Working Inside the Firehouse: Developing a Participant-Driven Intervention to Enhance Health-Promoting Behaviors
1The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.Health Promotion Practice (Impact Factor: 0.55). 10/2012; 14(3). DOI: 10.1177/1524839912461150
Cardiovascular disease (CVD) is the most common cause of on-duty death among U.S. firefighters among whom volunteers comprise 71% of the fire service. We sought to understand CVD risk among volunteer firefighters and to develop a CVD intervention based on their input. To accomplish these aims, we conducted a series of focus groups with volunteer firefighters and firefighters who serve with volunteers in Maryland. We conducted two additional focus groups with fire service leaders. Ninety-eight people participated in 15 focus groups. Participants discussed health and wellness, stress and the demanding nature of the volunteer fire service, and the challenges associated with healthy eating. They talked about food in the firehouse and the lack of quick, healthy, satisfying, and affordable food. Several suggestions for interventions to improve the food environment and firefighters' ability to choose and prepare healthy meals and snacks emerged. An intervention reflecting the participants' recommendations resulted. The way volunteer firefighters understand health and wellness and the specific factors that influence their food intake are valuable insights for addressing CVD risks in this population. To our knowledge, this is the first study that systematically brings firefighters into the process of developing an intervention to reduce CVD risk among this high-risk population.
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ABSTRACT: Between 1990 and 2012, 2775 firefighters were killed in the line of duty. Myocardial infarction (MI) was responsible for approximately 40% of these mortalities, followed by mechanical trauma, asphyxiation, and burns. Protective gear, safety awareness, medical care, and the age of the workforce have evolved since 1990, possibly affecting the nature of mortality during this 22-year time period. The purpose of this study is to determine whether the causes of firefighter mortality have changed over time to allow a targeted focus in prevention efforts. The U.S. Fire Administration fatality database was queried for all-cause on-duty mortality between 1990 to 2000 and 2002 to 2012. The year 2001 was excluded due to inability to eliminate the 347 deaths that occurred on September 11. Data collected included age range at the time of fatality (exact age not included in report), type of duty (on-scene fire, responding, training, and returning), incident type (structure fire, motor vehicle crash, etc), and nature of fatality (MI, trauma, asphyxiation, cerebrovascular accident [CVA], and burns). Data were compared between the two time periods with a χ test. Between 1990 and 2000, 1140 firefighters sustained a fatal injury while on duty, and 1174 were killed during 2002 to 2012. MI has increased from 43% to 46.5% of deaths (P = .012) between the 2 decades. CVA has increased from 1.6% to 3.7% of deaths (P = .002). Asphyxiation has decreased from 12.1% to 7.9% (P = .003) and burns have decreased from 7.7% to 3.9% (P = .0004). Electrocution is down from 1.8% to 0.5% (P = .004). Death from trauma was unchanged (27.8 to 29.6%, P = .12). The percentage of fatalities of firefighters over age 40 years has increased from 52% to 65% (P = .0001). Fatality by sex was constant at 3% female. Fatalities during training have increased from 7.3% to 11.2% of deaths (P = .00001). The nature of firefighter mortality has evolved over time. In the current decade, line-of-duty mortality is more likely to occur during training. Mortality from burns, asphyxiation, and electrocution has decreased; but death from MI and CVA has increased, particularly in older firefighters. Outreach and education should be targeted toward vehicle safety, welfare during training, and cardiovascular disease prevention in the firefighter population.
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ABSTRACT: This study aimed at exploring occupational well-being among volunteer firefighters (N=99). More in detail, we have investigated the influence of two important psychological resources, engagement and mindfulness, as protective factors against the risk of developing negative health effects, in terms of post-traumatic and psychosomatic symptoms. Firefighters completed the following self-report questionnaires: the Utrecht Work Engagement Scale-9; the Mindful Awareness Attention Scale; the Secondary Traumatic Stress Scale; and the General Health Questionnaire-12. The results, deriving from regression models, show that only mindfulness provides full protection against the risk of developing vicarious trauma and psychosomatic symptoms. From an applicative perspective, our findings suggest the importance of developing interventions aimed at increasing mindfulness, which may support volunteer firefighters in facing both chronic and acute occupational stressors.
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