Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK; Faculty of Education, University of Cambridge, Cambridge CB2 8PQ, UK.
Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK.
J Sport Health Sci. 2024 Jul;13(4):590-598. doi: 10.1016/j.jshs.2024.02.003. Epub 2024 Feb 15.
It is aimed to assess whether school uniforms are associated with population-level gender inequalities in physical activity, and whether associations differ by school level, country/region income, and assessment method.
An ecological study design was employed. We collected data about global uniform practices using an online survey. We searched for country/region-level estimates of school-aged youth meeting physical activity guidelines from international surveillance studies. Study selection was conducted in duplicate using a systematic process, and a random sample of all data was checked to ensure extraction and pooling processes were accurate. We calculated absolute and relative gender inequalities in physical activity for each country. Linear regression examined associations between country/region-level uniform practices (binary yes/no exposure variable) and country/region-level gender inequalities in physical activity guideline compliance (absolute and relative inequalities). We investigated moderation by school level, stratified analyses by income group, and repeated primary analyses using device-measured data.
Pooling data from 135 countries/regions (n = 1,089,852), we found no association between population-level uniform practices and gender inequalities in physical activity across all ages (absolute: β = -0.2; 95% confidence interval (95%CI): -1.7 to 1.3, p = 0.74; relative: β = 0.1; 95%CI: -0.1 to 0.2, p = 0.51). Subgroup analysis suggested a positive association in primary school settings (absolute: β = 4.3; 95%CI: -0.0 to 8.6, p = 0.05). Among high-income countries, absolute inequalities were significantly greater in countries/regions with uniform practices (N = 37) compared to those without (N = 48) (9.1 (SD = 3.6) vs. 7.8 percentage points (SD = 4.3)). Repeating analyses using device-measured data (n = 32,130; N = 24) did not alter our primary finding. From initial descriptive statistics, we found that in countries/regions where a majority of schools (>50%) reportedly use uniforms, there was lower compliance with physical activity guidelines among all genders (median: 16.0%, interquartile range: 13.2%-19.9%, N = 103) compared to generally non-uniform countries/regions (median: 19.5%, interquartile range: 16.4%-23.5%, N = 32) (z = 3.04, p = 0.002). (N = countries, regions and studies represented; n = sample size or participants included).
School uniforms are associated with greater gender inequalities in physical activity in primary school settings and in high-income countries. Our population-level findings warrant testing using individual-level data across contexts.
评估校服是否与人群层面的体力活动性别不平等有关，以及这种关联是否因学校层次、国家/地区收入和评估方法而异。
采用生态研究设计。我们使用在线调查收集了关于全球校服实践的数据。我们从国际监测研究中搜索了有关符合体力活动指南的学龄青年的国家/地区水平估计数。使用系统的过程进行了研究选择，并且对所有数据的随机样本进行了检查，以确保提取和汇总过程是准确的。我们为每个国家计算了体力活动方面的绝对和相对性别不平等。线性回归检验了国家/地区层面的校服实践（二元是/否暴露变量）与国家/地区层面体力活动指南遵守情况的性别不平等之间的关联（绝对和相对不平等）。我们调查了学校层次的调节作用，按收入群体进行分层分析，并使用设备测量数据重复了主要分析。
我们汇总了来自 135 个国家/地区（n=1089852）的数据，发现人群层面的校服实践与所有年龄段的体力活动性别不平等之间没有关联（绝对：β=-0.2；95%置信区间（95%CI）：-1.7 至 1.3，p=0.74；相对：β=0.1；95%CI：-0.1 至 0.2，p=0.51）。亚组分析表明，在小学环境中存在正相关（绝对：β=4.3；95%CI：0.0 至 8.6，p=0.05）。在高收入国家，有校服实践的国家/地区的绝对不平等程度明显大于没有校服实践的国家/地区（N=37）（9.1（SD=3.6）与 7.8 个百分点（SD=4.3））。使用设备测量数据（n=32130；N=24）重复分析并未改变我们的主要发现。从初始描述性统计数据来看，我们发现，在大多数学校（>50%）报告使用校服的国家/地区，所有性别群体的体力活动指南遵守情况都较低（中位数：16.0%，四分位距：13.2%-19.9%，N=103）与一般不使用校服的国家/地区（中位数：19.5%，四分位距：16.4%-23.5%，N=32）（z=3.04，p=0.002）。（N=国家、地区和研究代表；n=样本量或参与者人数）。
校服与小学阶段和高收入国家体力活动中的性别不平等程度更大有关。我们的人群层面发现需要在不同背景下使用个体层面的数据进行测试。
