title: Working inside the firehouse: developing a participant-driven intervention to enhance health-promoting behaviors.
abstract: 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.
authors.affiliation: The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Shannon
authors.initials: S
authors.lastname: Frattaroli
authors.forename: Keshia M
authors.initials: KM
authors.lastname: Pollack
authors.forename: Maryanne
authors.initials: M
authors.lastname: Bailey
authors.forename: Heather
authors.initials: H
authors.lastname: Schafer
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Cheskin
authors.forename: David R
authors.initials: DR
authors.lastname: Holtgrave
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D004032:Diet; D005260:Female; D061388:Firefighters; D017144:Focus Groups; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008396:Maryland; D008875:Middle Aged; D016272:Occupational Health; D012307:Risk Factors; D014838:Volunteers
keywords: cardiovascular disease; focus group; health promotion; nutrition; partnerships/coalitions; program planning and evaluation; worksite safety and health