Effectiveness of a Mind–Body Intervention at Improving Mental Health and Performance Among Career Firefighters
Abstract
1. Introduction
1.1. Exercise and Mental Health
1.2. Psychological Resilience and Mental Health
2. Materials and Methods
2.1. Participants and Exercise Pre-Screening
2.2. Pre- and Post-Intervention Procedures
2.3. Mental Health Outcome Measures
2.4. Intervention Protocols
2.5. Statistical Analyses
- Model 4 (AgeMC) controlled for participants’ mean-centered age at 39 years (M = 39.70 years, SD = 7.62, range = 23.00–57.00);
- Model 5 controlled for level of education, dichotomized into 0 (Some college but no degree [n = 2] or Associate degree [n = 13]) and 1 (Bachelor degree [n = 13] or Graduate degree [n = 2];
- Model 6 controlled for fire department rank, dichotomized into 0 (Firefighter [n = 8] or Engineer [n = 6]) and 1 (Captain [n = 10] or Battalion Chief [n = 6]);
- Model 7 (Years of serviceMC) controlled for years of service mean-centered at 15 (M = 15.43 years, SD = 8.27, range = 1.00–35.00);
- Model 8 controlled for participants’ combined race and ethnicity, dichotomized into 0 (Race: White [n = 1], Other [n = 1], Don’t know [n = 1], or Prefer not to say [n = 1]; Ethnicity: Hispanic [n = 3] or Prefer not to say [n = 1]) and 1 (Race: White [n = 26]; Ethnicity: Not Hispanic [n = 26]);
- Model 9 controlled for relationship status, dichotomized into 0 (Single [n = 3], In a relationship [n = 2], or Divorced [n = 1]) and 1 (Married [n = 24]);
- Model 10 controlled for participants’ biological sex as 0 (Male [n = 27]) and 1 (Female [n = 3]).
- Model 4 (Combined adherenceSTD) controlled for participants’ standardized combined adherence (see Tables S12–S15 for a description of variable standardization);
- Model 5 controlled for Combined adherenceSTD plus the Combined adherenceSTD × growth interaction;
- Model 6 controlled for Combined adherenceSTD, the Combined adherenceSTD × growth interaction, and additional fitness tracking variables (i.e., mean-centered additional weekly workouts, mean-centered additional weekly minutes of exercise, and mean-centered rating of perceived exertion [RPE] of additional workouts);
- Model 7 (HIFT adherenceSTD) controlled for participants’ standardized HIFT workout adherence;
- Model 8 controlled for HIFT adherenceSTD plus the HIFT adherenceSTD × growth interaction;
- Model 9 controlled for HIFT adherenceSTD, the HIFT adherenceSTD × growth interaction, and additional fitness tracking variables;
- Model 10 (RES adherenceSTD) controlled for participants’ standardized RES practice adherence;
- Model 11 controlled for RES adherenceSTD plus the RES adherenceSTD × growth interaction;
- Model 12 controlled for RES adherenceSTD, the RES adherenceSTD × growth interaction, and additional fitness tracking variables.
3. Results
3.1. Sample Characteristics
3.2. Anthropometric and Job-Task Performance Measurements
Group Differences Between Pre- and Post-Testing Samples
3.3. Intervention Adherence and Additional Fitness Tracking
3.4. Mental Health Outcome Mean Values
3.5. Repeated-Measures T-Tests and Effect Sizes
3.6. Multilevel Modeling Results
3.6.1. Main Effects of Demographics on Mental Health Outcomes
3.6.2. Main Effects of Intervention Adherence and Additional Fitness Tracking on Anthropometrics and Job-Task Performance
3.6.3. Main Effects of Intervention Adherence and Additional Fitness Tracking on Mental Health Outcomes
3.7. Mental Health Outcome Measurement Distributions
3.8. Post Hoc Sample Size and Power Analyses Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristic | n | % | |
---|---|---|---|
Sex | Female | 3 | 10.00 |
Male | 27 | 90.00 | |
Rank | Firefighter | 8 | 26.66 |
Engineer | 6 | 20.00 | |
Captain | 10 | 33.33 | |
Battalion Chief | 6 | 20.00 | |
Relationship Status | Single | 3 | 10.00 |
In a relationship | 2 | 6.66 | |
Married or domestic partnership | 24 | 80.00 | |
Divorced or separated | 1 | 3.33 | |
Education Level | Some college but no degree | 2 | 6.66 |
Associate degree | 13 | 43.33 | |
Bachelor degree | 13 | 43.33 | |
Graduate degree | 2 | 6.66 | |
Race | White | 27 | 90.00 |
Other | 1 | 3.33 | |
Don’t know | 1 | 3.33 | |
Prefer not to say | 1 | 3.33 | |
Ethnicity | Not Hispanic | 26 | 86.66 |
Hispanic | 3 | 10.00 | |
Prefer not to say | 1 | 3.33 | |
Characteristic | M (SD) | Range | |
Age (years) | 39.70 (7.71) | 23.00–57.00 | |
Years in fire service | 15.43 (8.37) | 1.00–35.00 |
Pre-Intervention, Full Sample (n = 30) | Pre-Intervention, Returning Sample (n = 20) | Post-Intervention, Returning Sample (n = 20) | ||||
---|---|---|---|---|---|---|
Variable | M (SD) | Range | M (SD) | Range | M (SD) | Range |
Height (cm) | 179.41 (7.68) | 160.02–190.50 | 181.36 (6.61) | 170.18–190.50 | 181.36 (6.61) | 170.18–190.50 |
Weight (kg) | 91.09 (12.65) | 64.33–120.95 | 93.33 (10.33) | 77.27–120.95 | 92.61 (9.61) | 78.41–115.77 |
LBM (kg) | 71.99 (9.51) | 50.44–86.67 | 74.83 (7.23) | 63.15–86.67 | 74.34 (7.34) | 63.24–87.40 |
BMI (kg·m−2) | 28.23 (2.96) | 22.48–35.25 | 28.36 (2.49) | 22.48–33.33 | 28.15 (2.32) | 22.81–31.90 |
%BF | 20.76 (5.44) | 11.10–31.80 | 19.57 (5.26) | 11.10–31.80 | 19.56 (4.76) | 11.30–29.10 |
T-CAC (stations) | 22.12 (3.83) | 15.00–30.00 | 22.91 (3.40) | 16.00–29.33 | 25.09 (3.94) | 17.00–32.47 |
Occasion | PHQ-9 | PCL-C | ||||
---|---|---|---|---|---|---|
M (SD) | Range | Missing (%) | M (SD) | Range | Missing (%) | |
Baseline (Week 0) | 3.43 (3.22) | 0–10 | 0 (0.00) | 32.11 (13.20) | 17–66 | 2 (6.66) |
Pre-Intervention (Week 4) | 3.77 (3.61) | 0–12 | 0 (0.00) | 32.33 (14.28) | 17–69 | 0 (0.00) |
Midpoint (Week 11) | 2.83 (2.71) | 0–11 | 1 (3.33) | 29.31 (13.88) | 17–73 | 1 (3.33) |
Post-Intervention (Week 17) | 2.93 (4.32) | 0–20 | 3 (10.00) | 28.33 (13.47) | 17–68 | 3 (10.00) |
Occasion | CD-RISC10 | WEMWBS | ||||
M (SD) | Range | Missing (%) | M (SD) | Range | Missing (%) | |
Baseline (Week 0) | 31.31 (5.97) | 16–40 | 1 (3.33) | 50.25 (7.93) | 31–61 | 2 (6.66) |
Pre-Intervention (Week 4) | 30.27 (5.60) | 16–39 | 0 (0.00) | 50.37 (9.20) | 30–68 | 0 (0.00) |
Midpoint (Week 11) | 31.00 (5.25) | 23–40 | 1 (3.33) | 50.48 (7.61) | 33–70 | 1 (3.33) |
Post-Intervention (Week 17) | 32.04 (5.73) | 19–40 | 3 (10.00) | 52.81 (9.74) | 33–70 | 4 (13.33) |
Hedges’ g | |||||||
---|---|---|---|---|---|---|---|
Outcome | M Diff. (SD) | 95% CI | t | p a | Missing (%) | Point Estimate | 95% CI |
PHQ-9 | 0.33 (2.48) | [−0.59, 1.26] | 0.74 | 0.47 | 0 (0.00) | 0.13 | [−0.22, 0.49] |
PCL-C | 0.89 (5.51) | [−1.24, 3.03] | 0.86 | 0.40 | 2 (6.66) | 0.16 | [−0.21, 0.53] |
CD-RISC10 | −1.00 (3.32) | [−2.26, 0.26] | −1.62 | 0.12 | 1 (3.33) | −0.30 | [−0.66, 0.07] |
WEMWBS | −0.46 (4.54) | [−2.23, 1.30] | −0.54 | 0.59 | 2 (6.66) | −0.10 | [−0.47, 0.27] |
Hedges’ g | |||||||
---|---|---|---|---|---|---|---|
Variable | M Diff. (SD) | 95% CI | t | p a | Missing (%) | Point Estimate | 95% CI |
BW (kg) | −0.72 (2.14) | [−1.72, 0.29] | −1.50 | 0.15 | 10 (33.33) | −0.32 | [−0.75, 0.12] |
LBM (kg) | −0.48 (2.05) | [−1.44, 0.48] | −1.06 | 0.30 | 10 (33.33) | −0.23 | [−0.65, 0.20] |
BMI (kg·m−2) | −0.21 (0.63) | [−0.51, 0.08] | −1.51 | 0.15 | 10 (33.33) | −0.32 | [−0.75, 0.11] |
%BF | −0.02 (1.50) | [−0.72, 0.69] | −0.05 | 0.97 | 10 (33.33) | −0.01 | [−0.43, 0.41] |
T-CAC (stations) | 2.18 (1.51) | [1.47, 2.88] | 6.46 | <0.001 | 10 (33.33) | 1.42 | [0.79, 2.03] |
Hedges’ g | |||||||
---|---|---|---|---|---|---|---|
Variable | M Diff. (SD) | 95% CI | t | p a | Missing (%) | Point Estimate | 95% CI |
PHQ-9 | −0.93 (2.90) | [−2.07, 0.22] | −1.66 | 0.11 | 3 (10.00) | −0.32 | [−0.69, 0.07] |
PCL-C | −5.00 (7.40) | [−7.93, −2.07] | −3.51 | 0.002 | 3 (10.00) | −0.67 | [−1.07, −0.25] |
CD-RISC10 | 2.19 (4.52) | [0.40, 3.97] | 2.51 | 0.02 | 3 (10.00) | 0.48 | [0.08, 0.87] |
WEMWBS | 2.39 (7.10) | [−0.48, 5.25] | 1.71 | 0.10 | 4 (13.33) | 0.33 | [−0.06, 0.72] |
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Santos, A.C.; Long, S.; Moreno, C.P.; Bycura, D. Effectiveness of a Mind–Body Intervention at Improving Mental Health and Performance Among Career Firefighters. Int. J. Environ. Res. Public Health 2025, 22, 1227. https://doi.org/10.3390/ijerph22081227
Santos AC, Long S, Moreno CP, Bycura D. Effectiveness of a Mind–Body Intervention at Improving Mental Health and Performance Among Career Firefighters. International Journal of Environmental Research and Public Health. 2025; 22(8):1227. https://doi.org/10.3390/ijerph22081227
Chicago/Turabian StyleSantos, Anthony C., Seth Long, Christopher P. Moreno, and Dierdra Bycura. 2025. "Effectiveness of a Mind–Body Intervention at Improving Mental Health and Performance Among Career Firefighters" International Journal of Environmental Research and Public Health 22, no. 8: 1227. https://doi.org/10.3390/ijerph22081227
APA StyleSantos, A. C., Long, S., Moreno, C. P., & Bycura, D. (2025). Effectiveness of a Mind–Body Intervention at Improving Mental Health and Performance Among Career Firefighters. International Journal of Environmental Research and Public Health, 22(8), 1227. https://doi.org/10.3390/ijerph22081227