The goal of this two-arm, Cluster Randomized Trial is to evaluate an e-health training program for volunteer firefighters to reduce their risk of exposures to carcinogens and to increase their understanding and intentions of behavior towards cancer prevention. One arm will receive an online e-health intervention for six months and the other arm will be considered as a waitlist control group which will be placed on a waitlist and receive the online treatment program some months later.

The project aims to evaluate the firefighters by measurement of current behavior, perceived importance, future behavioral intentions and perceived barriers for implementing decontamination behaviors at baseline, after the intervention and after 3-month follow-up before and after the intervention.

The intervention consists of three components:

1. a novel health information strategy, 90SecondFire Cancer health letters
2. a brief on-line course
3. a problem-solving asynchronous bulletin board to mobilize existing knowledge

Firefighters face a serious risk of exposure to carcinogens from products of combustion. Modern materials burn hotter and may be even more toxic than older wood construction. Preventing the increased risk of cancer in volunteer firefighters has raised attention as they are more vulnerable to carcinogen exposure.

The goal of this two-arm, Cluster Randomized Trial is to evaluate an e-health training program for volunteer firefighters to reduce their risk of exposures to carcinogens and to increase their understanding and intentions of behavior towards cancer prevention. One arm will receive an online e-health intervention for six months and the other arm will be considered as a waitlist control group which will be placed on a waitlist and receive the online treatment program some months later. Up to 800 volunteer firefighters from approximately 40 volunteer fire departments in Canada will be recruited for both arms.

The project aims to evaluate the firefighters by measurement of current behavior, perceived importance, future behavioral intentions and perceived barriers for implementing decontamination behaviors at baseline, after the intervention and after 3-month follow-up through an online validated survey: Firefighter Exposure to Carcinogens Scale (FECS).

The intervention consists of three components:

1. a novel health information strategy, 90SecondFire Cancer health letters
2. a brief on-line course
3. a problem-solving asynchronous bulletin board to mobilize existing knowledge

Inclusion Criteria:

Departments will be screened to meet the following criteria

1. Be a Volunteer Department
2. Be located in Canada
3. Consent to participate in the study via the Chief or delegate

Participant in the CRT study must meet all the following criteria to be eligible to proceed with the study:

1. Be a volunteer firefighter
2. Working for an all-volunteer fire department that has joined the study
3. Live in Canada
4. Has access to internet
5. Be able to read, write and understand English or French
6. Consent to participate in the study

Exclusion Criteria:

The exclusion for Departments

1. Not a volunteer Department in other words to be a composite department with some volunteers and some career fire fighters or a department that has not joined the study
2. Not located in Canada
3. Not Consent to be in the study via the Chief or delegate

Any of the following criteria will exclude individuals from proceeding to consent:

1. NOT a volunteer firefighter
2. Working for a composite department with some volunteers and some career fire fighters or a department that has not joined the study
3. Does NOT live in Canada
4. Does not have access to internet
5. Is NOT able to read, write and understand English or French
6. Does NOT consent to participate in the study

Since this study is a Cluster Randomized Trial (CRT), first, Departments will be recruited and randomized to the treatment arm or the control arm, with a 1:1 allocation ratio stratified by region. The randomization sequence will be generated by a trained person that is not related to the study participants in any way. The investigators and study staff will be blinded to the randomization sequence until the end of the study. Participant randomization will be performed in REDCap. REDCap maintains an automated audit trail which includes the assigned study identification number, treatment allocation, and date and time of the allocation assignment.

Once a department is recruited and assigned to a study group, all the members in that department will be assigned to the same group.