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Background Occupational exercise training programs can improve overall health and fitness in firefighters, but evidence beyond clinical and performance outcomes is needed before fire departments invest in and successfully adopt health promotion programs. Objective This mixed methods pilot study sought to pair clinical and performance outcomes with participants’ qualitative feedback (eg, participants’ enjoyment, lifestyle behavior changes, and team structure) with the goal of informing recommendations for future programs. Methods Professional firefighters participated in a 14-week occupational exercise training program with assessments conducted pre- and posttraining. Clinical outcomes included weight, BMI, body fat percentage, resting heart rate, systolic blood pressure, and diastolic blood pressure. Performance outcomes included the sharpened Romberg balance test, 1-repetition maximum leg press and bench press, graded exercise test (estimated VO2max), knee range of motion, shoulder flexibility, and hamstring flexibility. Self-administered surveys (Short Form-36, International Physical Activity Questionnaire, Barriers Self-Efficacy Scale, and Barriers to Being Active Quiz) were completed. In 3 private focus groups of 3 to 4 participants, firefighters' experiences in the training program and their health behaviors were explored. Results Male firefighters (n=14; age: mean 36.4, SD 2.6 years) completed 20 training sessions. There were no significant changes to weight (P=.20), BMI (P=.15), body fat percentage (P=.16), systolic blood pressure (P=.12), estimated VO2max (P=.34), balance (P=.24), knee range of motion (left: P=.35; right: P=.31), or hamstring flexibility (P=.14). There was a significant decrease in diastolic blood pressure (P=.04) and significant increases in shoulder flexibility (P<.001) and leg press 1-repetition maximum volume (P=.04). Participants reported improvements in overall health, endurance, flexibility, and mood as well as improvements to team environment and health behaviors around the station; however, there was a decline in overcoming barriers to physical activity. Conclusions A 14-week program of exercise training in firefighters elicited improvements in clinical, performance, and self-reported physical activity outcomes. This occupational exercise training program for firefighters increased time spent exercising, improved team building, and led to physical and mental health benefits. Results from this pilot study set a broad, informed, and meaningful foundation for future efforts to increase firefighter participation in occupational fitness programs.

Experiential learning pedagogies, including internship and service-learning experiences, are becoming increasingly popular in higher education. An internship engages students with hands-on experiences that enhance their learning or skills within their fields of study. In contrast, service-learning is a type of experiential education in which students participate in service, typically within the community, and reflect on their involvement to gain further understanding of the discipline as well as its relationship to societal needs. To date, no study has directly compared these teaching modalities. Therefore, the present study systematically evaluated a service-learning experience against an internship experience using a mixed-methods model with the primary outcome being student self-efficacy. Sixteen exercise physiology students (13 females) completed a community-based wellness internship with a subgroup (nine students, 7 females) allocated to a service-learning component of internship designed to improve self-efficacy. At the end of the semester, students completed a 15-item online self-efficacy and satisfaction survey. Three focus groups were conducted in which 3-4 participants responded to a series of nine questions that explored their experience. Overall responses to the self-efficacy and satisfaction survey were favorable for both groups, but the internship group was more likely to agree or strongly agree with statements of self-efficacy. Focus groups found that the internship experience reinforced classroom learning, but the ability to work with different populations and ability levels was mentioned only by the service-learning group. Themes from reflective assignments, such as engaging with community members and professional exploration, were evident only in the service-learning group responses. Therefore, the findings indicate that service-learning reflection assignments successfully connect the service experience to relevant course outcomes promoting student development but may not improve self-reported self-efficacy beyond that of a typical internship experience.

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Metabolic syndrome (MetS) is associated with an increase in cardiovascular (CV) mortality, partially due to arterial stiffening, which can be measured non‐invasively via pulse wave velocity (PWV). Arterial stiffness is a clinically relevant CV marker of mortality, an increase in PWV by only 1 SD is associated with an increase of CV risk by 15%. We tested the hypothesis that 8 weeks, 3 days per week, of deep water exercise can lower the PWV in individuals with MetS.10 women (age=58±5) were recruited to participate in the study. Carotid to femoral PWV was measured using applanation tonometry; radial artery waveforms were used for pulse wave analysis and to calculate central pressures. Aquatic exercise significantly lowered PWV by 0.53 m/s (p<0.05). Other significant changes that were observed were BMI (p=0.03) from 33.5±1.5 to 32.9±1.5, blood glucose (p=0.01, from 110±8 to 101±7), insulin (p=0.02, from 20±2 to 14±1), insulin resistance (p=0.01, from 5.39±0.81 to 3.55±0.50), augmentation index (p=0.05, from 25±2 to 22±2), and aerobic capacity (p=0.02, from 15.9±1.3 to 17.8±1.7).These findings indicate that the introduction of deep‐water exercise positively influences the PWV. This decrease in PWV portends improvements in overall CV health and it may be useful in managing other CV related diseases. Much of the data showed significant improvement in clinical measures and this shows the efficacy of deep‐water exercise. While the benefits of land based exercise have long been well known, these findings show that aquatic based exercise is also a very effective method for improving CV health.

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