Dataset Information

Exertional Heat Illness Preparedness Strategies: Environmental Monitoring Policies in United States High Schools.

ABSTRACT: Background and objectives: Environmental monitoring allows for an analysis of the ambient conditions affecting a physically active person's ability to thermoregulate and can be used to assess exertional heat illness risk. Using public health models such as the precaution adoption process model (PAPM) can help identify individual's readiness to act to adopt environmental monitoring policies for the safety of high school athletes. The purpose of this study was to investigate the adoption of policies and procedures used for monitoring and modifying activity in the heat in United States (US) high schools. Materials and Methods: Using a cross-sectional design, we distributed an online questionnaire to athletic trainers (ATs) working in high schools in the US. The questionnaire was developed based on best practice standards related to environmental monitoring and modification of activity in the heat as outlined in the 2015 National Athletic Trainers' Association Position Statement: Exertional Heat Illness. The PAPM was used to frame questions as it allows for the identification of ATs' readiness to act. PAPM includes eight stages: unaware of the need for the policy, unaware if the school has this policy, unengaged, undecided, decided not to act, decided to act, acting, and maintaining. Invitations were sent via email and social media and resulted in 529 complete responses. Data were aggregated and presented as proportions. Results: Overall, 161 (161/529, 30.4%) ATs report they do not have a written policy and procedure for the prevention and management of exertional heat stroke. The policy component with the highest adoption was modifying the use of protective equipment (acting = 8.2%, maintaining = 77.5%). In addition, 28% of ATs report adoption of all seven components for a comprehensive environmental monitoring policy. Conclusions: These findings indicate a lack of adoption of environmental monitoring policies in US high schools. Secondarily, the PAPM, facilitators and barriers data highlight areas to focus future efforts to enhance adoption.

SUBMITTER: Scarneo-Miller SE

PROVIDER: S-EPMC7597963 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Exertional Heat Illness Preparedness Strategies: Environmental Monitoring Policies in United States High Schools.

Scarneo-Miller Samantha E SE Belval Luke N LN Yeargin Susan W SW Hosokawa Yuri Y Kerr Zachary Y ZY Casa Douglas J DJ

Medicina (Kaunas, Lithuania) 20200923 10

<i>Background and objectives:</i> Environmental monitoring allows for an analysis of the ambient conditions affecting a physically active person's ability to thermoregulate and can be used to assess exertional heat illness risk. Using public health models such as the precaution adoption process model (PAPM) can help identify individual's readiness to act to adopt environmental monitoring policies for the safety of high school athletes. The purpose of this study was to investigate the adoption of ...[more]

PMID: 32977387

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Project description:BackgroundThe risk of heat-related illness and death may continue to increase in many locations as a consequence of climate change, but information on the effectiveness of policies to protect populations from the adverse effects of excessive heat is limited. In 2009, the National Athletic Trainers' Association Inter-Association Task Force (NATA-IATF) released guidelines to reduce exertional heat illness (EHI) among U.S. high school athletes participating in preseason sports activities, including preseason practice sessions for American football. A subset of state high school athletic associations have implemented state-mandated guidelines consistent with the 2009 NATA-IATF recommendations, but their effectiveness for reducing preseason EHI is unknown.ObjectivesThis study examines the association between the enactment of state high school athletic association-mandated NATA-IATF guidelines and the rate of EHI among high school students during preseason American football practice sessions.MethodsWe performed a quasi-experimental interrupted time-series study of EHI during high school American football practices in the 2005/2006-2016/2017 school years. We estimated state-level EHI rates using High School Reporting Information Online injury and athlete-exposure data, and used generalized estimating equations Poisson regression models to estimate incidence rate ratios (IRRs) and 95% confidence intervals (CIs) comparing state-years with and without mandated NATA-IATF guidelines. State-level covariates included state-year-specific average August temperatures, yearly deviations from each state's August average temperature across the study period, and school year.ResultsData were available for 455 state-years from 48 states, including 32 state-years (7.0%) from 8 states when mandated guidelines consistent with the NATA-IATF recommendations were implemented. During an estimated 2,697,089 athlete-exposures, 190 EHIs were reported. Estimated preseason EHI rates were lower during state-years with versus without mandated guidelines (adjusted [Formula: see text], 95% CI: 0.23, 0.87).ConclusionsOur findings suggest that high school athletes would benefit from enactment of the 2009 NATA-IATF guidelines. Similar analyses of the effectiveness of other public health policies to reduce adverse health effects from ambient heat are warranted. https://doi.org/10.1289/EHP4163.

Project description:BackgroundBest practice recommendations for sports-related emergency preparation include implementation of venue-specific emergency action plans (EAPs), access to early defibrillation, and first responders-specifically coaches-trained in cardiopulmonary resuscitation and automated external defibrillator (AED) use. The objective was to determine whether high schools had implemented these 3 recommendations and whether schools with a certified athletic trainer (AT) were more likely to have done so.HypothesisSchools with an AT were more likely to have implemented the recommendations.Study designCross-sectional study.Level of evidenceLevel 4.MethodsAll Oregon School Activities Association member school athletic directors were invited to complete a survey on sports-related emergency preparedness and AT availability at their school. Chi-square and Fisher exact tests were used to analyze the associations between emergency preparedness and AT availability.ResultsIn total, 108 respondents (37% response rate) completed the survey. Exactly half reported having an AT available. Only 11% (95% CI, 6%-19%) of the schools had implemented all 3 recommendations, 29% (95% CI, 21%-39%) had implemented 2, 32% (95% CI, 24%-42%) had implemented 1, and 27% (95% CI, 19%-36%) had not implemented any of the recommendations. AT availability was associated with implementation of the recommendations (χ2 = 10.3, P = 0.02), and the proportion of schools with ATs increased with the number of recommendations implemented (χ2 = 9.3, P < 0.01). Schools with an AT were more likely to implement venue-specific EAPs (52% vs 24%, P < 0.01) and have an AED available for early defibrillation (69% vs 44%, P = 0.02) but not more likely to require coach training (33% vs 28%, P = 0.68).ConclusionsDespite best practice recommendations, most schools were inadequately prepared for sports-related emergencies. Schools with an AT were more likely to implement some, but not all, of the recommendations. Policy changes may be needed to improve implementation.Clinical relevanceMost Oregon high schools need to do more to prepare for sports-related emergencies. The results provide evidence for sports medicine professionals and administrators to inform policy changes that ensure the safety of athletes.

Project description:IntroductionChildren are one of the most vulnerable groups in disasters. Improving students' knowledge and skills to prepare for disasters can play a major role in children's health. School as a place to teach children can make a significant contribution to provide the necessary skills. This study aims to identify the effects, strengths and weaknesses of interventions in schools to prepare children for disasters.Methods and analysisWe use Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to develop a protocol for this systematic review. The included studies will report on the results of interventions targeting 'schoolchildren' defined as individuals between 4 and under 18 years old studying in schools. Different electronic databases will be used for a comprehensive literature search, including MEDLINE, Web of Science, CINAHL, PsycINFO, Cochrane Register of Controlled Trials and EMBASE to identify the records that match the mentioned inclusion criteria published till December 2020. The main search terms are 'disaster', 'preparedness', 'children' and 'school'. Four types of data will be extracted from the qualified studies including study characteristics (study design, year of publication and geographical region where the study was conducted), participant characteristics (sample size, age and gender), intervention characteristics (aim of intervention, intervention facilitators and barriers) and intervention outcomes. The quality appraisal of the selected papers will be conducted using Cochrane Collaboration's Risk of Bias for quantitative studies and Critical Appraisal Skills Programme checklist for qualitative studies. We use a narrative synthesis for this systematic review. The narrative synthesis refers to an approach to systematic reviews which focuses mostly on applying words and texts to summarise and explain findings.Ethics and disseminationThis paper is a part of a Ph.D. thesis of Hamed Seddighi at University of Social welfare and Rehabilitation Sciences with ethics code IR.USWR.REC.1399.008 approved by the Ethics Committee of the above-mentioned university.Prospero registration numberCRD42020146536.

Dataset Information

Exertional Heat Illness Preparedness Strategies: Environmental Monitoring Policies in United States High Schools.

Publications

Exertional Heat Illness Preparedness Strategies: Environmental Monitoring Policies in United States High Schools.

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