Integrating Principles of Community-Based Participatory Research with Intervention Mapping to Reduce Cardiovascular Disease Risk Factors in a Firefighter Community

Cardiovascular disease (CVD) constitutes the leading cause of on-duty death and disability in firefighters. Community involvement in shaping research processes is a promising strategy for effective delivery of CVD health promotion programs in firefighters. This study describes the methods a Community Academic Partnership (CAP) used to engage firefighters in the participatory processes of planning, implementing, and evaluating a CVD intervention. Researchers integrated principles of Community-Based Participatory Research (CBPR) into the steps of Intervention Mapping (IM), thus creating specific strategies relevant to the socio-cultural norms of firefighters. Key elements included: establishing department wide annual CVD health screenings; training firefighters to serve as health mentors; individually-tailoring CVD interventions for high risk firefighters; validating instrumentation for measuring cardiorespiratory health; incorporating environmental modifications for promoting physical activity; improving access to equipment for physical activity; and instituting policy changes to mandate on-duty physical activity. The CAP created and delivered a CVD health program resulting in an 8% increase in cardiorespiratory fitness (p=0.001) in high-risk firefighters, while capitalizing on the community capacity, thus, requiring minimal financial resources. Community academic partnerships are an efficacious and economical approach for engaging firefighters in the participatory processes of applying Intervention Mapping to CVD prevention efforts.