R ESEARCH A RTICLE Association of Education Outside the Classroom and Pupils’ Psychosocial Well-Being: Results From a School Year Implementation MADS BØLLING, MEd PhD a JANNI NICLASEN, MSc, PhD b PETER BENTSEN, MSc, PhD c GLEN NIELSEN, MSc, PhD d ABSTRACT BACKGROUND: Education Outside the Classroom (EOtC) is a teaching method that is gaining traction, aiming to promote learning and well-being. However, research on the association between EOtC and well-being is limited. METHODS: This quasi-experimental trial involved pupils (9-13 years) from 16 Danish public schools which implemented EOtC in some classes. Pupils (N = 511) from 27 classes were regularly exposed to EOtC (2-7 hours per week), and pupils (N = 120) from 7 parallel comparison classes were much less exposed (less than 2 hours per week). The pupils’ psychosocial well-being was measured at the beginning and end of the school year using the Strengths and Difficulties Questionnaire. The results were compared between the groups. RESULTS: Pupils regularly exposed to EOtC showed the greatest improvement in prosocial behavior. Negative associations were seen between EOtC and hyperactivity-inattention and peer problems in pupils of low socioeconomic status (SES). The observed improvements were smaller when the EOtC was spread over a larger number of sessions. Results were independent of sex. CONCLUSIONS: Regular exposure to EOtC was found to promote social well-being, especially for pupils of low SES, and was most beneficial when concentrated in fewer, longer sessions. Keywords: mental health; outdoor learning; school-based outdoor education; school-based health promotion; udeskole. Citation: Bølling M, Niclasen J, Bentsen P, Nielsen G. Association of education outside the classroom and pupils’ psychosocial well-being: results from a school year implementation. J Sch Health. 2019; DOI: 10.1111/josh.12730 E ducation Outside the Classroom (EOtC) is a teaching method that is gaining traction in Scandinavia, Germany, UK, United States, and other Western countries. 1 It can broadly be defined as relocating standard curriculum teaching to places outside the buildings and walls of the schools for a single or a few days per week as a supplement to indoor classroom teaching. 2 Places used in EOtC include forests, school gardens, and museums. 3-5 a PhD Student, (mads.boelling@regionh.dk), Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Nørre All´ e 51, DK-2200 Copenhagen N, Denmark. b Assistant Professor, (janni.niclasen@psy.ku.dk), Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353 Copenhagen K, Denmark. c Senior Researcher, (peter.bocz.bentsen@regionh.dk), Health Promotion, Steno Diabetes Center Copenhagen, The Capital Region of Denmark, Niels Steensens Vej 6, DK-2820 Gentofte, Denmark. d Associate Professor, (gnielsen@nexs.ku.dk), Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Nørre All´ e 51, DK-2200 Copenhagen N, Denmark. Address correspondence to: Mads Bølling, Postdoc, (mads.boelling@regionh.dk), Health Promotion, Steno Diabetes Center Copenhagen, The Capital Region of Denmark, Niels Steensens Vej 6, DK-2820 Gentofte, Denmark. We would like to express our greatest thankfulness to the participating children, parents, teachers, and schools for their cooperation. In addition, we would like to thank our colleagues at the TEACHOUT project and CHESS research group for their feedback. We appreciate the thorough revision of the final manuscript by Lærke Mygind. This study was funded by the Danish foundation TrygFonden (ID #102171). The funders have not been involved in the study design, analyses, interpretation, writing, or the decision to submit this paper. The authors declare that they have no potential conflict of interest in the research. EOtC creates variation in school days and typically aims to promote learning, positive social relations, motivation for school, and psychosocial well-being. 6,7 EOtC often includes activities described as child- led, hands-on problem solving and experimentation, peer collaboration, and inductive learning approaches, as well as physical activity, games, and play. 8 Although EOtC can be regarded as a school-based health initiative integrated into academic curricular Journal of School Health • 2019 •  2019, American School Health Association • 1