First Twenty for Volunteer Firefighters

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The First Twenty for Volunteer Firefighters assessed the efficacy of an internet-based firefighter tailored health and wellness program for volunteer firefighters using a cluster randomized controlled trial (CRCT)

  • TF20 included nutrition, fitness, and stress management education and activities including prescribed messages, goal setting, resource materials (recipes, exercise plans, etc.), and personalized health coaching from a trained firefighter
  • Assessed the dietary intake, physical activity, anxiety, stress depression, smoking, occupational injuries and sociodemographic factors pre and post
  • Outcomes include BMI, percent body fat, waist circumference, diet, and physical activity
  • 6-month intervention including 5 treatment and 5 wait-list control volunteer fire departments across the nation including over 400 firefighters

CRCT Methods

6 month, 2-arm, CRCT - TF20 vs. Control (controls receive treatment after 6 months)

Unit of Randomization
Department (cluster design)

Department Sample
National sample of 10 VF departments by region of country & department size (5 randomized to each condition)

VFF with BMI ≥25.0 kg/m2 (~78%); (data for analyses, but all interested may enroll) Average enrollment = 22/dept or N=110 in each condition

Treatment outcome: weight loss
Measured at baseline & 6 months

Body composition, diet & supplement intake, physical activity, estimated VO2max, blood pressure, pulse, tobacco, alcohol, anxiety, depression, sleep, Rx, disease hx, injuries, demographics

Process Evaluation
Barriers, challenges, intervention experience, usage, coaching assessment at 6 months post intervention

Purpose: To determine the efficacy and acceptability of an inexpensive, culturally tailored internet based health and wellness intervention focused on diet and fitness

Funding Agency: FEMA (2014-2017)

Study Design: Cluster randomized controlled trial to address volunteer firefighters’ obesity