PA knowledge/behavior and lifestyle program.
The specific aims are to: 1) Conduct formative research with key stakeholders in the VFF community (e.g., physicians, department leadership, VFFs) to determine best practices for implementing a clinic-based, web-mobile health and wellness program with VFFs and physicians; 2) Develop a clinic-based version of TF20 (CB-TF20) and beta-test it with VFFs; and 3) Conduct a 6 month, 2-arm, pilot cluster (i.e., department) randomized clinical trial (PCRCT) to determine the comparative effectiveness of the revised CB-TF20 to LS7 on body composition and diet and PA knowledge/behavior among VFF with BMI e25.0kg/m2; and conduct an evaluation of the CB-TF20 materials and technology. This innovative R34 study is a critical step in providing a much needed intervention for volunteer firefighters and those providing their annual medical examinations.
Rates of overweight/obesity, poor fitness, and cardiovascular disease are at epidemic proportions among volunteer firefighters (VFF). Unfortunately, no health promotion interventions exist for the volunteer fire service and the only contact many VFFs have with the healthcare system is during their annual fire service medical physical. Using a mixed-methods approach, this study will tailor the components of and pilot test a highly promising clinic-based diet and fitness intervention for VFFs, The First20, in preparation for a national randomized clinical trial.
