The First Twenty for Volunteer Firefighters

The purpose of this study is to assess the efficacy of an internet-based firefighter health and wellness program for volunteer fire departments.

A national sample of volunteer fire departments will be recruited for a 6 month, CRCT with a cross-over treatment design to determine the efficacy of The First Twenty (TF20), a wellness program focused on nutrition and fitness for firefighters. Modifications to the existing TF20 will be made to enhance the health coaching features and include tools for program evaluation. Study outcomes (changes in weight, BMI, body fat percentage, waist circumference, dietary intakes, blood pressure, and fitness activities) will be assessed pre- and post-intervention. This will be the first internet-based, occupationally tailored health and wellness program implemented for the volunteer fire service. TF20 will be an essential cost effective tool to address the epidemic of unhealthy body composition, nutrition and fitness among firefighters.

The investigators will conduct a 6 month, two-arm, CRCT: TF20 vs. Control (which will receive delayed treatment after 6 months). Eligible fire departments volunteering for the trial will be randomized to one of the two study treatment arms. Treatment outcomes will be assessed at baseline and 6 months by our staff.

The TF20 incorporates individual goal setting and health coaching, leveraging cultural aspects of the fire service and group cohesion to motivate behavior change. The TF20 focuses on the unique needs of FF with culturally relevant nutrition and fitness strategies. TF20 was primarily designed as a cost-effective, stand-alone program for departments which have no health promotion initiative. Program components include practical approaches to nutrition, fitness and mental health.

Participants in this arm will not be asked to change anything in their lifestyle during the 6 month period.

The TF20 incorporates individual goal setting and health coaching, leveraging cultural aspects of the fire service and group cohesion to motivate behavior change. The TF20 focuses on the unique needs of FF with culturally relevant nutrition and fitness strategies. TF20 was primarily designed as a cost-effective, stand-alone program for departments which have no health promotion initiative. Program components include practical approaches to nutrition, fitness and mental health.

The Food and Frequency Questionnaire (FFQ) is a self-administered, semi-quantitative, food frequency questionnaire developed by the principal investigator. The FFQ presents a food list, which contains items contributing most to selected nutrient intakes among firefighters and foods encouraged by the intervention. FFQ data will be used to calculate usual nutrient intakes using the Food Intake Analysis System (FIASMe).

Inclusion Criteria: first responder within a participating fire department willing to complete all assessments internet accessibility through a computer, tablet or smartphone and ability to use devices appropriately Exclusion Criteria: - not a first responder within a participating fire department