Feasibility and Perception of a Diet and Exercise Intervention Delivered via Telehealth to Firefighters

Donahue, Stephanie; McMorrow, Carly; Almeida, Andrew A; Feairheller, Deborah L.

doi:10.5195/ijt.2022.6458

Cited by 5 publications

(5 citation statements)

References 17 publications

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“…We observed that a large proportion of firefighters in our study have a high inflammatory diet, something that is expected, as we had previously observed that most of our study population follows a Standard American Diet, which is characterized by high consumption of meat and processed food (40). This observation is in agreement with previous studies that also conducted an in-depth investigation on the dietary habits of firefighters (41)(42)(43)(44).…”

Section: Discussionsupporting

confidence: 93%

The dietary inflammatory index and cardiometabolic parameters in US firefighters

Christodoulou,

Christophi,

Sotos-Prieto

et al. 2024

Front. Nutr.

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IntroductionDietary choices play a crucial role in influencing systemic inflammation and the eventual development of cardiovascular diseases (CVD). The Dietary Inflammatory Index (DII®) is a novel tool designed to assess the inflammatory potential of one’s diet. Firefighting, which is characterized by high-stress environments and elevated CVD risk, represents an interesting context for exploring the dietary inflammatory-CVD connection.AimThis study aims to investigate the associations between Energy-adjusted Dietary Inflammatory Index (E-DII™) scores and cardiometabolic risk parameters among US firefighters.MethodsThe study analyzed 413 participants from the Indianapolis Fire Department who took part in a Federal Emergency Management Agency (FEMA)-sponsored Mediterranean diet intervention trial. Thorough medical evaluations, encompassing physical examinations, standard laboratory tests, resting electrocardiograms, and submaximal treadmill exercise testing, were carried out. Participants also completed a detailed food frequency questionnaire to evaluate dietary patterns, and E-DII scores were subsequently computed based on the gathered information.ResultsParticipants had a mean body mass index (BMI) of 30.0 ± 4.5 kg/m2 and an average body fat percentage of 28.1 ± 6.6%. Regression analyses, adjusted for sex, BMI, maximal oxygen consumption (VO2 max), max metabolic equivalents (METS), age, and body fat percentage, revealed significant associations between high vs. low E-DII scores and total cholesterol (β = 10.37, p = 0.04). When comparing low Vs median E-DII scores there is an increase in glucose (β = 0.91, p = 0.72) and total cholesterol (β = 5.51, p = 0.26).ConclusionOur findings support an association between higher E-DII scores and increasing adiposity, as well as worse lipid profiles.

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Section: Discussionsupporting

confidence: 93%

The dietary inflammatory index and cardiometabolic parameters in US firefighters

Christodoulou,

Christophi,

Sotos-Prieto

et al. 2024

Front. Nutr.

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“…In addition, they generally focused on one-dimensional interventions, such as personal protective equipment to reduce respiratory exposure and hearing protection and improved hygiene to reduce dermal carcinogen exposure. We and others have reported on more comprehensive programs for career structural firefighters [21,22,49,50]. To our knowledge, this is the first report of a TWH program for those fighting wildland fires.…”

Section: Comparison With Prior Workmentioning

confidence: 73%

A Web-Based Total Worker Health Intervention for Those Fighting Wildland Fires: Mixed Methods Development and Effectiveness Trial

Kuehl,

Elliot,

DeFrancesco

et al. 2023

J Med Internet Res

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Background Fire seasons are longer, with more and larger wildfires, placing increased demands and risks on those fighting wildland fires. There are multiple agencies involved with fighting wildland fires and unique worksite conditions make meeting these workers’ needs a challenge. Objective The aim of the study is to develop and establish the effectiveness of a web-based safety and health program for those fighting wildland fires. Methods This mixed methods project had 3 phases. The initial qualitative phase assessed the needs of 150 diverse firefighters through interviews and focus groups across 11 US sites to establish and prioritize program content. Interview transcripts were read for thematic content with iterative readings used to identify, code, and rank health and safety issues. The second phase used that information to build a comprehensive Total Worker Health program for those fighting wildfires. The program content was based on the qualitative interview data and consisted of 6 core and 8 elective 30-minute, web-based modules primarily done individually on a smartphone or computer. The final, third phase evaluated the program with a quantitative prospective proof-of-concept, usability, and effectiveness trial among wildland firefighter participants. Effectiveness was assessed with paired 2-tailed t tests for pre- and post-Likert agreement scale survey items, adjusted for multiple comparisons. In addition to assessing mean and SD at baseline and postsurvey, observed effect sizes were calculated (Cohen d). Usability and reaction to the program among firefighters who responded to postsurvey were also assessed. Results The qualitative themes and subthemes were used to inform the program’s content. For the effectiveness trial, 131 firefighters completed the presurvey, and 50 (38.2%) completed the postsurvey. The majority of the participants were White (n=123, 93.9%), male (n=117, 89.3%), with an average age of 41 (SD 12.9) years. Significant increases in knowledge and desired health and safety behaviors were found for both cancer (P<.001) and cardiovascular risk (P=.01), nutrition behaviors (P=.01), hydration or overheating (P=.001), binge drinking (P=.002), and getting medical checkups (P=.001). More than 80% (n=40) of postsurvey respondents agreed or strongly agreed that the program was easy to use and would recommend it to others. Conclusions An innovative web-based safety and health promotion program for those fighting wildland fires was feasible, scalable, and usable. It improved the health and safety of those fighting wildland fires. Trial Registration ClinicalTrials.gov NCT05753358; https://classic.clinicaltrials.gov/ct2/show/NCT05753358

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“…Interestingly, firefighters reported eating more fruits and vegetables than participants in other studies. However, there have been recent efforts to improve the nutrition of firefighters through educational materials and interventions (Carey, Al-Zaiti, Liao, et al, 2011; Donahue et al, 2022), which could possibly explain the increased consumption of fruits and vegetables. One out of five (20%) firefighters were ever cigarette users, which is lower than the estimated U.S. adult population of 33% from the HINTS 6 survey conducted in 2022 (Health Information National Trends Survey [HINTS], 2023b).…”

Section: Discussionmentioning

confidence: 99%

Cancer Prevention Among Firefighters: Examining Lifestyle, Screening Behavior, and Beliefs

Glasgow,

Burch,

Arcan

et al. 2024

Workplace Health Saf

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Background: Firefighters are at increased risk of developing cancer due to occupational exposures, but they may also face increased risk due to their lifestyle, such as the quality of their diet and physical activity. Cancer beliefs and screening behavior could also influence their cancer risk. The current study aimed to identify individual differences associated with lifestyle behaviors, cancer screening, and cancer beliefs among firefighters; to describe the strategies firefighters use to adapt to their work schedule; and to describe topics firefighters believe are the most important to address in their workplace. Methods: Career firefighters ( N = 171) in a medium-sized U.S. city completed an online survey. Findings: Logistic regression analyses identified age, education, racial identity, years of fire service, perceived stress, and rank as predictors of responses to items addressing cancer screening, lifestyle behaviors, and cancer beliefs. Although results varied, age, education, and racial identity were associated with most of the outcomes. Strategies related to sleep such as getting the right amount and napping, exercise, and getting family/roommate support were selected as the top adaptive strategies for work. Sleep, mental health/well-being, and work-life balance were selected most often as the most important topics to address in the fire service, with topics related to reducing occupational exposures receiving less attention. Conclusions/Application to Practice: The findings suggest individual differences, such as age, education, and racial identity, should be considered when developing occupational health interventions for firefighters. Interventions related to mental health, work-life balance, and sleep may be desired most by those in the fire service.

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Feasibility and Perception of a Diet and Exercise Intervention Delivered via Telehealth to Firefighters

Cited by 5 publications

References 17 publications

The dietary inflammatory index and cardiometabolic parameters in US firefighters

The dietary inflammatory index and cardiometabolic parameters in US firefighters

A Web-Based Total Worker Health Intervention for Those Fighting Wildland Fires: Mixed Methods Development and Effectiveness Trial

Cancer Prevention Among Firefighters: Examining Lifestyle, Screening Behavior, and Beliefs

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