U.S. Department of Homeland Security Award Number EMW-2020-FP-00063
P.I. Stefanos N. Kales MD, MPH, FACP, FACOEM; Harvard School of Public Health
Period of Performance: 09/08/2021 – 09/07/2024
Purpose and Aims
Aim 1- Develop a prototype smartphone application (app) for future Healthy Lifestyle (HLS) Interventions directed at new firefighters.
Aim 2- Field pilot test (beta-testing) the HLS app with new firefighters in their academy and firefighting probationary environments.
Aim 3- Validate the HLS app for its ability to maintain adherence to the HLS program for 3-6 months and for its effects on maintaining/improving HLS parameters (Lifestyle Scores, body composition, physical fitness, behavioral health (trauma/depression) screens).
Research documents that health/fitness improve during training academies, but after graduation, these training-derived gains are rapidly lost. Developing and sustaining healthy lifestyles over firefighters’ career-spans are key to the fire service’s goals of reducing cancer, cardiovascular disease (CVD) and behavioral health risks.
Aim 1- Develop a prototype smartphone application (app) for future Healthy Lifestyle (HLS) Interventions directed at new firefighters. The steps will sequentially include the following with continuous refinements throughout: content analysis across all HLS domains, usability testing, building a viable prototype app, “alpha” or internal testing by the research team. Subsequently, “pre-beta” testing by our fire service panel and other firefighters (n=15-20) will be completed. Pre-beta participants will then be engaged in focus groups for final refinements of the prototype before field tests of the “end-user” version.
Aim 2- Field pilot test (beta-testing) the HLS app with new firefighters (n=30) in their academy and probationary firefighting environments. After completing pilot testing period, the Beta testing participants will give feedback in Focus Groups (n=20) and via surveys (n=30) to get additional “end-consumer” advice to further refine the content and usability of the application and linked materials.
Aim 3- Validate the refined HLS app for ability to maintain adherence to the HLS program for 3-6 months (n=75) and examine its effects on maintaining/improving HLS parameters (Lifestyle Scores, body composition, physical fitness, behavioral health (trauma/depression) screens). Results will be adjusted for the potential influence of new firefighters’ demographic and working conditions. The latter will include volunteer/career status and fire crew, station and department cultures/policies. After the validation study, we will conduct final Focus Groups (n=25) and surveys (n=75) to obtain further feedback to make additional content and usability refinements of the app and linked materials to create an improved final product for further study in future intervention trials.
We will create a viable, user-friendly HLS app that is well-suited to new firefighters. Most firefighters who are open and willing to use the app will remain engaged at least weekly with the app and for at least three to six months. After adjustment for working and demographic conditions, users of the app should produce biologically plausible changes in the direction of better maintenance/improvement HLS parameters as compared to baseline data and historical control data.