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Regional Requirements Influence Adoption of Exertional Heat Illness Preparedness Strategies in United States High Schools

Background and objectives: Exertional heat stroke (EHS) continues to be a prevalent health issue affecting all athletes, including our pediatric populations. The purpose of this study was to evaluate the effect of a state policy requirement for EHS prevention and treatment on local high school polic...

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Autores principales: Scarneo-Miller, Samantha E., Saltzman, Benjamin, Adams, William M., Casa, Douglas J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7598211/
https://www.ncbi.nlm.nih.gov/pubmed/32977447
http://dx.doi.org/10.3390/medicina56100488
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author Scarneo-Miller, Samantha E.
Saltzman, Benjamin
Adams, William M.
Casa, Douglas J.
author_facet Scarneo-Miller, Samantha E.
Saltzman, Benjamin
Adams, William M.
Casa, Douglas J.
author_sort Scarneo-Miller, Samantha E.
collection PubMed
description Background and objectives: Exertional heat stroke (EHS) continues to be a prevalent health issue affecting all athletes, including our pediatric populations. The purpose of this study was to evaluate the effect of a state policy requirement for EHS prevention and treatment on local high school policy adoption in the United States (US). Materials and Methods: Athletic trainers (ATs) from high schools across the US participated in an online survey (n = 365). This survey inquired about their compliance with nine components of an EHS policy which was then compared to their state requirements for the policies. Evaluation of the number of components adopted between states with a requirement versus states without a requirement was conducted with a Wilcoxon Sign Rank test. Finally, an ordinal logistic regression with proportional odds ratios (OR) with 95% confidence intervals (CI) were run to determine the effect of a state requirement and regional differences on the number of components adopted. Results: ATs working in states with a requirement reported adoption of more components in their heat modification policy compared to states that did not require schools to develop a heat modification policy (with requirement mean = 5.34 ± 3.68, median = 7.0; without requirement mean = 4.23 ± 3.59, median = 5.0; Z = −14.88, p < 0.001). ATs working in region 3 (e.g., hotter regions) reported adopting more components than those in region 1 (e.g., cooler regions) (OR = 2.25, 95% CI: 1.215–4.201, p = 0.010). Conclusions: Our results demonstrate a positive association between state policy requirements and subsequently increased local policy adoption for EHS policies. Additionally, the results demonstrate that regional differences exist, calling for the need for reducing disparities across the US. These findings may imply that policy adoption is a multifactorial process; furthermore, additional regional specific investigations must be conducted to determine the true determinants of high school policy adoption rates for EHS policies.
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spelling pubmed-75982112020-10-31 Regional Requirements Influence Adoption of Exertional Heat Illness Preparedness Strategies in United States High Schools Scarneo-Miller, Samantha E. Saltzman, Benjamin Adams, William M. Casa, Douglas J. Medicina (Kaunas) Review Background and objectives: Exertional heat stroke (EHS) continues to be a prevalent health issue affecting all athletes, including our pediatric populations. The purpose of this study was to evaluate the effect of a state policy requirement for EHS prevention and treatment on local high school policy adoption in the United States (US). Materials and Methods: Athletic trainers (ATs) from high schools across the US participated in an online survey (n = 365). This survey inquired about their compliance with nine components of an EHS policy which was then compared to their state requirements for the policies. Evaluation of the number of components adopted between states with a requirement versus states without a requirement was conducted with a Wilcoxon Sign Rank test. Finally, an ordinal logistic regression with proportional odds ratios (OR) with 95% confidence intervals (CI) were run to determine the effect of a state requirement and regional differences on the number of components adopted. Results: ATs working in states with a requirement reported adoption of more components in their heat modification policy compared to states that did not require schools to develop a heat modification policy (with requirement mean = 5.34 ± 3.68, median = 7.0; without requirement mean = 4.23 ± 3.59, median = 5.0; Z = −14.88, p < 0.001). ATs working in region 3 (e.g., hotter regions) reported adopting more components than those in region 1 (e.g., cooler regions) (OR = 2.25, 95% CI: 1.215–4.201, p = 0.010). Conclusions: Our results demonstrate a positive association between state policy requirements and subsequently increased local policy adoption for EHS policies. Additionally, the results demonstrate that regional differences exist, calling for the need for reducing disparities across the US. These findings may imply that policy adoption is a multifactorial process; furthermore, additional regional specific investigations must be conducted to determine the true determinants of high school policy adoption rates for EHS policies. MDPI 2020-09-23 /pmc/articles/PMC7598211/ /pubmed/32977447 http://dx.doi.org/10.3390/medicina56100488 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Scarneo-Miller, Samantha E.
Saltzman, Benjamin
Adams, William M.
Casa, Douglas J.
Regional Requirements Influence Adoption of Exertional Heat Illness Preparedness Strategies in United States High Schools
title Regional Requirements Influence Adoption of Exertional Heat Illness Preparedness Strategies in United States High Schools
title_full Regional Requirements Influence Adoption of Exertional Heat Illness Preparedness Strategies in United States High Schools
title_fullStr Regional Requirements Influence Adoption of Exertional Heat Illness Preparedness Strategies in United States High Schools
title_full_unstemmed Regional Requirements Influence Adoption of Exertional Heat Illness Preparedness Strategies in United States High Schools
title_short Regional Requirements Influence Adoption of Exertional Heat Illness Preparedness Strategies in United States High Schools
title_sort regional requirements influence adoption of exertional heat illness preparedness strategies in united states high schools
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7598211/
https://www.ncbi.nlm.nih.gov/pubmed/32977447
http://dx.doi.org/10.3390/medicina56100488
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