BackgroundEducation Outside the Classroom (EOTC) is a teaching method that aims to promote schoolchildren’s learning, physical activity (PA), social relations, motivation, and well-being. EOTC activities are characterized by teachers using the local environment in their teaching, and involve innovative teaching methods, child-led approaches to problem-solving, experimentation, cooperation, PA, and play. EOTC has become common practice for many teachers in Scandinavia; however, only case studies have evaluated its impacts.The TEACHOUT study aims to evaluate the impacts of EOTC on Danish schoolchildren’s PA, social relations, motivation, well-being, and learning.MethodsTEACHOUT is a quasi-experimental, cross-disciplinary study. Sixteen schools participated, containing 19 EOTC school classes and 19 parallel non-EOTC classes, with a total of 834 children aged 9 to 13 years. Measures of the children’s social relations, motivation for school, well-being, and academic performance were collected at the beginning and end of the school year. Data on PA levels were collected over ten-day periods during the school year using accelerometers. The amount and characteristics of the actual EOTC provided in both EOTC and non-EOTC classes were monitored day-to-day throughout the school year, using an online teacher survey platform. The effects of EOTC are mainly analysed by comparing EOTC pupils to non-EOTC (i.e. control) pupils based on their scores on the outcome variables (i.e. school performance, well-being, motivation, and social relations) at the end of the school year, adjusting for the baseline values (from the beginning of the year). The impacts of EOTC on PA are evaluated by comparing the total as well as context-specific amounts of PA of children participating in EOTC to those of children in their parallel non-EOTC classes. Furthermore, the interdependencies between PA, social relations, well-being, motivation, and learning are explored using path analysis. To help describe and understand the processes that have led to the quantitative outcomes, qualitative case observations of children’s practices and interactions in EOTC as well as classroom teaching were carried out and combined with qualitative interviews about children’s perceptions of these practices.DiscussionThe TEACHOUT study represents a holistic multidisciplinary approach to educational and school health-promotion research through its study design and combination of scientific disciplines and methods, as well as its focus on the interdependent relations between learning, PA, social relations, well-being, and motivation. This will result in a comprehensive picture of school health promotion and children’s health and well-being, which will broaden the understanding of the potential benefits of EOTC in school health promotion and primary education. These results can be used to inform and guide future policy and practice.

BackgroundEducation outside the classroom (EOtC) is a curriculum-based approach to teaching that has shown positive associations with children’s physical activity and academic learning in small-scale case studies. The purpose of this large-scale quasi-experimental study was to determine if children who participate regularly in EOtC spend more time being physically active than children who do not.MethodsIn the 2014/2015 study TEACHOUT, classes were recruited in pairs such that each EOtC class had a non-EOtC comparison class at the same school and grade level. Participants in 17 EOtC classes and 16 comparison parallel classes across Denmark wore an Axivity AX3 accelerometer taped to the lower back for seven consecutive days. Data from 201 EOtC participants (63.3% girls, age 10.82 ± 1.05,) and 160 comparison participants (59.3% girls, age 10.95 ± 1.01) were analysed using an ‘intention to treat’ (ITT) approach. The amount of EOtC the participants were exposed to was monitored. Associations between time spent in different physical activity intensities and EOtC group and sex were assessed using generalised linear models adjusted for age. In a second analysis, we modified the sample using a ‘per protocol’ (PP) approach, only including EOtC and comparison class pairs where the EOtC class had >150 min and the comparison had <150 min of EOtC during the measured week.ResultsOn average, EOtC participants spent 8.4 (ITT) and 9.2 (PP) minutes more in moderate-to-vigorous physical activity (MVPA) per day than comparison participants (p < 0.05). However, EOtC boys spent 18.7 (ITT) and 20.8 (PP) minutes more in MVPA per day than comparison boys (p < 0.01), while there were no significant between-group differences for girls.ConclusionsFor boys, EOtC was associated with more daily time being spent moderately and vigorously physically active. No differences were observed for girls. Implementing EOtC into schools’ weekly practice can be a time- and cost-neutral, supplementary way to increase time spent in PA for boys through grades three to six.Trial registrationThe Scientific Ethical Committee in the Capital Region of Denmark protocol number H-4-2014-FSP. 5 March, 2014.

PurposeThe aim of the present study was to examine the convergent validity of two commonly-used accelerometers for estimating time spent in various physical activity intensities in adults.MethodsThe sample comprised 37 adults (26 males) with a mean (SD) age of 37.6 (12.2) years from San Diego, USA. Participants wore ActiGraph GT3X+ and Actical accelerometers for three consecutive days. Percent agreement was used to compare time spent within four physical activity intensity categories under three counts per minute (CPM) threshold protocols: (1) using thresholds developed specifically for each accelerometer, (2) applying ActiGraph thresholds to regression-rectified Actical CPM data, and (3) developing new ‘optimal’ Actical thresholds.ResultsUsing Protocol 1, the Actical estimated significantly less time spent in light (-16.3%), moderate (-2.8%), and vigorous (-0.4%) activity than the ActiGraph, but greater time spent sedentary (+20.5%). Differences were slightly more pronounced when the low frequency extension filter on the ActiGraph was enabled. The two adjustment methods (Protocols 2 and 3) improved agreement in this sample.ConclusionsOur findings show that ActiGraph and Actical accelerometers provide significantly different estimates of time spent in various physical activity intensities. Regression and threshold adjustment were able to reduce these differences, although some level of non-agreement persisted. Researchers should be aware of the inherent limitations of count-based physical activity assessment when reporting and interpreting study findings.

BackgroundMovement integration (MI) into traditional classroom teaching is a promising opportunity for children to increase physical activity (PA). Education outside the classroom (EOtC) can be regarded as MI, and has increased children’s PA in case studies. The aim of this study is to investigate the effects of EOtC on children’s PA by segmenting weekly activity-related behavior into a range of day types and domains.MethodsIn a quasi-experimental design, 33 classes were recruited and participants’ PA was objectively measured using accelerometers taped to the lower back. In total, 361 (10.89 ± 1.03 years) participants with 7 days of 24 h wear time per day were included in a day type PA analysis, and 194 of these participants (10.46 ± 0.99 years) provided information on time spent in specific domains (e.g. EOtC or recess) and were included in a domain-specific PA analysis. Differences in proportion of time spent in PA intensities were tested using mixed-effects regression models.ResultsMore moderate-to-vigorous physical activity (MVPA) occurred on days with physical education (PE) than days with EOtC (girls 0.79%, p = .001, CI = .26% to 1.31%; boys 1.35%, p = .003, CI = .32% to 2.38%), while no difference was found between EOtC days and school days without EOtC and PE. Light physical activity (LPA) was higher on EOtC days than school days without EOtC and PE (girls 2.43% p < .001, CI = 1.21% to 3.65%; boys 2.08%, p < .001, CI = .69% to 3.47%) and PE days (girls 2.18%, p < .001, CI = .80% to 3.56%; boys 2.40%, p < .001, CI = .83% to 3.96%). Comparing EOtC and classroom domains, boys proportionally spent 7.95% (p < .001, CI = 3.00% to 12.90%) more time in MVPA while no difference (p = 1.000) was measured for LPA, and girls had no difference (p = .176) in MVPA, but spent 9.76% (p < .001, CI = 7.12% to 12.41%) more time in LPA.ConclusionsEOtC was implemented without the provision of additional resources and with positive effects on PA. Findings suggest EOtC as a way to provide children with an additional opportunity to accumulate PA within the existing school setting.