Total Worker Health for Wildland Firefighters

Study Overview
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Brief Summary
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The overarching goal is to develop, refine and disseminate a comprehensive, easily accessible and effective Total Worker Health (TWH) program for wildland firefighters (WFF). The term Total Worker Health® (TWH) (NIOSH) refers to the synergistic combination of 1) health promotion (e.g., healthy nutrition, exercise, restorative sleep), 2) worker safety issues, such as protective equipment and hazard control, merged with 3) work organization change to support and promote TWH.

Official Title
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Total Worker Health for Wildland Firefighters

Conditions
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Health Behavior, Total Worker Health, Occupational Health

Intervention / Treatment
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* Other: Total Worker Health for Wildland Firefighters


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: any firefighter attending an OHSU-led informational meeting Exclusion Criteria: Firefighters planning to retire from fire fighting work within 12 months will be excluded.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Intervention Model: Single Group Assignment
Interventional Model Description: This mixed-methods project had three phases. The initial qualitative phase was assessing the needs of wildland firefighters across segments and geographic locations to identify and prioritize program components. During the first phase, we recruited firefighters and collected baseline data in order to assess their needs. The second phase was to build a comprehensive, engaging TWH program for those fighting wildfires. It needed to be accessible on smartphone, tablet or computer, and suitable for individual, group and classroom settings. The final, third phase was to evaluate the program with a prospective proof-of-concept, usability and effectiveness trial among all types of wildland firefighters in different geographic locations.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Needs Assessment and Total Worker Health Program<br>The initial phase was a needs assessment for wildland firefighters across segments and geographic locations to identify and prioritize program components. During the first phase, we recruited firefighters and collected baseline data in order to assess their needs using surveys for quantitative data and interviews and focus groups for qualitative data. The total worker health program includes 14, 30-minute modules on health topics highlighted during the needs assessment phase. Participants completed the program either individually or as part of a group. | Other: Total Worker Health for Wildland Firefighters<br>* The program is structured as 30-minute modules that can be done individually, with a partner, as a group or in a classroom setting. The six core modules are supplemented with eight elective modules. The program can be accessed on a smartphone, tablet or computer, and if needed can be downloaded as a pdf.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Cardiovascular Risk Knowledge | Change in cardiovascular risk knowledge was assessed using this survey question: I know my risk factors for cardiovascular disease.. This was measured using a seven-point Likert agreement scale (1 = strongly disagree to 7 = strongly agree). | 0 weeks to 14 weeks | 
| Change in Physical Activity | Change in physical activity was assessed using this survey question: On average, I get 150 minutes of moderate physical activity per week (including your work).. This was measured using a seven-point Likert agreement scale (1 = strongly disagree to 7 = strongly agree). | 0 weeks to 14 weeks | 
| Change in Supplement Knowledge | Change in supplement knowledge was assessed using this survey question: I need supplements to balance the additional nutritional needs of being a wildland firefighter.. This was measured using a seven-point Likert agreement scale (1 = strongly disagree to 7 = strongly agree). | 0 weeks to 14 weeks | 
| Change in Hydration Knowledge | Change in hydration knowledge was assessed using the survey questions: Camelback systems are more effective for maintaining hydration than canteens. and Dehydration begins to affect performance when fluid loss equals 2% of body weight.. Both were measured using a seven-point Likert agreement scale (1 = strongly disagree to 7 = strongly agree). | 0 weeks to 14 weeks | 
| Change in Nutrition Knowledge | Change in nutrition knowledge was assessed using the survey questions: Carbohydrates are the primary fuel for moderate to intense physical activity. and Protein is contained in many foods, including bread and rice.. This was measured using a seven-point Likert agreement scale (1 = strongly disagree to 7 = strongly agree). | 0 weeks to 14 weeks | 
| Change in Alcohol Knowledge | Change in alcohol knowledge was assessed using the survey questions: I know the definition of binge drinking. and  Drinking alcohol increases my cancer risk.. This was measured using a seven-point Likert agreement scale (1 = strongly disagree to 7 = strongly agree). | 0 weeks to 14 weeks | 
| Change in Sleep Knowledge | Change in sleep knowledge was assessed using the survey questions: Power naps (15 to 30 minutes) will restore alertness and reduce accidents. and Staying awake for 24 hours is equivalent to having a blood alcohol level greater than 0.08, the legal limit. and Getting less than 5 hours of sleep lowers testosterone levels equal to someone 10 years older.. Both were measured using a seven-point Likert agreement scale (1 = strongly disagree to 7 = strongly agree). | 0 weeks to 14 weeks | 
| Change in Mental Health Behavior | Change in mental health behavior was assessed using the survey questions: I am able to bounce back from stressful events. and In general, I manage stress in a healthy way.. This was measured using a seven-point Likert agreement scale (1 = strongly disagree to 7 = strongly agree). | 0 weeks to 14 weeks | 
| Change in Blood Pressure Knowledge | Change in blood pressure knowledge was assessed using this survey question: I know my blood pressure.. This was measured using a seven-point Likert agreement scale (1 = strongly disagree to 7 = strongly agree). | 0 weeks to 14 weeks | 
| Change In Nutrition Behavior | Change in nutrition behavior was assessed using this survey question: I intend to eat every 2 hours while doing arduous wildland firefighting.. This was measured using a seven-point Likert agreement scale (1 = strongly disagree to 7 = strongly agree). | 0 weeks to 14 weeks | 
| Change in Cancer Risk Knowledge | Change in cancer risk knowledge was assessed using this survey question: I know my risk factors for cancer.. This was measured using a seven-point Likert agreement scale (1 = strongly disagree to 7 = strongly agree). | 0 weeks to 14 weeks | 
| Change in Alcohol Behavior with Sleep | Change in alcohol behavior was assessed using this survey question: I use alcohol to get to sleep.. This was measured using a seven-point Likert agreement scale (1 = strongly disagree to 7 = strongly agree). | 0 weeks to 14 weeks | 
| Change in Primary Care Behavior | Change in primary care behavior was assessed using this survey question: It is important for me to have a primary care physician.. This was measured using a seven-point Likert agreement scale (1 = strongly disagree to 7 = strongly agree). | 0 weeks to 14 weeks | 
| Change in Physical Activity Perception | Change in physical activity perception was assessed using this survey question: I can get in shape two weeks before a wildland fire season.. This was measured using a seven-point Likert agreement scale (1 = strongly disagree to 7 = strongly agree). | 0 weeks to 14 weeks | 
| Change in Mental Health Self Perception | Change in mental health self perception was assessed using the survey questions: I feel overwhelmed with my work. and During the last month, I felt significantly depressed.. This was measured using a seven-point Likert agreement scale (1 = strongly disagree to 7 = strongly agree). | 0 weeks to 14 weeks | 
| Change in Alcohol Cancer Risk Knowledge | Change in alcohol cancer risk knowledge was assessed using this survey question: Drinking alcohol increases my cancer risk.. This was measured using a seven-point Likert agreement scale (1 = strongly disagree to 7 = strongly agree). | 0 weeks to 14 weeks | 
| Change in Alcohol Behavior | Change in alcohol behavior was assessed using this survey question: I am currently trying to moderate my drinking.. This was measured using a seven-point Likert agreement scale (1 = strongly disagree to 7 = strongly agree). | 0 weeks to 14 weeks | 
| Change in Support Perception | Change in support perception was assessed using this survey question: I can rely on people at work to support me.. This was measured using a seven-point Likert agreement scale (1 = strongly disagree to 7 = strongly agree). | 0 weeks to 14 weeks | 
| Change in Sleep Hygiene Behavior | Change in sleep hygiene behavior was assessed using this survey question: Before going to sleep, I wipe soot and ash from my skin.. This was measured using a seven-point Likert agreement scale (1 = strongly disagree to 7 = strongly agree). | 0 weeks to 14 weeks | 
| Change in Cardiovascular Risk Behavior | Change in cardiovascular risk behavior was assessed using this survey question: I intend to keep track of my risks for cardiovascular disease.. This was measured using a seven-point Likert agreement scale (1 = strongly disagree to 7 = strongly agree). | 0 weeks to 14 weeks | 
| Change in Physical Exam Behavior | Change in physical exam behavior was assessed using this survey question: I intend to get a physical exam once a year.. This was measured using a seven-point Likert agreement scale (1 = strongly disagree to 7 = strongly agree). | 0 weeks to 14 weeks | 
| Change in Heat Illness Knowledge | Change in heat illness knowledge was assessed using this survey question: When feeling over heated, the first thing to do is stop working.. This was measured using a seven-point Likert agreement scale (1 = strongly disagree to 7 = strongly agree). | 0 weeks to 14 weeks | 
| Change in Injury Knowledge | Change in injury knowledge was assessed using this survey question: On steep and rocky terrain, it is best to move quickly to reduce risk of injury.. This was measured using a seven-point Likert agreement scale (1 = strongly disagree to 7 = strongly agree). | 0 weeks to 14 weeks | 
| Program Usability and Effectiveness | Program usability and effectiveness was assessed using the survey question: During the program, the educational modules were valuable for improving my health. and This program was easy to use. and This was an efficient way to learn the material. and I learned ways to improve my health. and These topics should be part of our training. and I would recommend this program to my co-workers.. This was measured using a seven-point Likert agreement scale (1 = strongly disagree to 7 = strongly agree). | 14 weeks | 
| Technology Used for Program | Technology used for program was assessed using the survey question: I primarily used this program on: The options were 1) Phone, 2) Tablet, 3) Computer, 4) Other. For other, space was provided for participants to write in their answer. | 14 weeks | 
| How the Program was Completed | How the program was completed was assessed using the survey question: I primarily used this program on: The options were 1) By myself, 2) With other firefighters, 3) With my family, 4) Other. For other, space was provided for participants to write in their answer. | 14 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Body Mass Index | Change in body mass index was measured in kg/m2. | 0 weeks to 14 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Sleep Hygiene, Cardiovascular Disease, Firefighter, Wildland, Occupational Hazards, Occupational Safety, health promotion