The First Twenty (TF20) for Volunteer Firefighters in a Clinic Based Setting

A Clinic and Tech-Based Diet and Fitness Intervention for Volunteer Firefighters

The First Twenty® (TF20) was recently developed as a not-for-profit, web-mobile program for firefighters (FFs) specifically focused on improving fitness and nutrition knowledge and practices. The program was designed by FFs with backgrounds in tactical fitness, marketing and program development professionals, and nutrition and exercise scientists. Preliminary data suggests the program is well-received by FFs and results in significant improvement in body composition and physical fitness. One innovative approach for the eventual dissemination of TF20 to VFFs is through their fitness-for duty medical exams. The synergy created by linking the TF20 intervention components, feedback to the VFFs from their medical exam, and health messages from their physician is predicted to maximize the impact of this much-needed intervention. The goal of the proposed project is to tailor TF20 for use in a clinic based setting (CB-TF20) for VFFs and to pilot test it in comparison to the American Heart Association's Life's Simple 7 (LS7), a web-based diet and physical activity knowledge/behavior and lifestyle program. The specific aims are to: 1) Conduct formative research with key stakeholders in the VFF community (e.g., physicians, department leadership, VFFs) to determine best practices for implementing a clinic-based, web-mobile health and wellness program with VFFs and medical providers; 2) Develop a clinic-based version of TF20 (CB-TF20) and beta-test it with VFFs; and, 3) Conduct a 6 month, 2-arm, pilot cluster (i.e., department) randomized clinical trial (PCRCT) to determine the comparative effectiveness of the revised CB-TF20 to LS7 on body composition, Framingham Risk Scores, and diet/physical activity knowledge and behaviors among VFF with BMI >25.0kg/m2; and conduct an evaluation of the CB-TF20 materials and technology. This innovative R34 study is a critical step in providing a much needed intervention for VFFs and those providing their annual examinations.

Study Overview

• Status: Completed
• Conditions: Obesity
• Intervention / Treatment: Behavioral: The First Twenty (TF20); Behavioral: Life Simple 7 (LS7)

Detailed Description

The US fire service serves as the front line of defense against any domestic emergency and volunteer firefighters comprise the majority of firefighters, often with negative consequences for the health of personnel. While rates of overweight and obesity remain high among firefighters and cardiovascular disease remains the leading cause of line of duty deaths, few resources tailored to the unique culture and needs of firefighters are available to help occupational medicine physicians who provide their fitness for duty examinations. By engaging firefighters and occupational medicine clinicians in tailoring an internet/mobile intervention and pilot testing the program with a sample of volunteer firefighters, the investigators will be poised to implement a full-scale clinical trial with the developed program.

• Study Type: Interventional
• Enrollment (Actual): 198
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Kansas
    • Leawood, Kansas, United States, 66224
      • NDRI Institute of Bioebehavioral Health Research
  • New York
    • New York, New York, United States, 10010
      • National Development and Research Institutes

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Willing to complete all assessments
• Internet accessibility via computer, tablet or smartphone and ability to use devices appropriately
• Medically cleared to participate in the program through clinicians
• ≥18 years

Exclusion Criteria:

• Not meeting inclusion criteria

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: The First Twenty (TF20); Participants in TF20 will be provided an online wellness program focused on fitness and nutrition tailored to firefighters. TF20 is interactive and involves health coaching.	Behavioral: The First Twenty (TF20); TF20 is an online wellness program for firefighters focused on improving cardiovascular risk factors through behavioral changes.
Placebo Comparator: Life Simple Seven (LS7); Participants assigned to the LS7 arm will be directed to a website that contains information about health and wellness from the American Heart Association that was developed for the general population. No health coaching is present and the site is not tailored for the fire service.	Behavioral: Life Simple 7 (LS7); LS7 is a wellness program designed and implemented by the American Heart Association focused on improving cardiovascular health.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Body Fat	Body fat as measured by foot-to-foot bio-electrical impedance	6 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Framingham Risk Score		6 months
Body Mass Index (BMI)	BMI as calculated by weight in kilograms/height in meters squared	6 months
Waist circumference	Waist circumference as measured in centimeters	6 months

Collaborators and Investigators

• Sponsor: National Development and Research Institutes, Inc.
• Collaborators: The University of Texas Health Science Center, Houston
• Investigators: Principal Investigator: Sara Jahnke, PhD, National Development & Research Institutes

Study record dates

Study Major Dates

• Study Start (Actual): December 15, 2015
• Primary Completion (Actual): February 18, 2018
• Study Completion (Actual): February 18, 2018

Study Registration Dates

• First Submitted: April 29, 2016
• First Submitted That Met QC Criteria: April 30, 2016
• First Posted (Estimate): May 3, 2016

Study Record Updates

• Last Update Posted (Actual): August 22, 2018
• Last Update Submitted That Met QC Criteria: August 20, 2018
• Last Verified: August 1, 2018

More Information

Terms related to this study

• Other Study ID Numbers: 1R34HL125790-01 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED