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

Year: 2026

Type: article

Study designs: Randomized Controlled Trial, Clinical Trial

Abstract: Background: 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. Methods: 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. Findings: 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. Conclusions: The intervention was feasible and showed potential to improve cancer prevention–related perceptions and behaviors. Recruitment challenges indicate the need for enhanced engagement strategies. Application to Practice: Online educational programs may support scalable cancer prevention training for volunteer fire departments, especially for rural and resource-limited settings.

Source: Workplace Health & Safety

DOI: 10.1177/21650799261429946