title: Weight Advice Associated With Male Firefighter Weight Perception and Behavior.
abstract: BACKGROUND
  The high prevalence of overweight and obesity threatens the health and safety of the fire service. Healthcare professionals may play an important role in helping firefighters achieve a healthy weight by providing weight loss counseling to at-risk firefighters. This study characterizes the impact of healthcare professional weight loss advice on firefighter weight perceptions and weight loss behaviors among overweight and obese male firefighters.
  
  
  METHODS
  A national sample of 763 overweight and obese male firefighters who recalled visiting a healthcare provider in the past 12 months reported information regarding healthcare visits, weight perceptions, current weight loss behaviors, and other covariates in 2011-2012. Analyzed in 2013, four unique multilevel logistic regression models estimated the association between healthcare professional weight loss advice and the outcomes of firefighter-reported weight perceptions, intentions to lose weight, reduced caloric intake, and increased physical activity.
  
  
  RESULTS
  Healthcare professional weight loss advice was significantly associated with self-perception as overweight (OR=4.78, 95% CI=2.16, 10.57) and attempted weight loss (OR=2.06, 95% CI=1.25, 3.38), but not significantly associated with reduced caloric intake (OR=1.26, 95% CI=0.82, 1.95) and increased physical activity (OR=1.51, 95% CI=0.89, 2.61), after adjusting for confounders.
  
  
  CONCLUSIONS
  Healthcare professional weight loss advice appears to increase the accuracy of firefighter weight perceptions, promote weight loss attempts, and may encourage dieting and physical activity behaviors among overweight firefighters. Healthcare providers should acknowledge their ability to influence the health behaviors of overweight and obese patients and make efforts to increase the quality and frequency of weight loss recommendations for all firefighters.
authors.affiliation: Division of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas Health Sciences Center at Houston, Houston, Texas.
authors.forename: Austin L
authors.initials: AL
authors.lastname: Brown
authors.affiliation: Center for Fire, Rescue, and EMS Health Research, Institute for Biobehavioral Health Research, National Development and Research Institutes, Leawood, Kansas.
authors.forename: Walker S C
authors.initials: WS
authors.lastname: Poston
authors.affiliation: Center for Fire, Rescue, and EMS Health Research, Institute for Biobehavioral Health Research, National Development and Research Institutes, Leawood, Kansas.
authors.forename: Sara A
authors.initials: SA
authors.lastname: Jahnke
authors.affiliation: Center for Fire, Rescue, and EMS Health Research, Institute for Biobehavioral Health Research, National Development and Research Institutes, Leawood, Kansas.
authors.forename: C Keith
authors.initials: CK
authors.lastname: Haddock
authors.affiliation: Division of Biostatistics, School of Public Health, University of Texas Health Sciences Center at Houston, Houston, Texas.
authors.forename: Sheng
authors.initials: S
authors.lastname: Luo
authors.affiliation: Division of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas Health Sciences Center at Houston, Houston, Texas.
authors.forename: George L
authors.initials: GL
authors.lastname: Delclos
authors.affiliation: Division of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas Health Sciences Center at Houston, Houston, Texas. Electronic address: rena.s.day@uth.tmc.edu.
authors.forename: R Sue
authors.initials: RS
authors.lastname: Day
mesh_terms: D000328:Adult; D037001:Directive Counseling; D061388:Firefighters / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000523:psychology* / Q000628:therapy; D015431:Weight Loss