Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, the Capital Region of Denmark, Copenhagen, Denmark.
Health Promotion Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark.
BMC Public Health. 2023 Sep 19;23(1):1825. doi: 10.1186/s12889-023-16618-3.
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.
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.
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.
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).
教育可以为健康创造更好的机会，反之亦然。通过所谓的“附加”方法，在学校推广身体活动（PA）和预防久坐行为可以提高学生的幸福感和学习成绩，从长远来看，还可以降低非传染性疾病的风险。PA“附加”方法涉及将 PA 融入教师的课程义务中，而不会增加额外的负担，而不是“附加”方法，它需要额外的运营资源，并包括那些不会明确有助于课程目标的活动，使其在学校环境中不太长期可接受。以前的研究表明，课堂外教育（EOtC）对儿童和青少年的健康和教育结果都有互惠互利。然而，证据的质量参差不齐，确定性也值得怀疑，这需要进一步调查。本研究方案旨在描述和讨论研究设计和方法，以调查 EOtC 作为健康和教育的载体的疗效和机制。该研究调查了在 TEACHOUT 研究中开发和实施的干预措施，并更新和加强了设计和措施。
将采用整群随机等待名单设计来研究 EOtC 的疗效。参与者将是丹麦约 30 所小学的~54 个班级，4-10 年级（10-15 岁）的学生。15 所学校将被随机分为干预组：为期两天的针对教师的 EOtC 培训课程，随后教师在一学年内每周实施 EOtC>5 小时。将在健康（PA 和幸福感）和学习（学校动机和学业成绩）方面进行预测和后测。对教育性和激励性机制的调查将基于 EOtC 的观察。
更新的随机对照设计将为 EOtC 的疗效和机制提供更确凿的证据，并提供关于如何获得健康和教育的互惠互利的知识。
在 ClinicalTrials.gov 注册（ID NCT05237674）[哥本哈根大学。MOVEOUT：一项关于课堂外教育干预对青少年身体活动影响的疗效、机制和中介的聚类 RCT，2023 年]，2022 年 2 月 14 日。最近一次更新于 2022 年 11 月 23 日（第 2 版）。
