Table 4.

Evidence-Based Best Practices for Environment-Based Activity Modification Policies in Secondary School Athletics^15,19

No.	Recommendation	No. (%) of States Meeting Recommendations
1W	State requires all schools to have a heat modification policy.	27 (53)
2W	The recommended heat policy is based on wet-bulb globe temperature (optimal method of measure) or heat index (adequate method of measure).	25 (49)
3W	The environmental conditions guidelines are based on epidemiologic data specific to that state/region (for bigger states, a more comprehensive analysis may be needed).	8 (16)
4W	The heat policy has at minimum 4 levels of modification, including the modification of practice time.	19 (37)
5W	Policy includes modification of equipment (if applicable to the sport).	20 (39)
6W	Policy includes modification of work : rest ratios, including unrestricted access to fluids.	19 (37)
7W	Policy mentions the use of a shaded area for rest breaks.	6 (12)