title: The PHLAME (Promoting Healthy Lifestyles: Alternative Models' Effects) firefighter study: outcomes of two models of behavior change.
abstract: OBJECTIVE
  PHLAME's (Promoting Healthy Lifestyles: Alternative Models' Effects) objective was to assess and compare two means to promote healthy lifestyles.
  
  
  METHODS
  Prospective trial among 599 firefighters randomized by station to 1) team-centered curriculum, 2) one-on-one motivational interviewing (MI), and 3) controls. Assessment included dietary behavior, physical activity, weight, and general well-being at baseline and 12 months. Program effects were determined using an analysis of covariance (ANCOVA) based approach, and models for relationships were evaluated with path analysis.
  
  
  RESULTS
  Both interventions were acceptable and delivered with high fidelity. The team and MI programs increased fruit and vegetable consumption (P < 0.01 and 0.05, respectively) and general well-being (P < 0.01). Significantly less weight gain occurred in both (P < 0.05). A cross-sectional model was consistent with mediation differing between interventions.
  
  
  CONCLUSIONS
  Both a team-centered and individual-oriented intervention promoted healthy behaviors. The scripted team curriculum is innovative, exportable, and may enlist influences not accessed with individual formats.
authors.affiliation: Division of Health Promotion & Sports Medicine, Oregon Health & Science University, Portland, Oregon 97239-3098, USA. elliotd@ohsu.edu
authors.forename: Diane L
authors.initials: DL
authors.lastname: Elliot
authors.forename: Linn
authors.initials: L
authors.lastname: Goldberg
authors.forename: Kerry S
authors.initials: KS
authors.lastname: Kuehl
authors.forename: Esther L
authors.initials: EL
authors.lastname: Moe
authors.forename: Rosemary K R
authors.initials: RK
authors.lastname: Breger
authors.forename: Michael A
authors.initials: MA
authors.lastname: Pickering
mesh_terms: D000328:Adult; D003479:Curriculum; D004032:Diet; D005260:Female; D005390:Fires; D006126:Group Processes; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009786:Occupational Health Services / Q000379:methods*; D009790:Occupations; D016896:Treatment Outcome