Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jan-Feb;16(1):58-69.
doi: 10.1177/19417381231155107. Epub 2023 Mar 5.

Exertional Heat Illness: Adoption of Policies and Influencing Contextual Factors as Reported by Athletic Administrators

Samantha E Scarneo-Miller  1 , William M Adams  2   3 , Kelly A Coleman  4 , Rebecca M Lopez  5
Affiliations

Exertional Heat Illness: Adoption of Policies and Influencing Contextual Factors as Reported by Athletic Administrators

Samantha E Scarneo-Miller et al. Sports Health. 2024 Jan-Feb.

Abstract

Background: Little is known about the adoption by athletic administrators (AAs) of exertional heat illness (EHI) policies, and the corresponding facilitators and barriers of such policies within high school athletics. This study describes the adoption of comprehensive EHI policies by high school AAs and explores factors influencing EHI policy adoption.

Hypothesis: We hypothesized that <50% of AAs would report adoption of an EHI policy, and that the most common facilitator would be access to an athletic trainer (AT), whereas the most common barrier would be financial limitations.

Study design: Cross-sectional.

Level of evidence: Level 4.

Methods: A total of 466 AAs (82.4% male; age, 48 ± 9 years) completed a validated online survey to assess EHI prevention and treatment policy adoption (11 components), as well as facilitators and barriers to policy implementation. Access to athletic training services was ascertained by matching the participants' zip codes with the Athletic Training Locations and Services Project. Policy adoption, facilitators, and barriers data are presented as summary statistics (proportions, interquartile range (IQR)). A Welch t test evaluated the association between access to athletic training services and EHI policy adoption.

Results: Of the AAs surveyed, 77.9% (n = 363) reported adopting a written EHI policy. The median of EHI policy components adopted was 5 (IQR = 1,7), with only 5.6% (n = 26) of AAs reporting adoption of all policy components. AAs who had access to an AT (P = 0.04) were more likely to adopt a greater number of EHI-related policies, compared with those without access to an AT. An AT employed at the school was the most frequently reported facilitator (36.9%).

Conclusion: Most AAs reported having written EHI policy components, and access to an AT resulted in a more comprehensive policy.

Clinical relevance: Employment of an AT within high school athletics may serve as a vital component in facilitating the adoption of comprehensive EHI policies.

Keywords: diagnosis; exertional heat stroke; high school; precaution adoption process model; treatment.

PubMed Disclaimer

Conflict of interest statement

The following authors declared potential conflicts of interest: S.E.S-M. received a grant from the Eastern Athletic Trainers’ Association, gave expert testimonies in legal cases pertaining to sport-related death, has grants pending with the NIH relating to work, and was a guest speaker at state and national meetings. W.M.A. received royalties from Springer Nature for an edited textbook.

Figures

Figure 1.
Figure 1.
Number of components of an EHI policy adopted (0-11 components, median = 5; IQR = 1,7). EHI, exertional heat illness; IQR, interquartile range.
See this image and copyright information in PMC

References

    1. Athletic Training Locations and Services (ATLAS Project). Korey Stringer Institute. https://ksi.uconn.edu/atlas/. Accessed February 15, 2022.
    1. Belval LN, Casa DJ, Adams WM, et al. Consensus statement - prehospital care of exertional heat stroke. Prehosp Emerg Care. 2018;22(3):392-397. - PubMed
    1. Casa DJ, Almquist J, Anderson SA, et al. The inter-association task force for preventing sudden death in secondary school athletics programs: best-practices recommendations. J Athl Train. 2013;48(4):546-553. - PMC - PubMed
    1. Casa DJ, DeMartini JK, Bergeron MF, et al. National Athletic Trainers’ Association position statement: exertional heat illnesses. J Athl Train. 2015;50(9):986-1000. - PMC - PubMed
    1. Cooper ER, Grundstein AJ, Miles JD, et al. Heat policy revision for Georgia high school football practices based on data-driven research. J Athl Train. 2020;55(7):673-681. - PMC - PubMed