Impact of Organizational-level Factors on Cancer Screening Activities in Fire Departments: A Cross-sectional Study from the Sylvester Firefighter Cancer Initiative

Despite known individual-level facilitators of cancer screening, the impact of work-related organizational-level characteristics on cancer screening is unknown particularly in the firefighter workforce who is experiencing a disproportionate burden of cancer. We examine the association between fire service organizational-level factors and implementation of cancer screening activities within Florida fire departments. We used a cross-sectional observational study design to survey fire department leaders attending the Florida Fire Chiefs' Association Health and Safety conference about cancer screening activities implemented by their fire departments. Measures assessing organizational-level characteristics include: fire department workforce size, total health and safety officers, fire department geographic location, employment type, leadership support and capacity. Among the 126 fire departments participating (response rate = 47.7%), approximately 44% reported some type of cancer screening activity in the 12 months prior to survey administration. The proportion of fire departments with two or more health and safety officers was significantly greater among those with cancer screening activities as compared with departments without cancer screening activities (46.3% vs. 24.2%; P = 0.016). There were no statistical differences noted for cancer screening activities among all other organizational-level characteristics including workforce size, fire department geographic location, employment type, leadership support, and individual capacity measures. Most organizational-level characteristics of a fire department evaluated in this study were not associated with cancer screening activities; however, having two or more dedicated health and safety officers supports the delivery of cancer screening activities. These officers may be a key to improving availability of cancer screening activities at work.