Premium
Barriers and facilitators to community participation for preschool age children born very preterm: a prospective cohort study
Author(s) -
Cameron Kate L,
FitzGerald Tara L,
Albesher Reem A,
McGinley Jennifer L,
Allison Kim,
Lee Katherine J,
Cheong Jeanie L Y,
Spittle Alicia J
Publication year - 2021
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.14809
Subject(s) - odds ratio , medicine , pediatrics , confidence interval , affect (linguistics) , cohort study , psychology , premature birth , demography , gestation , pregnancy , communication , pathology , sociology , biology , genetics
Aim We compared preschool age children born very preterm with term‐born controls to: (1) understand the association between very preterm birth and community participation, (2) determine if motor impairment or social risk affect participation differently between groups, and (3) understand environmental barriers and supports to participation for parents. Method Forty‐eight children born very preterm (<30wks’ gestation; 22 males, 26 females) and 96 controls (47 males, 49 females) were assessed at 4 to 5 years’ corrected age for community participation using the Young Children’s Participation and Environment Measure. Motor skills were assessed using the Movement Assessment Battery for Children, Second Edition and the Little Developmental Coordination Disorder Questionnaire. Results Children born very preterm participated less frequently than term‐born children (difference in means=–0.28, 95% confidence interval [CI] –0.54 to –0.03, p =0.029). Social risk was associated with lower frequency (interaction p <0.001) and involvement (interaction p =0.05) in community activities for children in the very preterm group only. Parents of children born very preterm perceived more barriers (odds ratio=4.32, 95% CI 1.46–12.77, p =0.008) and environmental factors to be less supportive of participation than parents of controls (difference in medians=–6.21, 95% CI –11.42 to –1.00, p =0.02). Interpretation Children born very preterm may benefit from ongoing support to promote participation, especially in families of higher social risk. What this paper adds Children born preterm attend community activities less often than term‐born children. When attending community activities, involvement was similar between preschool age children born preterm and at term. Social risk negatively impacted participation for children born preterm, but not at term. Motor impairment did not appear to influence participation frequency or involvement. Parents of children born preterm perceived more barriers to participation than parents of term‐born children.