BMJ Open · 4 authors, 3 centres
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This is a protocol for a scoping review that aims to synthesize evidence on the effects of physical activity on coronary heart disease risk factors among firefighters. The review will follow PRISMA-ScR guidelines and search multiple databases for peer-reviewed articles up to November 2021. The findings are intended to inform physical activity guidelines and policy for fire departments.
**Background:** Sudden cardiac events are a leading cause of death and disability among active-duty firefighters in developed countries. Firefighters with increased incidence of coronary heart disease risk factors (CHDRF) have significant personal and occupational functioning impairments and are at risk of cardiac disease. While physical activity interventions have been used for various health conditions, including cardiovascular disease, the literature is still limited regarding the effect of physical activity on coronary heart disease among firefighters. A preliminary search of PROSPERO and MEDLINE found no existing or ongoing scoping or systematic reviews focusing on this research study, highlighting the need to conduct a scoping review on physical activity/exercise for firefighters with CHDRF.
**Methods:** This scoping review will be conducted according to recommendations from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) and the six-stage framework outlined in Arksey and O’Malley. The start date of this study is 1 January 2021 and intention to complete by 31 December 2023. The review will include English full-text peer-reviewed articles from inception to November 2021, inclusive of qualitative, quantitative and mixed-method studies. Studies using secondary data, not peer reviewed, not published in the English language and data from other professionals (e.g., police officers) will be excluded. The search will be performed in the following databases: Cochrane database, PubMed, Medline (EbscoHost), Web of Science, Academic Search Complete, CINAHL (EBSCO), SAGE journals, ScienceDirect and Scopus. Search terms will include: (physical activity OR exercise OR fitness OR physical exercise AND coronary artery disease OR cad OR coronary heart disease OR chd AND firefighters OR fire fighters OR fire service OR firefighting). Screening of titles, abstracts and full text of potential articles will be done by two independent authors using EndNote V.9 software tool. A standardized data extraction form will be designed for the extraction. Two authors will independently extract the data from the selected articles and all differences will be discussed by an invited third reviewer if a consensus cannot be reached. The primary outcomes will be the impact of physical fitness on firefighters experiencing coronary artery disease. Secondary outcomes, such as physiological, psychological, biological and occupational where available, will be recorded. Critical appraisal of articles will be performed using adapted tools from the Critical Appraisal Skill Programme (2014) and the Evaluative Tool for Mixed Method Studies. Rating scales will produce a composite score indicating quality from weak (0–30), moderate (31–65), strong (66–80) and excellent (81–100). The predetermined threshold score for inclusion will be studies within the categories of strong and above. Data will be narratively synthesized and results reported according to the PRISMA flow chart. The proposed date to start analyzing data for this study is 1 April 2023.
**Key Results:** As this is a protocol for a scoping review, no results are reported. The review will provide a synthesis of current evidence on the effects of physical activity on coronary heart disease among firefighters.
**Clinical Implications:** This information can assist policy-makers in decision-making related to the use of physical activity in firefighters experiencing coronary heart disease. The findings will be disseminated through publications and the physical activity guidelines will be submitted to the Fire Departments within the City of Cape Town. The review aims to identify, collate and synthesize results reported in studies impacting coronary artery disease and health risk behaviors among firefighters, potentially leading to firefighter-specific interventions and comprehensive wellness and fitness programs.