Context Little is known about how educating runners may correct common misconceptions surrounding heat safety and hydration strategies. Objective To investigate (1) beliefs and knowledge about heat safety and hydration strategies among recreational runners and (2) the effectiveness of an educational video in optimizing performance in the heat. Design Cross-sectional study. Setting Survey. Patients or Other Participants A total of 2091 (25.1%) of 8319 runners registered for the 2017 Falmouth Road Race completed at least 1 of the 3 administered surveys. Intervention(s) A 5.3-minute video and an 11-question survey regarding heat safety and hydration strategies were developed, validated, and implemented. The survey was e-mailed to registrants 9 weeks before the race (PRERACE), after they viewed the video (POSTEDU), and the afternoon of the race (POSTRACE). Main Outcome Measure(s) The total score for responses to 2 multiple choice questions and nine 5-point (response range = strongly agree to strongly disagree) Likert-scale questions. Results The PRERACE results showed that more than 90% of respondents recognized the importance of staying hydrated beginning the day before the planned activity, correctly identified that dark color urine is not a sign of euhydration, and believed that dehydration may increase the risk for heat syncope. Conversely, fewer than 50% of respondents knew the number of days required to achieve heat acclimatization, the role of sweat-rate calculation in optimizing one's hydration strategy, or the risk of water intoxication from drinking too much water. An improvement in survey score from PRERACE to POSTEDU was observed (mean difference = 2.00; 95% confidence interval = 1.68, 2.33; P < .001) among runners who watched the video, and 73% of the improvement in their scores was retained from POSTEDU to POSTRACE (mean difference = -0.54; 95% confidence interval = -0.86, -0.21; P < .001). Conclusions The video successfully shifted runners' beliefs and knowledge to enable them to better optimize their performance in the heat.
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