The studies objective is to assess the efficacy of hydration education and the use of a self-assessment worksheet vs. a no-intervention control on improving fluid intake and hydration status in underhydrated wildland firefighters (WLFFs) and their surrogates. Part I allows to understand hydration status of the participants (screening phase), Part II confirms if participants indeed are deemed to be low fluid consumers, and Part III of this research is a clinical trial that will focus on the optimization of hydration by improving fluid intake (and as a result lowering urine concentration) allowing participants theoretically to improve exercise performance (acute) and optimize health on the long term.
Enrollment will take place until enough people have been screened and be eligible to be enrolled in PART III of the study. Aside from allowing the investigators to better understand the hydration status of participants in PART I, this part will help to determine potentially eligible participants that can be confirmed through PART II by collecting again a urine sample, and if again concentrated urine is confirmed the research team will take a 5 mL venous blood draw performed by a trained phlebotomist to confirm elevated a copeptin level. These confirmed participants can then be enrolled in PART III of the study when eligible. PART I includes all participants: Two urine samples and questionnaire at one day. Expected duration of 2-3 minutes per urine sample and 2-3 minutes for the participant demographics questionnaire which will also be used as a screener to identify eligibility for PART II and III. PART II includes a smaller sample: Collection of a urine sample and a blood sample at one follow up day for the duration of 10 minutes. PART III, the intervention study (being a clinical trial): Includes n=38 participants, that will invest a maximum of 2 hours and 15 minutes as part of the data collection over a period of 6 days, which includes: * Education session (pre: INT, or post: CON) of 25 minutes. * Consuming labelled water and providing a urine sample and bodyweight the day before the start of the study, 10-15 minutes. * Participate in the study for 6 days (during normal work days) and bodyweight will be measured at day 2, 4 and 6 of the study, during all study days both INT and CON will provide a morning urine sample (and if possible an afternoon/evening sample after work), and during each days sensors will be attached to participants upper arm and gear, 5 minutes per day, 25-30 minutes total. * The intervention group will track its use of the tools we have provided them with, while the other group will not perform any additional self-assessments during the study period, 10 minutes per day 25-50 minutes total. * Final hydration strategy questionnaire for INT and CON, 5-10 minutes. Allocation to INT or CON depends on the total number of participants at different locations that will be eligible. The investigators will try to match participants based on their sex, age and bodyweight, and then randomly assign these matched participants to the intervention or placebo.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
38
Hydration education is a 25-minute session based on the theory of planned behavior, including the instructions how to use a worksheet for hydration self-assessment and materials.
ASU Health Futures Center
Phoenix, Arizona, United States
Fluid turnover
Fluid turnover based on D2O analysis
Time frame: Over a period of 4 days, in two 48-hour segments.
Urine concentration
Urine concentration (osmolality).
Time frame: Afternoon sample day 1, morning sample day 2/4/6
Urine concentration
Urine concentration (USG ) for morning and when available afternoon/evening samples.
Time frame: Afternoon sample day 1, morning (and potential afternoon) samples day 1/2/3/4/5/6.
Activity
Activity pattern using an activity tracker attached to the upper arm to allow comparing activity between INT and CON.
Time frame: Throughout the study during working hours, which may vary between 8-16 hours per working day.
Hydration strategy
Retrospective hydration strategy (questionnaire) of INT and CON.
Time frame: Day 6 of the data collection, covering the hydration strategy during the study period.
Heat stress
Direct experienced environmental heat, measured by a heat sensor mounted on helmet or gear.
Time frame: Throughout the study during working hours, which may vary between 8-16 hours per working day.
INT: Self-reported hydration measures
Self-reported hydration measures in INT only (daily fluid intake in mL).
Time frame: Study days 2/3/4/5/6.
INT: Self-reported hydration measures
Self-reported hydration measures in INT only (urine frequency, number of voids per 24-hour).
Time frame: Study days 2/3/4/5/6.
INT: Self-reported hydration measures
Self-reported hydration measures in INT only (first morning urine volume in mL).
Time frame: Study days 2/3/4/5/6.
INT: Self-reported hydration measures
Self-reported hydration measures in INT only (urine color, assessed on a scale from 1-7 ranging from light to dark).
Time frame: Study days 2/3/4/5/6.
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