Nutrition can be a difficult topic to discuss, so it’s inevitable that I get somewhat nervous on my first day at a new fire department. My specialty is designing nutrition education programs for firefighters, but that doesn’t make it any easier to make it through that first meeting. I was told that firefighters can smell fear and will tell you like it is, so my strategy was to present nutrition in a realistic and simple manner, bring a balanced sense of enthusiasm, and hope that I could answer everyone’s questions accurately and with ease.
My first day at Shrewsbury, MA, Fire Department (SFD) went smoothly, and the response from the department seemed positive. That was until someone asked, “What are your thoughts about Expedia?” My heart felt like it could come out of my chest. I took a deep breath and replied, “I think Expedia is a great way to travel. Do you mean Stevia (a sweetener)?” The room filled with laughter, and it served as a perfect icebreaker. After answering question after question, I left SFD that day with a huge smile, hoping that I would continue to work with them in the future.
The fire department
The SFD, located in central Massachusetts, has 38 full-time uniformed personnel and 15 call firefighters. After working with another department in Massachusetts, I reached out to Shrewsbury Fire Chief James Vuona about health and wellness opportunities. Chief Vuona discussed his progressive approach and explained his interest in promoting health via NFPA 1583: Standard on Health-Related Fitness Programs for Fire Department Members as well as the relevant NFFF Life Safety Initiatives (LSIs), including those that focus on cultural change, accountability, and medical and fitness standards. The program design and department’s response are what would determine the potential presence and success of a nutrition program.
The primary goal of the nutrition program at SFD has always been to make positive changes on a cultural level. A nutrition program allows firefighters to identify resources that can help in making the necessary cultural change.
This article details my work with the SFD, which extended over the course of a year, and the resulting nutrition program.
First steps and baseline data
During my initial meeting with SFD personnel, we focused on gauging their nutrition goals. Common goals focused on making healthier food choices, with mention of weight loss and improving overall diets. One firefighter responded that “he wanted to make lifestyle changes that he would still enjoy,” while others wanted to focus on meal timing and frequency. Many firefighters were interested in meal planning, portion control, and trying new meals and snacks, while some firefighters were content with their current diets and were not interested in making any changes. Further, based on an initial survey, the firefighters seemed most interested in resources focused on healthy recipes, meal plans, group nutrition challenges and group meetings.
Creating program components
As a non-firefighter attempting to work with the fire community, I knew that I would have to create a trustworthy relationship with firefighters, which would come with time and them learning my teaching style. Because the nutrition program is mandatory, it was important to work on simple and realistic nutrition goals; if I didn’t focus on this, I think the training would have been rejected.
If a program has a sustainable approach and involves firefighters’ feedback, it is highly likely that, over time, more firefighters will come on board, especially when or if they see the benefits. The reasoning may vary. One firefighter may lose some weight and the others see what he/she did and want to do the same. Or perhaps the healthy behavior becomes contagious, so to speak. Or maybe someone ends up being the odd person out for not participating and they become interested by default.
I created multiple program components to address the department’s nutrition goals. Following a basic nutrition lecture, plan components included group meetings, newsletters, healthy recipes, meal plans and a nutrition challenge, all geared toward increasing nutrition awareness and implementing healthier dietary changes.
Basic nutrition lecture: To start, I presented nutrition information that covered topics relevant to the firefighter lifestyle, including how to achieve a healthy diet, diet and heart health, recovery nutrition, and increasing nutrition awareness.
Group Meetings: Having separate meetings with each group is an ideal strategy to promote nutrition-related behaviors, especially since groups bond, cook and eat together. I met with each group four times throughout the year, alternating between interactive presentations and open discussion. Two meetings consisted of presentations, the first being the basic lecture and the second focusing on increasing nutrition awareness related to sugar intake, portion control and alcohol nutrition.
The remaining meetings involved data collection through surveys and conversation. Surveys administered addressed current eating habits (collected every 6 months), nutrition topics of interest, and program evaluation. Finding out how firefighters rate their diets and if they are interested in changing their eating habits provided information for a needs assessment.
Meetings also served as time to touch base with each group. We discussed barriers to consuming a healthy diet based on the firefighter lifestyle and schedule. The firefighters also sampled various products (ex: nutrition bars and natural nut or seed butters) that served as healthy snack options for them to gain exposure to try new foods. I was able to gauge what people were interested in, what resources would be helpful for firefighters, and how I could be of help to them.
After a year, firefighters filled out a survey about the effectiveness of the program, which included questions addressing their likes and dislikes about the program, areas for improvement, and general thoughts about the program and my approach.
Healthy recipes and meal plans: I wanted to provide resources that allowed for flexibility and differences among firefighters’ diets. Healthy recipes were made available via recommended cookbooks and blogs. Additional recipes were also included with meal and snack ideas to go along with eating challenges. Other resources focused on making small positive nutrition changes that fit comfortably within firefighters’ diets. For instance, I created a list of healthy ingredient swaps for cooking and baking so that firefighters could make simple changes to existing recipes and dishes.
Newsletters: I developed monthly newsletters as another source of nutrition education. I started by providing the firefighters a list of potential newsletter topics—such as meal planning strategies and decoding dietary supplements—and surveyed interest at group meetings. Other topics were suggested by firefighters, and I used this information to create newsletters that would achieve optimal reading rates.
Eating Challenges: I created several eating challenges for the firefighters. For example, after learning about sugar’s presence within our diets, firefighters would be challenged to avoid added sugar in its many forms for 10 days as an awareness exercise, thereby shedding light on sugar’s hidden presence within many foods. Another challenge was created based on one group’s nutrition goal of “eating clean.” The 30-day challenge focused on eating whole foods with simple ingredients and minimal processing. I provided simple meal and snack ideas, recipes and newsletters tailored to the challenge as well. Throughout the process, there was always a focus on increasing participation within the group to help build a support system.
Assessing their progress
I evaluated the firefighters’ progress using surveys and general feedback. Program strengths that were noted included teaching style, resources, and nutrition education and awareness. Timing in between trainings was also noted as beneficial; by introducing new initiatives and/or training every few months, it allows for interest, awareness and behavior changes to be sustainable among firefighters.
Firefighters shared how the program has influenced their food choices and how information has been eye-opening. Common responses for changing eating habits for the better involved decreasing sugar intake and fast food, focusing on meal timing, eating more vegetables, and working on portion control. One firefighter stated that the program provides self-awareness and “insight into what we are really eating.” Another firefighter mentioned that the program “provides open conversation that would not otherwise be facilitated.”
One of the most revealing survey responses came from a question about rating the effectiveness of the nutrition program. As one firefighter noted, the “program is only as effective as those who want to make changes.”
To make the program more successful, firefighters provided feedback about areas for improvement and what they wanted the program to provide in the future. This is a great example of the importance of making adjustments to program planning when it is warranted. No program or idea has to be concrete; instead, the program should evolve as new behaviors are adopted and different interests arise.
Challenges noted within surveys have to do with varying nutrition goals and interest levels for making dietary changes. An area for improvement involves finding a balance between addressing personal and group nutrition goals to optimize changes within a firehouse’s eating environment. Increasing interest and “getting others on board” is an ongoing goal. Creating a program that pleases the majority of a department is a difficult task but can be done with time and evaluation.
Now that a general background on nutrition has been covered, I look forward to diving deeper and focusing on implementing specific nutrition initiatives. For instance, putting meal planning and healthy cooking into place, as one firefighter suggested that the next steps focus on “finding ways to adopt these changes and have them fit into lifestyles at work and at home.” Another area of focus will be to continue discussions and classes that emphasize important nutrition topics, such as eating for performance or nutrition and heart health.
When I started working with fire departments, I was told that I wasn’t going to reach everyone, which is something that comes with the nutrition profession. Some individuals may not be willing to change their behaviors because they’re not ready or don’t want to. Maybe there isn’t a need, or there could be some resistance present, especially if a program is mandatory.
Creating a non-threatening environment that encourages nutrition awareness and promotes healthy eating habits is key to a sustainable program. Instead of having an “all-or-nothing” approach, such as “eat this, don’t eat that,” it is more beneficial to focus on nutrition’s importance and connection with our health in order to create a program that is accepted by a department. A goal is to strive to make changes that fit comfortably within current diets. By having this approach, it may be easier for firefighters to adopt healthier eating habits.
In graduate school I learned about the importance of building a trustworthy relationship, being approachable, and using different data collection techniques. It wasn’t until I learned through experience and made adjustments along the way to a proposed plan that I was truly able to see how my efforts could influence other people’s nutrition-related behaviors for the better.
Reading feedback about my “non-confrontational” style and efforts make everything worthwhile. It meant that I wasn’t an outsider anymore and instead, I was a part of the community.
There is never a dull moment discussing nutrition within the fire community. The environment is filled with humor, distractions and traditions, but we’ve still managed to create a feasible nutrition program presenting sustainable behavior changes that will be molded over time. I am forced to think creatively and enjoy the challenge of decreasing barriers to healthy eating habits within the fire service. SFD has motivated me to keep pursuing this nutrition niche. Their feedback, results and enthusiasm make me want to continue to strive to work with the fire community. For that, I can’t thank them enough.