The PHLAME (Promoting Healthy Lifestyles: Alternative Models' Effects) firefighter study: outcomes of two models of behavior change.

OBJECTIVE PHLAME's (Promoting Healthy Lifestyles: Alternative Models' Effects) objective was to assess and compare two means to promote healthy lifestyles. METHODS Prospective trial among 599 firefighters randomized by station to 1) team-centered curriculum, 2) one-on-one motivational interviewing (MI), and 3) controls. Assessment included dietary behavior, physical activity, weight, and general well-being at baseline and 12 months. Program effects were determined using an analysis of covariance (ANCOVA) based approach, and models for relationships were evaluated with path analysis. RESULTS Both interventions were acceptable and delivered with high fidelity. The team and MI programs increased fruit and vegetable consumption (P < 0.01 and 0.05, respectively) and general well-being (P < 0.01). Significantly less weight gain occurred in both (P < 0.05). A cross-sectional model was consistent with mediation differing between interventions. CONCLUSIONS Both a team-centered and individual-oriented intervention promoted healthy behaviors. The scripted team curriculum is innovative, exportable, and may enlist influences not accessed with individual formats.