Education outside the classroom as upstream school health promotion: 'adding-in' physical activity into children's everyday life and settings

Individual and day-to-day differences in domain-specific physical activity of 10- to 11-year-old children in Denmark-Measured using GPS and accelerometry

OBJECTIVE

Physical activity (PA) and the achievement of 60 min of moderate-to-physical-activity daily is declining in school-aged-children, and effective strategies to increase PA is needed. We aimed to examine the individual and day-to-day distribution of PA on schooldays among children aged 10-11 in 4 domains-school, home, transport, and other.

METHODS

Data were collected from August to September 2020 using accelerometer and GPS data to measure daily PA-levels and to locate in which domain PA occurs. Daily PA-levels were assessed in each domain, and analyses of the individual and day-to-day differences in PA-levels were calculated.

RESULTS

The school domain contributed the most to children's daily MVPA with 47% of average MVPA, followed by the home domain with 26% of daily average MVPA, the other domain with 19% of daily average MVPA and the transport domain with 8% of daily average MVPA. Our results showed individual differences in where PA occurs, day-to-day differences in total MVPA and day-to-day differences in the MVPA-levels across domains.

CONCLUSIONS

The school domain contributed the most to children's MVPA-levels followed by the domains of home, other, and transport. Our study indicated that PA-levels and the distribution of PA across domains differ from day-to-day. Future interventions should target more than one domain to accommodate these individual- and day-to-day differences in the goal of increasing PA-levels and to reduce the decline in PA seen from childhood to adolescence.

Efficacy and mechanisms of an education outside the classroom intervention on pupils' health and education: the MOVEOUT study protocol

BACKGROUND

Education can create better opportunities for health, and vice versa. Using a so-called 'add-in' approach, school-based physical activity (PA) promotion and prevention of sedentary behaviours can increase pupils' wellbeing and learning and, on the longer term, reduce the risk of non-communicable diseases. A PA 'add-in' approach involves integrating PA into teachers' curricular obligations without being an extra burden as opposed to an 'add-on' approach which requires additional operational resources and include activities that do not explicitly contribute towards curricular targets making them less long-term acceptable in a school-based context. Previous studies investigating education outside the classroom (EOtC) show mutual benefits for both health and education outcomes among children and adolescents. However, the evidence is of mixed quality and questionable certainty, which calls for further investigation. The aim of this study protocol is to describe and discuss the study design and methods to investigate the efficacy and mechanisms of EOtC as a vehicle for health and education. The study investigates the intervention developed and conducted in the TEACHOUT study with updated and strengthened design and measures.

METHODS

The efficacy of EOtC will be investigated in a cluster randomised waitlist design. Participants will be pupils in ~54 classes, grades 4-10 (ages 10-15 years) in ~30 Danish elementary schools. Fifteen schools will be randomised to the intervention: a two-day EOtC training course targeting teachers followed by the teachers implementing EOtC >5 hours weekly over the course of one school year. Pre- and post-measures of health (PA and wellbeing) and learning (school motivation and academic achievement) will be collected. Investigation of pedagogical and motivational mechanisms will be based on observations of EOtC.

DISCUSSION

The updated randomised controlled design will provide firmer evidence for the efficacy and mechanisms of EOtC and provide knowledge about how mutual benefits of health and education can be obtained.

TRIAL REGISTRATION

Registered with ClinicalTrials.gov (ID NCT05237674 ) [University of Copenhagen. MOVEOUT: a Cluster RCT of the Efficacy, Mechanisms, and Mediation of an Education Outside the Classroom Intervention on Adolescents' Physical Activity, 2023], February 14, 2022. Most recently updated on November 23, 2022 (Version 2).

Choice matters: Pupils' stress regulation, brain development and brain function in an outdoor education project

BACKGROUND

Education outside the classroom (EOtC) is considered beneficial to children's physical and mental health. Especially, stress resilience has been linked to nature experience.

AIMS

This study experimentally explored the effects of pupils' autonomy support (AUT) and physical activity (PA) on their biological stress responses and brain development in EOtC.

SAMPLE

The study comprised 48 fifth and sixth graders.

METHODS

The intervention consisted of one day/week taught in a forest over one school year. Structural magnetic resonance imaging (MRI) was conducted at the beginning and the end of the school year, functional MRI under a stress condition at the end. Regions of interest were amygdala, hippocampus and the anterior cingulate cortex (ACC). All other measures were obtained at the beginning, at mid-term and at the end of the school year. PA was measured using accelerometry. Cortisol levels were obtained three times during the examined school days. AUT was measured with a paper-based survey. Data were analysed using Bayesian multivariate models.

RESULTS

EOtC students exhibit more efficient regulation of biological stress-reactivity and show a reduction of cortisol over the day associated with light PA in the forest. Cortisol is further associated with amygdala activation in the stress condition. Cerebral structural change is best explained by age; however, AUT has a positive direct effect on the maturation of the ACC, which is stronger in EOtC.

CONCLUSIONS

Our results support the idea that autonomy supportive teaching fosters cerebral maturation and that EOtC can have a positive effect on biological stress regulation.

Changes in social interaction, social relatedness, and friendships in Education Outside the Classroom: A social network analysis

Introduction

Social interaction is associated with many effects on the psychological level of children such as mental health, self-esteem, and executive functions. Education Outside the Classroom (EOtC) describes regular curricular classes/lessons outside the school building, often in natural green and blue environments. Applied as a long-term school concept, EOtC has the potential to enable and promote social interaction. However, empirical studies on this topic have been somewhat scant.

Methods

One class in EOtC (N  = 24) and one comparison class (N = 26) were examined in this study to explore those effects. Statistical Actor-Oriented Models and Exponential Random Graph Models were used to investigate whether there are differences between EOtC and comparison class regarding changes over time in social interaction parameters; whether a co-evolution between social interaction during lessons and breaks and attendant social relatedness and friendships exists; whether students of the same gender or place of residence interact particularly often (homophily).

Results

Besides inconsistent changes in social interaction parameters, no co-evolutional associations between social interaction and social relatedness and friendships could be determined, but grouping was evident in EOtC. Both classes showed pronounced gender homophily, which in the case of EOtC class contributes to a fragmentation of the network over time.

Discussion

The observed effects in EOtC could be due to previously observed tendencies of social exclusion as a result of a high degree of freedom of choices. It therefore seems essential that in future studies not only the quality of the study design and instruments should be included in the interpretation - rather, the underlying methodological-didactic concept should also be evaluated in detail. At least in Germany, it seems that there is still potential for developing holistic concepts with regards to EOtC in order to maximize the return on the primarily organizational investment of implementing EOtC in natural environments.

When are you taking us outside? An exploratory study of the integration of the outdoor learning in preschool and primary education in Quebec

Introduction

Recent research investigating the benefits of being outdoors and contact with nature in children showed strong associations with children’s health and development. More teachers are choosing to integrate outdoor learning (OL) into their practice in Quebec, but few studies have focused on OL in the school environment, particularly in Canada and more specifically in Quebec, despite the fact that the school context lends itself favorably to this practice.

Objective

The purpose of this study was to portray OL in preschool and primary schools in Québec by identifying three key elements: (1) teachers’ perception of the outdoors, (2) the uses of OL in schools, and (3) teaching strategies and factors that influence teachers’ integration of OL.

Methodology

Semi-structured group interviews (n = 4) conducted with 14 teachers and participant observations (n = 4) were used for data collection. Inclusion criteria were to be a preschool or primary school teacher, to have taught at least eight sessions of OL in the past year, and to have no connection or contact with the research team prior to the start of the study.

Results

First, the results showed that teachers commonly understood the outdoors as being in the open air, practicing a physical activity, having the presence of nature, providing physical freedom and targeting a pedagogical intention. Second, teachers appeared to incorporate a variety of pedagogical intentions in OL (e.g., environmental awareness, interdisciplinary learning), in a variety of settings (e.g., city parks, woodlands), and with a variety of academic subjects (e.g., French, mathematics) and learning tasks (e.g., walking, nature shelter building). Third, teachers used a wide range of teaching strategies in OL (e.g., flexible planning, well-established routines). Participants also identified multiple factors specific to their setting that appeared to facilitate (e.g., parental support) or limit (e.g., storage of materials) their integration of OL into the school environment.

Conclusion

This study provided a better understanding of the current use of the OL in the Quebec school environment by identifying the common characteristics, limitations and winning strategies of its use in schools. Teachers and schools interested in OL could benefit from the results of this study, particularly those interested in adopting a Forest School or Udeskole approach.

Health-related quality of life, motivational regulation and Basic Psychological Need Satisfaction in Education Outside the Classroom: an explorative longitudinal pilot study

BACKGROUND

Given a suboptimal state of mental health among children, an urgent need exists to seek approaches related to health promotion in this population's settings, such as in schools. Increased health-related quality of life (HRQoL) and improved school motivation could be crucial for children's mental health. Based on self-determination theory, paths can be identified that could lead to such improvements by strengthening the basic psychological needs (BPN). This study aimed to examine the impact on and the relationships among HRQoL, school motivation and BPN within the promising concept of education outside the classroom (EOtC).

METHODS

In this exploratory study, we employed a between-subjects cohort study design with no blinding or randomisation. We surveyed fifth graders (mean = 10.1 years) attending EOtC (experimental group [EG], n = 25) and normal indoor lessons (control group, [CG], n = 41) at the beginning (T1) and end (T2) of a semester. We used the translations of validated questionnaires and established linear mixed-effects models to evaluate whether the students in EOtC show higher scores of HRQoL and school motivation and, whether the satisfaction of BPN of autonomy (PAut), competence (PCom), social relatedness with classmates (PSRC) and teachers (PSRT) show associations with these outcomes.

RESULTS

Regarding intrinsic and identified motivational regulation, results showed significant increases over time in the overall sample and significant higher scores in the EG than in the CG. For HRQoL, no group differences were found, but a significant decrease over time in the EG. Regarding possible associations between the outcomes and BPN, such could only be found between HRQoL and PSRC, but not for the other BPN and not for motivational regulation and BPN.

CONCLUSIONS

Without having been able to explain this on the basis of increased BPN values, our results show that EOtC can support improvements in specific regulation types of school motivation. This could contribute to an improvement in the mental health situation in children, as school represents a major stressor for them. Future steps in terms of researching HRQoL in this setting are discussed, as this pilot study does preliminary work for necessary examinations, e.g. in structural equation approaches.

The Association between Education Outside the Classroom and Physical Activity: Differences Attributable to the Type of Space?

Education outside the classroom (EOtC) has become an attractive approach, not only for learning but also for health. This explorative, cross-sectional study investigated children’s sedentary behaviours (SED), light physical activity (LPA) and moderate-to-vigorous PA (MVPA) on school days with an EOtC session in green space compared to school days with EOtC in other environments and without EOtC. Teachers from 17 Danish school classes practised EOtC for one school year on a weekly basis and self-reported the characteristics of the EOtC environment. The pupils’ PA was device-measured for seven consecutive days in a random period during the school year with AX3 accelerometers. Across 617 pupils (age 9–13 years), PA intensity cases (N = 2264) on school days (8:10–14:00 h) with (n = 317) or without (n = 1947) EOtC were included in a mixed-effects regression analysis. Mean exposure to EOtC was 262 min per session. School days with green EOtC (e.g., parks, forests and nature schools) were associated with (mean, [95% CI]) −24.3 [−41.8, −7.7] min SED and +21.3 [7.7, 36.4] min LPA compared to school days with non-green EOtC (e.g., cultural and societal institutions or companies) and with +6.2 [−0.11, 11.48] min MVPA compared to school days with a school-ground EOtC. No sex differences were found. In conclusion, school days with green EOtC must be considered promising to counteract children’s sedentary behaviours during school hours.