{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:40:48Z","timestamp":1792806048039,"version":"4.5.0"},"reference-count":60,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T00:00:00Z","timestamp":1700092800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008464","name":"Federal Emergency Management Agency","doi-asserted-by":"publisher","award":["EMW-2014-FP-00945"],"award-info":[{"award-number":["EMW-2014-FP-00945"]}],"id":[{"id":"10.13039\/100008464","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Firefighting is inherently dangerous, though recently concerns have shifted from traditional fireground injuries (burns and asphyxiation) to a focus on mental and behavioral health. Although firefighters are remarkably resilient, research suggests many suffer negative psychological consequences from repeated exposures to trauma. While the Stress First Aid (SFA) model has gained increased attention and adoption among fire departments as a model for behavioral health training, it has not been formally evaluated. This cluster randomized controlled trial used a crossover design comparing the immediate SFA group to delayed SFA control to test the impact of the SFA on firefighters\u2019 mental and behavioral health changes after 10\u201312 months (n = 400; Mage = 37.6, 4.8% women). A convenience sample of 79 firefighters (Mage = 41.4; 8.7% women) provided evaluations on one or more of the training modules. Participants reported satisfaction with all training components (Peer team training 97.6%, Online SFA 94.9%, Curbside Manner 88.4%, After Action Review 89.4%) and reported success in changing personnel\u2019s perception of their department\u2019s ability to respond to behavioral health issues (SFA M = 3.93, Control 3.50; t = 2.52, p = 0.042). Future work should focus on additional resources and training to augment existing efforts to help departments continue their efforts.<\/jats:p>","DOI":"10.3390\/ijerph20227067","type":"journal-article","created":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T01:56:29Z","timestamp":1700099789000},"page":"7067","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Evaluation of the Implementation of the NFFF Stress First Aid Intervention in Career Fire Departments: A Cluster Randomized Controlled Trial"],"prefix":"10.3390","volume":"20","author":[{"given":"Sara A.","family":"Jahnke","sequence":"first","affiliation":[{"name":"Center for Fire, Rescue & EMS Health Research, NDRI-USA, Inc., Leawood, KS 66224, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Watson","sequence":"additional","affiliation":[{"name":"National Center for PTSD, White River Junction, VT 05009, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Leto","sequence":"additional","affiliation":[{"name":"FDNY, Counseling Services Unit, Fort Totten, NY 10314, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6010-773X","authenticated-orcid":false,"given":"Nattinee","family":"Jitnarin","sequence":"additional","affiliation":[{"name":"Center for Fire, Rescue & EMS Health Research, NDRI-USA, Inc., Leawood, KS 66224, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher M.","family":"Kaipust","sequence":"additional","affiliation":[{"name":"Center for Fire, Rescue & EMS Health Research, NDRI-USA, Inc., Leawood, KS 66224, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6350-8210","authenticated-orcid":false,"given":"Brittany S.","family":"Hollerbach","sequence":"additional","affiliation":[{"name":"Center for Fire, Rescue & EMS Health Research, NDRI-USA, Inc., Leawood, KS 66224, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher K.","family":"Haddock","sequence":"additional","affiliation":[{"name":"Center for Fire, Rescue & EMS Health Research, NDRI-USA, Inc., Leawood, KS 66224, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. S. Carlos","family":"Poston","sequence":"additional","affiliation":[{"name":"Center for Fire, Rescue & EMS Health Research, NDRI-USA, Inc., Leawood, KS 66224, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Gist","sequence":"additional","affiliation":[{"name":"KCMO Fire Department, Kansas City, MO 64106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,16]]},"reference":[{"key":"ref_1","unstructured":"Fahy, R., Evarts, B., and Stein, G. (2022). US Fire Department Profile 2020, National Fire Protection Association. No. USS07."},{"key":"ref_2","unstructured":"Streich, J. (2023, May 09). The Role of a Modern Firefighter. Minnesota State Fire Department Association. 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