A Clinic and Tech-based Diet and Fitness Intervention for Volunteer Firefighters

 消防员对公共卫生安全至关重要，代表全国100多万人，其中大多数是志愿消防员（VFF）。由于他们被要求在接到通知后立即对几乎每一个国内紧急情况作出反应，人们普遍认为，他们的健康和准备对我们的公共安全网至关重要。然而，目前的证据表明，VFF的健康状况不佳，健身水平低，包括超重和肥胖率非常高（> 80%）。这导致心血管事件成为消防部门每年死亡的主要原因。除了消防特有的风险因素（例如，在火灾中接触颗粒物）外， VFF在保持健康和健身方面面临着许多独特的障碍，例如每周7天，每天24小时待命的压力，以及在管理家庭生活压力和全职主要工作的同时保持训练。不幸的是，没有专门针对志愿消防服务的健康促进干预措施，很少有志愿部门向其人员提供任何服务。此外，对于许多VFF，他们与医疗保健系统的唯一互动是他们的年度医疗健康责任考试。前二十（R）（TF 20）是最近开发的一个非营利，网络移动程序的消防员（FF）专门专注于提高健身和营养知识和做法。该计划是由具有战术健身，营销和计划开发专业人士，营养和运动科学家背景的FF设计的。初步数据显示，该计划深受FF的欢迎，并导致身体成分和身体素质的显着改善。最终将TF-20分发给退伍军人的一个创新方法是通过他们的健康体检。通过将TF 20干预组件、来自其医学检查的VFF反馈以及来自其医生的健康信息联系起来而产生的协同作用预计将最大限度地发挥这种急需的干预的影响。拟议项目的目标是为那些为VFF提供医学检查的人定制TF 20用于基于诊所的环境（CB-TF 20），并将其与美国心脏协会的Life's Simple 7（LS 7）进行初步测试，LS 7是一种基于网络的饮食和PA知识/行为和生活方式计划。具体目标是：1）与VFF社区的主要利益相关者（例如，医生、部门领导、VFF），以确定与VFF和医生一起实施基于诊所的网络移动健康和保健计划的最佳实践; 2）开发基于诊所的TF 20版本（CB-TF 20）并与VFF一起进行β测试;以及3）进行为期6个月的双臂试点集群（即，部门）随机临床试验（PCRCT），以确定修订后的CB-TF 20与LS 7对BMI e25.0 kg/m2的VFF的身体成分、饮食和PA知识/行为的比较有效性;并对CB-TF 20材料和技术进行评估。这项创新的R34研究是为志愿消防员和提供年度体检的人提供急需干预的关键一步。

 DESCRIPTION (provided by applicant): 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.