Physically and mentally healthy student-athletes are in a good position to thrive academically, socially, and athletically. Unfortunately, many student-athletes fail to get the mental health help they need due to factors such as lack of knowledge and mental health stigma. The purpose of this research was to create and evaluate a multimedia, interactive website (www.SupportForSport.org) to enable studentathletes to gain the necessary knowledge and confidence to make effective mental health referrals. Study 1 was conducted to determine if the website functioned as intended. In Study 2, 27 intercollegiate athletic directors and coaches evaluated the website. Their favorable evaluations led to Study 3, a controlled field trial with a national sample of 153 student-athletes. Results indicated that viewing the www. SupportForSport.org site resulted in enhanced mental health referral knowledge and efficacy relative to a control group. These results suggest that tailored online programming can affect outcomes for student-athletes across geographic regions and resource availability levels.

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Background:Prior reports on metabolic derangements observed in distance running frequently have small sample sizes, lack prerace laboratory measures, and report sodium as the sole measure.Hypothesis:Metabolic abnormalities—hyponatremia, hypokalemia, renal dysfunction, hemoconcentration—are frequent after completing a full or half marathon. Clinically significant changes occur in these laboratory values after race completion.Study Design:Observational, cross-sectional study.Methods:Consenting marathon and half marathon racers completed a survey as well as finger stick blood sampling on race day of the National Marathon to Fight Breast Cancer (Jacksonville, Florida, February 2008). Parallel blood measures were obtained before and after race completion (prerace, n = 161; postrace, n = 195).Results:The prevalence of prerace and postrace hyponatremia was 8 of 161 (5.0%) and 16 of 195 (8.2%), respectively. Hypokalemia was not present prerace but was present in 1 runner postrace (1 of 195). Renal dysfunction occurred prerace in 14 of 161 (8.7%) and postrace in 83 of 195 (42.6%). Among those with postrace renal dysfunction, 45.8% (38 of 83) were classified as moderate or severe. Hemoconcentration was present in 2 of 161 (1.2%) prerace and 6 of 195 (3.1%) postrace. The mean changes in laboratory values were (postrace minus prerace): sodium, 1.6 mmol/L; potassium, −0.2 mmol/L; blood urea nitrogen, 2.8 mg/dL; creatinine, 0.2 mg/dL; and hemoglobin, 0.3 g/dL for 149 pairs (except blood urea nitrogen, n = 147 pairs). Changes were significant for all comparisons (P < 0.01) except potassium (P = 0.08) and hemoglobin (P = 0.01).Conclusions:Metabolic abnormalities are common among endurance racers, and they may be present prerace, including hyponatremia. The clinical significance of these findings is unknown.Clinical relevance:It is unclear which runners are at risk for developing clinically important metabolic derangements. Participating in prolonged endurance exercise appears to be safe in the majority of racers.