A Cluster Randomized Trial of an Online Training Program on Cancer Prevention Behaviors in Volunteer Firefighters: A...

Volunteer firefighters face elevated cancer risks from exposure to combustion by-products, exacerbated by limited decontamination resources, especially in rural departments. This proof-of-concept study assessed the feasibility and preliminary effectiveness of an online educational intervention to improve cancer prevention behaviors among Canadian English and French volunteer firefighters.

A two-arm cluster randomized controlled trial was conducted across 23 volunteer fire departments. Departments were assigned to a 6-month online intervention (health letters, moderated chat room, and a 45-minute summary course) or a waitlist control. Firefighters completed the 20-item Firefighter Exposure to Carcinogens Scale (FECS) at baseline and 6 months, assessing intention, perceived importance, behavior, and barriers.

A total of 115 firefighters enrolled; participant retention rates were 48.39% in the intervention group and 81.13% in the control group. The intervention group showed greater improvement in perceived importance (p = .04) and a trend toward reduced perceived barriers (p = .05). Intention scores trended positively (p = .08). Behavioral changes were not significant in the primary analysis, but when clustering was accounted for, behavior improvement reached significance (p = .01). Perceived barriers were negatively correlated with intention, importance, and behavior, with stronger correlations post-intervention.

The intervention was feasible and showed potential to improve cancer prevention-related perceptions and behaviors. Recruitment challenges indicate the need for enhanced engagement strategies.

Online educational programs may support scalable cancer prevention training for volunteer fire departments, especially for rural and resource-limited settings.