NCT05753358

Brief 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.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
150

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Feb 2020

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

February 24, 2020

Completed
2.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 14, 2022

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

April 14, 2022

Completed
10 months until next milestone

First Submitted

Initial submission to the registry

February 10, 2023

Completed
21 days until next milestone

First Posted

Study publicly available on registry

March 3, 2023

Completed
Last Updated

March 3, 2023

Status Verified

February 1, 2023

Enrollment Period

2.1 years

First QC Date

February 10, 2023

Last Update Submit

February 21, 2023

Conditions

Keywords

Sleep HygieneCardiovascular DiseaseFirefighterWildlandOccupational HazardsOccupational Safetyhealth promotion

Outcome Measures

Primary Outcomes (26)

  • 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 Outcomes (1)

  • Change in Body Mass Index

    0 weeks to 14 weeks

Study Arms (1)

Needs Assessment and Total Worker Health Program

EXPERIMENTAL

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

Interventions

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.

Needs Assessment and Total Worker Health Program

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • any firefighter attending an OHSU-led informational meeting

You may not qualify if:

  • Firefighters planning to retire from fire fighting work within 12 months will be excluded.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Oregon Health & Science University

Portland, Oregon, 97239, United States

Location

Related Publications (20)

  • 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.

    PMID: 20458016BACKGROUND
  • 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.

    PMID: 24996680BACKGROUND
  • 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.

    PMID: 17377158BACKGROUND
  • 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.

    PMID: 12645102BACKGROUND
  • 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.

    PMID: 26792645BACKGROUND
  • 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.

    PMID: 23158597BACKGROUND
  • 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.

    PMID: 26452576BACKGROUND
  • 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.

    PMID: 24569086BACKGROUND
  • 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.

    PMID: 24847475BACKGROUND
  • 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.

    PMID: 27158956BACKGROUND
  • 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.

    PMID: 14977155BACKGROUND
  • 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.

    PMID: 17293760BACKGROUND
  • 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.

    PMID: 24284761BACKGROUND
  • 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.

    PMID: 27543931BACKGROUND
  • 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.

    PMID: 27528533BACKGROUND
  • 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.

    PMID: 23985292BACKGROUND
  • 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.

    PMID: 20604695BACKGROUND
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    PMID: 17941714BACKGROUND
  • 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.

    PMID: 28740688BACKGROUND
  • Kuehl K, Elliot D, DeFrancesco C, McGinnis W, Ek S, Garg B. A Web-Based Total Worker Health Intervention for Those Fighting Wildland Fires: Mixed Methods Development and Effectiveness Trial. J Med Internet Res. 2023 Oct 25;25:e47050. doi: 10.2196/47050.

Related Links

MeSH Terms

Conditions

Health BehaviorSleep HygieneCardiovascular Diseases

Condition Hierarchy (Ancestors)

Behavior

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NA
Masking
NONE
Purpose
PREVENTION
Intervention Model
SINGLE GROUP
Model Details: 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.
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor of Medicine, Section Chief, and Director of Human Performance Laboratory

Study Record Dates

First Submitted

February 10, 2023

First Posted

March 3, 2023

Study Start

February 24, 2020

Primary Completion

April 14, 2022

Study Completion

April 14, 2022

Last Updated

March 3, 2023

Record last verified: 2023-02

Data Sharing

IPD Sharing
Will not share

Locations