Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Mar 9, 2023
Date Accepted: Aug 30, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
A Mixed-Methods Development and Effectiveness Trial of a Web-based Total Worker Health Intervention for Those Fighting Wildland Fires
ABSTRACT
Background:
Fire seasons are longer, with more and larger wildfires, placing increased demands and risks on those fighting wildland fires. The multiple agencies involved and unique worksite conditions make meeting these workers needs a challenge.
Objective:
To develop and establish efficacy for an online safety and health program for those fighting wildland fires.
Methods:
This mixed-methods project had three phases. The initial qualitative phase assessed the needs of 150 diverse firefighters by interview and focus groups across 11 U.S. sites to establish and prioritize program content. Interview transcripts were read for thematic content with reiterative readings used to identify, code, and rank health and safety issues. The second phase used that information to build a comprehensive Total Worker Health™ program for those fighting wildfires. The program content was based on the qualitative interview data and consisted of 6 core and 8 elective 30-minute, interactive modules primarily done individually on a smartphone or computer. The final, third phase evaluated the program with a quantitative prospective proof-of-concept, usability and effectiveness trial among wildland firefighter participants. Efficacy was assessed with paired t-tests for pre- and post- Likert agreement scale survey items, adjusted for multiple comparisons. In addition to assessing mean and standard deviation at baseline and post-survey, observed effect sizes were calculated (Cohen’s d). Usability and reaction to the program among firefighters who responded to post-survey also was assessed.
Results:
The qualitative themes and subthemes were used to inform the program’s content. For the efficacy trial, a total of 131 firefighters completed the pre-survey, and 50 also completed the post-survey (38.2%). The majority of the participants were white (93.9%), males (89.3%), with average age of 41 years. Significant (P<0.01) increases in knowledge and desired health and safety behaviors were found for both cancer and cardiovascular risk, nutrition behaviors, hydration/overheating, binge drinking and getting medical check-ups. More than 80% agreed or strongly agreed that the program was easy to use and would recommend it to others.
Conclusions:
An innovative online safety and health promotion program for those fighting wildland fires was feasible, scalable, and usable. It improved the health and safety of those fighting wildland fires. Clinical Trial: ClinicalTrials.gov registration NCT05753358 Registered February 3, 2023
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.