Barbie audit data.

ObjectivesTo explore the correlations/relationships between foot posture, equity and diversity, employment, and time in Barbie Land.DesignA retrospective audit of the Barbie population (or their data from online catalogues) using a customised FEET system. That is Foot posture (flat or equinus); Equity (diversity and inclusion (EDI)); Employment (fashion vs employed); and Time period (decade of manufacture).SettingBarbie Land (Online Barbie catalogues of doll types).Participants2750 Barbies and friends who lived in Barbie Land between 1959 to June 2024.Main outcome measuresOver time there was a decreased prevalence in equinus foot posture from 100% in the first time period to 40% in the last. Barbie’s flat foot posture had a very strong positive correlation with employment (r = 0.89, 95% Confidence Interval (95%CI) = 0.50 to 1.29), and time point (r = 0.85, 95%CI = 0.40 to 1.31), while equinus foot posture had a very strong positive correlation with fashion (r = 0.99, 95%CI = 0.87 to 1.11). Similarly, equity (diversity) had a very strong positive correlation with fashion (r = 0.98, 95%CI = 0.82 to 1.15), and strong positive correlation with employment (r = 0.79, 95%CI = 0.26 to 1.33).ConclusionBarbie’s equinus foot posture is directly related to her high heel wearing. Barbie models her footwear choice based on task demands, being flat footed and wearing flat shoes when she needs to work on her feet, be physically active or more stable. Given Barbie is known to reflect societal norms, we contend this is most likely true for most high-heel wearers. While Barbie has moved with the times, it appears footwear health messaging about high heel wearing needs to catch up. Health professionals castigating high heels through public messaging, should remember that emphasising health benefits consistently drives positive behaviour change, over highlighting negative consequences. Barbie clearly makes sensible determinations regarding her body autonomy; high heel wearers should have that same ability.研究目的：探究足部姿势、公平与多样性、就业状况以及时间维度与芭比乐园（Barbie Land）场景间的关联关系。 研究设计：采用定制化FEET系统对芭比群体（或其在线目录数据）开展回顾性审计。该系统涵盖四大维度：足部姿势（扁平足或马蹄足（equinus））、公平、多元化与包容性（EDI，Equity, Diversity and Inclusion）、就业状况（时尚造型 vs 在岗状态）以及时间周期（生产年代）。 研究场景：芭比乐园（Barbie Land），即芭比玩偶类型的在线目录。 研究对象：1959年至2024年6月期间生活在芭比乐园的2750个芭比玩偶及其配套角色。 主要结局指标：随时间推移，马蹄足足部姿势的患病率从首个时间周期的100%降至最终周期的40%。芭比的扁平足足部姿势与就业状况（r=0.89，95%置信区间（95%CI）=0.50~1.29）、时间节点（r=0.85，95%CI=0.40~1.31）均呈极强正相关；而马蹄足足部姿势与时尚造型呈极强正相关（r=0.99，95%CI=0.87~1.11）。类似地，公平与多元化与时尚造型呈极强正相关（r=0.98，95%CI=0.82~1.15），与就业状况呈较强正相关（r=0.79，95%CI=0.26~1.33）。 研究结论：芭比的马蹄足足部姿势与其穿高跟鞋的行为直接相关。芭比会根据任务需求选择鞋履：当需要站立工作、开展体力活动或需要提升稳定性时，她会保持扁平足状态并搭配平底鞋。鉴于芭比形象向来反映社会主流规范，我们认为这一结论大概率适用于绝大多数高跟鞋佩戴者。尽管芭比的形象始终与时俱进，但当前关于高跟鞋穿戴的足部健康宣传仍有待更新。那些通过公共宣传抨击高跟鞋的医疗专业人士应谨记：相较于强调负面后果，持续传递健康益处更能推动积极的行为改变。芭比显然能就自身身体自主权做出合理抉择，高跟鞋佩戴者也应拥有同等的自主权利。