Scarneo-Miller Samantha E, Saltzman Benjamin, Adams William M, Casa Douglas J
Division of Athletic Training, School of Medicine, West Virginia University, Morgantown, WV 26508, USA.
Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA.
Medicina (Kaunas). 2020 Sep 23;56(10):488. doi: 10.3390/medicina56100488.
: 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). : Athletic trainers (ATs) from high schools across the US participated in an online survey ( = 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. : 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; = -14.88, < 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, = 0.010). : 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.
劳力性热射病（EHS）仍然是一个普遍存在的健康问题，影响着所有运动员，包括我们的儿童群体。本研究的目的是评估一项关于EHS预防和治疗的州政策要求对美国当地高中政策采纳情况的影响。：来自美国各地高中的运动训练师（ATs）参与了一项在线调查（n = 365）。该调查询问了他们对EHS政策九个组成部分的遵守情况，然后将其与该政策的州要求进行比较。使用Wilcoxon符号秩检验对有要求的州和无要求的州之间采纳的组成部分数量进行评估。最后，进行了具有比例优势比（OR）和95%置信区间（CI）的有序逻辑回归，以确定州要求和地区差异对采纳的组成部分数量的影响。：与那些不要求学校制定热调节政策的州相比，在有要求的州工作的ATs报告称，他们在热调节政策中采纳了更多的组成部分（有要求的州，均值 = 5.34 ± 3.68，中位数 = 7.0；无要求的州，均值 = 4.23 ± 3.59，中位数 = 5.0；Z = -14.88，P < 0.001）。在第3地区（例如，较炎热地区）工作的ATs报告称，他们采纳的组成部分比第1地区（例如，较凉爽地区）的ATs更多（OR = 2.25，95% CI：1.215 - 4.201，P = 0.010）。：我们的结果表明，州政策要求与随后当地对EHS政策采纳率的提高之间存在正相关。此外，结果表明存在地区差异，这就需要减少美国各地的差距。这些发现可能意味着政策采纳是一个多因素过程；此外，必须进行更多针对特定地区的调查，以确定高中EHS政策采纳率的真正决定因素。
