Pilot Implementation of a Heat Illness Prevention Program in the Southeastern US

Objective: To evaluate the ease of application of a heat illness prevention program (HIPP). Design: A mixed-method research design was used: questionnaire and semi-structured interview. Setting: Eleven South Florida high schools in August (mean ambient temperature=84.0°F, mean relative humidity=69.5%) participated in the HIPP. Participants: Certified Athletic Trainers (AT) (n=11; age=22.2+1.2yr; 63.6% female, 36.4% male; 63.6%) implemented the HIPP with their football athletes which included a pre-screening tool, the Heat Illness Index Score- Risk Assessment. Data Collection and Analysis: Participants completed a 17-item questionnaire, 4 of which provided space for open-ended responses. Additionally, semi-structured interviews were voice recorded, and separately transcribed. Results: Three participants (27.7%) were unable to implement the HIPP with any of their athletes. Of the 7 participants (63.6%) who implemented the HIPP to greater than 50% of their athletes, a majority reported that the HIPP was difficult (54.5%) or exceedingly difficult (18.2%) to implement. Lack of appropriate instrumentation (81.8%, n=9/11), lack of coaching staff/administrative support (54.5%, n=6/11), insufficient support staff (54.5%, n=6/11), too many athletes (45.5%, n=5/11), and financial restrictions (36.4%, n=4/11) deterred complete implementation of the HIPP. Conclusions: Because AT in the high school setting often lack the resources, time, and coaches’ support to identify risk factors, predisposing athletes to exertional heat Illnesses (EHI) researchers should develop and validate a suitable screening tool. Further, ATs charged with the health care of high school athletes should seek out prevention programs and screening tools to identify high-risk athletes and monitor athletes throughout exercise in extreme environments.