# Feasibility of a Train-the-Trainer Delivered Exercise Intervention in Firefighters

> **NIH ALLCDC R03** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2021 · $76,015

## Abstract

PROJECT SUMMARY/ABSTRACT
The fire service has one of the highest rates of occupational injuries incurring a large economic burden.
Sudden cardiac death, and strains and sprains from slips, trips and falls and overexertion are frequently cited
as the most common fatal and non-fatal injuries. Recent research has demonstrated that high-intensity interval
training (HIIT) and multi-factorial neuromuscular training programs that include dynamic stretching, core
stability, balance, and medicine ball exercises can specifically target the primary risk factors of these injuries,
while improving firefighter performance. However, 75% of firefighters fail to achieve minimum physical activity
recommendations, with those exercising on-duty experiencing surprisingly high rates of exercise-related
injuries. In addition, with only 27% of fire departments implementing fitness programs, novel strategies are
needed to improve implementation efforts of safe and evidence-based exercise that address key barriers to
worksite exercise adherence. Preliminary work from our team has demonstrated that a ‘train-the-trainer’
(TRAINER) model, including professional supervision, can reduce the risk of injury in similar populations (i.e.
military cadets). The objective of the current proposal is to determine the feasibility and obtain preliminary
data on the initial changes and intervention fidelity to a TRAINER delivered integrated exercise routine
(including a neuromuscular warm-up and HIIT) at fire stations. The main hypotheses are that firefighters will
adhere to the TRAINER delivered integrated exercise program as intended and will exhibit clinically important
improvements in primary risk factors for cardiovascular disease (CVD) and strain and sprain injuries. A two-
arm cluster randomized feasibility and proof-of-concept study of a 6-week TRAINER intervention will be
conducted with 40 career firefighters clustered by fire station. This study is innovative because 1) it includes an
exercise strategy that facilitates on-duty exercise adherence and targets the primary fatal and non-fatal injuries
in the fire service, and 2) explores a novel use of the TRAINER model to improve the implementation efforts of
exercise programs at fire stations. In Aim 1, our multidisciplinary team will examine the feasibility of the
TRAINER delivered integrated exercise program in firefighters. We will determine recruitment and retention
rates, the willingness to be randomized, and the adherence to and acceptability of the 6-week intervention. In
Aim 2, we will determine intervention fidelity and short-term changes in risk factors for CVD and strain and
sprain injuries. The expected outputs and outcomes of this innovative project are critical to further Research to
Practice (r2p) efforts in the fire service. Furthermore, a unique strength of this R03 includes the strong support
from a leading tactical fitness organization with a national network of certified fitness professionals to enhance
the dis...

## Key facts

- **NIH application ID:** 10218679
- **Project number:** 1R03OH011929-01A1
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Eric D Ryan
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2021
- **Award amount:** $76,015
- **Award type:** 1
- **Project period:** 2021-09-30 → 2023-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10218679

## Citation

> US National Institutes of Health, RePORTER application 10218679, Feasibility of a Train-the-Trainer Delivered Exercise Intervention in Firefighters (1R03OH011929-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10218679. Licensed CC0.

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