About

Mission Statement:

To support peak athletic performance and ensure athlete safety by educating trusted personnel on how to support proper hydration for athletes.

Program Goals:

  1. Increase the knowledge and confidence of athletic trainers, sports physiotherapists, and other trusted personnel who regularly work with athletes about supporting proper hydration habits for athletes.
  2. Improve athlete hydration habits to improve athletic performance and reduce the risk of health issues relating to dehydration, hypohydration, hypernatremia, and hyperkalemia.

Program Objectives

  1. Develop a health promotion program that provides a wide range of information regarding athlete hydration habits, including the impact of beverage choices, how to determine fluid consumption needs based on weather, exercise type, exercise intensity, and sweat rate, motivational factors for improving hydration habits, and additional lifestyle factors that contribute to hydration status.
  2. Assess the outcome of the Hydration Hero educational training program by measuring athlete hydration status before training sessions and competitions before their athletic trainer, sports physiotherapist, coach, or other trusted fitness personnel complete the program and six weeks after.
  3. Increase awareness of the benefits and value of the Hydration Heroes educational training program, leading to long-term increased program participation.

Program Rationale – Why Was the Hydration Heroes Nutrition Education Program Created?

Although the importance of adequate hydration is regularly expressed to athletes, many athletes still enter practices or competitions in a state of hypohydration. Research indicates that a majority (over 50%) of professional, collegiate, high school, and youth athletes arrive at workouts and competitions in a hypohydrated state (McDermott et al., 2017). As an example, considering that even a 2% decrease in dehydration can lead to decreased skill performance, reduced strength, and reduced endurance, this means that six out of twelve basketball players on a given team could derive a significant improvement or a significant decrease in performance based on a small difference in fluid consumption habits (Baker et al., 2007; Judge et al., 2021).

In addition, hyperhydration, or more dangerously, hypernatremia, is also a concern, although data is not available on definitive rates of athletes and hyperhydration. Due to the wide range of athletes who regularly train and compete in a hypohydrated state, the “Hydration Heroes” educational program will target any and all athletic trainers and sports physiotherapists, regardless of the age group or ability level they are working with.

Athletes of all levels can accrue life-long benefits from learning more from their athletic trainer or sports physiotherapist about the benefits of adequately hydrating themselves, and this program aims to bring education to as wide a population range as possible.

It is clear that the current infrastructure for supporting the hydration needs of athletes is inadequate, and the Hydration Heroes Nutrition Education Program aims to close the gap between athletes and acceptable hydration habits.

Hydration is an important concept for athletes as not only does it support adequate performance, but it also prevents health problems ranging from muscle cramps to fainting and death (Nuccio et al., 2017; Oppliger & Bartok, 2002; Whitfield, 2006). The Hydration Heroes Nutrition Education Program will provide significant and long-lasting improvements in the knowledge of athletes about managing hydration through educating athletic trainers and sports physiotherapists, who are trusted sources of knowledge for athletes.

Aspects of the program will include:

  • Best and Worst Beverage Choices for Supporting Hydration
  • Learning How to Determine Fluid Consumption Needs Based on Weather, Exercise Type, Exercise Intensity, Sweat Rate
  • Motivation Factors for Hydration Habits
  • Additional Lifestyle Factors Contributing to Hydration Status

By improving the education of athletic trainers and sports physiotherapists on the subject of hydration, they will have a greater potential to positively impact the knowledge level of every athlete they work with.

Why Doesn’t the Program Target Athletes Directly?

Unlike a nutrition education program that directly targets athletes, this program will affect many more athletes as these athletic trainers and sports physiotherapists will work with new athletes each year. In addition, athletic trainers and sports physiotherapists are a primary target for improving the hydration education of athletes as several research studies have concluded that athletic trainers are a top source of trusted nutrition knowledge for athletes, and there is an ingrained reason to believe that when one of these individuals counsels an athlete, the athlete will make a change in their habits (Klein et al., 2021; Weeden et al., 2014).

Substantial evidence shows that providing additional education to athletic trainers and other individuals in similar roles can produce rapid improvements.

In one study, ten web-based modules were developed to promote knowledge of evidence-based practice use amongst athletic trainers (Welch et al., 2014). Although the research did not assess the effect of the increased knowledge, the educational intervention that utilized ten web-based modules demonstrated to be an effective mechanism for increasing knowledge of foundational, evidence-based practices amongst athletic trainers (Welch et al., 2014).

In another example, the CDC HEADS UP to Athletic Trainers: Online Concussion Training provides education to athletic trainers on concussion protocol (CDC, 2022). The CDC HEADS UP to Athletic Trainers program is only a 120 min online training program, and although it is brief, research has indicated that attitudes about concussion safety, behavioral intentions, and knowledge about concussions increased immediately following completion of the program (Daugherty et al., 2020).

The Hydration Heroes Nutrition Education Program aims to produce similar increases in knowledge, attitudes, and abilities relating to promoting hydration in athletes.

Short term results can be monitored objectively through pre and post-program urine hydration analysis of the players of teams that these athletic trainers and sports physiotherapists work with, but additional benefits to this program will be seen as the athletes should develop positive hydration habits that remain with them for the course of their careers. Furthermore, there are additional ways to monitor the effectiveness of this nutrition education program, such as comparing rates of pre-training or pre-competition hypohydration rates of teams where athletic trainers who have completed the nutrition education program work, compared to those where their trainer has not completed the nutrition education program.

Monitoring the program’s effectiveness with this type of comparison should provide a relatively easy way to determine its effectiveness. The overarching value provided through this nutrition education program is the development of consistently better athletes who are fueled by proper hydration habits. By supporting this nutrition education program, you support the development of athletes in terms of physical and skill ability and support their life-long general health.

Program Theory and Design

The Hydration Heroes Nutrition Education Program was developed to improve athlete hydration habits, improve athletic performance, and reduce health risks associated with poor hydration habits. To accomplish these goals, the Hydration Heroes program is rooted in the values of the social-ecological approach, in that it aims to influence the habits of athletes through increasing the education of a group of people (athlete trainers, sports physiotherapists, fitness coaches, etc.) that are seen as a trusted source of information for the athletes.

In other words, the Hydration Heroes program influences the social context of the athlete’s lives to improve their athletic performances and health (McKenzie et al., 2017, p. 155).

Additionally, the Hydration Heroes Nutrition Education Program is based on the Theory of Planned Behavior for its goals of educating the trusted fitness personnel, as the program understands these individuals likely will have a reasoned approach to providing hydration knowledge to athletes and further education will provide immediate improvements to the advice they provide (McKenzie et al., 2017, p. 160).

Program Format

The Hydration Heroes Nutrition Education Program will consist of eight weekly, one-hour synchronous online educational sessions on the Zoom platform, accompanied by additional asynchronous educational resources. Participants will begin the educational training program with a test to determine baseline knowledge of various aspects relating to hydration and athletes, including the impact of beverage choices, how to determine fluid consumption needs based on weather, exercise type, exercise intensity, and sweat rate, motivational factors for improving hydration habits, and more.

Each weekly educational lesson will focus on a specific aspect of hydration and athletes. Weekly lessons will include a 45-minute seminar, in which the goal will be direct increases in knowledge about topics relating to hydration and athlete. Additionally, each weekly lesson will include a 15-minute question and answer session to engage participants and further the week’s lesson with additional applications to real-world scenarios.

The initial training program will undergo pilot testing with a group of twenty athletic trainers and sports physiotherapists. The pilot testing program will scrutinize the program’s educational content, analyze the program’s educational value, and determine whether the program will produce statistically significant improvements in knowledge, self-efficacy, confidence, and attitude towards providing education for athletes about hydration needs.

Internal evaluation will test the knowledge about the impact of beverage choices, how to determine fluid consumption needs based on weather, exercise type, exercise intensity, and sweat rate, motivational factors for improving hydration habits, and other aspects of hydration for athletes. In addition, the internal evaluation will avoid issues of bias or conflicts of interest by providing direct documentation of pre-program and post-program results.

References

Baker, L. B., Dougherty, K. A., Chow, M., & Kenney, W. L. (2007). Progressive dehydration causes a progressive decline in basketball skill performance. Medicine & Science in Sports & Exercise, 39(7), 1114–1123. https://doi.org/10.1249/mss.0b013e3180574b02

CDC. (2022, February 9). HEADS UP to Athletic Trainers: Online Concussion Training | HEADS UP | CDC Injury Center. Www.cdc.gov. https://www.cdc.gov/headsup/athletictrainers/training/index.html

Daugherty, J., DePadilla, L., & Sarmiento, K. (2020). Assessment of HEADS UP online training as an educational intervention for sports officials/athletic trainers. Journal of Safety Research, 74, 133–141. https://doi.org/10.1016/j.jsr.2020.04.015

Judge, L. W., Bellar, D. M., Popp, J. K., Craig, B. W., Schoeff, M. A., Hoover, D. L., Fox, B., Kistler, B. M., & Al-Nawaiseh, A. M. (2021). Hydration to maximize performance and recovery: knowledge, attitudes, and behaviors among collegiate track and field throwers. Journal of Human Kinetics, 79(1), 111–122. https://doi.org/10.2478/hukin-2021-0065

Klein, D. J., Eck, K. M., Walker, A. J., Pellegrino, J. K., & Freidenreich, D. J. (2021). Assessment of sport nutrition knowledge, dietary practices, and sources of nutrition information in ncaa division III collegiate athletes. Nutrients, 13(9), 2962. https://doi.org/10.3390/nu13092962

McDermott, B. P., Anderson, S. A., Armstrong, L. E., Casa, D. J., Cheuvront, S. N., Cooper, L., Kenney, W. L., O’Connor, F. G., & Roberts, W. O. (2017). National athletic trainers’ association position statement: fluid replacement for the physically active. Journal of Athletic Training, 52(9), 877–895. https://doi.org/10.4085/1062-6050-52.9.02

McKenzie, J., Neiger, B., & Thackeray, R. (2017). Planning, implementing, and evaluating health promotion programs: A primer (7th ed.). Pearson/Benjamin Cummings.

Nuccio, R. P., Barnes, K. A., Carter, J. M., & Baker, L. B. (2017). Fluid balance in team sport athletes and the effect of hypohydration on cognitive, technical, and physical performance. Sports Medicine, 47(10), 1951–1982. https://doi.org/10.1007/s40279-017-0738-7

Oppliger, R. A., & Bartok, C. (2002). Hydration testing of athletes. Sports Medicine, 32(15), 959–971. https://doi.org/10.2165/00007256-200232150-00001

Weeden, A.M., Olsen, J., Batacan, J.M., & Peterson, T. (2014). Differences in collegiate athlete nutrition knowledge as determined by athlete characteristics. The sport journal, 17.

Welch, C. E., Van Lunen, B. L., & Hankemeier, D. A. (2014). An evidence-based practice educational intervention for athletic trainers: A randomized controlled trial. Journal of Athletic Training, 49(2), 210–219. https://doi.org/10.4085/1062-6050-49.2.13

Whitfield A. H. (2006). Too much of a good thing? The danger of water intoxication in endurance sports. The British journal of general practice : the journal of the Royal College of General Practitioners, 56(528), 542–545.