The PHLAME (Promoting Healthy Lifestyles: Alternative Models??? Effects) Firefighter Study: Outcomes of Two Models of Behavior Change

Elliot, Diane L.; Goldberg, Linn; Kuehl, Kerry S.; Moe, Esther; Breger, Rosemary; Pickering, Michael

doi:10.1097/jom.0b013e3180329a8d

Cited by 174 publications

(240 citation statements)

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“…The promoting healthy lifestyles (PHLAME) wellness/injury reduction program was developed, shown efficacious, and beta-tested with funding from the National Institutes of Health [11][12][13]. The PHLAME curriculum offers 12 45-min interactive sessions to be completed once per week over approximately 4 months.…”

Section: Discussionmentioning

confidence: 99%

Worksite wellness program implementation: a model of translational effectiveness

Elliot

MacKinnon

Mabry

et al. 2012

Behav. Med. Pract. Policy Res.

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Occupational health promotion programs with documented efficacy have not penetrated worksites. Establishing an implementation model would allow focusing on mediating aspects to enhance installation and use of evidence-based occupational wellness interventions. The purpose of the study was to implement an established wellness program in fire departments and define predictors of program exposure/dose to outcomes to define a cross-sectional model of translational effectiveness. The study is a prospective observational study among 12 NW fire departments. Data were collected before and following installation, and findings were used to conduct mediation analysis and develop a translational effectiveness model. Worker age was examined for its impact. Leadership, scheduling/competing demands, and tailoring were confirmed as model components, while organizational climate was not a factor. The established model fit data well (χ 2 (9)=25.57, CFI = 0.99, RMSEA = 0.05, SRMR = 0.03). Older firefighters, nearing retirement, appeared to have influences that both enhanced and hindered participation. Findings can inform implementation of worksite wellness in fire departments, and the prioritized influences and translational model can be validated and manipulated in these and other settings to more efficiently move health promotion science to service.

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Section: Discussionmentioning

confidence: 99%

Worksite wellness program implementation: a model of translational effectiveness

Elliot

MacKinnon

Mabry

et al. 2012

Behav. Med. Pract. Policy Res.

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“…Buttriss et al (22) drew special attention to one of these studies, the Treatwell 5-a-Day Study, showing that involving family members could be a promising strategy to increase fruit and vegetable intake (24) , with potential benefits for the whole family (25) . Tailored health information and different counselling opportunities were provided in two more recently published intervention studies, one among construction labourers using telephone-delivered and mailed intervention (26) and another targeting firefighters either through a team-centred curriculum or through individual motivational interviews (27) . In these cases, intervention effects of approximately 1-1.5 servings of fruit and vegetables were observed, comparable to the effect found in a study targeting solely the physical environment, making fruit and vegetables in lunch meals easily available and more appealing at worksite canteens (28,29) .…”

Section: Discussionmentioning

confidence: 99%

Improving the diet of employees at blue-collar worksites: results from the ‘Food at Work’ intervention study

Lassen

Thorsen

Sommer

et al. 2011

Public Health Nutr.

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Objective: To examine the impact of a 6-month participatory and empowermentbased intervention study on employees' dietary habits and on changes in the canteen nutrition environment. Design: Worksites were stratified by company type and by the presence or absence of an in-house canteen, and randomly allocated to either an intervention group (five worksites) or a minimum intervention control group (three worksites). The study was carried out in partnership with a trade union and guided by an ecological framework targeting both individual and environment levels. Outcome measures included: (i) changes in employees' dietary habits derived from 4 d pre-coded food diaries of a group of employees at the worksites (paired-data structure); and (ii) the canteen nutrition environment as identified by aggregating chemical nutritional analysis of individual canteen lunches (different participants at baseline and at endpoint). Setting: Eight blue-collar worksites (five of these with canteens). Subjects: Employees. Results: In the intervention group (n 102), several significant positive nutritional effects were observed among employees, including a median daily decrease in intake of fat (22?2 %E, P 5 0?002) and cake and sweets (218 g/10 MJ, P 5 0?002) and a median increase in intake of dietary fibre (3 g/10 MJ, P , 0?001) and fruit (55 g/d, P 5 0?007 and 74 g/10 MJ, P 5 0?009). With regard to the canteen nutrition environment, a significant reduction in the percentage of energy obtained from fat was found in the intervention group (median difference 11 %E, P , 0?001, n 144).Conclusions: The present study shows that moderate positive changes in dietary patterns can be achieved among employees in blue-collar worksites.

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“…Some investigators (Carey et al 2011;Elliot et al 2007;Winick et al 2002) have reported short-term (<6 months) beneficial effects of health promotion programs on the weight and BMI of firefighters. However, the initial program effects did not last long after the completion of the programs (MacKinnon et al 2010;Ranby et al 2011;Winick et al 2002).…”

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confidence: 99%

Comparison of body mass index with waist circumference and skinfold-based percent body fat in firefighters: adiposity classification and associations with cardiovascular disease risk factors

Choi

Steiss

García-Rivas

et al. 2015

Int Arch Occup Environ Health

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firefighters had substantially higher CVD risk profiles. Obesity and overweight were less prevalent in female and Asian male firefighters. Conclusions BMI overestimated the prevalence of total overweight and obesity among male firefighters, compared to WC and skinfold-based PBF. Overweight by BMI needs to be more narrowly defined, or the prevalence of BMI-based overweight (27.5-29.9 kg/m 2 ) should be reported additionally for prevention of CVD among male firefighters.Keywords California · Professional firefighters · Obesity · Overweight · Ethnicity · Gender IntroductionObesity is a well-documented risk factor for chronic diseases such as hypertension, coronary heart disease, osteoarthritis, dyslipidemia, type II diabetes, some cancers as well as increased mortality (Flegal et al. 2013 . The prevalence of obesity in the working population of the USA as in the general population has increased, particularly over the last three decades (Caban et al. 2005). Male firefighters are among the top three occupational groups with the highest obesity prevalence in the USA (Caban et al. 2005;Choi et al. 2011;Haddock et al. 2011). As a result, overweight and obesity is an important occupational health issue to be urgently addressed for the 1.1 million US firefighters ) who are at high risk of on-duty cardiovascular disease (CVD) mortality (Geibe et al. 2008;Kales et al. 2007) and musculoskeletal injuries Poplin et al. 2012). AbstractPurpose This study aims to examine whether body mass index (BMI) overestimates the prevalence of overweight or obese firefighters when compared to waist circumference (WC) and skinfold-based percent body fat (PBF) and to investigate differential relationships of the three adiposity measures with other biological cardiovascular disease (CVD) risk factors. Methods The adiposity of 355 (347 males and eight females) California firefighters was assessed using three different measures. Other CVD risk factors (high blood pressure, high lipid profiles, high glucose, and low VO 2 max) of the firefighters were also clinically assessed. Results The prevalence of total overweight and obesity was significantly (p < 0.01) higher by BMI (80.4 %) than by WC (48.7 %) and by PBF (55.6 %) in male firefighters. In particular, the prevalence of overweight firefighters was much higher (p < 0.01) by BMI (57.3 %) than by WC (24.5 %) and PBF (38.3 %). 60-64 % of male firefighters who were assessed as normal weight by WC and PBF were misclassified as overweight by BMI. When overweight by BMI was defined as 27.5-29.9 kg/m 2 (vs. the standard definition of 25.0-29.9 kg/m 2 ), the agreement of the adiposity classification increased between BMI and other two adiposity measures. Obese firefighters had the highest CVD risk profiles across all three adiposity measures. Only when overweight by BMI was defined narrowly, overweight

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The PHLAME (Promoting Healthy Lifestyles: Alternative Models??? Effects) Firefighter Study: Outcomes of Two Models of Behavior Change

Abstract: 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.

Cited by 174 publications

References 42 publications

Worksite wellness program implementation: a model of translational effectiveness

Worksite wellness program implementation: a model of translational effectiveness

Improving the diet of employees at blue-collar worksites: results from the ‘Food at Work’ intervention study

Comparison of body mass index with waist circumference and skinfold-based percent body fat in firefighters: adiposity classification and associations with cardiovascular disease risk factors

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