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Randomized Controlled Trial
. 2024 Nov 15;14(1):28213.
doi: 10.1038/s41598-024-79138-z.

Efficacy of education outside the classroom to increase adolescent physical activity

Peter Elsborg #  1   2 , Lærke Mygind #  3   4   5 , Mads Bølling  6   7   8 , Charlotte Demant Klinker  7 , Paulina S Melby  6 , Anne Helms Andreasen  6 , Jan Christian Brønd  9 , Peter Bentsen  6   10 , Glen Nielsen  11
Affiliations
Randomized Controlled Trial

Efficacy of education outside the classroom to increase adolescent physical activity

Peter Elsborg et al. Sci Rep. .

Abstract

Physical inactivity increases risks of cardiovascular disease, poor mental health, and morbidity. School-based physical activity (PA) promotion can reach children from differing backgrounds in a large proportion of their waking hours. Education outside the classroom (EOtC) is an PA-integrating pedagogical approach that aligns PA with the primary goals of schools and is therefore thought to present an acceptable, feasible, and efficacious model for school-based PA. This registered report used a cluster randomised wait list design to evaluate the efficacy of an EOtC intervention that aims to increase adolescents' (ages 10-16 years) school-based (school week) and overall (full week) PA by providing a course on the pedagogical and didactic methods of EOtC to teachers across 30 Danish schools, and subsequently the teachers implementing EOtC in their classes > 5 h weekly over the course of one school year. Across 20 schools, 503 pupils aged 9-14 years were enrolled. The intervention group classes delivered a weekly mean of 238 (± 50) minutes of EOtC per-protocol and engaged in 20.4% moderate-to-vigorous school-based PA above the control group, however with no effect on overall PA. Enhancing effectiveness on overall PA, supplementing the intervention with additional PA activities, or adjusting its delivery and implementation is necessary.Protocol registration The stage 1 protocol for this Registered Report was accepted in principle on 22/08/22. The protocol, as accepted by the journal, can be found at: https://doi.org/10.17605/OSF.IO/NTM9K .

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Conflict of interest statement

Competing interests PE, MB, LM, PB, and GN are engaged in the improvement of ‘regular use EOtC’ (Udeskole) in Denmark, e.g., the platform www.udeundervisning.dk, membership in the Association for Udeskole in Denmark, UdeskoleNet, or consultancy activities for municipalities or NGO’s. PB, GN, and MB are also the original developers of the EOtC intervention. However, by preregistering the study and analysis plan we ensure that the authors’ involvement in the field will not affect interpretation of data and/or conclusions of the study. The rest of the authors do not have any competing interest.

Figures

Fig. 1
Fig. 1
Theory of Change of the EOtC intervention. The figure outlines the intervention inputs (here, referred to as intervention education components), activities, output, and outcomes (both primary and secondary outcomes, as well as long-term impact).
Fig. 2
Fig. 2
Study design and timeline. The figure shows the timing of study milestones including measurements and implementation monitoring (in green), randomisation, training courses for both intervention and waitlist control groups (in orange), and the intervention period, 2022–2023.
Fig. 3
Fig. 3
Participants flowchart. The figure shows the flow of schools, classes, and pupils from enrolment to the inclusion in intention-to-treat and per-protocol analysis.
Fig. 4
Fig. 4
Log Ratio difference between intervention and control groups during a school week and during a full week per-protocol.
See this image and copyright information in PMC

References

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