Abstract
BACKGROUND: To effectively promote physical activity (PA) participation in preschool-aged children with disabilities (PACD), a comprehensive understanding of the associated factors is necessary. Consequently, this study aims to examine the factors influencing PA participation in PACD using the socio-ecological model. METHODS: The Disability Status Survey 2020 in South Korea has been used for the current study. PACD aged below five years were selected, resulting in 5825 children. Variables were selected across each level of the socio-ecological model: (1) intrapersonal level (child's sex, chronic condition, disability level, perceived health), (2) interpersonal level (siblings' status, grandparents' status, satisfaction with number of friends), (3) organizational level (enrollment in physical therapy, enrollment in occupational therapy), and (4) environmental level (residential area, government support). The decision tree analysis was conducted using chi-square automatic interaction detection to examine multi-level associated factors of PA participation in PACD. RESULTS: The decision tree analysis produced a three-level model with six terminal nodes. In the study sample, 48.4% of participants reported participating in PA. The most common location for PA was at home, with balance exercises being the most frequent type of activity, followed by stretching. Frequent barriers to regular PA participation included a lack of professionals who are knowledgeable about disabilities and the absence of disability-specific programs. The decision tree analysis identified living with grandparents, the child's sex, having a sibling, and enrollment in physical therapy as common predictors of PA participation in PACD. CONCLUSIONS: This study's strength lies in its thorough examination of the socio-ecological factors influencing PA participation in PACD. The associated factors span both intrapersonal and interpersonal levels. To enhance PA participation among PACD, interventions should target these levels.