Schneller Mikkel Bo, Duncan Scott, Schipperijn Jasper, Nielsen Glen, Mygind Erik, Bentsen Peter
Health Promotion Research; Steno Diabetes Center Copenhagen, Niels Steensens Vej 8, DK-2820, Gentofte, Denmark.
Research Unit for Active Living; Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, DK-5230, Odense M, Denmark.
BMC Public Health. 2017 May 26;17(1):523. doi: 10.1186/s12889-017-4430-5.
Education 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.
In 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.
On 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.
For 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.
The Scientific Ethical Committee in the Capital Region of Denmark protocol number H-4-2014-FSP . 5 March, 2014.
课外教育（EOtC）是一种基于课程的教学方法，在小规模案例研究中已显示出与儿童身体活动和学业学习呈正相关。这项大规模准实验研究的目的是确定经常参加课外教育的儿童是否比不参加的儿童花更多时间进行体育活动。
在2014/2015年的TEACHOUT研究中，班级成对招募，使得每个课外教育班级在同一学校和年级水平上都有一个非课外教育的对照班级。丹麦17个课外教育班级和16个对照平行班级的参与者在连续七天内将Axivity AX3加速度计贴在下背部佩戴。使用“意向性分析”（ITT）方法分析了201名课外教育参与者（63.3%为女孩，年龄10.82±1.05岁）和160名对照参与者（59.3%为女孩，年龄10.95±1.01岁）的数据。监测了参与者接受课外教育的时长。使用针对年龄进行调整的广义线性模型评估了在不同身体活动强度下花费的时间与课外教育组和性别的关联。在第二项分析中，我们使用“符合方案分析”（PP）方法对样本进行了调整，仅纳入了在测量周内课外教育班级有超过150分钟且对照班级有少于150分钟课外教育的课外教育班级和对照班级对。
平均而言，课外教育参与者每天在中度至剧烈身体活动（MVPA）上比对照参与者多花费8.4（ITT）和9.2（PP）分钟（p<0.05）。然而，课外教育男孩每天在中度至剧烈身体活动上比对照男孩多花费18.7（ITT）和20.8（PP）分钟（p<0.01），而女孩组间无显著差异。
对于男孩来说，课外教育与每天更多时间进行中度和剧烈身体活动相关。女孩未观察到差异。将课外教育纳入学校的每周教学实践可以是一种在时间和成本上中性的补充方式，以增加三至六年级男孩的体育活动时间。
丹麦首都地区科学伦理委员会方案编号H-4-2014-FSP。2014年3月5日。
