{
  "abstract": "Background School uniform policy is often based on traditional practice or anecdotal perceived benefits, with limited evidence-based decision making. The first systematic review of its kind, this review assessed existing evidence on if and how school uniforms impact child health behaviours and outcomes.Methods Twelve databases were searched using the following inclusion criteria: comparison of school uniform versus no uniform, students in full-time education, with at least one reported health-related outcome measure. Studies were excluded if not in English, published before 2000, not published in a peer-reviewed journal, and if only including qualitative data. The Critical Appraisal Skills Program (CASP) checklist and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria were used to assess study quality. Findings were synthesised using Synthesis Without Meta-Analysis guidelines.Results Twelve studies were included. Outcome measures were grouped into five themes, with several papers covering multiple themes: academic achievement (two studies), physical health (one study), psychosocial health (four studies), school attendance (three studies) and school discipline (six studies). Most evidence originated in the United States of America (nine studies). Results were inconsistent, with both positive and negative associations for health outcomes. Five studies found improved school behaviour or safety with uniform, one study found that uniform worsened gender inequality in physical activity, and three studies found no impact on academic achievement or psychosocial health. Evidence was of low-very low quality (ten studies), with high risk of bias (six studies), and low-very low validity (nine studies).Conclusion Existing evidence is limited in scope, reliability, quality, and geographic diversity. Current school uniform mandates are not based on high quality quantitative evidence of health benefit for children. There is a need for robust and diverse research before a conclusion can be drawn for the true impact of school uniforms on child health.",
  "authors": [
    {
      "affiliations": [
        "Institute for Child Health, University College London, London, UK"
      ],
      "name": "Katie Meadows"
    },
    {
      "affiliations": [
        "Institute for Child Health, University College London, London, UK"
      ],
      "name": "Niloofar Shoari"
    },
    {
      "affiliations": [
        "Health Data Science, Swansea University, Swansea, UK"
      ],
      "name": "Michaela James"
    },
    {
      "affiliations": [
        "Institute for Child Health, University College London, London, UK"
      ],
      "name": "Pia Hardelid"
    }
  ],
  "title": "P01-8 What are the impacts of school uniform on child health behaviours and outcomes? A systematic review",
  "uid": "36681eb4-06c3-53a4-8e1a-31cff7b95e94"
}