Total Worker Health for Wildland Firefighters

Health Behavior Clinical Trial

Official title:

Total Worker Health for Wildland Firefighters

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05753358
• Other study ID #: EMW-2018-FP-00284
• Status: Completed
• Phase: N/A
• Start date: February 24, 2020
• Est. completion date: April 14, 2022

Study information

• Verified date: February 2023
• Source: Oregon Health and Science University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 150
• Est. completion date: April 14, 2022
• Est. primary completion date: April 14, 2022
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

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.

Related Conditions & MeSH terms

• Health Behavior
• Occupational Health
• Total Worker Health

Intervention

Other:
• Total Worker Health for Wildland Firefighters
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.

Locations

Country	Name	City	State
United States	Oregon Health & Science University	Portland	Oregon

Sponsors (3)

Lead Sponsor	Collaborator
Oregon Health and Science University	Federal Emergency Management Agency, National Fallen Firefighters Foundation

Country where clinical trial is conducted

United States, 

References & Publications (19)

Andajani-Sutjahjo S, Liew TCH, Smith JF, Esekielu I, Mason G, Tariu I. Engaging community volunteers in participatory action research in Tamaki community of Auckland, New Zealand. Health Promot Int. 2018 Apr 1;33(2):219-228. doi: 10.1093/heapro/daw057. — View Citation

Britton C, Lynch CF, Ramirez M, Torner J, Buresh C, Peek-Asa C. Epidemiology of injuries to wildland firefighters. Am J Emerg Med. 2013 Feb;31(2):339-45. doi: 10.1016/j.ajem.2012.08.032. Epub 2012 Nov 15. — View Citation

Brook RD, Rajagopalan S, Pope CA 3rd, Brook JR, Bhatnagar A, Diez-Roux AV, Holguin F, Hong Y, Luepker RV, Mittleman MA, Peters A, Siscovick D, Smith SC Jr, Whitsel L, Kaufman JD; American Heart Association Council on Epidemiology and Prevention, Council on the Kidney in Cardiovascular Disease, and Council on Nutrition, Physical Activity and Metabolism. Particulate matter air pollution and cardiovascular disease: An update to the scientific statement from the American Heart Association. Circulation. 2010 Jun 1;121(21):2331-78. doi: 10.1161/CIR.0b013e3181dbece1. Epub 2010 May 10. — View Citation

Chen SY, Feng Z, Yi X. A general introduction to adjustment for multiple comparisons. J Thorac Dis. 2017 Jun;9(6):1725-1729. doi: 10.21037/jtd.2017.05.34. — View Citation

Clement S, Schauman O, Graham T, Maggioni F, Evans-Lacko S, Bezborodovs N, Morgan C, Rusch N, Brown JS, Thornicroft G. What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol Med. 2015 Jan;45(1):11-27. doi: 10.1017/S0033291714000129. Epub 2014 Feb 26. — View Citation

Elliot DL, Goldberg L, Duncan TE, Kuehl KS, Moe EL, Breger RK, DeFrancesco CL, Ernst DB, Stevens VJ. The PHLAME firefighters' study: feasibility and findings. Am J Health Behav. 2004 Jan-Feb;28(1):13-23. doi: 10.5993/ajhb.28.1.2. — View Citation

Elliot DL, Goldberg L, Kuehl KS, Moe EL, Breger RK, Pickering MA. The PHLAME (Promoting Healthy Lifestyles: Alternative Models' Effects) firefighter study: outcomes of two models of behavior change. J Occup Environ Med. 2007 Feb;49(2):204-13. doi: 10.1097/JOM.0b013e3180329a8d. — View Citation

Elliot DL, Goldberg L, MacKinnon DP, Ranby KW, Kuehl KS, Moe EL. Empiric validation of a process for behavior change. Transl Behav Med. 2016 Sep;6(3):449-56. doi: 10.1007/s13142-015-0343-y. — View Citation

Fritschi L, Glass DC. Firefighters and cancer: where are we and where to now? Occup Environ Med. 2014 Aug;71(8):525-6. doi: 10.1136/oemed-2014-102230. Epub 2014 Jul 4. No abstract available. — View Citation

Kales SN, Soteriades ES, Christophi CA, Christiani DC. Emergency duties and deaths from heart disease among firefighters in the United States. N Engl J Med. 2007 Mar 22;356(12):1207-15. doi: 10.1056/NEJMoa060357. — View Citation

Kuehl KS, Elliot DL, Goldberg L, MacKinnon DP, Vila BJ, Smith J, Miocevic M, O'Rourke HP, Valente MJ, DeFrancesco C, Sleigh A, McGinnis W. The safety and health improvement: enhancing law enforcement departments study: feasibility and findings. Front Public Health. 2014 May 8;2:38. doi: 10.3389/fpubh.2014.00038. eCollection 2014. — View Citation

Kuehl KS, Elliot DL, MacKinnon DP, O'Rourke HP, DeFrancesco C, Miocevic M, Valente M, Sleigh A, Garg B, McGinnis W, Kuehl H. The SHIELD (Safety & Health Improvement: Enhancing Law Enforcement Departments) Study: Mixed Methods Longitudinal Findings. J Occup Environ Med. 2016 May;58(5):492-8. doi: 10.1097/JOM.0000000000000716. — View Citation

Mabry L, Elliot DL, Mackinnon DP, Thoemmes F, Kuehl KS. Understanding the durability of a fire department wellness program. Am J Health Behav. 2013 Sep;37(5):693-702. doi: 10.5993/AJHB.37.5.13. — View Citation

MacKinnon DP, Elliot DL, Thoemmes F, Kuehl KS, Moe EL, Goldberg L, Burrell GL, Ranby KW. Long-term effects of a worksite health promotion program for firefighters. Am J Health Behav. 2010 Nov-Dec;34(6):695-706. doi: 10.5993/ajhb.34.6.6. — View Citation

Robertson M, Henning R, Warren N, Nobrega S, Dove-Steinkamp M, Tibirica L, Bizarro A; CPH-NEW Research Team. The Intervention Design and Analysis Scorecard: a planning tool for participatory design of integrated health and safety interventions in the workplace. J Occup Environ Med. 2013 Dec;55(12 Suppl):S86-8. doi: 10.1097/JOM.0000000000000036. — View Citation

Semmens EO, Domitrovich J, Conway K, Noonan CW. A cross-sectional survey of occupational history as a wildland firefighter and health. Am J Ind Med. 2016 Apr;59(4):330-5. doi: 10.1002/ajim.22566. Epub 2016 Jan 21. — View Citation

Vincent GE, Aisbett B, Hall SJ, Ferguson SA. Fighting fire and fatigue: sleep quantity and quality during multi-day wildfire suppression. Ergonomics. 2016 Jul;59(7):932-40. doi: 10.1080/00140139.2015.1105389. Epub 2015 Dec 18. — View Citation

von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med. 2007 Oct 16;4(10):e296. doi: 10.1371/journal.pmed.0040296. — View Citation

Walton SM, Conrad KM, Furner SE, Samo DG. Cause, type, and workers' compensation costs of injury to fire fighters. Am J Ind Med. 2003 Apr;43(4):454-8. doi: 10.1002/ajim.10200. — View Citation

* Note: There are 19 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	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
Primary	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
Primary	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
Primary	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
Primary	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
Primary	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
Primary	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
Primary	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
Primary	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
Primary	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
Primary	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
Primary	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
Primary	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
Primary	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
Primary	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
Primary	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
Primary	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
Primary	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
Primary	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
Primary	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
Primary	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
Primary	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
Primary	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
Primary	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
Primary	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
Primary	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	Change in Body Mass Index	Change in body mass index was measured in kg/m2.	0 weeks to 14 weeks

External Links

•   an open source, cloud-based, qualitative software
•   an open source, cloud-based, software that allows researchers to sort "cards" into different categories.
•   subscription platform for e-learning course development